LRB-4860/1
KMS:amn
2023 - 2024 LEGISLATURE
November 7, 2023 - Introduced by Senators Quinn, Tomczyk, Carpenter, Cowles,
Felzkowski, Marklein, Pfaff and Spreitzer, cosponsored by Representatives
Novak, Snyder, Bare, Armstrong, Billings, C. Anderson, Brandtjen,
Donovan, Doyle, Edming, Hurd, Joers, Kitchens, Kurtz, McGuire, Moses,
Mursau, O'Connor, Ohnstad, Oldenburg, Ortiz-Velez, Rozar, Schmidt,
Schutt and Tranel. Referred to Committee on Housing, Rural Issues and
Forestry.
SB643,1,5 1An Act to repeal 146.63 (6) (a) to (e) and 146.64 (4) (a) to (e); to renumber and
2amend
146.63 (6) (intro.), 146.64 (2) (a) and 146.64 (4) (intro.); to amend
320.435 (4) (bf), 146.64 (2) (c) 1. and 146.64 (3); and to create 146.64 (2) (a) 2.,
4146.64 (3m) and 146.645 of the statutes; relating to: expanding graduate
5medical training grants and making an appropriation.
Analysis by the Legislative Reference Bureau
Under current law, the Department of Health Services must distribute grants
to rural hospitals to establish graduate medical training (GMT) programs in a
specialty and to hospitals with existing GMT programs in a specialty to support the
addition of new positions in the programs. Current law includes a nonexhaustive list
of specialties in which a hospital's GMT program may specialize in order to be eligible
for a grant. This bill removes that list but retains the specialty requirement for grant
eligibility.
Under current law, the maximum amount of a grant DHS may distribute in a
fiscal year to a hospital with an existing GMT program to support the addition of new
positions in the program is $225,000. The bill removes that $225,000 maximum. The
bill also requires DHS to renew grant funding to hospitals with existing GMT
programs that received a grant in the previous fiscal year, without requiring the
hospital to reapply for the grant, provided the hospital still meets eligibility criteria
established by DHS, maintains an accredited GMT program, and wishes to receive
grant funding.

In addition, the bill creates a new grant program under which DHS is required
to distribute up to $375,000 in annual grants, plus any matching federal Medical
Assistance funds, to support GMT consortia. Under the bill, a GMT consortium is
defined as an independent, nonprofit organization formed by two or more entities to
oversee, support, and administer accredited GMT programs at rural hospitals. The
bill requires DHS to distribute grants to GMT consortia that apply for the grant and
meet certain requirements. DHS must also renew grant funding to GMT consortia
that received the grant in the previous fiscal year, without requiring the consortium
to reapply for the grant, provided the consortium still meets the grant requirements
and wishes to receive grant funding. DHS must give preference in awarding the
grants to GMT consortia that oversee, support, and administer GMT programs at
rural hospitals that have limited access to federal GMT funding from the federal
Centers for Medicare and Medicaid Services. Under the bill, a GMT consortium must
be accredited within 12 months of receiving a grant, and a GMT consortium may not
receive renewed grant funding if the consortium is not accredited.
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:
SB643,1 1Section 1. 20.435 (4) (bf) of the statutes is amended to read:
SB643,2,52 20.435 (4) (bf) Graduate medical training support grants. As a continuing
3appropriation, the amounts in the schedule to award grants to rural hospitals under
4s. 146.63, and to support graduate medical training programs under s. 146.64, and
5to support graduate medical training consortia under s. 146.645
.
SB643,2 6Section 2. 146.63 (6) (intro.) of the statutes is renumbered 146.63 (6) and
7amended to read:
SB643,2,118 146.63 (6) Eligibility. A rural hospital or group of rural hospitals may only
9receive a grant under sub. (3) if the plan to use the funds involves developing an
10accredited graduate medical training program in a specialty, including any of the
11following:
.
SB643,3 12Section 3. 146.63 (6) (a) to (e) of the statutes are repealed.
SB643,4
1Section 4. 146.64 (2) (a) of the statutes is renumbered 146.64 (2) (a) (intro.)
2and amended to read:
SB643,3,63 146.64 (2) (a) (intro.) Subject to par. (c) and sub. (4), the department shall
4distribute grants to hospitals to fund the addition of positions to existing accredited
5graduate medical training programs. The department shall distribute the grants
6under this paragraph to hospitals all of the following:
SB643,3,9 71. Hospitals that apply to receive a grant under sub. (3) and that satisfy the
8criteria established by the department under par. (b) and the eligibility requirement
9under sub. (4).
SB643,5 10Section 5. 146.64 (2) (a) 2. of the statutes is created to read:
SB643,3,1711 146.64 (2) (a) 2. Hospitals that received a grant under this paragraph in the
12immediately preceding fiscal year, unless the hospital no longer satisfies the criteria
13established by the department under par. (b), the hospital no longer has an
14accredited graduate medical training program, or the hospital has notified the
15department that the hospital no longer wishes to receive the grant. The department
16may not require a hospital under this subdivision to apply for a grant under this
17paragraph.
SB643,6 18Section 6. 146.64 (2) (c) 1. of the statutes is amended to read:
SB643,3,2419 146.64 (2) (c) 1. The department shall distribute funds for grants under par.
20(a) from the appropriation under s. 20.435 (4) (bf). The department may not
21distribute more than $225,000 from the appropriation under s. 20.435 (4) (bf) to a
22particular hospital in a given state fiscal year and
may not distribute more than
23$75,000 from the appropriation under s. 20.435 (4) (bf) to fund a given position in a
24graduate medical training program in a given state fiscal year.
SB643,7 25Section 7. 146.64 (3) of the statutes is amended to read:
SB643,4,3
1146.64 (3) Grant application. A Except as provided in sub. (2) (a) 2., a hospital
2may apply, in the form and manner determined by the department, to receive a grant
3under sub. (2) (a).
SB643,8 4Section 8 . 146.64 (3m) of the statutes is created to read:
SB643,4,95 146.64 (3m) Grant nonrenewal. A hospital that receives a grant under sub.
6(2) (a) shall notify the department, in the manner determined by the department, if
7the hospital no longer satisfies the criteria established by the department under sub.
8(2) (b), the hospital no longer has an accredited graduate medical training program,
9or the hospital no longer wishes to receive the grant.
SB643,9 10Section 9. 146.64 (4) (intro.) of the statutes is renumbered 146.64 (4) and
11amended to read:
SB643,4,1412 146.64 (4) Eligibility. A hospital that has an accredited graduate medical
13training program in a specialty, including any of the following, may apply to receive
14a grant under sub. (3):.
SB643,10 15Section 10. 146.64 (4) (a) to (e) of the statutes are repealed.
SB643,11 16Section 11. 146.645 of the statutes is created to read:
SB643,4,18 17146.645 Grants to support the establishment or operation of graduate
18medical training consortia.
(1) Definitions. In this section:
SB643,4,2119 (a) “Graduate medical training consortium” means an independent, nonprofit
20organization formed by 2 or more entities to operate as a sponsoring institution for
21accredited graduate medical training programs at rural hospitals in this state.
SB643,4,2222 (b) “Rural hospital” has the meaning given in s. 146.63 (1).
SB643,4,2423 (c) “Sponsoring institution” means an entity that oversees, supports, and
24administers one or more accredited graduate medical training programs.
SB643,5,4
1(2) Departmental duties. (a) The department shall distribute grants from the
2appropriation under s. 20.435 (4) (bf) to support the operational expenses of graduate
3medical training consortia. Subject to par. (c) and sub. (3), the department shall
4distribute grants to all of the following:
SB643,5,75 1. Graduate medical training consortia that apply to receive a grant under sub.
6(4) and that satisfy the criteria established by the department under par. (b) and the
7eligibility requirement under sub. (3).
SB643,5,158 2. A graduate medical training consortium that received a grant under this
9paragraph in the immediately preceding fiscal year, unless the graduate medical
10training consortium no longer satisfies the criteria established by the department
11under par. (b) or the eligibility requirement under sub. (3), the consortium is not
12accredited as a sponsoring institution by the Accreditation Council for Graduate
13Medical Education, or any successor organization, or another accrediting body as
14determined by the department, or the consortium has notified the department that
15the consortium no longer wishes to receive the grant.
SB643,5,1816 (b) The department shall establish criteria for approving and distributing
17grants under par. (a). The department may not require a consortium under par. (a)
182. to apply for a grant under that subdivision.
SB643,5,2019 (c) 1. The department shall distribute up to $375,000 in annual grants under
20par. (a) from the appropriation under s. 20.435 (4) (bf).
SB643,5,2321 2. If the department receives matching federal Medical Assistance funds, the
22department shall distribute those funds for grants under par. (a) in addition to any
23funds distributed under subd. 1.
SB643,6,524 (d) In awarding grants under par. (a), the department shall give preference to
25graduate medical training consortia that are the sponsoring institutions for

1graduate medical training programs in rural hospitals that have limited or no direct
2access to graduate medical training funding from the federal centers for medicare
3and medicaid services or have reached the maximum available amount of graduate
4medical training funding from the federal centers for medicare and medicaid
5services.
SB643,6,8 6(3) Eligibility. A graduate medical training consortium may only receive a
7grant under this section if the graduate medical training consortium includes at least
8one partner rural hospital or health system.
SB643,6,13 9(4) Grant application. Except as provided in sub. (2) (a) 2., a graduate medical
10training consortium may apply, in the manner determined by the department, to
11receive a grant under sub. (2) (a). A graduate medical training consortium shall
12identify all of the partner rural hospitals and health systems in the consortium in its
13grant application.
SB643,6,21 14(5) Grant nonrenewal. A graduate medical training consortium that receives
15a grant under sub. (2) (a) shall notify the department, in the manner determined by
16the department, if the consortium no longer satisfies the criteria established by the
17department under sub. (2) (b) or the eligibility requirement under sub. (3), the
18consortium is not accredited as a sponsoring institution by the Accreditation Council
19for Graduate Medical Education, or any successor organization, or another
20accrediting body as determined by the department, or the consortium no longer
21wishes to receive the grant.
SB643,6,24 22(6) Eligibility. A graduate medical training consortium may only receive a
23grant under this section if the graduate medical training consortium includes at least
24one partner rural hospital or health system.
SB643,7,5
1(7) Accreditation. A graduate medical training consortium shall, within 12
2months of receiving a grant under sub. (2) (a), obtain and maintain accreditation as
3a sponsoring institution by the Accreditation Council for Graduate Medical
4Education, or any successor organization, or another accrediting body as determined
5by the department.
SB643,7,10 6(8) Effect on graduate medical training expansion grants. The receipt of a
7grant under this section by a graduate medical training consortium does not affect
8the eligibility for a grant under s. 146.64 of any hospital that has an accredited
9graduate medical training program facilitated, organized, or implemented by the
10graduate medical training consortium.
SB643,7,1111 (End)
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