LRBs0055/1
MLJ&TJD:cdc
2021 - 2022 LEGISLATURE
ASSEMBLY SUBSTITUTE AMENDMENT 1,
TO ASSEMBLY BILL 240
April 13, 2021 - Offered by Representatives Anderson, Baldeh,
Billings, Bowen,
Brostoff, Cabrera, Conley, Considine, Doyle, Drake, Emerson, Goyke,
Haywood, Hebl, Hesselbein, Hintz, Hong, McGuire, B. Meyers, Milroy,
Moore Omokunde, L. Myers, Neubauer, Ohnstad, Ortiz-Velez, Pope,
Riemer, S. Rodriguez, Shankland, Shelton, Sinicki, Snodgrass, Spreitzer,
Stubbs, Subeck, Vining and Vruwink.
AB240-ASA1,1,8
1An Act to repeal 49.45 (2p) and 49.45 (23);
to renumber and amend 323.29
2(3) (a);
to amend 20.435 (4) (jw), 49.45 (23b) (title), 49.45 (23b) (b), 49.45 (23b)
3(c), 49.45 (23b) (e), 49.471 (4) (a) 4. b. and 49.686 (3) (d); and
to create 49.471
4(1) (cr), 49.471 (4) (a) 8., 49.471 (4g), 323.29 (3) (a) 2. and 323.29 (3) (b) 3. of the
5statutes;
relating to: eligibility expansion under the Medical Assistance
6program, a statewide public safety interoperable communication system,
7emergency services IP network contracts, a geographic information systems
8database, and mental health treatment capacity.
Analysis by the Legislative Reference Bureau
Eligibility expansion under the Medical Assistance program
BadgerCare Plus and BadgerCare Plus Core are programs under the state's
Medical Assistance program, which provides health services to individuals who have
limited financial resources. The federal Patient Protection and Affordable Care Act
allows a state to receive an enhanced federal medical assistance percentage payment
for providing benefits to certain individuals through a state's Medical Assistance
program. This bill changes the family income eligibility level to up to 133 percent
of the federal poverty line for parents and caretaker relatives under BadgerCare Plus
and for childless adults currently covered under BadgerCare Plus Core and who are
incorporated into BadgerCare Plus in this bill. The bill requires the Department of
Health Services to comply with all federal requirements and to request any
amendment to the state Medical Assistance plan, waiver of Medicaid law, or other
federal approval necessary to qualify for the highest available enhanced federal
medical assistance percentage for childless adults under the BadgerCare Plus
program.
Under current law, certain parents and caretaker relatives with incomes of not
more than 100 percent of the federal poverty line, before a 5 percent income disregard
is applied, are eligible for BadgerCare Plus benefits. Under current law, childless
adults who 1) are under age 65; 2) have family incomes that do not exceed 100 percent
of the federal poverty line, before the 5 percent income disregard is applied; and 3)
are not otherwise eligible for Medical Assistance, including BadgerCare Plus, are
eligible for benefits under BadgerCare Plus Core. The bill eliminates the childless
adults demonstration project, known as BadgerCare Plus Core, as a separate
program.
Statewide public safety interoperable communication system
Under current law, the Department of Military Affairs provides staff support
for the Interoperability Council and is charged with overseeing the development and
operation of a statewide public safety interoperable communication system, which
is a system that allows various public safety entities, public works and
transportation agencies, hospitals, and volunteer emergency services agencies to
communicate via radio or other communication technology in an emergency.
The bill provides that DMA must also administer any current or future
statewide public safety interoperable communication system, and allows DMA to
enter into agreements for maintenance and support of, upgrades to, and
enhancements for the statewide public safety interoperable communication system.
The bill provides $66,000,000 to DMA in the 2021-22 fiscal year to develop an
updated statewide public safety interoperable communication system.
Emergency services IP network contracts
Under current law, DMA must contract for the creation, operation, and
maintenance of an emergency services IP network to provide all public safety
answering points with the necessary infrastructure to implement Next Generation
911. The bill provides $37,000,000 to DMA in the 2021-22 fiscal year for contracts
to develop the emergency services IP network.
Geographic information systems database
The bill provides $3,400,000 to DMA in the 2021-22 fiscal year to develop a
statewide geographic information systems database.
Grants for regional psychiatric bed and crisis stabilization capacity
This bill allows the Building Commission to award grants to entities in the
cumulative amount of $30,000,000 for the purpose of expanding capacity psychiatric
beds and for crisis stabilization. An entity that is awarded a grant under the bill
must do all of the following: 1) serve individuals who meet the criteria for emergency
detention or are in need of crisis stabilization services and who are from one of the
Northwest Wisconsin counties specified in the bill; 2) identify measures the entity
believes will serve the needs of residents with mental health needs, especially in
reducing the burden on the Winnebago Mental Health Institute; 3) report annually
to the legislature on the services provided with grant moneys; and 4) recognize that
it is liable to repay the grant to the state if the entity fails to maintain continued
expanded services as described in the bill. Emergency detention is a current law
procedure for temporary involuntary commitment of individuals who are believed to
be mentally ill, drug dependent, or developmentally disabled and who demonstrate
a substantial probability of causing harm to themselves or others or an inability to
satisfy certain basic needs due to a mental illness. If the entity's space for which the
grant is awarded under this bill is not used for the purpose agreed to when the grant
is awarded, the state retains an ownership interest in the entity's expansion space
to the amount of the state's grant.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB240-ASA1,1c
1Section 1c. 20.435 (4) (jw) of the statutes is amended to read:
AB240-ASA1,3,92
20.435
(4) (jw)
BadgerCare Plus and hospital assessment. All
moneys received
3from payment of enrollment fees under the program under s. 49.45 (23), all moneys
4transferred under s. 50.38 (9), all moneys transferred from the appropriation account
5under par. (jz), and 10 percent of all moneys received from penalty assessments
6under s. 49.471 (9) (c),
for administration of the program under s. 49.45 (23), to
7provide a portion of the state share of administrative costs for the BadgerCare Plus
8Medical Assistance program under s. 49.471
, and for administration of the hospital
9assessment under s. 50.38.
AB240-ASA1,1e
10Section 1e. 49.45 (2p) of the statutes is repealed.
AB240-ASA1,1g
11Section 1g. 49.45 (23) of the statutes is repealed.
AB240-ASA1,1h
12Section 1h. 49.45 (23b) (title) of the statutes is amended to read:
AB240-ASA1,3,1413
49.45
(23b) (title)
Childless adults
demonstration project reform waiver
14implementation required.
AB240-ASA1,1j
1Section 1j. 49.45 (23b) (b) of the statutes is amended to read:
AB240-ASA1,4,52
49.45
(23b) (b) Beginning as soon as practicable after October 31, 2018, and
3ending no sooner than December 31, 2023, the department shall do all of the
4following with regard to
the childless adults
demonstration project under
sub. (23)
5s. 49.471 (4) (a) 8.:
AB240-ASA1,4,116
1. Require in each month persons, except exempt individuals, who are eligible
7to receive Medical Assistance under
sub. (23)
s. 49.471 (4) (a) 8. and who are at least
819 years of age but have not attained the age of 50 to participate in, document, and
9report 80 hours per calendar month of community engagement activities. The
10department, after finding good cause, may grant a temporary exemption from the
11requirement under this subdivision upon request of a Medical Assistance recipient.
AB240-ASA1,4,1412
2. Require persons with incomes of at least 50 percent of the poverty line to pay
13premiums in accordance with par. (c) as a condition of eligibility for Medical
14Assistance under
sub. (23) s. 49.471 (4) (a) 8.
AB240-ASA1,4,1615
3. Require as a condition of eligibility for Medical Assistance under
sub. (23) 16s. 49.471 (4) (a) 8. completion of a health risk assessment.
AB240-ASA1,4,1917
4. Charge recipients of Medical Assistance under
sub. (23) s. 49.471 (4) (a) 8.
18an $8 copayment for nonemergency use of the emergency department in accordance
19with
42 USC 1396o-1 (e) (1) and
42 CFR 447.54.
AB240-ASA1,4,2420
5. Disenroll from Medical Assistance under
sub. (23) s. 49.471 (4) (a) 8. for 6
21months any individual who does not pay a required premium under subd. 2. and any
22individual who is required under subd. 1. to participate in a community engagement
23activity but who does not participate for 48 aggregate months in the community
24engagement activity.
AB240-ASA1,1k
25Section 1k. 49.45 (23b) (c) of the statutes is amended to read:
AB240-ASA1,5,6
149.45
(23b) (c) 1. Persons who are eligible
for the demonstration project under
2sub. (23) s. 49.471 (4) (a) 8. and who have monthly household income that exceeds
350 percent of the poverty line shall pay a monthly premium amount of $8 per
4household. A person who is eligible to receive an item or service furnished by an
5Indian health care provider is exempt from the premium requirement under this
6subdivision.
AB240-ASA1,5,127
2. The department may disenroll under par. (b) 5. a person for nonpayment of
8a required monthly premium only at annual eligibility redetermination after
9providing notice and reasonable opportunity for the person to pay. If a person who
10is disenrolled for nonpayment of premiums pays all owed premiums or becomes
11exempt from payment of premiums, he or she may reenroll in Medical Assistance
12under
sub. (23) s. 49.471 (4) (a) 8.
AB240-ASA1,5,1613
3. The department shall reduce the amount of the required household premium
14by up to half for a recipient of Medical Assistance under
sub. (23) s. 49.471 (4) (a) 8. 15who does not engage in certain behaviors that increase health risks or who attests
16to actively managing certain unhealthy behaviors.
AB240-ASA1,1m
17Section 1m. 49.45 (23b) (e) of the statutes is amended to read:
AB240-ASA1,5,2218
49.45
(23b) (e) Before December 31, 2023, the
demonstration project 19requirements under this subsection may not be withdrawn and the department may
20not request from the federal government withdrawal, suspension, or termination of
21the
demonstration project requirements under this subsection unless legislation has
22been enacted specifically allowing for the withdrawal, suspension, or termination.
AB240-ASA1,1p
23Section 1p. 49.471 (1) (cr) of the statutes is created to read:
AB240-ASA1,5,2524
49.471
(1) (cr) “Enhanced federal medical assistance percentage" means a
25federal medical assistance percentage described under
42 USC 1396d (y) or (z).
AB240-ASA1,1q
1Section 1q. 49.471 (4) (a) 4. b. of the statutes is amended to read:
AB240-ASA1,6,42
49.471
(4) (a) 4. b. The individual's family income does not exceed
100 133 3percent of the poverty line
before application of the 5 percent income disregard under
442 CFR 435.603 (d).
AB240-ASA1,1r
5Section 1r. 49.471 (4) (a) 8. of the statutes is created to read:
AB240-ASA1,6,66
49.471
(4) (a) 8. An individual who meets all of the following criteria:
AB240-ASA1,6,77
a. The individual is an adult under the age of 65.
AB240-ASA1,6,98
b. The individual has a family income that does not exceed 133 percent of the
9poverty line, except as provided in sub. (4g).
AB240-ASA1,6,1110
c. The individual is not otherwise eligible for the Medical Assistance program
11under this subchapter or the Medicare program under
42 USC 1395 et seq.
AB240-ASA1,1s
12Section 1s. 49.471 (4g) of the statutes is created to read:
AB240-ASA1,6,2213
49.471
(4g) Medicaid expansion; federal medical assistance percentage. For
14services provided to individuals described under sub. (4) (a) 8., the department shall
15comply with all federal requirements to qualify for the highest available enhanced
16federal medical assistance percentage. The department shall submit any
17amendment to the state medical assistance plan, request for a waiver of federal
18Medicaid law, or other approval request required by the federal government to
19provide services to the individuals described under sub. (4) (a) 8. and qualify for the
20highest available enhanced federal medical assistance percentage. Sections 20.940
21and 49.45 (2t) do not apply to a submission to the federal government under this
22subsection.
AB240-ASA1,1t
23Section 1t. 49.686 (3) (d) of the statutes is amended to read:
AB240-ASA1,7,424
49.686
(3) (d) Has applied for coverage under and has been denied eligibility
25for medical assistance within 12 months prior to application for reimbursement
1under sub. (2). This paragraph does not apply to an individual who is eligible for
2benefits under
the demonstration project for childless adults under s. 49.45 (23) or 3to an individual who is eligible for benefits under BadgerCare Plus under s. 49.471
4(4) (a) 8. or (11).
AB240-ASA1,1v
5Section 1
v. 323.29 (3) (a) of the statutes is renumbered 323.29 (3) (a) (intro.)
6and amended to read:
AB240-ASA1,7,77
323.29
(3) (a) (intro.) The department shall
provide do all of the following:
AB240-ASA1,7,8
81. Provide staff support for the council
and oversight of.
AB240-ASA1,7,10
93. Oversee the development and operation of
a any current or future statewide
10public safety interoperable communication system.