Wisconsin 2023-2024 Regular Session

Wisconsin Senate Bill SB1074 Compare Versions

Only one version of the bill is available at this time.

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3	3	2023 - 2024 LEGISLATURE
4	4	2023 SENATE BILL 1074
5	5	February 26, 2024 - Introduced by Senators MARKLEIN, BALLWEG, TESTIN, QUINN
6	6	and FELZKOWSKI, cosponsored by Representatives KURTZ, SUMMERFIELD,
7	7	DITTRICH, GREEN, MAXEY, MELOTIK, MICHALSKI, MURSAU, NOVAK, O'CONNOR,
8	8	PALMERI, ROZAR, SCHMIDT, SNODGRASS and TRANEL. Referred to Committee on
9	9	Health.
10	10	*AUTHORS SUBJECT TO CHANGE*
11	11	AN ACT to amend 79.05 (2) (c); and to create 20.235 (1) (dr), 20.292 (1) (b), 20.465
12	12	(3) (du), 38.04 (9m), 39.378, 66.0602 (3) (e) 6m., 101.575 (6) (a) 5. and 256.04 (3)
13	13	of the statutes; relating to: reimbursement of emergency services under the
14	14	Medical Assistance program when a patient is not transported; emergency
15	15	medical services education; tuition and materials reimbursement for
16	16	emergency medical responders and emergency medical services practitioners;
17	17	reporting on changes to the scope of practice of emergency medical responders
18	18	and emergency medical services practitioners; a levy limit exemption for
19	19	regional emergency medical systems; eligible expenses of fire dues program; a
20	20	live 911 pilot program; eligibility for the expenditure restraint incentive
21	21	program; and making an appropriation.
22	22	Analysis by the Legislative Reference Bureau
23	23	Medical Assistance reimbursement for nontransport ambulance services
24	24	Under current law, the Department of Health Services uses a standardized
25	25	coding system produced by the federal Centers for Medicare and Medicaid Services
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38	38	SENATE BILL 1074
39	39	to describe certain products, supplies, and services for those submitting claims for
40	40	reimbursement under the Medical Assistance program, which is known as the
41	41	Healthcare Common Procedure Coding System (HCPCS). The Medical Assistance
42	42	program is a joint state and federal program that provides health services to
43	43	individuals who have limited financial resources. This bill directs DHS to change,
44	44	for dates of service beginning January 1, 2025, the current maximum
45	45	reimbursement allowed under the Medical Assistance program for services provided
46	46	under HCPCS code A0998, often referenced as “ambulance response and treatment,
47	47	no transport,” from the current maximum allowable fee to a rate that matches the
48	48	maximum allowable rate under the Medical Assistance program for reimbursement
49	49	of ambulance services that include patient transport.
50	50	Emergency medical services education
51	51	The bill requires the Technical College System Board to provide grants to
52	52	technical colleges that provide emergency medical services courses that train and
53	53	prepare individuals for initial certification or initial licensure as an emergency
54	54	medical responder or an emergency medical services practitioner.
55	55	Tuition and materials costs for emergency medical responders and
56	56	emergency medical services practitioners
57	57	The bill requires the Higher Educational Aids Board to develop a program to
58	58	reimburse individuals or their employers for the cost of tuition and materials
59	59	necessary for the individual to qualify for initial certification or initial licensure as
60	60	an emergency medical responder or an emergency medical services practitioner. To
61	61	be eligible for reimbursement for the costs necessary to qualify for an initial
62	62	certification or license, the individual must satisfactorily complete any required
63	63	course of instruction, pass any required examination, satisfy any further
64	64	requirement established by HEAB, and receive a certification or license from DHS.
65	65	Report on scope of practice changes
66	66	The bill requires the Emergency Medical Services Board, in consultation with
67	67	DHS and the Technical College System Board, to annually submit a report to the
68	68	legislature on national changes to the scope of practice of emergency medical
69	69	responders, emergency medical services practitioners, or any equivalent
70	70	practitioners in other jurisdictions and how those scope of practice changes may
71	71	affect training for emergency medical responders and emergency medical services
72	72	practitioners in this state.
73	73	Levy limit exception
74	74	Generally, under current law, local levy limits are applied to the property tax
75	75	levies that are imposed by political subdivisions. A political subdivision may not
76	76	increase its levy by a percentage that exceeds its “valuation factor," which is the
77	77	greater of 0 percent or the percentage change in the political subdivision's equalized
78	78	value due to new construction, less improvements removed. Current law also
79	79	contains a number of exceptions to the levy limit, such as amounts a county levies
80	80	for a countywide emergency medical system, for a county children with disabilities
81	81	education board, and for certain bridge and culvert construction and repair. The bill
82	82	creates an additional exception to local levy limits. Under the bill, the amounts a city, - 3 -2023 - 2024 Legislature
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85	85	SENATE BILL 1074
86	86	village, or town levies for a regional emergency medical system are exempt. Under
87	87	the bill, “regional” refers to an area consisting of at least 232 square miles or
88	88	including at least eight municipalities.
89	89	Eligible expenses of fire dues program
90	90	The bill allows cities, villages, and towns to spend fire dues payments received
91	91	from the Department of Safety and Professional Services on purchasing emergency
92	92	medical services equipment and training emergency medical responders and
93	93	emergency medical services practitioners. Under current law, eligible cities,
94	94	villages, and towns receive fire dues payments from DSPS, which are funded from
95	95	assessments equal to 2 percent of premiums for private fire insurance and 2 percent
96	96	of premiums paid to the state fire fund for the insurance of certain local government
97	97	property. Current law requires fire dues payments to be spent on purchasing fire
98	98	protection equipment, providing fire inspection and public education, training fire
99	99	fighters and fire inspectors, and funding fire fighters' pension funds or other special
100	100	funds benefiting disabled or aged fire fighters.
101	101	Live 911 pilot program
102	102	The bill directs the Department of Military Affairs to distribute moneys
103	103	through grants to enable real-time video and multimedia communications between
104	104	public safety answering points and individuals who call for emergency services.
105	105	Further, the bill requires DMA to annually report to the legislature on the
106	106	performance of the pilot program, including information on outcomes from the pilot
107	107	program, the number of responses from dispatch that were altered due to increased
108	108	information from the pilot program, and any cost savings associated with the pilot
109	109	program. The bill does not require DMA to submit a report to the legislature in any
110	110	year that DMA does not award any moneys through grants for the live 911 pilot
111	111	program.
112	112	Expenditure restraint incentive program
113	113	The bill excludes the following from being considered in determining eligibility
114	114	for an expenditure restraint incentive program payment: 1) amounts levied for a
115	115	regional emergency medical system that are exempt from local levy limits; and 2) fee
116	116	increases apportioned to each municipality operating a joint fire department or joint
117	117	emergency medical services district that are exempt from local levy limits. Under
118	118	current law, a municipality is eligible to receive an expenditure restraint incentive
119	119	program payment if its property tax levy is greater than 5 mills and if the annual
120	120	increase in its municipal budget, subject to certain exceptions, is less than the sum
121	121	of factors based on inflation and the increased value of property in the municipality
122	122	as a result of new construction.
123	123	For further information see the state and local fiscal estimate, which will be
124	124	printed as an appendix to this bill.
125	125	The people of the state of Wisconsin, represented in senate and assembly, do
126	126	enact as follows: - 4 -2023 - 2024 Legislature LRB-5899/1
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128	128	SECTION 1 SENATE BILL 1074
129	129	SECTION 1. 20.005 (3) (schedule) of the statutes: at the appropriate place, insert
130	130	the following amounts for the purposes indicated:
131	131	2023-24 2024-25
132	132	20.235 Higher educational aids board
133	133	(1) STUDENT SUPPORT ACTIVITIES
134	134	(dr)Emergency medical services edu
135	135	cation reimbursement GPR B -0- 3,500,000
136	136	20.292 Technical College System Board
137	137	(1) TECHNICAL COLLEGE SYSTEM
138	138	(b)Emergency medical services edu
139	139	cation GPR A 7,000,000 7,000,000
140	140	20.465 Military affairs, department of
141	141	(3) EMERGENCY MANAGEMENT SERVICES
142	142	(du)Live 911 pilot program GPR C -0- 100,000
143	143	SECTION 2. 20.235 (1) (dr) of the statutes is created to read:
144	144	20.235 (1) (dr) Emergency medical services education reimbursement.
145	145	Biennially, the amounts in the schedule to reimburse individuals for the cost of
146	146	tuition and materials necessary to qualify for initial licensure or initial certification
147	147	as an emergency medical services practitioner or an emergency medical responder
148	148	under s. 256.15.
149	149	SECTION 3. 20.292 (1) (b) of the statutes is created to read:
150	150	20.292 (1) (b) Emergency medical services education. The amounts in the
151	151	schedule for the provision of emergency medical services courses under s. 38.04 (9m).
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176	176	SECTION 4
177	177	SENATE BILL 1074
178	178	SECTION 4. 20.465 (3) (du) of the statutes is created to read:
179	179	20.465 (3) (du) Live 911 pilot program. As a continuing appropriation, the
180	180	amounts in the schedule for grants under 2023 Wisconsin Act .... (this act), section
181	181	11 (2).
182	182	SECTION 5. 38.04 (9m) of the statutes is created to read:
183	183	38.04 (9m) EMERGENCY MEDICAL SERVICES EDUCATION. From the appropriation
184	184	account under s. 20.292 (1) (b), the board shall provide grants to technical colleges
185	185	that provide emergency medical services courses that train and prepare individuals
186	186	for initial certification or initial licensure as an emergency medical responder, as
187	187	defined in s. 256.01 (4p), or an emergency medical services practitioner, as defined
188	188	in s. 256.01 (5).
189	189	SECTION 6. 39.378 of the statutes is created to read:
190	190	39.378 Tuition and material costs for emergency medical services. (1)
191	191	From the appropriation under s. 20.235 (1) (dr), the board shall develop a program
192	192	to reimburse the individuals described under sub. (2) for the tuition and materials
193	193	costs incurred in completing a course at a technical college in this state as necessary
194	194	to qualify for initial licensure or initial certification.
195	195	(2) Individuals eligible for reimbursement under this section include all of the
196	196	following:
197	197	(a) An individual who is applying for an initial license as an emergency medical
198	198	services practitioner under s. 256.15 (6) if the individual has personally paid the
199	199	tuition or materials costs for the course.
200	200	(b) An individual who is applying for initial certification as an emergency
201	201	medical responder under s. 256.15 (8) if the individual has personally paid the tuition
202	202	or materials costs for the course.
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229	229	SECTION 6 SENATE BILL 1074
230	230	(c) The employer of an individual listed under par. (a) or (b) if the employer has
231	231	paid for the applicant's cost of tuition or materials for the course.
232	232	(3) To be eligible for reimbursement under this section, an individual described
233	233	under sub. (2) shall satisfy the following criteria:
234	234	(a) For individuals who are applying for initial licensure as an emergency
235	235	medical services practitioner under s. 256.15 (6) (a):
236	236	1. The individual has satisfactorily completed a course of instruction and
237	237	training required under s. 256.15 (6) (a) 2.
238	238	2. The individual has passed any examination required under s. 256.15 (6) (a)
239	239	3.
240	240	3. The individual has met all additional qualifications for licensure as may be
241	241	required by the department of health services under s. 256.15 (6) (a) 4.
242	242	4. The individual has received an initial license from the department of health
243	243	services as an emergency medical services practitioner under s. 256.15 (6).
244	244	(b) For individuals who are applying for initial certification as an emergency
245	245	medical responder under s. 256.15 (8) (b), the individual has satisfactorily completed
246	246	a course of instruction required under s. 256.15 (8) (b) 3. and has received
247	247	certification as an emergency medical responder from the department of health
248	248	services under s. 256.15 (8) (b).
249	249	(c) For employers who have paid for an individual's costs of tuition or materials
250	250	as described under sub. (2) (c), the individual satisfies the criteria under par. (a) or
251	251	(b).
252	252	(4) To receive reimbursement under this section, individuals described under
253	253	sub. (2) who are eligible for reimbursement under sub. (3) shall apply to the board
254	254	for reimbursement on a form prescribed by the board.
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282	282	SECTION 7
283	283	SENATE BILL 1074
284	284	SECTION 7. 66.0602 (3) (e) 6m. of the statutes is created to read:
285	285	66.0602 (3) (e) 6m. The amount that a municipality levies in that year for a
286	286	regional emergency medical system. In this subdivision, “regional” means an area
287	287	consisting of at least 232 square miles or including at least 8 municipalities.
288	288	SECTION 8. 79.05 (2) (c) of the statutes, as affected by 2023 Wisconsin Act 12,
289	289	is amended to read:
290	290	79.05 (2) (c) Its municipal budget; exclusive of principal and interest on
291	291	long-term debt and exclusive of revenue sharing payments under s. 66.0305,
292	292	payments of premiums under s. 66.0137 (5) (c) 1. and 1m., levy limit adjustments
293	293	under s. 66.0602 (3) (e) 6m. and (h), revenues generated from a tax imposed under
294	294	s. 77.701, payments received under s. 79.038, expenditures of payments due to the
295	295	termination of a tax incremental district under s. 79.096 (3), recycling fee payments
296	296	under s. 289.645, expenditures of grant payments under s. 16.297 (1m),
297	297	unreimbursed expenses related to an emergency declared under s. 323.10,
298	298	expenditures from moneys received pursuant to P.L. 111-5, grants received from the
299	299	state or federal government for the purpose of providing law enforcement, fire
300	300	protection, or emergency medical services, and expenditures made pursuant to a
301	301	purchasing agreement with a school district whereby the municipality makes
302	302	purchases on behalf of the school district; for the year of the statement under s.
303	303	79.015 increased over its municipal budget as adjusted under sub. (6); exclusive of
304	304	principal and interest on long-term debt and exclusive of revenue sharing payments
305	305	under s. 66.0305, payments of premiums under s. 66.0137 (5) (c) 1. and 1m., levy limit
306	306	adjustments under s. 66.0602 (3) (e) 6m. and (h), revenues generated from a tax
307	307	imposed under s. 77.701, payments received under s. 79.038, expenditures of
308	308	payments due to the termination of a tax incremental district under s. 79.096 (3),
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335	335	SECTION 8 SENATE BILL 1074
336	336	recycling fee payments under s. 289.645, expenditures of grant payments under s.
337	337	16.297 (1m), unreimbursed expenses related to an emergency declared under s.
338	338	323.10, expenditures from moneys received pursuant to P.L. 111-5, grants received
339	339	from the state or federal government for the purpose of providing law enforcement,
340	340	fire protection, or emergency medical services, and expenditures made pursuant to
341	341	a purchasing agreement with a school district whereby the municipality makes
342	342	purchases on behalf of the school district; for the year before that year by less than
343	343	the sum of the inflation factor and the valuation factor, rounded to the nearest 0.10
344	344	percent.
345	345	SECTION 9. 101.575 (6) (a) 5. of the statutes is created to read:
346	346	101.575 (6) (a) 5. The purchase of emergency medical services equipment and
347	347	training of emergency medical responders, as defined in s. 256.01 (4p), and
348	348	emergency medical services practitioners, as defined in s. 256.01 (5).
349	349	SECTION 10. 256.04 (3) of the statutes is created to read:
350	350	256.04 (3) Annually, no later than September 15, in consultation with the
351	351	department of health services and the technical college system board, submit a
352	352	report to the chief clerk of each house of the legislature for distribution to the
353	353	legislature under s. 13.172 (2) on national changes to the scope of practice of
354	354	emergency medical responders, emergency medical services practitioners, or any
355	355	equivalent practitioners in other jurisdictions and how those scope of practice
356	356	changes may affect training for emergency medical responders and emergency
357	357	medical services practitioners in this state.
358	358	SECTION 11.0Nonstatutory provisions.
359	359	(1) MEDICAL ASSISTANCE REIMBURSEMENT RATES FOR NONTRANSPORT AMBULANCE
360	360	SERVICES. For dates of service beginning January 1, 2025, the department of health
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388	388	SECTION 11
389	389	SENATE BILL 1074
390	390	services shall increase reimbursement rates for services provided and reimbursable
391	391	under the healthcare common procedure coding system code A0998 with a
392	392	description of “ambulance response and treatment, no transport” from the current
393	393	maximum allowable fee to a rate that matches the maximum allowable rate under
394	394	the Medical Assistance program for reimbursement of ambulance services that
395	395	include patient transport.
396	396	(2) LIVE 911 PILOT PROGRAM.
397	397	(a) Grants. From the appropriation under s. 20.465 (3) (du), the department
398	398	of military affairs may distribute moneys through grants to public safety answering
399	399	points to enable real-time video and multimedia communications between public
400	400	safety answering points and individuals who call for emergency services.
401	401	(b) Report. Annually, no later than October 15, the department of military
402	402	affairs shall submit a report to the chief clerk of each house of the legislature for
403	403	distribution to the legislature under s. 13.172 (2) on the performance of the pilot
404	404	program under this subsection. The report shall include information on outcomes
405	405	from the pilot program, the number of responses from dispatch that were altered due
406	406	to increased information from the pilot program, and any cost savings associated
407	407	with the pilot program. This paragraph does not apply in any year that the
408	408	department of military affairs does not distribute any moneys through grants under
409	409	this subsection.
410	410	SECTION 12.0Fiscal changes.
411	411	(1) MEDICAL ASSISTANCE RATE INCREASE; NONTRANSPORT AMBULANCE SERVICES. In
412	412	the schedule under s. 20.005 (3) for the appropriation to the department of health
413	413	services under s. 20.435 (4) (b), the dollar amount for fiscal year 2024-25 is increased
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439	439	SECTION 12 SENATE BILL 1074
440	440	by $860,000 to increase Medical Assistance reimbursement rates for nontransport
441	441	ambulance services under Section 11 (1) of this act.
442	442	(2) POSITION INCREASE IN THE DEPARTMENT OF MILITARY AFFAIRS. In the schedule
443	443	under s. 20.005 (3) for the appropriation to the department of military affairs under
444	444	s. 20.465 (3) (qm), the dollar amount for fiscal year 2023-24 is increased by $100,000
445	445	to increase the authorized FTE positions for the department by 1.0 SEG position for
446	446	the purpose of administering the grants under Section 11 (2) (a) of this act. In the
447	447	schedule under s. 20.005 (3) for the appropriation to the department of military
448	448	affairs under s. 20.465 (3) (qm), the dollar amount for fiscal year 2024-25 is increased
449	449	by $100,000 for the purpose of funding the position authorized under this subsection.
450	450	SECTION 13.0Effective dates. This act takes effect on the day after publication,
451	451	except as follows:
452	452	(1) MUNICIPAL BUDGET TEST; EXPENDITURE RESTRAINT INCENTIVE PROGRAM. The
453	453	treatment of s. 79.05 (2) (c) takes effect on July 1, 2024.
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