SB767: Bill Text

LRB-5311/1

MD/TK/KP/EW/AG:all

2017 - 2018 LEGISLATURE

2017 Senate BILL 767

February 2, 2018 - Introduced by Senators Darling, Feyen, Bewley, Moulton, Roth, Testin and Wanggaard, cosponsored by Representatives Nygren, Pronschinske, Duchow, Snyder, Petryk, Rodriguez, Novak, Kitchens, Zimmerman, Tusler, VanderMeer, Horlacher, Krug, Rohrkaste, Petersen, E. Brooks, Edming, Spiros, Ballweg, Tittl, Tranel, Knodl, Born, Sanfelippo, Skowronski, Jagler, Genrich, Kolste and Billings. Referred to Joint Committee on Finance.

SB767,2,2 An Act to repeal 457.02 (5) and 457.02 (5m); to renumber and amend 448.665 and 449.06 (2m); to amend 118.01 (2) (d) 6., 118.01 (2) (d) 7., 440.88 (3) (a) (intro.), 440.88 (3m), 440.88 (7), 441.16 (3) (d), 447.056 (1) (intro.), 448.07 (1) (d), 961.385 (2) (cm) 1. (intro.) and 961.385 (2) (cm) 2.; and to create 20.285 (1) (c), 36.25 (55), 49.45 (29z), 118.01 (2) (d) 2. d., 440.043, 441.19, 447.02 (2) (k), 448.038, 448.13 (1) (a) 3., 448.13 (4), 448.20 (3) (c), 448.40 (2) (ck), 448.40 (2) (cm), 448.665 (1) (b) and 449.06 (2m) (b) of the statutes; relating to: continuing education in prescribing controlled substances for certain health care practitioners; maintenance and detoxification treatment provided by physician assistants and advanced practice nurse prescribers; requiring school boards to provide instruction about drug abuse awareness and prevention; graduate training of psychiatric nurses; training materials for social services workers handling substance abuse-related cases; substance abuse counseling and modifying and creating administrative rules related to substance abuse counseling; 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:

SB767,1 Section 1. 20.005 (3) (schedule) of the statutes: at the appropriate place, insert the following amounts for the purposes indicated: - See PDF for table

SB767,2 Section 2. 20.285 (1) (c) of the statutes is created to read:

SB767,5,2 20.285 (1) (c) Graduate psychiatric nursing education. The amounts in the schedule for the purposes specified in s. 36.25 (55) (a).

SB767,3 Section 3. 36.25 (55) of the statutes is created to read:

SB767,5,8 36.25 (55) Graduate psychiatric nursing education at the University of Wisconsin-Madison. (a) In consultation with the chancellor of the University of Wisconsin-Madison, the board shall do all of the following with respect to the graduate program in psychiatric mental health nursing at the University of Wisconsin-Madison:

SB767,5,10 1. Increase the number of students provided the opportunity to study to be board-eligible psychiatric mental health nurse practitioners.

SB767,5,12 2. Expand the instructional capacity available to teach psychiatric mental health nursing.

SB767,5,17 3. 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. In order to receive a fellowship under this subdivision, a student shall commit to passing applicable board certification and to practicing in this state for at least 2 years after graduation from the program.

SB767,5,19 (b) Costs associated with the board's duties under par. (a) shall be funded from the appropriation account under s. 20.285 (1) (c).

SB767,4 Section 4. 49.45 (29z) of the statutes is created to read:

SB767,6,2 49.45 (29z) Opioid treatment authorization. The department may not require prior authorization for or other limitation on prescribing and dispensing of buprenorphine combination products to a recipient, who is not pregnant, under the Medical Assistance program under this subchapter by a health care provider who possesses a valid waiver under 21 USC 823, if the prior authorization or other limitation is not required by 21 USC 823.

SB767,5 Section 5. 118.01 (2) (d) 2. d. of the statutes is created to read:

SB767,6,5 118.01 (2) (d) 2. d. Awareness about drug abuse, including prescription drug abuse, and prevention.

SB767,6 Section 6. 118.01 (2) (d) 6. of the statutes is amended to read:

SB767,6,10 118.01 (2) (d) 6. Knowledge of the prevention of accidents and promotion of safety on the public highways, including instruction on the relationship between highway safety and the use of alcohol and controlled substances , including prescription drugs, under ch. 961.

SB767,7 Section 7. 118.01 (2) (d) 7. of the statutes is amended to read:

SB767,6,18 118.01 (2) (d) 7. The skills needed to make sound decisions, knowledge of the conditions which may cause and the signs of suicidal tendencies, knowledge of the relationship between youth suicide and the use of alcohol and controlled substances, including prescription drugs, under ch. 961 and knowledge of the available community youth suicide prevention and intervention services. Instruction shall be designed to help prevent suicides by pupils by promoting the positive emotional development of pupils.

SB767,8 Section 8. 440.043 of the statutes is created to read:

SB767,6,24 440.043 Behavioral health review committee. (1) The secretary shall appoint an advisory committee under s. 440.042 to provide advice concerning behavioral health. The advisory committee shall semiannually conduct a review of the requirements for obtaining a credential under s. 440.88 or ch. 457 or for other credentials related to behavioral health.

SB767,7,4 (2) The advisory committee shall accept comments from the public related to its review under sub. (1). Before conducting a review under sub. (1), the department shall publish a class 1 notice under ch. 985 and shall publish notice on its Internet site announcing the opportunity for public comment.

SB767,7,6 (3) The advisory committee established under sub. (1) may propose changes in statutes and rules to the department.

SB767,9 Section 9. 440.88 (3) (a) (intro.) of the statutes is amended to read:

SB767,7,13 440.88 (3) (a) (intro.) Subject to pars. (b) and (c) and except as provided in sub. (3m), the department shall promulgate rules that establish minimum standards and qualifications for the certification of all of the following, including substance abuse counselors and clinical supervisors described under s. HFS 75.02 (11) and (84), Wis. Adm. Code, in effect on December 15, 2006, as defined by the department of health services by rule:

SB767,10 Section 10. 440.88 (3m) of the statutes is amended to read:

SB767,7,20 440.88 (3m) Exception. This section does not apply to a physician, as defined in s. 448.01 (5), a clinical social worker, as defined in s. 457.01 (1r), or a licensed psychologist, as defined in s. 455.01 (4), a marriage and family therapist, as defined in s. 457.01 (3), or a professional counselor, as defined in s. 457.01 (7), who practices as a substance abuse clinical supervisor or provides substance abuse counseling, treatment, or prevention services within the scope of his or her licensure.

SB767,11 Section 11. 440.88 (7) of the statutes is amended to read:

SB767,8,2 440.88 (7) Reciprocal certification. The department may shall, upon application and payment of the required fee, issue certification as a substance abuse counselor, clinical supervisor, or prevention specialist to an individual who holds a similar unexpired certification issued to the individual by another state for which the requirements for certification are of a standard that is not lower than that specified in this subchapter.

SB767,12 Section 12. 441.16 (3) (d) of the statutes is amended to read:

SB767,8,12 441.16 (3) (d) Establishing procedures for maintaining a certificate to issue prescription orders, including requirements for continuing education and a requirement to complete the nursing workforce survey and submit the fee required under s. 441.01 (7). The requirements established by the board under this paragraph shall include continuing education requirements regarding best practices in prescribing controlled substances, as defined in s. 961.01 (4), for any advanced practice nurse who is authorized to dispense controlled substances under 21 USC 821 to 831, and the board shall specify a minimum number of hours of such instruction that must be completed in each 2-year period.