WI
Wisconsin Assembly Bill AB1168

Wisconsin 2023-2024 Regular Session

Wisconsin Assembly Bill AB1168 Compare Versions

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33 2023 - 2024 LEGISLATURE
44 2023 ASSEMBLY BILL 1168
55 March 22, 2024 - Introduced by Representatives KURTZ, SUMMERFIELD, DITTRICH,
66 GREEN, MAXEY, MELOTIK, MICHALSKI, MURSAU, NOVAK, O'CONNOR, PALMERI,
77 ROZAR, SCHMIDT, SNODGRASS and TRANEL, cosponsored by Senators MARKLEIN,
88 QUINN, TESTIN, BALLWEG and FELZKOWSKI. Referred to Committee on Health,
99 Aging and Long-Term Care.
1010 AN ACT to amend 79.05 (2) (c); and to create 20.235 (1) (dr), 20.292 (1) (b), 20.465
1111 (3) (du), 38.04 (9m), 39.378, 66.0602 (3) (e) 6m., 101.575 (6) (a) 5. and 256.04 (3)
1212 of the statutes; relating to: reimbursement of emergency services under the
1313 Medical Assistance program when a patient is not transported; emergency
1414 medical services education; tuition and materials reimbursement for
1515 emergency medical responders and emergency medical services practitioners;
1616 reporting on changes to the scope of practice of emergency medical responders
1717 and emergency medical services practitioners; a levy limit exemption for
1818 regional emergency medical systems; eligible expenses of fire dues program; a
1919 live 911 pilot program; eligibility for the expenditure restraint incentive
2020 program; and making an appropriation.
2121 Analysis by the Legislative Reference Bureau
2222 Medical Assistance reimbursement for nontransport ambulance services
2323 Under current law, the Department of Health Services uses a standardized
2424 coding system produced by the federal Centers for Medicare and Medicaid Services
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3737 ASSEMBLY BILL 1168
3838 to describe certain products, supplies, and services for those submitting claims for
3939 reimbursement under the Medical Assistance program, which is known as the
4040 Healthcare Common Procedure Coding System (HCPCS). The Medical Assistance
4141 program is a joint state and federal program that provides health services to
4242 individuals who have limited financial resources. This bill directs DHS to change,
4343 for dates of service beginning January 1, 2025, the current maximum
4444 reimbursement allowed under the Medical Assistance program for services provided
4545 under HCPCS code A0998, often referenced as “ambulance response and treatment,
4646 no transport,” from the current maximum allowable fee to a rate that matches the
4747 maximum allowable rate under the Medical Assistance program for reimbursement
4848 of ambulance services that include patient transport.
4949 Emergency medical services education
5050 The bill requires the Technical College System Board to provide grants to
5151 technical colleges that provide emergency medical services courses that train and
5252 prepare individuals for initial certification or initial licensure as an emergency
5353 medical responder or an emergency medical services practitioner.
5454 Tuition and materials costs for emergency medical responders and
5555 emergency medical services practitioners
5656 The bill requires the Higher Educational Aids Board to develop a program to
5757 reimburse individuals or their employers for the cost of tuition and materials
5858 necessary for the individual to qualify for initial certification or initial licensure as
5959 an emergency medical responder or an emergency medical services practitioner. To
6060 be eligible for reimbursement for the costs necessary to qualify for an initial
6161 certification or license, the individual must satisfactorily complete any required
6262 course of instruction, pass any required examination, satisfy any further
6363 requirement established by HEAB, and receive a certification or license from DHS.
6464 Report on scope of practice changes
6565 The bill requires the Emergency Medical Services Board, in consultation with
6666 DHS and the Technical College System Board, to annually submit a report to the
6767 legislature on national changes to the scope of practice of emergency medical
6868 responders, emergency medical services practitioners, or any equivalent
6969 practitioners in other jurisdictions and how those scope of practice changes may
7070 affect training for emergency medical responders and emergency medical services
7171 practitioners in this state.
7272 Levy limit exception
7373 Generally, under current law, local levy limits are applied to the property tax
7474 levies that are imposed by political subdivisions. A political subdivision may not
7575 increase its levy by a percentage that exceeds its “valuation factor," which is the
7676 greater of 0 percent or the percentage change in the political subdivision's equalized
7777 value due to new construction, less improvements removed. Current law also
7878 contains a number of exceptions to the levy limit, such as amounts a county levies
7979 for a countywide emergency medical system, for a county children with disabilities
8080 education board, and for certain bridge and culvert construction and repair. The bill
8181 creates an additional exception to local levy limits. Under the bill, the amounts a city, - 3 -2023 - 2024 Legislature
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8484 ASSEMBLY BILL 1168
8585 village, or town levies for a regional emergency medical system are exempt. Under
8686 the bill, “regional” refers to an area consisting of at least 232 square miles or
8787 including at least eight municipalities.
8888 Eligible expenses of fire dues program
8989 The bill allows cities, villages, and towns to spend fire dues payments received
9090 from the Department of Safety and Professional Services on purchasing emergency
9191 medical services equipment and training emergency medical responders and
9292 emergency medical services practitioners. Under current law, eligible cities,
9393 villages, and towns receive fire dues payments from DSPS, which are funded from
9494 assessments equal to 2 percent of premiums for private fire insurance and 2 percent
9595 of premiums paid to the state fire fund for the insurance of certain local government
9696 property. Current law requires fire dues payments to be spent on purchasing fire
9797 protection equipment, providing fire inspection and public education, training fire
9898 fighters and fire inspectors, and funding fire fighters' pension funds or other special
9999 funds benefiting disabled or aged fire fighters.
100100 Live 911 pilot program
101101 The bill directs the Department of Military Affairs to distribute moneys
102102 through grants to enable real-time video and multimedia communications between
103103 public safety answering points and individuals who call for emergency services.
104104 Further, the bill requires DMA to annually report to the legislature on the
105105 performance of the pilot program, including information on outcomes from the pilot
106106 program, the number of responses from dispatch that were altered due to increased
107107 information from the pilot program, and any cost savings associated with the pilot
108108 program. The bill does not require DMA to submit a report to the legislature in any
109109 year that DMA does not award any moneys through grants for the live 911 pilot
110110 program.
111111 Expenditure restraint incentive program
112112 The bill excludes the following from being considered in determining eligibility
113113 for an expenditure restraint incentive program payment: 1) amounts levied for a
114114 regional emergency medical system that are exempt from local levy limits; and 2) fee
115115 increases apportioned to each municipality operating a joint fire department or joint
116116 emergency medical services district that are exempt from local levy limits. Under
117117 current law, a municipality is eligible to receive an expenditure restraint incentive
118118 program payment if its property tax levy is greater than 5 mills and if the annual
119119 increase in its municipal budget, subject to certain exceptions, is less than the sum
120120 of factors based on inflation and the increased value of property in the municipality
121121 as a result of new construction.
122122 For further information see the state and local fiscal estimate, which will be
123123 printed as an appendix to this bill.
124124 The people of the state of Wisconsin, represented in senate and assembly, do
125125 enact as follows: - 4 -2023 - 2024 Legislature LRB-5503/1
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127127 SECTION 1 ASSEMBLY BILL 1168
128128 SECTION 1. 20.005 (3) (schedule) of the statutes: at the appropriate place, insert
129129 the following amounts for the purposes indicated:
130130 2023-24 2024-25
131131 20.235 Higher educational aids board
132132 (1) STUDENT SUPPORT ACTIVITIES
133133 (dr)Emergency medical services edu­
134134 cation reimbursement GPR B -0- 3,500,000
135135 20.292 Technical College System Board
136136 (1) TECHNICAL COLLEGE SYSTEM
137137 (b)Emergency medical services edu­
138138 cation GPR A 7,000,000 7,000,000
139139 20.465 Military affairs, department of
140140 (3) EMERGENCY MANAGEMENT SERVICES
141141 (du)Live 911 pilot program GPR C -0- 100,000
142142 SECTION 2. 20.235 (1) (dr) of the statutes is created to read:
143143 20.235 (1) (dr) Emergency medical services education reimbursement.
144144 Biennially, the amounts in the schedule to reimburse individuals for the cost of
145145 tuition and materials necessary to qualify for initial licensure or initial certification
146146 as an emergency medical services practitioner or an emergency medical responder
147147 under s. 256.15.
148148 SECTION 3. 20.292 (1) (b) of the statutes is created to read:
149149 20.292 (1) (b) Emergency medical services education. The amounts in the
150150 schedule for the provision of emergency medical services courses under s. 38.04 (9m).
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175175 SECTION 4
176176 ASSEMBLY BILL 1168
177177 SECTION 4. 20.465 (3) (du) of the statutes is created to read:
178178 20.465 (3) (du) Live 911 pilot program. As a continuing appropriation, the
179179 amounts in the schedule for grants under 2023 Wisconsin Act .... (this act), section
180180 11 (2).
181181 SECTION 5. 38.04 (9m) of the statutes is created to read:
182182 38.04 (9m) EMERGENCY MEDICAL SERVICES EDUCATION. From the appropriation
183183 account under s. 20.292 (1) (b), the board shall provide grants to technical colleges
184184 that provide emergency medical services courses that train and prepare individuals
185185 for initial certification or initial licensure as an emergency medical responder, as
186186 defined in s. 256.01 (4p), or an emergency medical services practitioner, as defined
187187 in s. 256.01 (5).
188188 SECTION 6. 39.378 of the statutes is created to read:
189189 39.378 Tuition and material costs for emergency medical services. (1)
190190 From the appropriation under s. 20.235 (1) (dr), the board shall develop a program
191191 to reimburse the individuals described under sub. (2) for the tuition and materials
192192 costs incurred in completing a course at a technical college in this state as necessary
193193 to qualify for initial licensure or initial certification.
194194 (2) Individuals eligible for reimbursement under this section include all of the
195195 following:
196196 (a) An individual who is applying for an initial license as an emergency medical
197197 services practitioner under s. 256.15 (6) if the individual has personally paid the
198198 tuition or materials costs for the course.
199199 (b) An individual who is applying for initial certification as an emergency
200200 medical responder under s. 256.15 (8) if the individual has personally paid the tuition
201201 or materials costs for the course.
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228228 SECTION 6 ASSEMBLY BILL 1168
229229 (c) The employer of an individual listed under par. (a) or (b) if the employer has
230230 paid for the applicant's cost of tuition or materials for the course.
231231 (3) To be eligible for reimbursement under this section, an individual described
232232 under sub. (2) shall satisfy the following criteria:
233233 (a) For individuals who are applying for initial licensure as an emergency
234234 medical services practitioner under s. 256.15 (6) (a):
235235 1. The individual has satisfactorily completed a course of instruction and
236236 training required under s. 256.15 (6) (a) 2.
237237 2. The individual has passed any examination required under s. 256.15 (6) (a)
238238 3.
239239 3. The individual has met all additional qualifications for licensure as may be
240240 required by the department of health services under s. 256.15 (6) (a) 4.
241241 4. The individual has received an initial license from the department of health
242242 services as an emergency medical services practitioner under s. 256.15 (6).
243243 (b) For individuals who are applying for initial certification as an emergency
244244 medical responder under s. 256.15 (8) (b), the individual has satisfactorily completed
245245 a course of instruction required under s. 256.15 (8) (b) 3. and has received
246246 certification as an emergency medical responder from the department of health
247247 services under s. 256.15 (8) (b).
248248 (c) For employers who have paid for an individual's costs of tuition or materials
249249 as described under sub. (2) (c), the individual satisfies the criteria under par. (a) or
250250 (b).
251251 (4) To receive reimbursement under this section, individuals described under
252252 sub. (2) who are eligible for reimbursement under sub. (3) shall apply to the board
253253 for reimbursement on a form prescribed by the board.
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281281 SECTION 7
282282 ASSEMBLY BILL 1168
283283 SECTION 7. 66.0602 (3) (e) 6m. of the statutes is created to read:
284284 66.0602 (3) (e) 6m. The amount that a municipality levies in that year for a
285285 regional emergency medical system. In this subdivision, “regional” means an area
286286 consisting of at least 232 square miles or including at least 8 municipalities.
287287 SECTION 8. 79.05 (2) (c) of the statutes, as affected by 2023 Wisconsin Act 12,
288288 is amended to read:
289289 79.05 (2) (c) Its municipal budget; exclusive of principal and interest on
290290 long-term debt and exclusive of revenue sharing payments under s. 66.0305,
291291 payments of premiums under s. 66.0137 (5) (c) 1. and 1m., levy limit adjustments
292292 under s. 66.0602 (3) (e) 6m. and (h), revenues generated from a tax imposed under
293293 s. 77.701, payments received under s. 79.038, expenditures of payments due to the
294294 termination of a tax incremental district under s. 79.096 (3), recycling fee payments
295295 under s. 289.645, expenditures of grant payments under s. 16.297 (1m),
296296 unreimbursed expenses related to an emergency declared under s. 323.10,
297297 expenditures from moneys received pursuant to P.L. 111-5, grants received from the
298298 state or federal government for the purpose of providing law enforcement, fire
299299 protection, or emergency medical services, and expenditures made pursuant to a
300300 purchasing agreement with a school district whereby the municipality makes
301301 purchases on behalf of the school district; for the year of the statement under s.
302302 79.015 increased over its municipal budget as adjusted under sub. (6); exclusive of
303303 principal and interest on long-term debt and exclusive of revenue sharing payments
304304 under s. 66.0305, payments of premiums under s. 66.0137 (5) (c) 1. and 1m., levy limit
305305 adjustments under s. 66.0602 (3) (e) 6m. and (h), revenues generated from a tax
306306 imposed under s. 77.701, payments received under s. 79.038, expenditures of
307307 payments due to the termination of a tax incremental district under s. 79.096 (3),
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334334 SECTION 8 ASSEMBLY BILL 1168
335335 recycling fee payments under s. 289.645, expenditures of grant payments under s.
336336 16.297 (1m), unreimbursed expenses related to an emergency declared under s.
337337 323.10, expenditures from moneys received pursuant to P.L. 111-5, grants received
338338 from the state or federal government for the purpose of providing law enforcement,
339339 fire protection, or emergency medical services, and expenditures made pursuant to
340340 a purchasing agreement with a school district whereby the municipality makes
341341 purchases on behalf of the school district; for the year before that year by less than
342342 the sum of the inflation factor and the valuation factor, rounded to the nearest 0.10
343343 percent.
344344 SECTION 9. 101.575 (6) (a) 5. of the statutes is created to read:
345345 101.575 (6) (a) 5. The purchase of emergency medical services equipment and
346346 training of emergency medical responders, as defined in s. 256.01 (4p), and
347347 emergency medical services practitioners, as defined in s. 256.01 (5).
348348 SECTION 10. 256.04 (3) of the statutes is created to read:
349349 256.04 (3) Annually, no later than September 15, in consultation with the
350350 department of health services and the technical college system board, submit a
351351 report to the chief clerk of each house of the legislature for distribution to the
352352 legislature under s. 13.172 (2) on national changes to the scope of practice of
353353 emergency medical responders, emergency medical services practitioners, or any
354354 equivalent practitioners in other jurisdictions and how those scope of practice
355355 changes may affect training for emergency medical responders and emergency
356356 medical services practitioners in this state.
357357 SECTION 11.0Nonstatutory provisions.
358358 (1) MEDICAL ASSISTANCE REIMBURSEMENT RATES FOR NONTRANSPORT AMBULANCE
359359 SERVICES. For dates of service beginning January 1, 2025, the department of health
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387387 SECTION 11
388388 ASSEMBLY BILL 1168
389389 services shall increase reimbursement rates for services provided and reimbursable
390390 under the healthcare common procedure coding system code A0998 with a
391391 description of “ambulance response and treatment, no transport” from the current
392392 maximum allowable fee to a rate that matches the maximum allowable rate under
393393 the Medical Assistance program for reimbursement of ambulance services that
394394 include patient transport.
395395 (2) LIVE 911 PILOT PROGRAM.
396396 (a) Grants. From the appropriation under s. 20.465 (3) (du), the department
397397 of military affairs may distribute moneys through grants to public safety answering
398398 points to enable real-time video and multimedia communications between public
399399 safety answering points and individuals who call for emergency services.
400400 (b) Report. Annually, no later than October 15, the department of military
401401 affairs shall submit a report to the chief clerk of each house of the legislature for
402402 distribution to the legislature under s. 13.172 (2) on the performance of the pilot
403403 program under this subsection. The report shall include information on outcomes
404404 from the pilot program, the number of responses from dispatch that were altered due
405405 to increased information from the pilot program, and any cost savings associated
406406 with the pilot program. This paragraph does not apply in any year that the
407407 department of military affairs does not distribute any moneys through grants under
408408 this subsection.
409409 SECTION 12.0Fiscal changes.
410410 (1) MEDICAL ASSISTANCE RATE INCREASE; NONTRANSPORT AMBULANCE SERVICES. In
411411 the schedule under s. 20.005 (3) for the appropriation to the department of health
412412 services under s. 20.435 (4) (b), the dollar amount for fiscal year 2024-25 is increased
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438438 SECTION 12 ASSEMBLY BILL 1168
439439 by $860,000 to increase Medical Assistance reimbursement rates for nontransport
440440 ambulance services under Section 11 (1) of this act.
441441 (2) POSITION INCREASE IN THE DEPARTMENT OF MILITARY AFFAIRS. In the schedule
442442 under s. 20.005 (3) for the appropriation to the department of military affairs under
443443 s. 20.465 (3) (qm), the dollar amount for fiscal year 2023-24 is increased by $100,000
444444 to increase the authorized FTE positions for the department by 1.0 SEG position for
445445 the purpose of administering the grants under Section 11 (2) (a) of this act. In the
446446 schedule under s. 20.005 (3) for the appropriation to the department of military
447447 affairs under s. 20.465 (3) (qm), the dollar amount for fiscal year 2024-25 is increased
448448 by $100,000 for the purpose of funding the position authorized under this subsection.
449449 SECTION 13.0Effective dates. This act takes effect on the day after publication,
450450 except as follows:
451451 (1) MUNICIPAL BUDGET TEST; EXPENDITURE RESTRAINT INCENTIVE PROGRAM. The
452452 treatment of s. 79.05 (2) (c) takes effect on July 1, 2024.
453453 (END)
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