Amendment AA1-AB371

AB371-AA1, s. 1e Section 1e. 48.983 (6) (a) (intro.) of the statutes is amended to read:

AB371-AA1,5,3 48.983 (6) (a) (intro.) The part of an application, other than a renewal application, submitted by a county, private agency, or Indian tribe that relates to evidence-based home visitation programs shall include all of the following:

AB371-AA1, s. 1f Section 1f. 48.983 (6) (a) 1. of the statutes is amended to read:

AB371-AA1,5,11 48.983 (6) (a) 1. Information on how the applicant's home visitation program is evidence-based, comprehensive, incorporates practice standards that have been developed for home visitation programs by entities concerned with the prevention of poor birth outcomes and child abuse and neglect and that are acceptable to the department, and incorporates practice standards and critical elements that have been developed for successful home visitation programs by a nationally recognized home visitation program model and that are acceptable to the department.

AB371-AA1, s. 1g Section 1g. 48.983 (6) (a) 2. of the statutes is amended to read:

AB371-AA1,5,18 48.983 (6) (a) 2. Documentation that the application was developed through collaboration among public and private organizations that provide services to children and families, especially children who are at risk of child abuse or neglect and families that are at risk of poor birth outcomes, or that are otherwise interested in child welfare and a description of how that collaboration effort will support a comprehensive, evidence-based home visitation program.

AB371-AA1, s. 1h Section 1h. 48.983 (6) (a) 3. of the statutes is amended to read:

AB371-AA1,5,24 48.983 (6) (a) 3. An identification of existing poor birth outcome and child abuse and neglect prevention services that are available to residents of the county, the area in which the private agency is providing services, or the reservation of the Indian tribe and a description of how those services and any additional needed services will support a comprehensive, evidence-based home visitation program.

AB371-AA1, s. 1i Section 1i. 48.983 (6) (a) 4. of the statutes is amended to read:

AB371-AA1,6,4 48.983 (6) (a) 4. An explanation of how the evidence-based home visitation program will build on existing poor birth outcome and child abuse and neglect prevention programs, including programs that provide support to families, and how the evidence-based home visitation program will coordinate with those programs.

AB371-AA1, s. 1j Section 1j. 48.983 (6) (a) 4m. of the statutes is amended to read:

AB371-AA1,6,8 48.983 (6) (a) 4m. An explanation of how the applicant will encourage private organizations to provide services under the applicant's evidence-based home visitation program.

AB371-AA1, s. 1k Section 1k. 48.983 (6) (a) 6. of the statutes is amended to read:

AB371-AA1,6,14 48.983 (6) (a) 6. An identification of how the evidence-based home visitation program is comprehensive and incorporates the practice standards and critical elements for successful home visitation programs referred to in subd. 1., including how services will vary in intensity levels depending on the needs and strengths of the participating family.

AB371-AA1,6,15 Section 1L 48.983 (6) (a) 6m. of the statutes is amended to read:

AB371-AA1,6,18 48.983 (6) (a) 6m. An explanation of how the services to be provided under the evidence-based home visitation program, including the risk assessment under sub. (4) (b) 1., will be provided in a culturally competent manner.

AB371-AA1, s. 1m Section 1m. 48.983 (6) (b) 1. of the statutes is amended to read:

AB371-AA1,7,5 48.983 (6) (b) 1. `Flexible fund for evidence-based home visitation programs.' The applicant demonstrates in the application that the applicant has established, or has plans to establish, if selected, a fund from which payments totaling not less than $250 per calendar year may be made for appropriate expenses of each family that is participating in the evidence-based home visitation program under sub. (4) (b) 1. or that is receiving home visitation services under s. 49.45 (44). The payments shall be authorized by an individual designated by the applicant. If an applicant makes a payment to or on behalf of a family under this subdivision, one-half of the payment shall be from grant moneys received under this section and one-half of the payment shall be from moneys provided by the applicant from sources other than grant moneys received under this section.

AB371-AA1, s. 1n Section 1n. 48.983 (6) (c) of the statutes is amended to read:

AB371-AA1,7,12 48.983 (6) (c) Case management benefit. The applicant states in the grant application that it has elected, or, if selected, that it will elect, under s. 49.45 (25) (b), to make the case management benefit under s. 49.45 (25) available to the category of beneficiaries under s. 49.45 (25) (am) 9. who are children and who are members of families receiving evidence-based home visitation program services under sub. (4) (b) 1.

AB371-AA1, s. 1p Section 1p. 48.983 (6g) (a) and (b) of the statutes are amended to read:

AB371-AA1,7,23 48.983 (6g) (a) Except as permitted or required under s. 48.981 (2), no person may use or disclose any information concerning any individual who is selected for an assessment under sub. (4) (b), including an individual who declines to undergo the assessment, or concerning any individual who is offered services under a an evidence-based home visitation program funded under this section, including an individual who declines to receive those services, unless the use or disclosure is connected with the administration of the evidence-based home visitation program or the administration of the Medical Assistance program under ss. 49.43 to 49.497 or unless the individual has given his or her written informed consent to the use or disclosure.

AB371-AA1,8,4 (b) A county, private agency, or Indian tribe that is selected to participate in the program under this section shall provide or shall designate an individual or entity to provide an explanation of the confidentiality requirements under par. (a) to each individual who is offered an assessment under sub. (4) (b) or who is offered services under the evidence-based home visitation program of the county, private agency, or Indian tribe.

AB371-AA1, s. 1q Section 1q. 48.983 (6m) of the statutes is amended to read:

AB371-AA1,8,14 48.983 (6m) Notification of parent prior to making abuse or neglect report. If a person who is providing services under a an evidence-based home visitation program under sub. (4) (b) 1. determines that he or she is required or permitted to make a report under s. 48.981 (2) about a child in a family to which the person is providing those services, the person shall, prior to making the report under s. 48.981 (2), make a reasonable effort to notify the child's parent that a report under s. 48.981 (2) will be made and to encourage the parent to contact a county department to request assistance. The notification requirements under this subsection do not affect the reporting requirements under s. 48.981 (2).

AB371-AA1, s. 1r Section 1r. 48.983 (6r) of the statutes is amended to read:

AB371-AA1,8,20 48.983 (6r) Home Evidence-based home visitation program informational materials. Any informational materials about a an evidence-based home visitation program under sub. (4) (b) 1. that are distributed to a person who is offered or who is receiving home visitation program services under that program shall state the sources of funding for the program.

AB371-AA1, s. 1s Section 1s. 48.983 (7) (title) and (a) (intro.) of the statutes are amended to read:

AB371-AA1,9,2 48.983 (7) (title) Home Evidence-based home visitation program evaluation. (a) (intro.) The department shall conduct or shall select an evaluator to conduct an evaluation of the evidence-based home visitation program. The evaluation shall measure all of the following criteria in families that have participated in the home visitation that program and that are selected for evaluation:

AB371-AA1, s. 1t Section 1t. 48.983 (7) (ag) of the statutes is amended to read:

AB371-AA1,9,8 48.983 (7) (ag) The department shall evaluate the availability of evidence-based home visitation programs in the state and determine whether there are gaps in home visitation services in the state. The department shall cooperate with counties, private agencies, and Indian tribes providing evidence-based home visitation programs to address any gaps in services identified.

AB371-AA1, s. 1u Section 1u. 48.983 (7) (ar) of the statutes is amended to read:

AB371-AA1,9,14 48.983 (7) (ar) Each county, private agency, and Indian tribe providing a an evidence-based home visitation program shall collect and report data to the department, as required by the department. The department shall require each county, private agency, and Indian tribe providing a an evidence-based home visitation program to collect data using forms prescribed by the department.

AB371-AA1, s. 1v Section 1v. 48.983 (7) (b) of the statutes is amended to read:

AB371-AA1,9,18 48.983 (7) (b) In the evaluation, the department shall determine the number of families who remained in the evidence-based home visitation program for the time recommended in the family's case plan.

AB371-AA1, s. 1w Section 1w. 48.983 (7) (c) of the statutes is amended to read:

AB371-AA1,9,25 48.983 (7) (c) Each county, private agency, and Indian tribe providing a an evidence-based home visitation program shall develop a plan for evaluating the effectiveness of its program for approval by the department. The plan shall demonstrate how the county, private agency, or Indian tribe will use the evaluation of its program to improve the quality and outcomes of the program and to ensure continued compliance with the home visitation program criteria under sub. (6) (a). The plan shall demonstrate how the outcomes will be tracked and measured. Under the plan, the extent to which all of the following outcomes are achieved shall be tracked and measured:

AB371-AA1,10,6 1. Parents receiving evidence-based home visitation services acquiring knowledge of early learning and child development and interacting with their children in ways that enhance the children's development and early learning.

AB371-AA1,10,7 2. Children receiving evidence-based home visitation services being healthy.

AB371-AA1,10,9 3. Children receiving evidence-based home visitation services living in a safe environment.

AB371-AA1,10,11 4. Families receiving evidence-based home visitation services accessing formal and informal support networks.

AB371-AA1,10,13 5. Children receiving evidence-based home visitation services achieving milestones in development and early learning.

AB371-AA1,10,15 6. Children receiving evidence-based home visitation services who have developmental delays receiving appropriate intervention services.

AB371-AA1, s. 1x Section 1x. 48.983 (8) of the statutes is amended to read:

AB371-AA1,10,24 48.983 (8) Technical assistance and training. The department shall provide technical assistance and training to counties, private agencies, and Indian tribes that are selected to participate in the program under this section. The training may not be limited to a particular evidence-based home visitation model. The training shall include training in best practices regarding basic skills, uniform administration of screening and assessment tools, the issues and challenges that families face, and supervision and personnel skills for program managers. The training may also include training on data collection and reporting.

AB371-AA1, s. 1y Section 1y. 48.983 (9) of the statutes is created to read:

AB371-AA1,11,4 48.983 (9) Memorandum of understanding. The department shall enter into a memorandum of understanding with the department of health services that provides for collaboration between those departments in carrying out evidence-based home visiting programs under sub. (4) (b) 1.

AB371-AA1, s. 1z Section 1z. 49.45 (24w) of the statutes is created to read:

AB371-AA1,11,18 49.45 (24w) Services for pregnant women. (a) The department shall request a wavier of federal Medicaid law from the secretary of the federal department of health and human services to permit the department to provide services and support under medical assistance for pregnant women who face an increased risk of having a low-birth weight baby, a preterm birth, or other negative birth outcome because of medical or nonmedical factors, such as psychosocial, behavioral, environmental, educational, or nutritional factors. The department shall implement the programs and services authorized by this waiver in Milwaukee, Racine, Kenosha, Rock, and Dane counties, and in a rural multicounty region identified by the department in collaboration with the Great Lakes Intertribal Council. The multicounty region shall include counties experiencing the largest disparities in birth outcomes between Caucasian and Native American populations and shall be of sufficient size to enable meaningful implementation and evaluation of the programs and services.

AB371-AA1,11,20 (b) The department shall consider including all of the following as covered services or programs in the waiver request under par. (a):

AB371-AA1,11,23 1. Evidence-based social marketing of programs designed to reduce fetal and infant mortality, improve birth outcomes, and address needs of infants and their families.

AB371-AA1,11,25 2. Evidence-based social-support programs, including fatherhood initiatives designed to reduce fetal and infant mortality and improve birth outcomes.

AB371-AA1,12,4 3. Transportation services for persons who accompany a pregnant woman to prenatal appointments and transportation for the pregnant woman and her children to other destinations including social services' offices and locations where child care is provided for her children.

AB371-AA1,12,8 4. Data collection, including the pregnancy risk assessment and monitoring system, fetal and infant mortality review, vital statistics information, information from medical assistance data and chart reviews, and an assessment of nonmedical factors that may contribute to poor birth outcomes.

AB371-AA1,12,10 5. Full reimbursement for evidence-based group prenatal care, such as the Centering Pregnancy program.

AB371-AA1,12,11 6. Mental health services.

AB371-AA1,12,12 7. Smoking cessation services.

AB371-AA1,12,15 8. Initiatives to increase the utilization of public health and other health care providers with similar racial and socioeconomic backgrounds as the pregnant women and families served by the health care provider.

AB371-AA1,12,20 9. Coordinators to create social care plans for medical assistance recipients, to provide information and assistance regarding all programs that may impact low-income pregnant women, including programs regarding rental assistance, the earned income tax credit, available child care services for a pregnant woman's other children, and to provide breastfeeding support.

AB371-AA1,12,23 10. Demonstration projects developed by the department, to evaluate the effectiveness of evidence-based programs designed to serve under-served populations.

AB371-AA1,13,3 11. One or more initiatives, developed by the department, to increase the utilization of nurse-midwives licensed under s. 441.15 (3) and doulas in the delivery of care to underserved populations and to evaluate the outcomes of that care.

AB371-AA1,13,4 12. The establishment of freestanding birth centers.

AB371-AA1,13,8 13. Extension of the prenatal care coordination services that are available as a medical assistance benefit from the beginning of pregnancy to the first day of the 13th month after delivery and specifying that prenatal care coordination services are available to recipients' babies during that time period.

AB371-AA1,13,10 14. Expansion and full reimbursement of evidence-based, home-based prenatal care coordination services.

AB371-AA1,13,15 15. Full reimbursement for home visits made by registered nurses who are public health nurses or who meet the qualifications of a public health nurse as specified in s. 250.06 (1), by social workers as defined in s. 252.15 (1) (er), nurse-midwives licensed under s. 441.15 (3), and by persons who receive the training established under s. 38.04 (32).

AB371-AA1,13,17 16. Reimbursement of care provided through telemedicine visits on the same basis that reimbursement is provided for in-person visits.

AB371-AA1,13,19 17. Reimbursement of the costs of providing banked human donor milk to newborns when medically indicated.

AB371-AA1,13,22 (c) The department shall evaluate the programs and services implemented under the waiver and develop a plan to implement the programs and services statewide.

AB371-AA1,13,25 (d) The department shall consider prohibiting reimbursement for elective induction of labor or cesarean sections if either procedure is performed before 39 weeks gestation, unless medically indicated.

AB371-AA1, s. 2am Section 2am. 49.815 of the statutes is created to read:

AB371-AA1,14,3 49.815 Statewide data management and information system. (1) The department of health services shall do all of the following:

AB371-AA1,14,9 (a) Expand the department's electronic application and information system that enables an individual to determine his or her eligibility for, and to apply for or renew, benefits under the Medical Assistance program or other public assistance benefits. The system shall include information regarding all programs designed to assist low-income individuals, including housing assistance, rental assistance, and temporary child care assistance.

AB371-AA1,14,11 (b) Develop and implement a statewide, electronic data management and information system for public assistance programs that does all of the following:

AB371-AA1,14,13 1. Determines a person's eligibility for multiple public assistance programs by means of a single registration or application.

AB371-AA1,14,16 2. Allows administrators of public assistance programs to access data related to an individual that was previously collected in connection with a different public assistance program.

AB371-AA1,14,18 3. Provides a single, automated care plan identifying a comprehensive array of service activities needed to address the assessed risks for an individual.

AB371-AA1,14,21 4. Provides a scheduling or referral system that matches an individual's service needs with available health care, public assistance, or economic assistance providers.

AB371-AA1,14,25 (2) The department of health services shall develop a detailed plan to implement an expanded system under sub. (1) (a) no later than 12 months after the effective date of this subsection .... [LRB inserts date]. The plan shall contain cost estimates and a proposed timeline for implementation.

AB371-AA1,15,4 (3) The department of health services shall collaborate with appropriate state agencies to expand the system under sub. (1) (a) and to develop and implement the system under sub. (1) (b). State agencies shall cooperate with the department on these projects.

AB371-AA1, s. 2b Section 2b. 50.36 (2m) of the statutes is created to read:

AB371-AA1,15,8 50.36 (2m) The department shall promulgate rules that require hospitals to ensure that best practices for postpartum patients and newborns are supported in the hospital. The rules shall do all of the following:

AB371-AA1,15,10 (a) Require that a hospital develop for all postpartum patients an appropriate discharge plan that shall do all of the following:

AB371-AA1,15,15 1. Ensure that, to the extent practicable, an appointment with a health care provider has been scheduled for the newborn within an appropriate time after discharge, considering the nutritional and health needs of the newborn, in accordance with the recommendations established by the American Academy of Pediatrics.

AB371-AA1,15,17 2. Ensure that the mother is consulted and provided with assistance regarding health care resources available to her newborn.

AB371-AA1,15,19 3. Ensure that the mother is consulted and provided with assistance regarding the safe transportation of her newborn.

AB371-AA1,15,23 (b) Require education of postpartum patients, orally in person, before discharge on newborn care, including safe sleeping arrangements, how to access breastfeeding information and support, including reliable information on Internet Web site, and car seat safety, prior to discharge.

AB371-AA1,16,4 (c) Require that health care providers, including physicians, orally in person, recommend and actively support breastfeeding for all newborns for whom breastfeeding is not medically contraindicated, provide parents with complete, up-to-date information to ensure that their feeding decision is fully informed, and provide a referral to a lactation specialist or a public health nurse for a home visit at the parent's request.

AB371-AA1, s. 2c Section 2c. 50.36 (3i) of the statutes is created to read:

AB371-AA1,16,12 50.36 (3i) A hospital may grant a nurse-midwife licensed under s. 441.15 (3) who is covered under the injured patients and families compensation fund under s. 655.27 any hospital staff privilege that a hospital must, under sub. (3) (a), afford to persons licensed to practice medicine and surgery under subch. II of ch. 448 or to practice podiatry under subch. IV of ch. 448, including hospital staff privileges to admit, treat, and discharge any patient for whom a nurse-midwife is qualified to provide care.