AB43,1140 Section 1140 . 50.09 (1) (h) of the statutes is amended to read:

AB43,755,14 50.09 (1) (h) Meet with, and participate in activities of social, religious, and community groups at the resident's discretion, unless medically contraindicated as documented by the resident's physician, physician assistant, or advanced practice registered nurse prescriber in the resident's medical record.

AB43,1141 Section 1141 . 50.09 (1) (k) of the statutes is amended to read:

AB43,756,2 50.09 (1) (k) Be free from mental and physical abuse, and be free from chemical and physical restraints except as authorized in writing by a physician, physician assistant, or advanced practice registered nurse prescriber for a specified and limited period of time and documented in the resident's medical record. Physical restraints may be used in an emergency when necessary to protect the resident from injury to himself or herself or others or to property. However, authorization for continuing use of the physical restraints shall be secured from a physician, physician assistant, or advanced practice registered nurse prescriber within 12 hours. Any use of physical restraints shall be noted in the resident's medical records. “ Physical restraints" includes, but is not limited to, any article, device, or garment that interferes with the free movement of the resident and that the resident is unable to remove easily, and confinement in a locked room.

AB43,1142 Section 1142. 50.36 (3s) of the statutes is created to read:

AB43,756,9 50.36 (3s) The department shall require a hospital that provides emergency services to have sufficient qualified personnel at all times to manage the number and severity of emergency department cases anticipated by the location. At all times, a hospital that provides emergency services shall have on-site at least one physician who, through education, training, and experience, specializes in emergency medicine.

AB43,1143 Section 1143 . 50.49 (1) (b) (intro.) of the statutes is amended to read:

AB43,756,19 50.49 (1) (b) (intro.) “Home health services" means the following items and services that are furnished to an individual, who is under the care of a physician, physician assistant, or advanced practice registered nurse prescriber, by a home health agency, or by others under arrangements made by the home health agency, that are under a plan for furnishing those items and services to the individual that is established and periodically reviewed by a physician, physician assistant, or advanced practice registered nurse prescriber and that are, except as provided in subd. 6., provided on a visiting basis in a place of residence used as the individual's home:

AB43,1144 Section 1144. 51.036 of the statutes is created to read:

AB43,756,22 51.036 Crisis urgent care and observation facilities. (1) Definitions. In this section:

AB43,757,2 (a) “Crisis” means a situation caused by an individual's apparent mental or substance use disorder that results in a high level of stress or anxiety for the individual, persons providing care for the individual, or the public and that is not resolved by the available coping methods of the individual or by the efforts of those providing ordinary care or support for the individual.

AB43,757,6 (b) “Crisis urgent care and observation facility” means a treatment facility that admits an individual to prevent, de-escalate, or treat the individual's mental health or substance use disorder and includes the necessary structure and staff to support the individual's needs relating to the mental health or substance use disorder.

AB43,757,16 (2) Certification required; exemption. (a) The department shall establish a certification process for crisis urgent care and observation facilities and may establish criteria by rule for the certification of crisis urgent care and observation facilities. The department may limit the number of certifications it grants to operate crisis urgent care and observation facilities. No person may operate a crisis urgent care and observation facility without a certification under this section. The department shall establish by rule a process for crisis urgent care and observation facilities to apply to the department for certification of the facility for the receipt of funds for services provided as a benefit to a recipient under the Medical Assistance program.

AB43,757,21 (b) A crisis urgent care and observation facility certified under this section is not subject to facility regulation under ch. 50, unless otherwise required due to the facility's licensure or certification for other services or purposes. A crisis urgent care and observation facility is not a hospital under s. 50.32 and nothing in this paragraph limits services a hospital may provide under s. 50.32.

AB43,757,23 (c) A crisis urgent care and observation facility certified under this section shall do all of the following:

AB43,758,2 1. Accept referrals for crisis services for both youths and adults, including involuntary patients under emergency detention, voluntary patients, walk-ins, and individuals brought by law enforcement, emergency medical responders, and other emergency medical services practitioners.

AB43,758,4 2. Abstain from having a requirement for medical clearance before admission assessment.

AB43,758,6 3. Provide assessments for physical health, substance use disorder, and mental health.

AB43,758,7 4. Provide screens for suicide and violence risk.

AB43,758,8 5. Provide medication management and therapeutic counseling.

AB43,758,9 6. Provide coordination of services for basic needs.

AB43,758,14 7. Have adequate staffing 24 hours a day, 7 days a week, with a multidisciplinary team including, as needed, psychiatrists or psychiatric nurse practitioners, nurses, licensed clinicians capable of completing assessments and providing necessary treatment, peers with lived experience, and other appropriate staff.

AB43,758,18 8. Allow for voluntary and involuntary treatment of individuals in crisis as a means to avoid unnecessary placement of those individuals in hospital inpatient beds and allow for an effective conversion to voluntary stabilization when warranted in the same setting.

AB43,758,23 (3) Admission. (a) A crisis urgent care and observation facility certified under this section may accept individuals for voluntary stabilization, observation and treatment, including for assessments for mental health or substance use disorder, screening for suicide and violence risk, and medication management and therapeutic counseling.

AB43,759,5 (b) A crisis urgent care and observation facility certified under this section may accept individuals for emergency detention under s. 51.15 if the facility agrees to accept the individual. A county crisis assessment under s. 51.15 (2) (c) is required prior to acceptance of an individual for purposes of emergency detention at a crisis urgent care and observation facility certified under this section. Medical clearance is not required before admission, but the facility shall provide necessary medical services on site.

AB43,759,8 (4) Grants. From the appropriation under s. 20.435 (5) (cj), the department shall award grants to individuals and entities to develop and support crisis urgent care and observation facilities under this section.

AB43,759,18 (5) Rules. The department may promulgate rules to implement this section, including requirements for admitting and holding individuals for purposes of emergency detention. The department may promulgate the rules under this section as emergency rules under s. 227.24. Notwithstanding s. 227.24 (1) (c) and (2), a rule promulgated under this subsection may remain in effect for not more than 24 months. Notwithstanding s. 227.24 (1) (a) and (3), the department is not required to provide evidence that promulgating a rule under this subsection as an emergency rule is necessary for the preservation of the public peace, health, safety, or welfare and is not required to provide a finding of emergency for a rule promulgated under this subsection.

AB43,1145 Section 1145. 51.042 (3m) of the statutes is created to read:

AB43,759,22 51.042 (3m) Grants. From the appropriation under s. 20.435 (5) (cc), the department shall award grants to organizations to develop and support youth crisis stabilization facilities.