SB546: Bill Text

SB546,16,10 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.

SB546,25 Section 25. 49.45 (24w) of the statutes is created to read:

SB546,16,24 49.45 (24w) Services for pregnant women. (a) The department shall request a waiver 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.

SB546,17,2 (b) The department shall consider including all of the following as covered services or programs in the waiver request under par. (a):

SB546,17,5 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.

SB546,17,7 2. Evidence-based social-support programs, including fatherhood initiatives designed to reduce fetal and infant mortality and improve birth outcomes.

SB546,17,11 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.

SB546,17,15 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.

SB546,17,18 5. Full reimbursement for evidence-based group prenatal care, such as a multifaceted model of care that integrates health assessment, education, and support into a unified program within a group setting.

SB546,17,19 6. Mental health services.

SB546,17,20 7. Smoking cessation services.

SB546,17,23 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.

SB546,18,3 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.

SB546,18,6 10. Demonstration projects developed by the department to evaluate the effectiveness of evidence-based programs designed to serve under-served populations.

SB546,18,10 11. One or more initiatives, developed by the department, to increase the utilization of nurse-midwives licensed under s. 441.15 (3) and labor coaches or other nonmedical individuals who assist women before, during, or after child birth in the delivery of care to underserved populations and to evaluate the outcomes of that care.

SB546,18,11 12. The establishment of freestanding birth centers.

SB546,18,15 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.

SB546,18,17 14. Expansion and full reimbursement of evidence-based, home-based prenatal care coordination services.

SB546,18,22 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 (33).

SB546,18,24 16. Reimbursement of care provided through telehealth visits on the same basis that reimbursement is provided for in-person visits.

SB546,19,2 17. Reimbursement of the costs of providing banked human donor milk to newborns when medically indicated.

SB546,19,5 (c) The department shall evaluate the programs and services implemented under the waiver under par. (a) and develop a plan to implement the effective programs and services statewide.

SB546,19,8 (d) The department shall consider prohibiting reimbursement under Medical Assistance for elective induction of labor or cesarean sections if either procedure is performed before 39 weeks gestation, unless medically indicated.

SB546,26 Section 26. 49.815 of the statutes is created to read:

SB546,19,11 49.815 Statewide data management and information system. (1) The department of health services shall do all of the following:

SB546,19,17 (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.

SB546,19,19 (b) Develop and implement a statewide, electronic data management and information system for public assistance programs that does all of the following:

SB546,19,21 1. Determines an individual's eligibility for multiple public assistance programs by means of a single registration or application.

SB546,19,24 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.

SB546,20,3 3. Provides a single, automated care plan for an individual that identifies a comprehensive array of service activities needed to address the individual's assessed risks.

SB546,20,6 4. Provides a scheduling or referral system that matches an individual's service needs with available health care, public assistance, or economic assistance providers.

SB546,20,10 (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.

SB546,20,14 (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 of health services on these projects.

SB546,27 Section 27. 50.36 (2m) of the statutes is created to read:

SB546,20,18 50.36 (2m) The department shall promulgate rules that require hospitals to ensure that best practices for postpartum patients and newborns are supported in hospitals, including rules that do all of the following:

SB546,20,20 (a) Require hospitals to develop, for each postpartum patient, an appropriate discharge plan that does all of the following:

SB546,20,25 1. Ensures that, to the extent practicable and in accordance with the recommendations established by the American Academy of Pediatrics, an appointment with a health care provider has been scheduled for the newborn within an appropriate time after discharge to address the nutritional and health needs of the newborn.

SB546,21,3 2. Ensures that the postpartum patient is consulted and provided with assistance regarding health care resources available to her newborn and regarding the safe transportation of her newborn.

SB546,21,5 (b) Require that education is provided, orally and in person, to each postpartum patient prior to discharge on all of the following:

SB546,21,6 1. Newborn care, including safe sleeping arrangements.

SB546,21,8 2. Methods to access breastfeeding information and support, including reliable information on Internet sites.

SB546,21,9 3. Car seat safety.

SB546,21,11 (c) Require that health care providers, including physicians, do all of the following orally and in person:

SB546,21,13 1. Recommend and actively support breastfeeding for all newborns for whom breastfeeding is not medically contraindicated.

SB546,21,15 2. Provide parents with complete, up-to-date information to ensure that feeding decisions are fully informed.

SB546,21,17 3. Provide, upon a parent's request, referrals to lactation specialists or public health nurses for home visits.

SB546,28 Section 28. 50.36 (3i) of the statutes is created to read:

SB546,21,25 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.

SB546,29 Section 29. 69.02 (2) (c) of the statutes is created to read:

SB546,22,10 69.02 (2) (c) The department shall promulgate rules establishing designations of race and ethnicity to be used in reporting the race and ethnicity of a registrant under s. 69.14 (1) (i). The designations shall be sufficiently detailed to enable compilation and analysis of data related to births and birth outcomes among all significant racial and ethnic populations in the state and to assist in the design and evaluation of programs and policies designed to improve birth outcomes. The rules shall establish procedures designed to ensure that the racial and ethnic designations included on each certificate of birth accurately reflect the race and ethnicity of the registrant as directly reported by the registrant's mother.

SB546,30 Section 30. 69.14 (1) (i) of the statutes is created to read:

SB546,22,13 69.14 (1) (i) Registrant's race. A certificate of birth shall include the race and ethnicity of the registrant, as reported by the mother of the registrant.

SB546,31 Section 31. 71.07 (9e) (aj) (intro.) of the statutes is amended to read:

SB546,22,19 71.07 (9e) (aj) (intro.) For taxable years beginning after December 31, 2010, and subject to par. (h), an individual may credit against the tax imposed under s. 71.02 an amount equal to one of the following percentages of the federal basic earned income credit for which the person is eligible for the taxable year under section 32 (b) (1) (A) to (C) of the Internal Revenue Code:

SB546,32 Section 32. 71.07 (9e) (h) of the statutes is created to read:

SB546,23,2 71.07 (9e) (h) Notwithstanding the limitations in par. (aj), a person may claim the credit under par. (aj) even if, with regard to the child about whom the claim is made, the child does not have the same principal place of abode as the person claiming the credit and even if another person claims the credit under section 32 (b) (1) (A) to (C) of the Internal Revenue Code and under par. (aj) for that child, if all of the following apply:

SB546,23,4 1. The claimant is subject to and in compliance with a child support order under s. 767.511 with respect to that child.

SB546,23,6 2. The claimant meets the definition of parent under s. 48.02 (13) with respect to that child.

SB546,33 Section 33. 253.15 (2) of the statutes is amended to read:

SB546,24,5 253.15 (2) Informational materials. The board shall purchase or prepare or arrange with a nonprofit organization to prepare printed and audiovisual materials relating to shaken baby syndrome and impacted babies. The materials shall include information regarding the identification and prevention of shaken baby syndrome and impacted babies, the grave effects of shaking or throwing on an infant or young child, appropriate ways to manage crying, fussing, or other causes that can lead a person to shake or throw an infant or young child, and a discussion of ways to reduce the risks that can lead a person to shake or throw an infant or young child. The materials shall be prepared in English, Spanish, and other languages spoken by a significant number of state residents, as determined by the board. The board shall make those written and audiovisual materials available to all hospitals, maternity homes, and nurse-midwives licensed under s. 441.15 that are required to provide or make available materials to parents under sub. (3) (a) 1., to the department and to all county departments and nonprofit organizations that are required to provide the materials to child care providers under sub. (4) (d), and to all school boards and nonprofit organizations that are permitted to provide the materials to pupils in one of grades 5 to 8 and in one of grades 10 to 12 under sub. (5). The board shall also make those written materials available to all county departments and Indian tribes that are providing evidence-based home visitation services under s. 48.983 (4) (b) 1. and to all providers of prenatal, postpartum, and young child care coordination services under s. 49.45 (44). The board may make available the materials required under this subsection to be made available by making those materials available at no charge on the board's Internet site.

SB546,34 Section 34. 253.15 (6) of the statutes is amended to read:

SB546,24,12 253.15 (6) Information to home visitation or care coordination services recipients. A county department or Indian tribe that is providing evidence-based home visitation services under s. 48.983 (4) (b) 1. and a provider of prenatal, postpartum, and young child care coordination services under s. 49.45 (44) shall provide to a recipient of those services, without cost, a copy of the written materials purchased or prepared under sub. (2) and an oral explanation of those materials.

SB546,35 Section 35. 253.15 (7) (e) of the statutes is amended to read:

SB546,24,19 253.15 (7) (e) A county department or Indian tribe that is providing evidence-based home visitation services under s. 48.983 (4) (b) 1. and a provider of prenatal, postpartum, and young child care coordination services under s. 49.45 (44) is immune from liability for any damages resulting from any good faith act or omission in providing or failing to provide the written materials and oral explanation specified in sub. (6).

SB546,36 Section 36. 253.162 of the statutes is created to read:

SB546,24,22 253.162 Fetal and infant mortality and birth outcome report. (1) In this section:

SB546,24,23 (a) "Infant" means a child from birth to 12 months of age.

SB546,24,25 (b) "Low birth weight" means a birth weight that is more than 1,500 grams and less than 2,500 grams.

SB546,25,1 (c) "Very low birth weight" means a birth weight of 1,500 grams or less.

SB546,25,2 (d) "Very premature birth" means a birth at less than 32 weeks gestation.

SB546,25,15 (2) (a) The department shall annually prepare a report relating to fetal and infant mortality and birth outcomes in this state. The department shall include in the report data related to births and birth outcomes in this state in the previous calendar year and an analysis of that data. The department shall collaborate with local health departments, tribes, and other interested parties to determine the data and data analysis to be included in the report and the procedures by which the data will be collected and reported to the department. The department shall ensure that the report, to the greatest extent possible, includes data and analysis that are necessary and useful for the development and evaluation of programs to address disparities in birth outcomes among racial and ethnic groups in this state and shall periodically consult with interested parties to review and update the data and analysis to be included in the report, as is needed to ensure that this goal continues to be met.

SB546,25,17 (b) The department shall include, at a minimum, all of the following information in the report under par. (a):

SB546,25,18 1. The number and rate of infant deaths in each county.

SB546,25,19 2. The causes of infant deaths in each county.

SB546,25,20 3. The number and rate of very premature births in each county.

SB546,25,22 4. The number of low birth weight infants born in each county and the rate of those births in each county.

SB546,25,24 5. The number of very low birth weight infants born in each county and the rate of those births in each county.

SB546,26,2 6. The race or ethnicity of the infant provided on the birth or death certificate for births or deaths identified in subds. 1., 3., 4., and 5.

SB546,26,5 (c) The department, in collaboration with the persons described under par. (a), shall consider including in the report data related to the type of prenatal care, if any, received by the mother of each infant whose birth data is included in the report.

SB546,26,7 (d) On June 30, 2015, and on every June 30 after that, the department shall do all of the following:

SB546,26,9 1. Submit the report to the appropriate standing committees of the legislature under s. 13.172 (3).

SB546,26,10 2. Post the report on its Internet site.

SB546,26,14 3. Post on its Internet site the raw data collected in the previous calendar year for purposes of the annual report. The data shall be presented in a manner that does not disclose or enable the identification of any individual infant, mother, or birth attendant.

SB546,26,17 (3)   The department shall explore whether any of the costs of collecting the data and creating the report under sub. (2) may be funded by the Medical Assistance program.

SB546,37 Section 37. 253.18 of the statutes is created to read:

SB546,26,22 253.18 Neonatal intensive care unit report. (1) In this section, "neonatal intensive care unit" means a hospital unit on which special equipment and skilled medical personnel for the care of high-risk infants requiring immediate or continuous attention are concentrated.

SB546,26,24 (2) (a) Beginning on July 1, 2014, the department shall collect all of the following information from a hospital that has a neonatal intensive care unit:

SB546,26,25 1. The daily census of the neonatal intensive care unit.

SB546,27,1 2. The criteria for admission to the neonatal intensive care unit.