a. Work in exchange for money, goods, or services.
b. Unpaid work, such as volunteer work or community service.
c. Self-employment.
d. Participation in a work, job training, or job search program, as approved by the department, including the employment and training program under s. 49.79 (9), the Wisconsin Works program under ss. 49.141 to 49.161, programs under the federal workforce innovation and opportunity act, and tribal work programs.
2. “Exempt individual” means an individual who is any of the following:
a. Receiving temporary or permanent disability benefits from the federal or state government or a private source.
b. Determined by the department to be physically or mentally unable to work.
c. Verified as unable to work in a statement from a social worker or other health care professional.
d. Experiencing chronic homelessness.
e. Serving as primary caregiver for a person who cannot care for himself or herself.
f. Receiving or applying for unemployment compensation and complying with the work requirements for unemployment compensation.
g. Participating regularly in an alcohol or other drug abuse treatment or rehabilitation program, except for alcoholics anonymous or narcotics anonymous but including cultural interventions specific to American Indian tribes or bands.
h. Attending high school at least half time or enrolled in an institution of higher education, including vocational programs or high school equivalency programs, at least half time.
i. Exempt from work requirements under the food stamp program under s. 49.79.
(b) Beginning as soon as practicable after October 31, 2018, and ending no sooner than December 31, 2023, the department shall do all of the following with regard to the childless adults demonstration project under sub. (23):
1. Require in each month persons, except exempt individuals, who are eligible to receive Medical Assistance under sub. (23) and who are at least 19 years of age but have not attained the age of 50 to participate in, document, and report 80 hours per calendar month of community engagement activities. The department, after finding good cause, may grant a temporary exemption from the requirement under this subdivision upon request of a Medical Assistance recipient.
2. Require persons with incomes of at least 50 percent of the poverty line to pay premiums in accordance with par. (c) as a condition of eligibility for Medical Assistance under sub. (23).
3. Require as a condition of eligibility for Medical Assistance under sub. (23) completion of a health risk assessment.
4. Charge recipients of Medical Assistance under sub. (23) an $8 copayment for nonemergency use of the emergency department in accordance with
42 USC 1396o-1 (e) (1) and
42 CFR 447.54.
5. Disenroll from Medical Assistance under sub. (23) for 6 months any individual who does not pay a required premium under subd. 2. and any individual who is required under subd. 1. to participate in a community engagement activity but who does not participate for 48 aggregate months in the community engagement activity.
(c) 1. Persons who are eligible for the demonstration project under sub. (23) and who have monthly household income that exceeds 50 percent of the poverty line shall pay a monthly premium amount of $8 per household. A person who is eligible to receive an item or service furnished by an Indian health care provider is exempt from the premium requirement under this subdivision.
2. The department may disenroll under par. (b) 5. a person for nonpayment of a required monthly premium only at annual eligibility redetermination after providing notice and reasonable opportunity for the person to pay. If a person who is disenrolled for nonpayment of premiums pays all owed premiums or becomes exempt from payment of premiums, he or she may reenroll in Medical Assistance under sub. (23).
3. The department shall reduce the amount of the required household premium by up to half for a recipient of Medical Assistance under sub. (23) who does not engage in certain behaviors that increase health risks or who attests to actively managing certain unhealthy behaviors.
(d) The department shall comply with any other requirements not specified elsewhere in this subsection that are imposed by the federal department of health and human services in its approval effective October 31, 2018.
(e) Before December 31, 2023, the demonstration project requirements under this subsection may not be withdrawn and the department may not request from the federal government withdrawal, suspension, or termination of the demonstration project requirements under this subsection unless legislation has been enacted specifically allowing for the withdrawal, suspension, or termination.
(f) The department shall comply with all applicable timing in and requirements of s. 20.940.
370,15
Section 15
. 49.79 (9) (d) 1. of the statutes is repealed.
370,16
Section 16
. 49.79 (9) (d) 2. of the statutes is renumbered 49.79 (9) (d) and amended to read:
49.79 (9) (d) Subject to the promulgation of rules under subd. 1. s. 49.791, the department shall screen and, if indicated, test and treat participants in an employment and training program under this subsection who are able-bodied adults for illegal use of a controlled substance without a valid prescription for the controlled substance. Eligibility for an able-bodied adult to participate in an employment and training program under this subsection is subject to s. 49.791.
370,17
Section 17
. 49.791 of the statutes is created to read:
49.791 Substance abuse screening, testing, and treatment for employment and training programs. (1) Definitions. In this section:
(a) “Able-bodied adult” has the meaning given in s. 49.79 (1) (am).
(b) “Administering agency” means an administrative agency within the executive branch under ch. 15 or an entity that contracts with the state such as a single county consortia under s. 49.78 (1r), a multicounty consortia under s. 49.78 (1) (br), or a tribal governing body under s. 49.78 (1) (cr).
(c) “Confirmation test” means an analytical procedure used to quantify a specific controlled substance or its metabolite in a specimen through a test that is different in scientific principle from that of the initial test procedure and capable of providing the requisite specificity, sensitivity, and quantitative accuracy to positively confirm use of a controlled substance.
(d) “Controlled substance” has the meaning given in s. 49.79 (1) (b).
(e) “Employment and training program” means the food stamp employment and training program under s. 49.79 (9).
(f) “Food stamp program” has the meaning given in s. 49.79 (1) (c).
(g) “Medical review officer” means a licensed medical provider who is employed by or providing services under a contract to a qualified drug testing vendor, has knowledge of substance abuse disorders and laboratory testing procedures, and has the necessary training and experience to interpret and evaluate an individual's positive test result in relation to the individual's medical history and valid prescriptions.
(h) “Metabolite” means a chemical present in the body when a controlled substance is being broken down through natural metabolic processes that can be detected or measured as a positive indicator that a controlled substance associated with the metabolite has been used.
(i) “Prescription” means a current order for a controlled substance that indicates the specific regimen and duration of the order and that is transmitted electronically or in writing by an individual authorized in this state to order the controlled substance.
(j) “Qualified drug testing vendor” means a laboratory certified by the federal centers for medical and medicaid services under the federal Clinical Laboratory Improvement Amendments of 1988 to collect a specimen, carry out laboratory analysis of the specimen, store the specimen for a confirmation test if required, complete a confirmation test, and provide review by a medical review officer.
(k) “Screening” means completing a questionnaire specified by the department regarding an individual's current and prior use of any controlled substance.
(L) “Specimen” means tissue, fluid, or any other product of the human body required to be submitted by an individual for testing under this section.
(m) “Trauma-informed” means operating under the understanding of the science of adverse childhood experiences, toxic stress, trauma, and resilience, incorporating that understanding into organizational culture, policies, programs, and practices, and adhering to trauma-informed principles such as safety, trustworthiness and transparency, peer support, collaboration and mutuality, empowerment, and cultural, historical, and gender issue recognition.
(n) “Treatment” means any service that is conducted under clinical supervision to assist an individual through the process of recovery from controlled substance abuse, including screening, application of approved placement criteria, intake, orientation, assessment, individualized treatment planning, intervention, individual or group and family counseling, referral, discharge planning, after care or continuing care, record keeping, consultation with other professionals regarding treatment services, recovery and case management, crisis intervention, education, employment, and problem resolution in life skills functioning.
(o) “Treatment program” means a program certified by the department to provide treatment for controlled substance abuse as a medically managed inpatient service, a medically monitored treatment service, a day treatment service, an outpatient treatment service, a transitional residential treatment service, or a narcotic treatment service for opiate addiction or, as approved by the department, psychosocial rehabilitation services.
(p) “Treatment provider” means a provider of treatment for controlled substance abuse certified by the department, a provider certified under s. 440.88, or a licensed professional who meets criteria established by the department of safety and professional services.
(2) Notice of requirement. An administering agency shall provide information in a format approved by the department to any individual who expresses interest in or is referred to participate in an employment and training program to explain the requirement for participants in certain employment and training programs to undergo screening, testing, and treatment for abuse of controlled substances.
(3) Administering and evaluating a controlled substance abuse screening questionnaire. (a) At the time of application and at annual redetermination for eligibility in the food stamp program, an administering agency shall administer to any able-bodied adult who is subject to the work requirement under s. 49.79 (10) (a) and intends on meeting the work requirement through participation in the employment and training program a controlled substance abuse screening questionnaire approved by the department, which may include questions related to controlled substance abuse-related criminal background and controlled substance abuse. The administering agency shall determine whether answers to the controlled substance abuse screening questionnaire indicate possible use of a controlled substance without a valid prescription by the able-bodied adult.
(b) 1. An able-bodied adult who is administered a controlled substance abuse screening questionnaire under par. (a) shall answer all questions on the screening questionnaire, sign and date the questionnaire, and submit the questionnaire to the administering agency.
2. If the able-bodied adult indicates on the screening questionnaire submitted under subd. 1. the prescribed use of a controlled substance, the able-bodied adult shall provide evidence of the valid prescription to the administering agency.
(c) An able-bodied adult who is administered a controlled substance abuse screening questionnaire under par. (a) and who fails to comply with the requirements under par. (b) is not eligible to participate in the employment and training program, and the administering agency may not refer the individual to participate in the employment and training program. An able-bodied adult who is denied eligibility for participation in the employment and training program for failure to complete the requirements under par. (b) may complete the requirements under par. (b) at any time while eligible for the food stamp program.
(d) An able-bodied adult who completes a controlled substance abuse screening questionnaire under this subsection and whose answers to the screening questionnaire do not indicate possible abuse of a controlled substance has satisfied the requirements of this section and may participate in an employment and training program subject to this section.
(4) Testing for use of a controlled substance required. (a) Individuals required to undergo testing; exception. 1. Except as provided in subd. 2., an administering agency shall require an able-bodied adult whose answers on the controlled substance abuse screening questionnaire submitted under sub. (3) indicate possible use of a controlled substance without a prescription to undergo a test for the use of a controlled substance.
2. An administering agency may not require an able-bodied adult whose answers on the controlled substance abuse screening questionnaire submitted under sub. (3) indicate possible use of a controlled substance and who also indicates readiness to enter treatment for controlled substance abuse to undergo a test for the use of a controlled substance.
(b) Nature of testing required. A test for use of a controlled substance under this subsection consists of laboratory analysis of a specimen collected from an able-bodied adult described in par. (a) in a manner specified by the department that is consistent with guidelines from the federal department of health and human services by a qualified drug testing vendor or a provider approved by the department. The qualified drug testing vendor or other provider shall analyze the specimen for the presence of controlled substances specified by the department.
(c) Contracts for testing services. 1. The administering agency, subject to the department's approval, may contract with a trauma-informed qualified drug testing vendor to collect a specimen, carry out laboratory analysis of the specimen, store the specimen for confirmatory testing if required, complete confirmatory testing, provide review by a medical review officer, and document and report test results to the administering agency.
2. The department may require administering agencies to use a specific drug testing service procured through state contracting if the department determines that volume discounts or other preferential pricing terms may be achieved through a statewide contract.
(d) Effects of refusal to submit to drug test. 1. An able-bodied adult who is required to undergo a test for the use of a controlled substance under par. (a) but who refuses to submit to a drug test by doing any of the following is ineligible to participate in the employment and training program until the individual agrees to be tested for use of a controlled substance and test results have been reported:
a. Failing or refusing to appear for a scheduled drug test without good cause.
b. Failing or refusing to complete a form or release of information required for testing, including any form or release required by the qualified drug testing vendor to permit the vendor to report test results to the administering agency or department.
c. Failing or refusing to provide a valid specimen for testing.
d. Failing or refusing to provide verification of identity to the testing vendor.
2. The administering agency may direct an able-bodied adult who initially refused to submit to a drug test under subd. 1. and subsequently agrees to submit to a test to undergo drug testing on a random basis at any time within 10 business days after the able-bodied adult agrees to submit to a test.
(e) Confirmation test required. If an able-bodied adult tests positive for the use of a controlled substance, the qualified drug testing vendor shall perform a confirmation test using the same specimen obtained for the initial drug test. The vendor's medical review officer who is responsible for determining the presence of a controlled substance under par. (b) shall interpret all drug test results that are not negative.
(f) Accepting test results from other programs. For purposes of this section, an administering agency may use results of a drug test performed by the administering agency for the purpose of eligibility for another state program, including a work experience program under s. 49.162, 49.36, or 108.133, performed at the request of the department of corrections, or performed by other drug testing providers as approved by the department to determine whether to refer an able-bodied adult to treatment if all of the following apply:
1. The test results are provided directly to the administering agency.
2. The test results include tests for all controlled substances required by the department to be tested under this section.
3. The test occurred within 90 days before the results are provided to the administering agency.
(g) Effect of a negative test. An able-bodied adult who undergoes a test for use of a controlled substance under this subsection and tests negative for use of a controlled substance or who tests positive for use of a controlled substance but provides to the administering agency a prescription for each controlled substance for which the adult tests positive is not prohibited from participating in an employment and training program.
(h) Effect of a positive test. An able-bodied adult who undergoes a test for use of a controlled substance under this subsection, whose test results are positive, and who does not provide evidence of a prescription for the controlled substance, as determined by the qualified drug testing vendor's medical review officer, is required to participate in treatment under sub. (5) to participate in an employment and training program.
(5) Participation in treatment required. (a) Individuals required to participate in treatment. An able-bodied adult who is described under sub. (4) (a) or (h) is required to participate in trauma-informed treatment to be eligible to participate in an employment and training program.
(b) Referral for treatment; monitoring. The applicable administering agency shall provide to every able-bodied adult who is required to participate in treatment under par. (a) information about treatment programs and county-specific assessment and enrollment activities required for entry into treatment. The applicable administering agency shall monitor the able-bodied adult's progress in entering and completing treatment and the results of random testing for the use of a controlled substance carried out during and at the conclusion of treatment.
(c) Evaluation and assessment. A treatment provider shall conduct a trauma-informed substance abuse evaluation and assessment of each able-bodied adult and take any of the following actions, as appropriate, based on the evaluation and assessment:
1. If the treatment provider determines the able-bodied adult does not need treatment, notify the administering agency that the able-bodied adult does not need treatment.
2. If the treatment provider determines the able-bodied adult is in need of treatment, refer the individual to an appropriate treatment program to begin treatment and notify the administering agency of the referral and the expected start date and duration of treatment.
3. If a treatment provider determines the able-bodied adult is in need of treatment but is unable to refer the adult because there is a waiting list for enrollment, enter the able-bodied adult on the waiting list and notify the administering agency of the date the adult is expected to be enrolled.
(d) Eligibility when treatment not needed or on waiting list. 1. An able-bodied adult described in par. (c) 1. is determined to have satisfied the requirements of this section and is eligible under this section to participate in an employment and training program.
2. An able-bodied adult who is on a waiting list for enrollment in an appropriate treatment program under par. (c) 3. shall continue to take all necessary steps to continue seeking enrollment in the appropriate treatment program. The able-bodied adult is eligible under this section to participate in an employment and training program while on the waiting list if the adult is not eligible for immediate enrollment in another appropriate treatment program.
(e) Satisfying treatment requirement through another program. An administering agency shall accept as satisfying the requirements of this subsection participation in any treatment program. The able-bodied adult satisfying the requirements of this subsection by participating in another treatment program shall execute a release of information to allow the administering agency to obtain verification of successful participation in that treatment program.
(f) Effects of refusal to submit to treatment. An able-bodied adult who is required to participate in treatment under par. (a) but who refuses to participate in treatment by doing any of the following is ineligible to participate in the employment and training program until the individual agrees to participate in treatment while still eligible for the food stamp program:
1. Failing or refusing to complete a form or release required for treatment program administration, including a form or release required by the treatment provider in order to share information with the administering agency about the able-bodied adult's participation in treatment.
2. Failing or refusing to participate in a controlled substance test required by the treatment provider or the administering agency during the course of required treatment, including any random controlled substance testing directed by the treatment provider or administering agency.
3. Failing or refusing to meet attendance or participation requirements established by the treatment provider.
4. Failing or refusing to complete a substance abuse assessment.
(g) Completion of required treatment. An able-bodied adult required under par. (a) to participate in treatment is considered to have successfully completed treatment if all applicable components identified under par. (c) are satisfied.
(h) Work requirements while in treatment. An able-bodied adult who is participating in an employment and training program is exempt from complying with requirements to work a specified number of hours under s. 49.79 (9) or (10) while participating in treatment under this subsection.
(6) Effect of completion, withdrawal, or termination from employment and training program. An able-bodied adult who satisfies any of the following is no longer subject to s. 49.79 (9) (d) or this section:
(a) The able-bodied adult has completed or voluntarily withdrawn from participation in an employment and training program.
