January 31, 2018 - Introduced by Representatives Nygren, Pronschinske,
Duchow, Snyder, Rodriguez, Petryk, Novak, Zimmerman, Tusler,
VanderMeer, Horlacher, Krug, Rohrkaste, Petersen, E. Brooks, Edming,
Spiros, Ballweg, Tittl, Tranel, Kitchens, Knodl, Born, Jagler, Sanfelippo,
Skowronski, Billings, Kolste, Genrich, Kulp and Mursau, cosponsored by
Senators Darling, Moulton, Wanggaard, Testin and Feyen. Referred to
Joint Committee on Finance.
AB907,2,2
1An Act to repeal 457.02 (5) and 457.02 (5m);
to renumber and amend 448.665
2and 449.06 (2m);
to amend 118.01 (2) (d) 6., 118.01 (2) (d) 7., 440.88 (3) (a)
3(intro.), 440.88 (3m), 440.88 (7), 441.16 (3) (d), 447.056 (1) (intro.), 448.07 (1) (d),
4961.385 (2) (cm) 1. (intro.) and 961.385 (2) (cm) 2.; and
to create 20.285 (1) (c),
536.25 (55), 49.45 (29z), 118.01 (2) (d) 2. d., 440.043, 441.19, 447.02 (2) (k),
6448.038, 448.13 (1) (a) 3., 448.13 (4), 448.20 (3) (c), 448.40 (2) (ck), 448.40 (2)
7(cm), 448.665 (1) (b) and 449.06 (2m) (b) of the statutes;
relating to: continuing
8education in prescribing controlled substances for certain health care
9practitioners; maintenance and detoxification treatment provided by physician
10assistants and advanced practice nurse prescribers; requiring school boards to
11provide instruction about drug abuse awareness and prevention; graduate
12training of psychiatric nurses; training materials for social services workers
13handling substance abuse-related cases; substance abuse counseling and
1modifying and creating administrative rules related to substance abuse
2counseling; granting rule-making authority; and making appropriations.
Analysis by the Legislative Reference Bureau
Continuing education
This bill requires a physician, physician assistant, advanced practice nurse
prescriber, podiatrist, dentist, or optometrist who is authorized to prescribe
controlled substances, when renewing his or her license issued by the applicable
credentialing board, to submit proof of completion of continuing education
requirements promulgated by rule of the board regarding best practices in
prescribing controlled substances.
Buprenorphine combination products; federal waivers
Under current federal law, the federal Drug Enforcement Administration
(DEA) registers health care practitioners to dispense controlled substances, and
practitioners who dispense narcotic drugs to individuals for addiction treatment
must additionally obtain a separate DEA registration for that purpose. However,
qualifying health care practitioners may, subject to certain requirements and
limitations, obtain a waiver from the requirement to obtain a separate DEA
registration to dispense those drugs for addiction treatment. Health care
practitioners eligible to obtain and practice under such a waiver include qualifying
physicians and, until October 1, 2021, qualifying physician assistants and nurse
practitioners. In order to qualify for a waiver, a nurse practitioner or physician
assistant must be supervised by, or work in collaboration with, a qualifying
physician, if the nurse practitioner or physician assistant is required by state law to
act in collaboration with or under the supervision of a physician.
Under rules promulgated by the state Medical Examining Board, the practice
of a physician assistant must be under the supervision of one or more physicians, and
under rules promulgated by the state Board of Nursing, advanced practice nurse
prescribers must work in a collaborative relationship with a physician.
This bill provides that, with respect to the ability of an advanced practice nurse
prescriber or physician assistant to obtain and practice under a waiver, a physician
who satisfies any of the criteria specified in federal law to be eligible to obtain a
waiver is considered eligible to serve as a qualifying physician for purposes of the
collaboration or supervision requirement under federal law, regardless of whether
the physician himself or herself holds a waiver.
The bill prohibits the Department of Health Services from requiring prior
authorization for or another limitation on prescribing and dispensing of
buprenorphine combination products to a Medical Assistance recipient, who is not
pregnant, by a health care provider who possesses a valid waiver, if the prior
authorization or other limitation is not required under the federal law.
Substance abuse counseling
This bill makes the following changes regarding substance abuse counseling:
1. Allows marriage and family therapists and professional counselors to
represent themselves to the public as substance abuse counselors, clinical
supervisors, or prevention specialists without holding a certification for that purpose
granted by the Department of Safety and Professional Services.
2. Requires DSPS to grant a certification as a substance abuse counselor,
clinical supervisor, or prevention specialist to an individual who holds a similar
unexpired certification granted by another state that has requirements for
certification that are not lower than this state's certification requirements.
3. Requires the secretary of DSPS to appoint an advisory behavioral health
review committee to semiannually review the requirements for obtaining certain
substance abuse counseling certifications; for obtaining credentials granted by the
Marriage and Family Therapy, Professional Counseling, and Social Work Examining
Board; and for obtaining other credentials related to behavioral health. Under the
bill, the advisory committee is required to accept public comments related to its
review and may propose changes in statutes and administrative rules to DSPS.
4. Allows a person certified as a social worker, advanced practice social worker,
or independent social worker, within the scope of his or her credential, to treat
substance use disorder as a specialty. In order to treat substance use disorder as a
specialty, current law requires a person holding one of those certifications to satisfy
additional criteria related to education and amount of supervised practice, and to
complete continuing education every two years, or to obtain a substance abuse
counselor, clinical supervisor, or prevention specialist certification from DSPS.
5. Specifies the contents required in an application for certification as a
substance abuse counselor, clinical substance abuse counselor, intermediate or
independent clinical supervisor, prevention specialist, substance abuse
counselor-in-training, clinical supervisor-in-training, or prevention
specialist-in-training.
6. Adds various actions to the scope of unprofessional conduct for which DSPS
may discipline a substance abuse counselor or other related professional.
7. Specifies the requirements that a person with an expired substance abuse
counselor or other related certification must satisfy to renew or reinstate an expired,
surrendered, or revoked certification.
8. Specifies the contents required in an application to be approved by DSPS to
provide education that satisfies the educational requirements for a substance abuse
counselor or other related certification.
9. Specifies the continuing education requirements that a substance abuse
counselor, clinical substance abuse counselor, prevention specialist, or clinical
supervisor is required to satisfy in order to renew his or her certification.
Drug abuse awareness and prevention instruction
This bill requires each school board to incorporate drug abuse awareness and
prevention in its health instructional program. Current law requires school boards
to provide instruction about the effects of controlled substances and alcohol on the
human system, but a school board may not require a pupil to receive that instruction
if the pupil's parent or guardian files a written objection. Current law also requires
school boards to provide instruction to pupils on the relationship between highway
safety and controlled substances and the relationship between youth suicide and
controlled substances. This bill specifies that the references to controlled substances
in these requirements include prescription drugs included in the Uniform Controlled
Substances Act.
Graduate psychiatric nursing education
This bill requires the Board of Regents of the University of Wisconsin System,
in consultation with the chancellor of UW-Madison, to do all of the following with
respect to the graduate program in psychiatric mental health nursing at
UW-Madison: 1) increase the number of students provided the opportunity to study
to be board-eligible psychiatric mental health nurse practitioners; 2) expand the
instructional capacity available to teach psychiatric mental health nursing; and 3)
subject to certain student commitments, annually provide fellowships for psychiatric
mental health nursing students to participate in clinical rotations in rural
communities or areas with shortages of mental health professionals in this state.
The bill provides additional funding to the UW System for these purposes.
Training resources for social services workers
This bill provides $50,000 of funding to the Department of Children and
Families to develop and maintain online training resources for social services
workers who deal with substance abuse-related cases.
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:
AB907,1
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](https://docs.legis.wisconsin.gov/assets/image/file_acrobat.gif)
AB907,2
3Section
2. 20.285 (1) (c) of the statutes is created to read:
AB907,5,2
120.285
(1) (c)
Graduate psychiatric nursing education. The amounts in the
2schedule for the purposes specified in s. 36.25 (55) (a).
AB907,3
3Section
3. 36.25 (55) of the statutes is created to read:
AB907,5,84
36.25
(55) Graduate psychiatric nursing education at the University of
5Wisconsin-Madison. (a) In consultation with the chancellor of the University of
6Wisconsin-Madison, the board shall do all of the following with respect to the
7graduate program in psychiatric mental health nursing at the University of
8Wisconsin-Madison:
AB907,5,109
1. Increase the number of students provided the opportunity to study to be
10board-eligible psychiatric mental health nurse practitioners.
AB907,5,1211
2. Expand the instructional capacity available to teach psychiatric mental
12health nursing.
AB907,5,1713
3. Annually provide fellowships for psychiatric mental health nursing students
14to participate in clinical rotations in rural communities or areas with shortages of
15mental health professionals in this state. In order to receive a fellowship under this
16subdivision, a student shall commit to passing applicable board certification and to
17practicing in this state for at least 2 years after graduation from the program.
AB907,5,1918
(b) Costs associated with the board's duties under par. (a) shall be funded from
19the appropriation account under s. 20.285 (1) (c).
AB907,4
20Section
4. 49.45 (29z) of the statutes is created to read:
AB907,6,221
49.45
(29z) Opioid treatment authorization. The department may not require
22prior authorization for or other limitation on prescribing and dispensing of
23buprenorphine combination products to a recipient, who is not pregnant, under the
24Medical Assistance program under this subchapter by a health care provider who
1possesses a valid waiver under
21 USC 823, if the prior authorization or other
2limitation is not required by
21 USC 823.
AB907,5
3Section
5. 118.01 (2) (d) 2. d. of the statutes is created to read:
AB907,6,54
118.01
(2) (d) 2. d. Awareness about drug abuse, including prescription drug
5abuse, and prevention.
AB907,6
6Section
6. 118.01 (2) (d) 6. of the statutes is amended to read:
AB907,6,107
118.01
(2) (d) 6. Knowledge of the prevention of accidents and promotion of
8safety on the public highways, including instruction on the relationship between
9highway safety and the use of alcohol and controlled substances
, including
10prescription drugs, under ch. 961.
AB907,7
11Section
7. 118.01 (2) (d) 7. of the statutes is amended to read:
AB907,6,1812
118.01
(2) (d) 7. The skills needed to make sound decisions, knowledge of the
13conditions which may cause and the signs of suicidal tendencies, knowledge of the
14relationship between youth suicide and the use of alcohol and controlled substances
,
15including prescription drugs, under ch. 961 and knowledge of the available
16community youth suicide prevention and intervention services. Instruction shall be
17designed to help prevent suicides by pupils by promoting the positive emotional
18development of pupils.
AB907,8
19Section
8. 440.043 of the statutes is created to read:
AB907,6,24
20440.043 Behavioral health review committee.
(1) The secretary shall
21appoint an advisory committee under s. 440.042 to provide advice concerning
22behavioral health. The advisory committee shall semiannually conduct a review of
23the requirements for obtaining a credential under s. 440.88 or ch. 457 or for other
24credentials related to behavioral health.
AB907,7,4
1(2) The advisory committee shall accept comments from the public related to
2its review under sub. (1). Before conducting a review under sub. (1), the department
3shall publish a class 1 notice under ch. 985 and shall publish notice on its Internet
4site announcing the opportunity for public comment.
AB907,7,6
5(3) The advisory committee established under sub. (1) may propose changes in
6statutes and rules to the department.
AB907,9
7Section
9. 440.88 (3) (a) (intro.) of the statutes is amended to read:
AB907,7,138
440.88
(3) (a) (intro.) Subject to pars. (b) and (c) and except as provided in sub.
9(3m), the department shall promulgate rules that establish minimum standards and
10qualifications for the certification of all of the following, including substance abuse
11counselors and clinical supervisors
described under s. HFS 75.02 (11) and (84), Wis.
12Adm. Code, in effect on December 15, 2006, as defined by the department of health
13services by rule:
AB907,10
14Section
10. 440.88 (3m) of the statutes is amended to read:
AB907,7,2015
440.88
(3m) Exception. This section does not apply to a physician, as defined
16in s. 448.01 (5), a clinical social worker, as defined in s. 457.01 (1r),
or a licensed
17psychologist, as defined in s. 455.01 (4),
a marriage and family therapist, as defined
18in s. 457.01 (3), or a professional counselor, as defined in s. 457.01 (7), who practices
19as a substance abuse clinical supervisor or provides substance abuse counseling,
20treatment, or prevention services within the scope of his or her licensure.
AB907,11
21Section
11. 440.88 (7) of the statutes is amended to read:
AB907,8,222
440.88
(7) Reciprocal certification. The department
may shall, upon
23application and payment of the required fee, issue certification as a substance abuse
24counselor, clinical supervisor, or prevention specialist to an individual who holds a
25similar unexpired certification issued to the individual by another state for which the
1requirements for certification are of a standard that is not lower than that specified
2in this subchapter.
AB907,12
3Section
12. 441.16 (3) (d) of the statutes is amended to read:
AB907,8,124
441.16
(3) (d) Establishing procedures for maintaining a certificate to issue
5prescription orders, including requirements for continuing education and a
6requirement to complete the nursing workforce survey and submit the fee required
7under s. 441.01 (7).
The requirements established by the board under this paragraph
8shall include continuing education requirements regarding best practices in
9prescribing controlled substances, as defined in s. 961.01 (4), for any advanced
10practice nurse who is authorized to dispense controlled substances under 21 USC
11821 to 831, and the board shall specify a minimum number of hours of such
12instruction that must be completed in each 2-year period.
AB907,13
13Section
13. 441.19 of the statutes is created to read:
AB907,8,16
14441.19 Maintenance and detoxification treatment under federal
15waiver. (1) In this section, “waiver” means a waiver issued by the federal
16department of health and human services under
21 USC 823 (g) (2) (A).
AB907,8,22
17(2) With respect to the ability of an advanced practice nurse who is certified to
18issue prescription orders to obtain and practice under a waiver, a physician who
19meets any of the conditions specified in
21 USC 823 (g) (2) (G) (ii) shall be considered
20eligible to serve as a qualifying physician for purposes of the requirement under
21
21USC 823 (g) (2) (G) (iv) (III), regardless of whether the physician himself or herself
22holds a waiver.
AB907,14
23Section
14
. 447.02 (2) (k) of the statutes is created to read:
AB907,9,524
447.02
(2) (k) Continuing education requirements for dentists under s. 447.056
25regarding best practices in prescribing controlled substances, as defined in s. 961.01
1(4). The board shall specify a minimum number of hours of such instruction that
2must be completed in each 2-year period. Continuing education requirements
3established in the rules promulgated under this paragraph shall apply only with
4respect to a dentist who is authorized to dispense controlled substances under
21
5USC 821 to
831.
AB907,15
6Section
15. 447.056 (1) (intro.) of the statutes is amended to read:
AB907,9,177
447.056
(1) (intro.) Except as provided in subs. (2) to (4), a person is not eligible
8for renewal of a license to practice dentistry, other than a permit issued under s.
9447.02 (3), unless the person has taught, attended, or otherwise completed, during
10the 2-year period immediately preceding the renewal date specified under s. 440.08
11(2) (a), 30 credit hours of continuing education related to the practice of dentistry or
12the practice of medicine, including not less than 25 credit hours of instruction in
13clinical dentistry or clinical medicine
and including the credit hours of instruction
14regarding best practices in prescribing controlled substances that are required by
15the board in rules promulgated under s. 447.02 (2) (k). Not more than 4 of the 30
16hours may be from teaching. Continuing education does not satisfy the requirements
17under this subsection unless the continuing education is one of the following:
AB907,16
18Section
16. 448.038 of the statutes is created to read:
AB907,9,21
19448.038 Maintenance and detoxification treatment under federal
20waiver. (1) In this section, “waiver” means a waiver issued by the federal
21department of health and human services under
21 USC 823 (g) (2) (A).
AB907,9,24
22(2) With respect to the ability of a physician assistant to obtain and practice
23under a waiver, a physician who meets any of the conditions specified in
21 USC 823 24(g) (2) (G) (ii) shall be considered eligible to serve as a qualifying physician for
1purposes of the requirement under
21 USC 823 (g) (2) (G) (iv) (III), regardless of
2whether the physician himself or herself holds a waiver.
AB907,10,145
448.07
(1) (d) No registration may be permitted by the secretary of the board
6in the case of any physician
, physician assistant, or perfusionist who has failed to
7meet the requirements of s. 448.13 or any person whose license or certificate has been
8suspended or revoked and the registration of any such person shall be deemed
9automatically annulled upon receipt by the secretary of the board of a verified report
10of such suspension or revocation, subject to the person's right of appeal. A person
11whose license or certificate has been suspended or revoked and subsequently
12restored shall be registered by the board upon tendering a verified report of such
13restoration of the license or certificate, together with an application for registration
14and the registration fee.
AB907,18
15Section
18. 448.13 (1) (a) 3. of the statutes is created to read:
AB907,10,1816
448.13
(1) (a) 3. If the physician is authorized to dispense controlled substances
17under
21 USC 821 to
831, continuing education programs regarding best practices
18in prescribing controlled substances, as defined in s. 961.01 (4).
AB907,19
19Section
19. 448.13 (4) of the statutes is created to read:
AB907,10,2520
448.13
(4) Each person who is licensed as a physician assistant and who is
21authorized to dispense controlled substances under
21 USC 821 to
831 shall, in each
222nd year at the time of application for a certificate of registration under s. 448.07,
23submit proof of completion of continuing education requirements promulgated by
24rule by the board regarding best practices in prescribing controlled substances, as
25defined in s. 961.01 (4).
AB907,20
1Section
20. 448.20 (3) (c) of the statutes is created to read:
AB907,11,32
448.20
(3) (c) Promulgating the rules establishing continuing education
3requirements under s. 448.40 (2) (cm).
AB907,21
4Section
21. 448.40 (2) (ck) of the statutes is created to read:
AB907,11,105
448.40
(2) (ck) Establishing continuing education requirements under s.
6448.13 (1) (a) 3. regarding best practices in prescribing controlled substances, as
7defined in s. 961.01 (4), for renewal of a license to practice medicine and surgery by
8a physician authorized to dispense controlled substances under
21 USC 821 to
831.
9The board shall specify a minimum number of hours of such instruction that must
10be completed in each 2-year period.
AB907,22
11Section
22. 448.40 (2) (cm) of the statutes is created to read:
AB907,11,1812
448.40
(2) (cm) Establishing continuing education requirements under s.
13448.13 (4) regarding best practices in prescribing controlled substances, as defined
14in s. 961.01 (4), for renewal of a physician assistant license by a physician assistant
15authorized to dispense controlled substances under
21 USC 821 to
831. The board
16shall specify a minimum number of hours of such instruction that must be completed
17in each 2-year period. In promulgating rules under this paragraph, the board shall
18give deference to the recommendations of the council on physician assistants.
AB907,23
19Section
23. 448.665 of the statutes is renumbered 448.665 (1) (intro.) and
20amended to read:
AB907,11,2521
448.665
(1) (intro.) The affiliated credentialing board shall promulgate rules
22establishing requirements and procedures for licensees to complete continuing
23education programs or courses of study in order to qualify for renewal of a license
24granted under this subchapter. The rules
promulgated under this section shall
25require do all of the following:
AB907,12,3
1(a) Require a licensee to complete at least 30 hours of continuing education
2programs or courses of study within each 2-year period immediately preceding the
3renewal date specified under s. 440.08 (2) (a).