Analysis by the Legislative Reference Bureau
The text of Engrossed 2013 Assembly Bill 452 consists of the following
documents adopted in the assembly on November 12, 2013: the bill as affected by
Assembly Amendments 1 and 3.
Content of Engrossed 2013 Assembly Bill 452:
This bill requires the Department of Health Services (DHS) to create and
administer a child psychiatry consultation program (consultation program) to assist
participating clinicians in providing enhanced care to pediatric patients with mental
health care needs, to provide referral support for those patients, and to provide
additional services. The consultation program is not an emergency referral service.
Before January 1, 2015, DHS must review proposals submitted by organizations
seeking to provide consultation services through this consultation program
(consultation providers) and must designate regional program hubs, in a number
determined by DHS, based on organizations' submitted proposals. Beginning on
January 1, 2016, DHS must create any additional regional program hubs to expand
the consultation program statewide.
Under the bill, DHS must select qualified providers to provide consultation
program services. To be a qualified consultation provider, an organization must
demonstrate it meets certain criteria as specified in the bill. While required to have
the capability to provide consultation services by telephone, a consultation provider
may provide services by certain other means of communication including in-person
conference. A consultation provider may also provide the following services, which
are eligible for funding from DHS: certain second opinion diagnostic and medication
management evaluations and certain in-person or Internet site-based educational
seminars and refresher courses provided to any participating clinician who uses the
consultation program. A consultation provider must report to DHS any information
requested by DHS.
The bill also requires the department to conduct interviews and annual surveys
of participating clinicians who use the consultation program.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
20.005 (3) (schedule) of the statutes: at the appropriate place, insert 2
the following amounts for the purposes indicated:
- See PDF for table
(bw) Child psychiatry consultation program.
Biennially, the 6
amounts in the schedule for operating the child psychiatry consultation program 7
under s. 51.442.
951.442 Child psychiatry consultation program. (1)
In this section, 10
"participating clinicians" include pediatricians, family physicians, nurse 11
practitioners, and physician assistants.
The department shall create and administer a child psychiatry consultation 2
program to assist participating clinicians in providing enhanced care to pediatric 3
patients with mental health care needs, to provide referral support for pediatric 4
patients, and to provide additional services described in this section. The 5
consultation program created under this section is not an emergency referral service.
(a) In the period before January 1, 2015, the department shall review 7
proposals submitted by organizations seeking to provide consultation services 8
through the consultation program under this section and shall designate regional 9
program hubs, in a number determined by the department, based on the submitted 10
proposals. The department shall select and provide moneys to organizations to 11
provide consultation services through the consultation program in a manner that 12
maximizes medically appropriate access and services as described under sub. (4).
(b) Beginning on January 1, 2016, the department shall create any additional 14
regional program hubs in order to provide consultation services statewide.
The department shall select qualified organizations to provide consultation 16
program services through the regional hubs. Each regional hub shall make available 17
its own qualified provider or consortium of providers. To be a qualified provider in 18
the program under this section, an organization shall successfully demonstrate it 19
meets all of the following criteria:
(a) The organization has the required infrastructure to be located within the 21
geographic service area of the proposed regional hub.
(b) Any individual who would be providing consulting services through the 23
program is located in this state.
(c) The organization enters into a contract with the department agreeing to 2
satisfy all of the following criteria as a condition of providing services through the 3
1. The organization has at the time of participation in the program a 5
psychiatrist, who is either eligible for certification or certified by the American Board 6
of Psychiatry and Neurology, Inc., for either adult psychiatry or child and adolescent 7
psychiatry or both, and has and maintains additional staff as specified by the 8
2. The organization operates during the normal business hours of Monday to 10
Friday between 8 a.m. and 5 p.m., excluding weekends and holidays.
3. The organization shall be able to provide consultation services as promptly 12
as is practicable.
4. The organization shall provide all of the following services:
a. Support for participating clinicians to assist in the management of children 15
and adolescents with mental health problems and to provide referral support for 16
b. A triage-level assessment to determine the most appropriate response to 18
each request, including appropriate referrals to other mental health professionals.
c. When medically appropriate, diagnostic and therapeutic feedback.
d. Recruitment of other practices in the regional hub's service territory to the 21
5. The organization shall have the capability to provide consultation services 23
by telephone, at a minimum.
(a) An organization providing consultation services through the 25
consultation program under this section may provide services by teleconference,
video conference, voice over Internet protocol, electronic mail, pager, or in-person 2
(b) The organization providing consultation services through the consultation 4
program under this section may provide any of the following services, which are 5
eligible for funding from the department:
1. Second opinion diagnostic and medication management evaluations 7
conducted either by a psychiatrist or by a social worker or psychologist, or a 8
registered nurse with psychiatric training, either by in-person conference or by 9
teleconference, video conference, or voice over Internet protocol.
2. In-person or Internet site-based educational seminars and refresher 11
courses provided to any participating clinician who uses the consultation program 12
on a medically appropriate topic within child psychiatry.
An organization that provides consultation services through the 14
consultation program under this section shall report to the department any 15
information as requested by the department.
(a) The department shall conduct annual surveys of participating clinicians 17
who use the consultation program under this section to assess the amount of 18
pediatric mental health care provided, self-perceived levels of confidence in 19
providing pediatric mental health services, and the satisfaction with the 20
consultations and the educational opportunities provided.
(b) Immediately after a clinical practice group begins using the consultation 22
program under this section and again 6 to 12 months later, the department shall 23
conduct an interview of participating clinicians from that practice group to assess the 24
barriers to and benefits of participation to make future improvements and to
determine the participating clinician's treatment abilities, confidence, and 2
awareness of relevant resources before and after using the consultation program.