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.
AB240-ASA1,2 11Section 2 . 323.29 (3) (a) 2. of the statutes is created to read:
AB240-ASA1,7,1312 323.29 (3) (a) 2. Administer any current or future statewide public safety
13interoperable communication system.
AB240-ASA1,3 14Section 3 . 323.29 (3) (b) 3. of the statutes is created to read:
AB240-ASA1,7,1715 323.29 (3) (b) 3. Enter into agreements for maintenance and support of,
16upgrades to, and enhancements for the statewide public safety interoperable
17communication system under this section.
AB240-ASA1,9104 18Section 9104. Nonstatutory provisions; Building Commission.
AB240-ASA1,7,1919 (1) Grant for mental health treatment capacity.
AB240-ASA1,8,220 (a) The legislature finds and determines that expanding psychiatric bed
21capacity and crisis stabilization capacity as described in par. (b) would greatly
22benefit state residents by expanding access to timely inpatient mental health
23treatment and services and allowing public financial resources to be better
24distributed to more effectively improve delivery of mental health services. It is
25therefore in the public interest, and it is the public policy of this state, to assist the

1entities described under par. (b ) in expanding psychiatric bed capacity and
2stabilization services.
AB240-ASA1,8,73 (b) In fiscal year 2021-22, the building commission may award under s. 13.48
4(20s) grants in the amount of $30,000,000 cumulatively for the purpose of expanding
5capacity for psychiatric beds and for crisis stabilization to entities that apply to the
6building commission, that agree to provide psychiatric or stabilization services
7regionally, and meet all of the following criteria:
AB240-ASA1,8,13 81. The entity agrees to serve individuals who meet the criteria for emergency
9detention under s. 51.15 or are in need of crisis stabilization and who are from
10Ashland, Barron, Bayfield, Buffalo, Burnett, Chippewa, Clark, Douglas, Dunn, Eau
11Claire, Iron, Jackson, La Crosse, Lincoln, Marathon, Monroe, Oneida, Pepin, Pierce,
12Polk, Price, Rusk, Sawyer, St. Croix, Taylor, Trempealeau, Vilas, Washburn, or Wood
13Counties.
AB240-ASA1,8,16 142. The entity identifies measures that it believes will serve the needs of
15residents of the region with mental health needs, especially, as a critical component
16of the measures, in reducing the burden on the Winnebago Mental Health Institute.
AB240-ASA1,8,20 173. The entity agrees to annually report to the legislature, in the manner
18described under s. 13.172 (2), the services provided with the resources funded by the
19grant awarded under this subsection, including the number of individuals diverted
20from the Winnebago Mental Health Institute.
AB240-ASA1,8,25 214. The entity recognizes that it is liable to repay the grant funds to the state
22if the entity fails to continue to maintain the expanded services as proposed in the
23grant application. The amount the entity is liable for repayment is reduced
24proportionately each year for 10 years of continuing expanded services as described
25under par. (c).
AB240-ASA1,9,2
1(c) A determination of continued services shall be based on findings that the
2entity does all of the following:
AB240-ASA1,9,5 31. If the entity is expanding psychiatric bed capacity, the entity maintains an
4agreed upon number of beds for acceptance of admissions for emergency detention
5under s. 51.15.
AB240-ASA1,9,8 62. Enters into a contract with, at minimum, two-thirds of the counties specified
7in par. (b) 1. in which the entity agrees to accept for services individuals regardless
8of payment source.
AB240-ASA1,9,119 (d) Notwithstanding s. 150.93, any entity that is a hospital that expands
10psychiatric bed capacity under this subsection may increase its approved bed
11capacity.
AB240-ASA1,9,1612 (e) If, for any reason, the entity's facility space, for which the grant is awarded
13under par. (b), is not used for the purpose of expanding psychiatric bed or crisis
14stabilization capacity as agreed when awarded the grant, the state shall retain an
15ownership interest in the entity's expansion space equal to the amount of the state's
16grant.
AB240-ASA1,9119 17Section 9119. Nonstatutory provisions; Health Services.
AB240-ASA1,9,2418 (1) Childless adults demonstration project. The department of health
19services shall submit any necessary request to the federal department of health and
20human services for a state plan amendment or waiver of federal Medicaid law or to
21modify or withdraw from any waiver of federal Medicaid law relating to the childless
22adults demonstration project under s. 49.45 (23), 2019 stats., to reflect the
23incorporation of recipients of Medical Assistance under the demonstration project
24into the BadgerCare Plus program under s. 49.471 and the termination of the

1demonstration project. Sections 20.940 and 49.45 (2t) do not apply to a submission
2to the federal government under this subsection.
AB240-ASA1,9219 3Section 9219. Fiscal changes; Health Services.
AB240-ASA1,10,104 (1) Medicaid expansion. In the schedule under s. 20.005 (3) for the
5appropriation to the department of health services under s. 20.435 (4) (b), the dollar
6amount for fiscal year 2021-22 is decreased by $849,788,000 as a result of expanding
7eligibility for the Medical Assistance program. In the schedule under s. 20.005 (3)
8for the appropriation to the department of health services under s. 20.435 (4) (b), the
9dollar amount for fiscal year 2022-23 is decreased by $841,925,400 as a result of
10expanding eligibility for the Medical Assistance program.
AB240-ASA1,9231 11Section 9231. Fiscal changes; Military Affairs.
AB240-ASA1,10,1612 (1) Public safety interoperable radio network. In the schedule under s.
1320.005 (3) for the appropriation to the department of military affairs under s. 20.465
14(3) (a), the dollar amount for fiscal year 2021-22 is increased by $66,000,000 to
15develop an updated statewide public safety interoperable communication system as
16provided under s. 323.29 (3) (a) 3.
AB240-ASA1,10,2017 (2) Emergency services IP network contracts. In the schedule under s. 20.005
18(3) for the appropriation to the department of military affairs under s. 20.465 (3) (a),
19the dollar amount for fiscal year 2021-22 is increased by $37,000,000 to develop the
20emergency services IP network under s. 256.35 (3s) (b).
AB240-ASA1,10,2421 (3) Geographic information systems database. In the schedule under s. 20.005
22(3) for the appropriation to the department of military affairs under s. 20.465 (3) (a),
23the dollar amount for fiscal year 2021-22 is increased by $3,400,000 to develop a
24statewide geographic information systems database.
AB240-ASA1,9419
1Section 9419. Effective dates; Health Services. This act takes effect on the
2day after publication, except as follows:
AB240-ASA1,11,5 3(1) Medicaid expansion. The treatment of ss. 20.435 (4) (jw), 49.45 (2p), (23),
4and (23b) (title), (b), (c), and (e), 49.471 (1) (cr), (4) (a) 4. b. and 8. and (4g), and 49.686
5(3) (d) and Sections 9119 (1 ) and 9219 (1) of this act take effect on July 1, 2021.
AB240-ASA1,9431 6Section 9431. Effective dates; Military Affairs. This act takes effect on the
7day after publication, except as follows:
AB240-ASA1,11,108 (1) Public safety interoperable radio network, emergency services IP
9network contracts, and geographic information systems database. Section
9231
10(1) to (3) of this act take effect on July 1, 2021.
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