Wisconsin Legislative Council
AMENDMENT MEMO
One Ea st Ma in Stre e t, Suite 401 • Ma dison, W I 53703 • (608) 266-1304 • le g.council@le gis.wisconsin.gov • http://www.le gis.wisconsin.gov/lc
Memo published: February 13, 2024 Contact: Steve McCarthy, Senior Staff Attorney
2023 Assembly Bill 467 Assembly Amendments 1 and 2
2023 ASSEMBLY BILL 467
2023 Assembly Bill 467 requires the Department of Health Services (DHS) to establish a certification
process for crisis urgent care and observation facilities and a grant program to award grants to develop
and support these facilities. Under the bill, a crisis urgent care and observation facility is 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.
The bill provides that no person may operate a crisis urgent care and observation facility without a
certification from DHS. Under the bill, a certified crisis urgent care and observation facility is not
regulated as a hospital, except to the extent the facility is otherwise required due to the facility’s
licensure or certification for other services or purposes. The bill provides that the provisions of the bill
may not be construed to prohibit, limit, or otherwise interfere with services provided by a county or a
hospital or other facility that are provided consistent with the facility’s existing licensure or
certification, whether the facility is publicly or privately funded. The bill provides that DHS may certify
crisis urgent care and observation facilities that demonstrate the ability to do certain things. The bill
requires that DHS must provide the Joint Committee on Finance (JCF) with certain information and
obtain approval of that committee before granting certification to a crisis urgent care and observation
facility. The bill also requires DHS to provide an annual report to JCF regarding the facilities.
Under the bill, a certified crisis urgent care and observation facility must accept adult individuals for
emergency detention, and may accept youths for emergency detention. The bill provides that a certified
crisis urgent care and observation facility may accept individuals for services including 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.
The bill requires DHS, in accordance with existing requirements to obtain approval from JCF, to
request any necessary federal approval by seeking either a waiver, specifically, what is known as a 1115
waiver, or a Medical Assistance state plan amendment to add services provided by a crisis urgent care
and observation facility as a type of crisis intervention service reimbursable under the Medical
Assistance program. If DHS determines a state plan amendment is appropriate, DHS must follow the
procedures for review by JCF, regardless of whether the amendment is expected to have a fiscal effect of
$7.5 million or more. Under the bill, if federal approval is either unnecessary or is necessary and is
granted, DHS may provide reimbursement for these services. - 2 -
ASSEMBLY AMENDMENT 1
Together with some more minor changes, Assembly Amendment 1 makes the following modifications to
2023 Assembly Bill 467:
Permits DHS to make announced and unannounced inspections and complaint investigations of
crisis urgent care and observation facilities as it deems necessary, at reasonable times and in a
reasonable manner.
Adds physician assistants to the list of provider types that may comprise a multidisciplinary team
for adequate staffing.
Requires DHS to submit to the chief clerk of each house of the Legislature, for distribution to the
appropriate standing committees in addition to JCF, a report regarding crisis urgent care and
observation facilities.
Adds certain information requirements that DHS must provide JCF when submitting a proposal
regarding certification of a crisis urgent care and observation facility.
Allows any facility that currently is providing crisis intervention services that would otherwise
require certification as a crisis urgent care and observation facility continue to provide these
services without obtaining certification from DHS as a crisis urgent care and observation facility.
ASSEMBLY AMENDMENT 2
Assembly Amendment 2 adds a new section to the bill that provides for DHS certification of crisis
hostels, which are defined as a mental health stabilization program that provides certain crisis
stabilization services to individuals on a voluntary basis.
The amendment provides that a county program that already operates a crisis hostel under certain
circumstances and is certified by DHS is not required to receive additional licensure.
The amendment also provides DHS with administrative rule-making authority to implement
certification of crisis hostels.
BILL HISTORY
Representative Moses offered Assembly Amendment 1 on October 30, 2023, and Assembly Amendment
2 on February 6, 2024. On February 13, 2024, the Assembly Committee on Mental Health and
Substance Abuse Prevention recommended adoption of both amendments, and passage of the bill, as
amended, on votes of Ayes, 10; Noes, 0.
For a full history of the bill, visit the Legislature’s bill history page.
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