The bill also requires DHS to award a grant to an entity that is already under
contract to collect, analyze, and disseminate health care information of hospitals and
ambulatory surgery centers. To receive the grant, the entity must develop and

operate an Internet site and system to enable inpatient psychiatric units or hospitals
to enter certain information on availability of inpatient psychiatric beds and to
enable any hospital emergency department in the state to view the information
reported to the system.
For further information see the state fiscal estimate, which will be printed as
an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SB293,1 1Section 1. 20.005 (3) (schedule) of the statutes: at the appropriate place, insert
2the following amounts for the purposes indicated: - See PDF for table PDF
SB293,2 3Section 2. 20.435 (2) (cm) of the statutes is created to read:
SB293,2,54 20.435 (2) (cm) Grant program; inpatient psychiatric beds. The amounts in the
5schedule to award a grant under s. 51.045.
SB293,3 6Section 3. 20.435 (4) (bk) of the statutes is created to read:
SB293,2,107 20.435 (4) (bk) Mental health pilot projects. As a continuing appropriation, the
8amounts in the schedule to pay the state share of behavioral health care coordination
9pilot projects under s. 49.45 (29r) and the state share of a psychiatric consultation
10reimbursement pilot project under s. 49.45 (29u).
SB293,4
1Section 4. 49.45 (29r) of the statutes is created to read:
SB293,3,42 49.45 (29r) Behavioral health care coordination pilot projects. (a) In this
3subsection, "health care provider" does not include a health maintenance
4organization.
SB293,4,95 (b) Subject to par. (c), the department shall develop and award at least 2 pilot
6projects lasting no more than 3 years each to test alternative, coordinated care
7delivery and Medical Assistance payment models designed to reduce costs of
8recipients of Medical Assistance under this subchapter who have significant or
9chronic mental illness. A health care provider that is awarded a pilot project shall
10target a Medical Assistance population of high volume or high intensity users of
11non-behavioral health medical services, such as individuals with more than 5
12emergency department visits in a year or individuals who have frequent or longer
13than average inpatient hospital stays, who also have significant or chronic mental
14illness. The department may not limit eligibility for the pilot project or awards under
15this subsection on the basis that the health care provider that is awarded the pilot
16project serves a target population that includes individuals enrolled in a Medical
17Assistance health maintenance organization. Each pilot project under this
18subsection shall include either a Medical Assistance payment on a per member per
19month basis for a specified pilot project population that is in addition to existing
20payment for services provided under the Medical Assistance program, including
21services reimbursed on a fee-for-service basis and services provided under managed
22care, or shall include an alternative Medical Assistance payment for a specified pilot
23project. The department shall require health care providers that are awarded a pilot
24project to submit to the department interim and final reports analyzing differences
25in utilization of services and Medical Assistance expenditures between individuals

1in the pilot project population and individuals in a control group that is agreed upon
2by the health care provider awarded the pilot project and the department. A health
3care provider that is awarded a pilot project shall submit the interim report by
4January 1, 2017, and shall submit a final report by January 1, 2019, and at the
5conclusion of the pilot project if the project concludes later than January 1, 2019. The
6department shall provide to a health care provider that is awarded a pilot project the
7Medical Assistance utilization and expenditure data necessary for the health care
8provider to create the reports. The department shall award the pilot projects and
9allocate funding only to health care providers that meet all of the following criteria:
SB293,4,1110 1. The health care provider provides all of the following services directly or
11through an affiliated entity:
SB293,4,1212 a. Emergency department services.
SB293,4,1313 b. Outpatient psychiatric services.
SB293,4,1414 c. Outpatient primary care services.
SB293,4,1515 d. Inpatient psychiatric services.
SB293,4,1616 e. General inpatient hospital services.
SB293,4,1817 f. Services of a care coordinator or navigator for each individual in the pilot
18project.
SB293,4,2119 2. The health care provider provides, directly or through an affiliated entity or
20contracted entity, the coordination of social services fostering the individual's
21recovery following an inpatient psychiatric discharge.
SB293,4,2522 (c) Subject to approval by the federal department of health and human services
23of any required waiver of federal Medicaid law or any required amendment to the
24state Medical Assistance plan, the department shall implement the pilot projects
25under par. (b) beginning no earlier than January 1, 2016.
SB293,5,4
1(d) Subject to par. (c), the department shall allocate a total state share amount
2of $600,000 plus any federal matching moneys as funding for all 3-year pilot projects
3under this subsection. The department shall seek federal Medicaid moneys to match
4the state share allocated for the pilot projects under this subsection.
SB293,5 5Section 5. 49.45 (29u) of the statutes is created to read:
SB293,5,86 49.45 (29u) Psychiatric consultation reimbursement pilot project. (a) In
7this subsection, "health care provider" does not include a health maintenance
8organization.
SB293,6,39 (b) Subject to par. (e), the department shall develop and award a pilot project
10lasting up to 3 years to test a new Medical Assistance payment model for adult
11recipients of Medical Assistance that is designed to encourage the provision of
12psychiatric consultations by psychiatrists to health care providers treating primary
13care issues and to selected specialty health care providers to help those providers
14manage and treat adults with mild to moderate mental illness and physical health
15needs. An applicant for the pilot project under this subsection shall submit a
16strategy to use the pilot project funding to improve mental health access in the
17applicant's service area and to reduce overall Medical Assistance costs. The
18department shall require the health care provider that is awarded the pilot project
19to submit to the department interim and final reports analyzing the differences in
20utilization of services and Medical Assistance expenditures between individuals in
21the pilot project population and individuals in a control group that is agreed upon by
22the health care provider awarded the pilot project and the department. A health care
23provider that is awarded a pilot project shall submit the interim report by January
241, 2017, and shall submit a final report by January 1, 2019, and at the conclusion of
25the pilot project if the project concludes later than January 1, 2019. The department

1shall provide to a health care provider that is awarded a pilot project the Medical
2Assistance utilization and expenditure data necessary for the health care provider
3to create the reports.
SB293,6,134 (c) The department shall award a pilot project only to a health care provider
5that is an organization that provides outpatient psychiatric services and primary
6and specialty care outpatient services for physical health conditions. The
7department shall allocate funding to the health care provider that is awarded a pilot
8project or to individual psychiatrists providing care within the organization of the
9health care provider that is awarded a pilot project. The department shall allocate
10a total state share amount of $200,000 plus any federal matching moneys as funding
11for the 3-year pilot project under this subsection. The department shall seek federal
12Medicaid moneys to match the state share allocated for the pilot project under this
13subsection.
SB293,6,1614 (d) The department may limit a pilot project awarded to a health care provider
15described under par. (c) to specific providers or clinics within the multispecialty
16outpatient clinic organization.
SB293,6,2017 (e) Subject to approval by the federal department of health and human services
18of any required waiver of federal Medicaid law or any required amendment to the
19state Medical Assistance plan, the department shall implement the pilot project
20under par. (b) beginning no earlier than January 1, 2016.
SB293,6 21Section 6. 51.045 of the statutes is created to read:
SB293,7,5 2251.045 Availability of inpatient psychiatric beds. From the appropriation
23under s. 20.435 (2) (cm), the department shall award a grant in the amount of $80,000
24in fiscal year 2015-16 and $30,000 in each fiscal year thereafter to the entity under
25contract under s. 153.05 (2m) (a) to develop and operate an Internet site and system

1to show the availability of inpatient psychiatric beds statewide. To receive the grant,
2the entity shall use a password protected Internet site to allow an inpatient
3psychiatric unit or hospital to enter all of the following information and to enable any
4hospital emergency department in the state to view all of the following information
5reported to the system:
SB293,7,8 6(1) The number of available child, adolescent, adult, and geriatric inpatient
7psychiatric beds, as applicable, currently available at the hospital at the time of
8reporting by the hospital or unit.
SB293,7,10 9(2) Any special information that the hospital or unit reports regarding the
10available beds under sub. (1).
SB293,7,12 11(3) The date the hospital or unit reports the information under subs. (1) and
12(2).
SB293,7,13 13(4) The location of the hospital or unit that is reporting.
SB293,7,14 14(5) The contact information for admission coordination for the hospital or unit.
SB293,7,1515 (End)
Loading...
Loading...