LRB-5503/1
JPC/SWB/JAM/KP:wlj
2023 - 2024 LEGISLATURE
2023 ASSEMBLY BILL 1168
March 22, 2024 - Introduced by Representatives KURTZ, SUMMERFIELD, DITTRICH,
GREEN, MAXEY, MELOTIK, MICHALSKI, MURSAU, NOVAK, O'CONNOR, PALMERI,
ROZAR, SCHMIDT, SNODGRASS and TRANEL, cosponsored by Senators MARKLEIN,
QUINN, TESTIN, BALLWEG and FELZKOWSKI. Referred to Committee on Health,
Aging and Long-Term Care.
AN ACT to amend 79.05 (2) (c); and to create 20.235 (1) (dr), 20.292 (1) (b), 20.465
(3) (du), 38.04 (9m), 39.378, 66.0602 (3) (e) 6m., 101.575 (6) (a) 5. and 256.04 (3)
of the statutes; relating to: reimbursement of emergency services under the
Medical Assistance program when a patient is not transported; emergency
medical services education; tuition and materials reimbursement for
emergency medical responders and emergency medical services practitioners;
reporting on changes to the scope of practice of emergency medical responders
and emergency medical services practitioners; a levy limit exemption for
regional emergency medical systems; eligible expenses of fire dues program; a
live 911 pilot program; eligibility for the expenditure restraint incentive
program; and making an appropriation.
Analysis by the Legislative Reference Bureau
Medical Assistance reimbursement for nontransport ambulance services
Under current law, the Department of Health Services uses a standardized
coding system produced by the federal Centers for Medicare and Medicaid Services
1
2
3
4
5
6
7
8
9
10
11 - 2 -2023 - 2024 Legislature LRB-5503/1
JPC/SWB/JAM/KP:wlj
ASSEMBLY BILL 1168
to describe certain products, supplies, and services for those submitting claims for
reimbursement under the Medical Assistance program, which is known as the
Healthcare Common Procedure Coding System (HCPCS). The Medical Assistance
program is a joint state and federal program that provides health services to
individuals who have limited financial resources. This bill directs DHS to change,
for dates of service beginning January 1, 2025, the current maximum
reimbursement allowed under the Medical Assistance program for services provided
under HCPCS code A0998, often referenced as “ambulance response and treatment,
no transport,” from the current maximum allowable fee to a rate that matches the
maximum allowable rate under the Medical Assistance program for reimbursement
of ambulance services that include patient transport.
Emergency medical services education
The bill requires the Technical College System Board to provide grants to
technical colleges that provide emergency medical services courses that train and
prepare individuals for initial certification or initial licensure as an emergency
medical responder or an emergency medical services practitioner.
Tuition and materials costs for emergency medical responders and
emergency medical services practitioners
The bill requires the Higher Educational Aids Board to develop a program to
reimburse individuals or their employers for the cost of tuition and materials
necessary for the individual to qualify for initial certification or initial licensure as
an emergency medical responder or an emergency medical services practitioner. To
be eligible for reimbursement for the costs necessary to qualify for an initial
certification or license, the individual must satisfactorily complete any required
course of instruction, pass any required examination, satisfy any further
requirement established by HEAB, and receive a certification or license from DHS.
Report on scope of practice changes
The bill requires the Emergency Medical Services Board, in consultation with
DHS and the Technical College System Board, to annually submit a report to the
legislature on national changes to the scope of practice of emergency medical
responders, emergency medical services practitioners, or any equivalent
practitioners in other jurisdictions and how those scope of practice changes may
affect training for emergency medical responders and emergency medical services
practitioners in this state.
Levy limit exception
Generally, under current law, local levy limits are applied to the property tax
levies that are imposed by political subdivisions. A political subdivision may not
increase its levy by a percentage that exceeds its “valuation factor," which is the
greater of 0 percent or the percentage change in the political subdivision's equalized
value due to new construction, less improvements removed. Current law also
contains a number of exceptions to the levy limit, such as amounts a county levies
for a countywide emergency medical system, for a county children with disabilities
education board, and for certain bridge and culvert construction and repair. The bill
creates an additional exception to local levy limits. Under the bill, the amounts a city, - 3 -2023 - 2024 Legislature
LRB-5503/1
JPC/SWB/JAM/KP:wlj
ASSEMBLY BILL 1168
village, or town levies for a regional emergency medical system are exempt. Under
the bill, “regional” refers to an area consisting of at least 232 square miles or
including at least eight municipalities.
Eligible expenses of fire dues program
The bill allows cities, villages, and towns to spend fire dues payments received
from the Department of Safety and Professional Services on purchasing emergency
medical services equipment and training emergency medical responders and
emergency medical services practitioners. Under current law, eligible cities,
villages, and towns receive fire dues payments from DSPS, which are funded from
assessments equal to 2 percent of premiums for private fire insurance and 2 percent
of premiums paid to the state fire fund for the insurance of certain local government
property. Current law requires fire dues payments to be spent on purchasing fire
protection equipment, providing fire inspection and public education, training fire
fighters and fire inspectors, and funding fire fighters' pension funds or other special
funds benefiting disabled or aged fire fighters.
Live 911 pilot program
The bill directs the Department of Military Affairs to distribute moneys
through grants to enable real-time video and multimedia communications between
public safety answering points and individuals who call for emergency services.
Further, the bill requires DMA to annually report to the legislature on the
performance of the pilot program, including information on outcomes from the pilot
program, the number of responses from dispatch that were altered due to increased
information from the pilot program, and any cost savings associated with the pilot
program. The bill does not require DMA to submit a report to the legislature in any
year that DMA does not award any moneys through grants for the live 911 pilot
program.
Expenditure restraint incentive program
The bill excludes the following from being considered in determining eligibility
for an expenditure restraint incentive program payment: 1) amounts levied for a
regional emergency medical system that are exempt from local levy limits; and 2) fee
increases apportioned to each municipality operating a joint fire department or joint
emergency medical services district that are exempt from local levy limits. Under
current law, a municipality is eligible to receive an expenditure restraint incentive
program payment if its property tax levy is greater than 5 mills and if the annual
increase in its municipal budget, subject to certain exceptions, is less than the sum
of factors based on inflation and the increased value of property in the municipality
as a result of new construction.
For further information see the state and local 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: - 4 -2023 - 2024 Legislature LRB-5503/1
JPC/SWB/JAM/KP:wlj
SECTION 1 ASSEMBLY BILL 1168
SECTION 1. 20.005 (3) (schedule) of the statutes: at the appropriate place, insert
the following amounts for the purposes indicated:
2023-24 2024-25
20.235 Higher educational aids board
(1) STUDENT SUPPORT ACTIVITIES
(dr)Emergency medical services edu
cation reimbursement GPR B -0- 3,500,000
20.292 Technical College System Board
(1) TECHNICAL COLLEGE SYSTEM
(b)Emergency medical services edu
cation GPR A 7,000,000 7,000,000
20.465 Military affairs, department of
(3) EMERGENCY MANAGEMENT SERVICES
(du)Live 911 pilot program GPR C -0- 100,000
SECTION 2. 20.235 (1) (dr) of the statutes is created to read:
20.235 (1) (dr) Emergency medical services education reimbursement.
Biennially, the amounts in the schedule to reimburse individuals for the cost of
tuition and materials necessary to qualify for initial licensure or initial certification
as an emergency medical services practitioner or an emergency medical responder
under s. 256.15.
SECTION 3. 20.292 (1) (b) of the statutes is created to read:
20.292 (1) (b) Emergency medical services education. The amounts in the
schedule for the provision of emergency medical services courses under s. 38.04 (9m).
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22 - 5 -2023 - 2024 Legislature
LRB-5503/1
JPC/SWB/JAM/KP:wlj
SECTION 4
ASSEMBLY BILL 1168
SECTION 4. 20.465 (3) (du) of the statutes is created to read:
20.465 (3) (du) Live 911 pilot program. As a continuing appropriation, the
amounts in the schedule for grants under 2023 Wisconsin Act .... (this act), section
11 (2).
SECTION 5. 38.04 (9m) of the statutes is created to read:
38.04 (9m) EMERGENCY MEDICAL SERVICES EDUCATION. From the appropriation
account under s. 20.292 (1) (b), the board shall provide grants to technical colleges
that provide emergency medical services courses that train and prepare individuals
for initial certification or initial licensure as an emergency medical responder, as
defined in s. 256.01 (4p), or an emergency medical services practitioner, as defined
in s. 256.01 (5).
SECTION 6. 39.378 of the statutes is created to read:
39.378 Tuition and material costs for emergency medical services. (1)
From the appropriation under s. 20.235 (1) (dr), the board shall develop a program
to reimburse the individuals described under sub. (2) for the tuition and materials
costs incurred in completing a course at a technical college in this state as necessary
to qualify for initial licensure or initial certification.
(2) Individuals eligible for reimbursement under this section include all of the
following:
(a) An individual who is applying for an initial license as an emergency medical
services practitioner under s. 256.15 (6) if the individual has personally paid the
tuition or materials costs for the course.
(b) An individual who is applying for initial certification as an emergency
medical responder under s. 256.15 (8) if the individual has personally paid the tuition
or materials costs for the course.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25 - 6 -2023 - 2024 Legislature LRB-5503/1
JPC/SWB/JAM/KP:wlj
SECTION 6 ASSEMBLY BILL 1168
(c) The employer of an individual listed under par. (a) or (b) if the employer has
paid for the applicant's cost of tuition or materials for the course.
(3) To be eligible for reimbursement under this section, an individual described
under sub. (2) shall satisfy the following criteria:
(a) For individuals who are applying for initial licensure as an emergency
medical services practitioner under s. 256.15 (6) (a):
1. The individual has satisfactorily completed a course of instruction and
training required under s. 256.15 (6) (a) 2.
2. The individual has passed any examination required under s. 256.15 (6) (a)
3.
3. The individual has met all additional qualifications for licensure as may be
required by the department of health services under s. 256.15 (6) (a) 4.
4. The individual has received an initial license from the department of health
services as an emergency medical services practitioner under s. 256.15 (6).
(b) For individuals who are applying for initial certification as an emergency
medical responder under s. 256.15 (8) (b), the individual has satisfactorily completed
a course of instruction required under s. 256.15 (8) (b) 3. and has received
certification as an emergency medical responder from the department of health
services under s. 256.15 (8) (b).
(c) For employers who have paid for an individual's costs of tuition or materials
as described under sub. (2) (c), the individual satisfies the criteria under par. (a) or
(b).
(4) To receive reimbursement under this section, individuals described under
sub. (2) who are eligible for reimbursement under sub. (3) shall apply to the board
for reimbursement on a form prescribed by the board.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25 - 7 -2023 - 2024 Legislature
LRB-5503/1
JPC/SWB/JAM/KP:wlj
SECTION 7
ASSEMBLY BILL 1168
SECTION 7. 66.0602 (3) (e) 6m. of the statutes is created to read:
66.0602 (3) (e) 6m. The amount that a municipality levies in that year for a
regional emergency medical system. In this subdivision, “regional” means an area
consisting of at least 232 square miles or including at least 8 municipalities.
SECTION 8. 79.05 (2) (c) of the statutes, as affected by 2023 Wisconsin Act 12,
is amended to read:
79.05 (2) (c) Its municipal budget; exclusive of principal and interest on
long-term debt and exclusive of revenue sharing payments under s. 66.0305,
payments of premiums under s. 66.0137 (5) (c) 1. and 1m., levy limit adjustments
under s. 66.0602 (3) (e) 6m. and (h), revenues generated from a tax imposed under
s. 77.701, payments received under s. 79.038, expenditures of payments due to the
termination of a tax incremental district under s. 79.096 (3), recycling fee payments
under s. 289.645, expenditures of grant payments under s. 16.297 (1m),
unreimbursed expenses related to an emergency declared under s. 323.10,
expenditures from moneys received pursuant to P.L. 111-5, grants received from the
state or federal government for the purpose of providing law enforcement, fire
protection, or emergency medical services, and expenditures made pursuant to a
purchasing agreement with a school district whereby the municipality makes
purchases on behalf of the school district; for the year of the statement under s.
79.015 increased over its municipal budget as adjusted under sub. (6); exclusive of
principal and interest on long-term debt and exclusive of revenue sharing payments
under s. 66.0305, payments of premiums under s. 66.0137 (5) (c) 1. and 1m., levy limit
adjustments under s. 66.0602 (3) (e) 6m. and (h), revenues generated from a tax
imposed under s. 77.701, payments received under s. 79.038, expenditures of
payments due to the termination of a tax incremental district under s. 79.096 (3),
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25 - 8 -2023 - 2024 Legislature LRB-5503/1
JPC/SWB/JAM/KP:wlj
SECTION 8 ASSEMBLY BILL 1168
recycling fee payments under s. 289.645, expenditures of grant payments under s.
16.297 (1m), unreimbursed expenses related to an emergency declared under s.
323.10, expenditures from moneys received pursuant to P.L. 111-5, grants received
from the state or federal government for the purpose of providing law enforcement,
fire protection, or emergency medical services, and expenditures made pursuant to
a purchasing agreement with a school district whereby the municipality makes
purchases on behalf of the school district; for the year before that year by less than
the sum of the inflation factor and the valuation factor, rounded to the nearest 0.10
percent.
SECTION 9. 101.575 (6) (a) 5. of the statutes is created to read:
101.575 (6) (a) 5. The purchase of emergency medical services equipment and
training of emergency medical responders, as defined in s. 256.01 (4p), and
emergency medical services practitioners, as defined in s. 256.01 (5).
SECTION 10. 256.04 (3) of the statutes is created to read:
256.04 (3) Annually, no later than September 15, in consultation with the
department of health services and the technical college system board, submit a
report to the chief clerk of each house of the legislature for distribution to the
legislature under s. 13.172 (2) on national changes to the scope of practice of
emergency medical responders, emergency medical services practitioners, or any
equivalent practitioners in other jurisdictions and how those scope of practice
changes may affect training for emergency medical responders and emergency
medical services practitioners in this state.
SECTION 11.0Nonstatutory provisions.
(1) MEDICAL ASSISTANCE REIMBURSEMENT RATES FOR NONTRANSPORT AMBULANCE
SERVICES. For dates of service beginning January 1, 2025, the department of health
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25 - 9 -2023 - 2024 Legislature
LRB-5503/1
JPC/SWB/JAM/KP:wlj
SECTION 11
ASSEMBLY BILL 1168
services shall increase reimbursement rates for services provided and reimbursable
under the healthcare common procedure coding system code A0998 with a
description of “ambulance response and treatment, no transport” from the current
maximum allowable fee to a rate that matches the maximum allowable rate under
the Medical Assistance program for reimbursement of ambulance services that
include patient transport.
(2) LIVE 911 PILOT PROGRAM.
(a) Grants. From the appropriation under s. 20.465 (3) (du), the department
of military affairs may distribute moneys through grants to public safety answering
points to enable real-time video and multimedia communications between public
safety answering points and individuals who call for emergency services.
(b) Report. Annually, no later than October 15, the department of military
affairs shall submit a report to the chief clerk of each house of the legislature for
distribution to the legislature under s. 13.172 (2) on the performance of the pilot
program under this subsection. The report shall include information on outcomes
from the pilot program, the number of responses from dispatch that were altered due
to increased information from the pilot program, and any cost savings associated
with the pilot program. This paragraph does not apply in any year that the
department of military affairs does not distribute any moneys through grants under
this subsection.
SECTION 12.0Fiscal changes.
(1) MEDICAL ASSISTANCE RATE INCREASE; NONTRANSPORT AMBULANCE SERVICES. In
the schedule under s. 20.005 (3) for the appropriation to the department of health
services under s. 20.435 (4) (b), the dollar amount for fiscal year 2024-25 is increased
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24 - 10 -2023 - 2024 Legislature LRB-5503/1
JPC/SWB/JAM/KP:wlj
SECTION 12 ASSEMBLY BILL 1168
by $860,000 to increase Medical Assistance reimbursement rates for nontransport
ambulance services under Section 11 (1) of this act.
(2) POSITION INCREASE IN THE DEPARTMENT OF MILITARY AFFAIRS. In the schedule
under s. 20.005 (3) for the appropriation to the department of military affairs under
s. 20.465 (3) (qm), the dollar amount for fiscal year 2023-24 is increased by $100,000
to increase the authorized FTE positions for the department by 1.0 SEG position for
the purpose of administering the grants under Section 11 (2) (a) of this act. In the
schedule under s. 20.005 (3) for the appropriation to the department of military
affairs under s. 20.465 (3) (qm), the dollar amount for fiscal year 2024-25 is increased
by $100,000 for the purpose of funding the position authorized under this subsection.
SECTION 13.0Effective dates. This act takes effect on the day after publication,
except as follows:
(1) MUNICIPAL BUDGET TEST; EXPENDITURE RESTRAINT INCENTIVE PROGRAM. The
treatment of s. 79.05 (2) (c) takes effect on July 1, 2024.
(END)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15