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2 | 2 | | SWB:skw |
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3 | 3 | | 2023 - 2024 LEGISLATURE |
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4 | 4 | | 2023 ASSEMBLY BILL 281 |
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5 | 5 | | May 17, 2023 - Introduced by Representatives SNYDER, ARMSTRONG, DITTRICH, |
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6 | 6 | | DONOVAN, EDMING, GREEN, GUNDRUM, KITCHENS, MURPHY, MURSAU, SPIROS, |
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7 | 7 | | SUBECK and TITTL, cosponsored by Senators BALLWEG and JAMES. Referred to |
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8 | 8 | | Committee on Mental Health and Substance Abuse Prevention. |
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9 | 9 | | ***AUTHORS SUBJECT TO CHANGE*** |
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10 | 10 | | AN ACT to repeal 20.435 (5) (ct), 51.441 and 51.442; to amend 20.435 (5) (bw) |
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11 | 11 | | and 51.445 (3); and to create 20.435 (5) (bx) and 51.443 of the statutes; |
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12 | 12 | | relating to: mental health consultation program and making an |
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13 | 13 | | appropriation. |
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14 | 14 | | Analysis by the Legislative Reference Bureau |
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15 | 15 | | This bill combines the child psychiatry consultation program with additional |
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16 | 16 | | services into a new mental health consultation program. Currently, the child |
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17 | 17 | | psychiatry consultation program assists participating clinicians in providing care to |
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18 | 18 | | children with mental health care needs and provides referral support and additional |
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19 | 19 | | services. The 2019 biennial budget act requires the Department of Health Services |
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20 | 20 | | to convene interested persons, including the Medical College of Wisconsin, to develop |
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21 | 21 | | a plan and standards for a comprehensive mental health consultation program |
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22 | 22 | | incorporating various psychiatry specialties, including addiction medicine; a |
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23 | 23 | | perinatal psychiatry consultation program; and the child psychiatry consultation |
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24 | 24 | | program. This requirement from the 2019 biennial budget act is eliminated in the |
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25 | 25 | | bill along with the separate child psychiatry consultation program. The addiction |
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26 | 26 | | medicine consultation program currently assists participating clinicians in |
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27 | 27 | | providing care to patients with substance use addiction and provides referral |
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28 | 28 | | support and additional services, and the bill retains the addiction medicine |
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29 | 29 | | consultation program as a separate program. |
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30 | 30 | | The bill requires an organization to administer a mental health consultation |
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31 | 31 | | program (MHCP) that incorporates a comprehensive set of mental health |
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35 | 35 | | 4 - 2 -2023 - 2024 Legislature LRB-2059/1 |
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36 | 36 | | SWB:skw |
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37 | 37 | | ASSEMBLY BILL 281 |
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38 | 38 | | consultation services and may include perinatal, child, adult, geriatric, pain, |
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39 | 39 | | veteran, and general mental health consultation services. Under the bill, the |
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40 | 40 | | organization that currently administers the child psychiatry consultation program |
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41 | 41 | | must administer the MHCP during the 2023-25 fiscal biennium. After the 2023-25 |
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42 | 42 | | fiscal biennium, DHS may continue with that organization or select another |
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43 | 43 | | organization to administer the MHCP through its request-for-proposal procedures. |
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44 | 44 | | The organization administering the MHCP may contract with any other entity to |
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45 | 45 | | perform any operations and satisfy any requirements of the MHCP . The |
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46 | 46 | | organization must do all of the following: 1) ensure that mental health providers |
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47 | 47 | | providing services through the MHCP have the appropriate credentials as described |
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48 | 48 | | in the bill, 2) maintain infrastructure to provide services statewide on every |
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49 | 49 | | weekday, 3) provide consultation services as promptly as practicable, 4) report to |
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50 | 50 | | DHS any information DHS requires, 5) conduct surveys of participating clinicians |
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51 | 51 | | as described in the bill, and 6) provide certain specified services. Those specified |
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52 | 52 | | services are the following: support for clinicians participating in the MHCP to assist |
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53 | 53 | | in the management of mental health problems; triage-level assessments to |
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54 | 54 | | determine the most appropriate response; diagnostics and therapeutic feedback |
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55 | 55 | | when medically appropriate; and recruitment of other practices to a provider's |
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56 | 56 | | services. The MHCP must be able to provide consultation services by telephone and |
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57 | 57 | | email but may also provide services by other means. In addition to the services |
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58 | 58 | | required in the bill, which are eligible for funding by DHS, the organization may |
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59 | 59 | | provide any of the services specified in the bill that are eligible for funding by DHS. |
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60 | 60 | | For further information see the state fiscal estimate, which will be printed as |
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61 | 61 | | an appendix to this bill. |
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62 | 62 | | The people of the state of Wisconsin, represented in senate and assembly, do |
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63 | 63 | | enact as follows: |
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64 | 64 | | SECTION 1. 20.005 (3) (schedule) of the statutes: at the appropriate place, insert |
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65 | 65 | | the following amounts for the purposes indicated: |
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66 | 66 | | 2023-24 2024-25 |
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67 | 67 | | 20.435 Health services, department of |
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68 | 68 | | (5) MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES |
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69 | 69 | | (bx)Addiction medicine consultation |
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70 | 70 | | program GPR B -0- 500,000 |
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71 | 71 | | SECTION 2. 20.435 (5) (bw) of the statutes is amended to read: |
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79 | 79 | | LRB-2059/1 |
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80 | 80 | | SWB:skw |
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81 | 81 | | SECTION 2 |
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82 | 82 | | ASSEMBLY BILL 281 |
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83 | 83 | | 20.435 (5) (bw) Child psychiatry and addiction medicine consultation |
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84 | 84 | | programs Mental health consultation. Biennially, the amounts in the schedule for |
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85 | 85 | | operating the child psychiatry consultation program under s. 51.442 and the |
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86 | 86 | | addiction medicine consultation program under s. 51.448 mental health consultation |
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87 | 87 | | program under s. 51.443. |
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88 | 88 | | SECTION 3. 20.435 (5) (bx) of the statutes is created to read: |
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89 | 89 | | 20.435 (5) (bx) Addiction medicine consultation program. Biennially, the |
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90 | 90 | | amounts in the schedule for operating the addiction medicine consultation program |
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91 | 91 | | under s. 51.448. |
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92 | 92 | | SECTION 4. 20.435 (5) (ct) of the statutes is repealed. |
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93 | 93 | | SECTION 5. 51.441 of the statutes is repealed. |
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94 | 94 | | SECTION 6. 51.442 of the statutes is repealed. |
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95 | 95 | | SECTION 7. 51.443 of the statutes is created to read: |
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96 | 96 | | 51.443 Mental health consultation program. (1) In this section: |
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97 | 97 | | (a) 1. Before July 1, 2025, “organization” means the organization that provided |
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98 | 98 | | consultation services through the child psychiatry consultation program under s. |
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99 | 99 | | 51.442, 2021 stats., as of July 1, 2023. |
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100 | 100 | | 2. On or after July 1, 2025, “organization” means any of the following: |
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101 | 101 | | a. The organization described under subd. 1. |
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102 | 102 | | b. The organization selected by the department in accordance with its |
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103 | 103 | | request-for-proposal procedures to administer the mental health consultation |
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104 | 104 | | program under this section. |
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105 | 105 | | (b) “Participating clinicians” includes physicians, nurse practitioners, |
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106 | 106 | | physician assistants, and medically appropriate members of the care teams of |
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107 | 107 | | physicians, nurse practitioners, and physician assistants. |
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133 | 133 | | SWB:skw |
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134 | 134 | | SECTION 7 ASSEMBLY BILL 281 |
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135 | 135 | | (c) “Program” means the mental health consultation program under this |
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136 | 136 | | section. |
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137 | 137 | | (2) The organization shall administer a mental health consultation program |
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138 | 138 | | that incorporates a comprehensive set of mental health consultation services, which |
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139 | 139 | | may include perinatal, child, adult, geriatric, pain, veteran, and general mental |
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140 | 140 | | health consultation services, and may contract with any other entity to perform any |
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141 | 141 | | operations and satisfy any requirements under this section for the program. |
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142 | 142 | | (3) As a condition of providing services through the program, the organization |
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143 | 143 | | shall do all of the following: |
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144 | 144 | | (a) Ensure that all mental health care providers who are providing services |
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145 | 145 | | through the program have the applicable credential from this state; if a psychiatric |
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146 | 146 | | professional, that the provider is eligible for certification or is certified by the |
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147 | 147 | | American Board of Psychiatry and Neurology for adult psychiatry, child and |
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148 | 148 | | adolescent psychiatry, or both; and if a psychologist, that the provider is registered |
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149 | 149 | | in a professional organization, including the American Psychological Association, |
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150 | 150 | | National Register of Health Service Psychologists, Association for Psychological |
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151 | 151 | | Science, or the National Alliance of Professional Psychology Providers. |
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152 | 152 | | (b) Maintain the infrastructure necessary to provide the program's services |
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153 | 153 | | statewide. |
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154 | 154 | | (c) Operate the program on weekdays during normal business hours of 8 a.m. |
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155 | 155 | | to 5 p.m. |
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156 | 156 | | (d) Provide consultation services under the program as promptly as is |
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157 | 157 | | practicable. |
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158 | 158 | | (e) Have the capability to provide consultation services by, at a minimum, |
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159 | 159 | | telephone and email. Consultation through the program may be provided by |
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184 | 184 | | 25 - 5 -2023 - 2024 Legislature |
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185 | 185 | | LRB-2059/1 |
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186 | 186 | | SWB:skw |
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187 | 187 | | SECTION 7 |
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188 | 188 | | ASSEMBLY BILL 281 |
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189 | 189 | | teleconference, video conference, voice over Internet protocol, email, pager, |
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190 | 190 | | in-person conference, or any other telecommunication or electronic means. |
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191 | 191 | | (f) Provide all of the following services through the program: |
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192 | 192 | | 1. Support for participating clinicians to assist in the management of mental |
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193 | 193 | | health concerns. |
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194 | 194 | | 2. Triage-level assessments to determine the most appropriate response to |
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195 | 195 | | each request for services through the program, including appropriate referrals to any |
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196 | 196 | | community providers and health systems. |
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197 | 197 | | 3. When medically appropriate, diagnostics and therapeutic feedback. |
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198 | 198 | | 4. Recruitment of other clinicians into the program as participating clinicians |
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199 | 199 | | when possible. |
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200 | 200 | | (g) Report to the department any information requested by the department. |
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201 | 201 | | (h) Conduct annual surveys of participating clinicians who use the program to |
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202 | 202 | | assess the quality of care provided, self-perceived levels of confidence in providing |
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203 | 203 | | mental health services, and satisfaction with the consultations and other services |
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204 | 204 | | provided through the program. Immediately after participating clinicians begin |
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205 | 205 | | using the program and again 6 to 12 months later, the organization may conduct |
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206 | 206 | | assessments of participating clinicians to assess the barriers to and benefits of |
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207 | 207 | | participation in the program to make future improvements and to determine the |
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208 | 208 | | participating clinicians' treatment abilities, confidence, and awareness of relevant |
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209 | 209 | | resources before and after beginning to use the program. |
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210 | 210 | | (4) Services provided under sub. (3) (b) to (h) are eligible for funding from the |
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211 | 211 | | department. The organization also may provide any of the following services under |
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212 | 212 | | the program that are eligible for funding from the department: |
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237 | 237 | | SWB:skw |
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238 | 238 | | SECTION 7 ASSEMBLY BILL 281 |
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239 | 239 | | (a) Second opinion diagnostic and medication management evaluations and |
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240 | 240 | | community resource referrals conducted by either a psychiatrist or an allied health |
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241 | 241 | | professional. |
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242 | 242 | | (b) In-person or web-based educational seminars and refresher courses on a |
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243 | 243 | | medically appropriate topic within mental or behavioral health care provided to any |
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244 | 244 | | participating clinician who uses the program. |
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245 | 245 | | (c) Data evaluation and assessment of the program. |
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246 | 246 | | SECTION 8. 51.445 (3) of the statutes is amended to read: |
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247 | 247 | | 51.445 (3) The department shall provide moneys in the amount of $175,000 in |
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248 | 248 | | each fiscal year in, at least, fiscal years 2020-21 and 2021-22 to an organization that |
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249 | 249 | | provided consultation services through the child psychiatry consultation program |
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250 | 250 | | under s. 51.442, 2021 stats., as of January 1, 2019 2021, and the organization shall |
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251 | 251 | | provide consultation services through the consultation pilot program under this |
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252 | 252 | | section in Outagamie County in a manner that maximizes medically appropriate |
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253 | 253 | | access and services as described under sub. (4). |
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254 | 254 | | SECTION 9.0Fiscal changes. |
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255 | 255 | | (1) MENTAL HEALTH CONSULTATION PROGRAM. In the schedule under s. 20.005 (3) |
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256 | 256 | | for the appropriation to the department of health services under s. 20.435 (5) (bw), |
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257 | 257 | | the dollar amount for fiscal year 2024-25 is increased by $2,000,000 to fund the |
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258 | 258 | | mental health consultation program under s. 51.443. |
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259 | 259 | | (2) ADDICTION MEDICINE CONSULTATION PROGRAM. In the schedule under s. 20.005 |
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260 | 260 | | (3) for the appropriation to the department of health services under s. 20.435 (5) (bw), |
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261 | 261 | | the dollar amount for fiscal year 2024-25 is decreased by $500,000 to reflect that |
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262 | 262 | | expenditures for the addiction medicine consultation program are being paid from |
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263 | 263 | | a different appropriation. |
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288 | 288 | | 25 - 7 -2023 - 2024 Legislature |
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289 | 289 | | LRB-2059/1 |
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290 | 290 | | SWB:skw |
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291 | 291 | | SECTION 10 |
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292 | 292 | | ASSEMBLY BILL 281 |
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293 | 293 | | SECTION 10.0Effective date. |
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294 | 294 | | (1) This act takes effect on the day after publication, or on the 2nd day after |
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295 | 295 | | publication of the 2023 biennial budget act, whichever is later. |
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296 | 296 | | (END) |
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