Wisconsin 2023-2024 Regular Session

Wisconsin Senate Bill SB643 Compare Versions

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1		-	Date of enactment:
2		-	2023 Senate Bill 643 Date of publication*:
3		-	2023 WISCONSIN ACT
4		-	AN ACT to repeal 146.63 (6) (a) to (e) and 146.64 (4) (a) to (e); to renumber and amend 146.63 (6) (intro.), 146.64
5		-	(2) (a) and 146.64 (4) (intro.); to amend 20.435 (4) (bf), 146.64 (2) (c) 1. and 146.64 (3); and to create 146.64 (2)
6		-	(a) 2., 146.64 (3m) and 146.645 of the statutes; relating to: expanding graduate medical training grants and making
7		-	an appropriation.
8		-	The people of the state of Wisconsin, represented in
9		-	senate and assembly, do enact as follows:
10		-	SECTION 1. 20.435 (4) (bf) of the statutes is amended
11		-	to read:
12		-	20.435 (4) (bf) Graduate medical training support
13		-	grants. As a continuing appropriation, the amounts in the
14		-	schedule to award grants to rural hospitals under s.
15		-	146.63, and to support graduate medical training pro-
16		-	grams under s. 146.64, and to support graduate medical
17		-	training consortia under s. 146.645.
18		-	SECTION 2. 146.63 (6) (intro.) of the statutes is
19		-	renumbered 146.63 (6) and amended to read:
20		-	146.63 (6) ELIGIBILITY. A rural hospital or group of
21		-	rural hospitals may only receive a grant under sub. (3) if
22		-	the plan to use the funds involves developing an accred-
23		-	ited graduate medical training program in a specialty,
24		-	including any of the following:.
25		-	SECTION 3. 146.63 (6) (a) to (e) of the statutes are
26		-	repealed.
27		-	SECTION 4. 146.64 (2) (a) of the statutes is renum-
28		-	bered 146.64 (2) (a) (intro.) and amended to read:
29		-	146.64 (2) (a) (intro.) Subject to par. (c) and sub. (4),
30		-	the department shall distribute grants to hospitals to fund
31		-	the addition of positions to existing accredited graduate
32		-	medical training programs. The department shall distrib-
33		-	ute the grants under this paragraph to hospitals all of the
34		-	following:
35		-	1. Hospitals that apply to receive a grant under sub.
36		-	(3) and that satisfy the criteria established by the depart-
37		-	ment under par. (b) and the eligibility requirement under
38		-	sub. (4).
39		-	SECTION 5. 146.64 (2) (a) 2. of the statutes is created
40		-	to read:
41		-	146.64 (2) (a) 2. Hospitals that received a grant under
42		-	this paragraph in the immediately preceding fiscal year,
43		-	unless the hospital no longer satisfies the criteria estab-
44		-	lished by the department under par. (b), the hospital no
45		-	longer has an accredited graduate medical training pro-
46		-	gram, or the hospital has notified the department that the
47		-	hospital no longer wishes to receive the grant. The
48		-	department may not require a hospital under this subdivi-
49		-	sion to apply for a grant under this paragraph.
50		-	SECTION 6. 146.64 (2) (c) 1. of the statutes is
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	3	+	2023 - 2024 LEGISLATURE
	4	+	2023 SENATE BILL 643
	5	+	November 7, 2023 - Introduced by Senators QUINN, TOMCZYK, CARPENTER, COWLES,
	6	+	FELZKOWSKI, MARKLEIN, PFAFF and SPREITZER, cosponsored by Representatives
	7	+	NOVAK, SNYDER, BARE, ARMSTRONG, BILLINGS, C. ANDERSON, BRANDTJEN,
	8	+	DONOVAN, DOYLE, EDMING, HURD, JOERS, KITCHENS, KURTZ, MCGUIRE, MOSES,
	9	+	MURSAU, O'CONNOR, OHNSTAD, OLDENBURG, ORTIZ-VELEZ, ROZAR, SCHMIDT,
	10	+	SCHUTT and TRANEL. Referred to Committee on Housing, Rural Issues and
	11	+	Forestry.
	12	+	*AUTHORS SUBJECT TO CHANGE*
	13	+	AN ACT to repeal 146.63 (6) (a) to (e) and 146.64 (4) (a) to (e); to renumber and
	14	+	amend 146.63 (6) (intro.), 146.64 (2) (a) and 146.64 (4) (intro.); to amend
	15	+	20.435 (4) (bf), 146.64 (2) (c) 1. and 146.64 (3); and to create 146.64 (2) (a) 2.,
	16	+	146.64 (3m) and 146.645 of the statutes; relating to: expanding graduate
	17	+	medical training grants and making an appropriation.
	18	+	Analysis by the Legislative Reference Bureau
	19	+	Under current law, the Department of Health Services must distribute grants
	20	+	to rural hospitals to establish graduate medical training (GMT) programs in a
	21	+	specialty and to hospitals with existing GMT programs in a specialty to support the
	22	+	addition of new positions in the programs. Current law includes a nonexhaustive list
	23	+	of specialties in which a hospital's GMT program may specialize in order to be eligible
	24	+	for a grant. This bill removes that list but retains the specialty requirement for grant
	25	+	eligibility.
	26	+	Under current law, the maximum amount of a grant DHS may distribute in a
	27	+	fiscal year to a hospital with an existing GMT program to support the addition of new
	28	+	positions in the program is $225,000. The bill removes that $225,000 maximum. The
	29	+	bill also requires DHS to renew grant funding to hospitals with existing GMT
	30	+	programs that received a grant in the previous fiscal year, without requiring the
	31	+	hospital to reapply for the grant, provided the hospital still meets eligibility criteria
	32	+	established by DHS, maintains an accredited GMT program, and wishes to receive
	33	+	grant funding.
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	40	+	SENATE BILL 643
	41	+	In addition, the bill creates a new grant program under which DHS is required
	42	+	to distribute up to $375,000 in annual grants, plus any matching federal Medical
	43	+	Assistance funds, to support GMT consortia. Under the bill, a GMT consortium is
	44	+	defined as an independent, nonprofit organization formed by two or more entities to
	45	+	oversee, support, and administer accredited GMT programs at rural hospitals. The
	46	+	bill requires DHS to distribute grants to GMT consortia that apply for the grant and
	47	+	meet certain requirements. DHS must also renew grant funding to GMT consortia
	48	+	that received the grant in the previous fiscal year, without requiring the consortium
	49	+	to reapply for the grant, provided the consortium still meets the grant requirements
	50	+	and wishes to receive grant funding. DHS must give preference in awarding the
	51	+	grants to GMT consortia that oversee, support, and administer GMT programs at
	52	+	rural hospitals that have limited access to federal GMT funding from the federal
	53	+	Centers for Medicare and Medicaid Services. Under the bill, a GMT consortium must
	54	+	be accredited within 12 months of receiving a grant, and a GMT consortium may not
	55	+	receive renewed grant funding if the consortium is not accredited.
	56	+	For further information see the state fiscal estimate, which will be printed as
	57	+	an appendix to this bill.
	58	+	The people of the state of Wisconsin, represented in senate and assembly, do
	59	+	enact as follows:
	60	+	SECTION 1. 20.435 (4) (bf) of the statutes is amended to read:
	61	+	20.435 (4) (bf) Graduate medical training support grants. As a continuing
	62	+	appropriation, the amounts in the schedule to award grants to rural hospitals under
	63	+	s. 146.63, and to support graduate medical training programs under s. 146.64, and
	64	+	to support graduate medical training consortia under s. 146.645.
	65	+	SECTION 2. 146.63 (6) (intro.) of the statutes is renumbered 146.63 (6) and
51	66		amended to read:
52		-	146.64 (2) (c) 1. The department shall distribute
53		-	funds for grants under par. (a) from the appropriation
54		-	under s. 20.435 (4) (bf). The department may not distrib-
55		-	ute more than $225,000 from the appropriation under s.
56		-	20.435 (4) (bf) to a particular hospital in a given state fis-
57		-	cal year and may not distribute more than $75,000 from
58		-	* Section 991.11, WISCONSIN STATUTES: Effective date of acts. “Every act and every portion of an act enacted by the legislature over the governor’s
59		-	partial veto which does not expressly prescribe the time when it takes effect shall take effect on the day after its date of publication.” − 2 −2023 Wisconsin Act 2023 Senate Bill 643
60		-	the appropriation under s. 20.435 (4) (bf) to fund a given
61		-	position in a graduate medical training program in a
62		-	given state fiscal year.
63		-	SECTION 7. 146.64 (3) of the statutes is amended to
64		-	read:
65		-	146.64 (3) GRANT APPLICATION. A Except as pro-
66		-	vided in sub. (2) (a) 2., a hospital may apply, in the form
67		-	and manner determined by the department, to receive a
68		-	grant under sub. (2) (a).
69		-	SECTION 8. 146.64 (3m) of the statutes is created to
70		-	read:
71		-	146.64 (3m) GRANT NONRENEWAL. A hospital that
72		-	receives a grant under sub. (2) (a) shall notify the depart-
73		-	ment, in the manner determined by the department, if the
74		-	hospital no longer satisfies the criteria established by the
75		-	department under sub. (2) (b), the hospital no longer has
76		-	an accredited graduate medical training program, or the
77		-	hospital no longer wishes to receive the grant.
78		-	SECTION 9. 146.64 (4) (intro.) of the statutes is
79		-	renumbered 146.64 (4) and amended to read:
80		-	146.64 (4) ELIGIBILITY. A hospital that has an accred-
81		-	ited graduate medical training program in a specialty,
82		-	including any of the following, may apply to receive a
83		-	grant under sub. (3):.
84		-	SECTION 10. 146.64 (4) (a) to (e) of the statutes are
85		-	repealed.
	67	+	146.63 (6) ELIGIBILITY. A rural hospital or group of rural hospitals may only
	68	+	receive a grant under sub. (3) if the plan to use the funds involves developing an
	69	+	accredited graduate medical training program in a specialty, including any of the
	70	+	following:.
	71	+	SECTION 3. 146.63 (6) (a) to (e) of the statutes are repealed.
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	86	+	SECTION 4
	87	+	SENATE BILL 643
	88	+	SECTION 4. 146.64 (2) (a) of the statutes is renumbered 146.64 (2) (a) (intro.)
	89	+	and amended to read:
	90	+	146.64 (2) (a) (intro.) Subject to par. (c) and sub. (4), the department shall
	91	+	distribute grants to hospitals to fund the addition of positions to existing accredited
	92	+	graduate medical training programs. The department shall distribute the grants
	93	+	under this paragraph to hospitals all of the following:
	94	+	1. Hospitals that apply to receive a grant under sub. (3) and that satisfy the
	95	+	criteria established by the department under par. (b) and the eligibility requirement
	96	+	under sub. (4).
	97	+	SECTION 5. 146.64 (2) (a) 2. of the statutes is created to read:
	98	+	146.64 (2) (a) 2. Hospitals that received a grant under this paragraph in the
	99	+	immediately preceding fiscal year, unless the hospital no longer satisfies the criteria
	100	+	established by the department under par. (b), the hospital no longer has an
	101	+	accredited graduate medical training program, or the hospital has notified the
	102	+	department that the hospital no longer wishes to receive the grant. The department
	103	+	may not require a hospital under this subdivision to apply for a grant under this
	104	+	paragraph.
	105	+	SECTION 6. 146.64 (2) (c) 1. of the statutes is amended to read:
	106	+	146.64 (2) (c) 1. The department shall distribute funds for grants under par.
	107	+	(a) from the appropriation under s. 20.435 (4) (bf). The department may not
	108	+	distribute more than $225,000 from the appropriation under s. 20.435 (4) (bf) to a
	109	+	particular hospital in a given state fiscal year and may not distribute more than
	110	+	$75,000 from the appropriation under s. 20.435 (4) (bf) to fund a given position in a
	111	+	graduate medical training program in a given state fiscal year.
	112	+	SECTION 7. 146.64 (3) of the statutes is amended to read:
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	139	+	SECTION 7 SENATE BILL 643
	140	+	146.64 (3) GRANT APPLICATION. A Except as provided in sub. (2) (a) 2., a hospital
	141	+	may apply, in the form and manner determined by the department, to receive a grant
	142	+	under sub. (2) (a).
	143	+	SECTION 8. 146.64 (3m) of the statutes is created to read:
	144	+	146.64 (3m) GRANT NONRENEWAL. A hospital that receives a grant under sub.
	145	+	(2) (a) shall notify the department, in the manner determined by the department, if
	146	+	the hospital no longer satisfies the criteria established by the department under sub.
	147	+	(2) (b), the hospital no longer has an accredited graduate medical training program,
	148	+	or the hospital no longer wishes to receive the grant.
	149	+	SECTION 9. 146.64 (4) (intro.) of the statutes is renumbered 146.64 (4) and
	150	+	amended to read:
	151	+	146.64 (4) ELIGIBILITY. A hospital that has an accredited graduate medical
	152	+	training program in a specialty, including any of the following, may apply to receive
	153	+	a grant under sub. (3):.
	154	+	SECTION 10. 146.64 (4) (a) to (e) of the statutes are repealed.
86	155		SECTION 11. 146.645 of the statutes is created to read:
87		-	146.645 Grants to support the establishment or
88		-	operation of graduate medical training consortia. (1)
89		-	DEFINITIONS. In this section:
90		-	(a) “Graduate medical training consortium” means
91		-	an independent, nonprofit organization formed by 2 or
92		-	more entities to operate as a sponsoring institution for
93		-	accredited graduate medical training programs at rural
94		-	hospitals in this state.
95		-	(b) “Rural hospital” has the meaning given in s.
96		-	146.63 (1).
97		-	(c) “Sponsoring institution” means an entity that
98		-	oversees, supports, and administers one or more accred-
99		-	ited graduate medical training programs.
100		-	(2) DEPARTMENTAL DUTIES. (a) The department shall
101		-	distribute grants from the appropriation under s. 20.435
102		-	(4) (bf) to support the operational expenses of graduate
103		-	medical training consortia. Subject to par. (c) and sub.
104		-	(3), the department shall distribute grants to all of the fol-
105		-	lowing:
106		-	1. Graduate medical training consortia that apply to
107		-	receive a grant under sub. (4) and that satisfy the criteria
108		-	established by the department under par. (b) and the eligi-
109		-	bility requirement under sub. (3).
110		-	2. A graduate medical training consortium that
111		-	received a grant under this paragraph in the immediately
112		-	preceding fiscal year, unless the graduate medical train-
113		-	ing consortium no longer satisfies the criteria established
114		-	by the department under par. (b) or the eligibility require-
115		-	ment under sub. (3), the consortium is not accredited as
116		-	a sponsoring institution by the Accreditation Council for
117		-	Graduate Medical Education, or any successor organiza-
118		-	tion, or another accrediting body as determined by the
119		-	department, or the consortium has notified the depart-
120		-	ment that the consortium no longer wishes to receive the
121		-	grant.
122		-	(b) The department shall establish criteria for
123		-	approving and distributing grants under par. (a). The
124		-	department may not require a consortium under par. (a)
	156	+	146.645 Grants to support the establishment or operation of graduate
	157	+	medical training consortia. (1) DEFINITIONS. In this section:
	158	+	(a) “Graduate medical training consortium” means an independent, nonprofit
	159	+	organization formed by 2 or more entities to operate as a sponsoring institution for
	160	+	accredited graduate medical training programs at rural hospitals in this state.
	161	+	(b) “Rural hospital” has the meaning given in s. 146.63 (1).
	162	+	(c) “Sponsoring institution” means an entity that oversees, supports, and
	163	+	administers one or more accredited graduate medical training programs.
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	190	+	SECTION 11
	191	+	SENATE BILL 643
	192	+	(2) DEPARTMENTAL DUTIES. (a) The department shall distribute grants from the
	193	+	appropriation under s. 20.435 (4) (bf) to support the operational expenses of graduate
	194	+	medical training consortia. Subject to par. (c) and sub. (3), the department shall
	195	+	distribute grants to all of the following:
	196	+	1. Graduate medical training consortia that apply to receive a grant under sub.
	197	+	(4) and that satisfy the criteria established by the department under par. (b) and the
	198	+	eligibility requirement under sub. (3).
	199	+	2. A graduate medical training consortium that received a grant under this
	200	+	paragraph in the immediately preceding fiscal year, unless the graduate medical
	201	+	training consortium no longer satisfies the criteria established by the department
	202	+	under par. (b) or the eligibility requirement under sub. (3), the consortium is not
	203	+	accredited as a sponsoring institution by the Accreditation Council for Graduate
	204	+	Medical Education, or any successor organization, or another accrediting body as
	205	+	determined by the department, or the consortium has notified the department that
	206	+	the consortium no longer wishes to receive the grant.
	207	+	(b) The department shall establish criteria for approving and distributing
	208	+	grants under par. (a). The department may not require a consortium under par. (a)
125	209		2. to apply for a grant under that subdivision.
126		-	(c) 1. The department shall distribute up to $375,000
127		-	in annual grants under par. (a) from the appropriation
128		-	under s. 20.435 (4) (bf).
129		-	2. If the department receives matching federal Medi-
130		-	cal Assistance funds, the department shall distribute
131		-	those funds for grants under par. (a) in addition to any
	210	+	(c) 1. The department shall distribute up to $375,000 in annual grants under
	211	+	par. (a) from the appropriation under s. 20.435 (4) (bf).
	212	+	2. If the department receives matching federal Medical Assistance funds, the
	213	+	department shall distribute those funds for grants under par. (a) in addition to any
132	214		funds distributed under subd. 1.
133		-	(d) In awarding grants under par. (a), the department
134		-	shall give preference to graduate medical training con-
135		-	sortia that are the sponsoring institutions for graduate
136		-	medical training programs in rural hospitals that have
137		-	limited or no direct access to graduate medical training
138		-	funding from the federal centers for medicare and medic-
139		-	aid services or have reached the maximum available
140		-	amount of graduate medical training funding from the
141		-	federal centers for medicare and medicaid services.
142		-	(3) ELIGIBILITY. A graduate medical training consor-
143		-	tium may only receive a grant under this section if the
144		-	graduate medical training consortium includes at least
	215	+	(d) In awarding grants under par. (a), the department shall give preference to
	216	+	graduate medical training consortia that are the sponsoring institutions for
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	243	+	SECTION 11 SENATE BILL 643
	244	+	graduate medical training programs in rural hospitals that have limited or no direct
	245	+	access to graduate medical training funding from the federal centers for medicare
	246	+	and medicaid services or have reached the maximum available amount of graduate
	247	+	medical training funding from the federal centers for medicare and medicaid
	248	+	services.
	249	+	(3) ELIGIBILITY. A graduate medical training consortium may only receive a
	250	+	grant under this section if the graduate medical training consortium includes at least
145	251		one partner rural hospital or health system.
146		-	(4) GRANT APPLICATION. Except as provided in sub.
147		-	(2) (a) 2., a graduate medical training consortium may
148		-	apply, in the manner determined by the department, to
149		-	receive a grant under sub. (2) (a). A graduate medical
150		-	training consortium shall identify all of the partner rural
151		-	hospitals and health systems in the consortium in its grant
152		-	application.
153		-	(5) GRANT NONRENEWAL. A graduate medical train-
154		-	ing consortium that receives a grant under sub. (2) (a)
155		-	shall notify the department, in the manner determined by
156		-	the department, if the consortium no longer satisfies the
157		-	criteria established by the department under sub. (2) (b)
158		-	or the eligibility requirement under sub. (3), the consor-
159		-	tium is not accredited as a sponsoring institution by the
160		-	Accreditation Council for Graduate Medical Education,
161		-	or any successor organization, or another accrediting
162		-	body as determined by the department, or the consortium
163		-	no longer wishes to receive the grant.
164		-	(6) ACCREDITATION. A graduate medical training
165		-	consortium shall, within 12 months of receiving a grant
166		-	under sub. (2) (a), obtain and maintain accreditation as a
167		-	sponsoring institution by the Accreditation Council for
168		-	Graduate Medical Education, or any successor organiza-
169		-	tion, or another accrediting body as determined by the
170		-	department. − 3 − 2023 Wisconsin Act 2023 Senate Bill 643
171		-	(7) EFFECT ON GRADUATE MEDICAL TRAINING EXPAN-
172		-	SION GRANTS. The receipt of a grant under this section by
173		-	a graduate medical training consortium does not affect
174		-	the eligibility for a grant under s. 146.64 of any hospital
175		-	that has an accredited graduate medical training program
176		-	facilitated, organized, or implemented by the graduate
177		-	medical training consortium.
	252	+	(4) GRANT APPLICATION. Except as provided in sub. (2) (a) 2., a graduate medical
	253	+	training consortium may apply, in the manner determined by the department, to
	254	+	receive a grant under sub. (2) (a). A graduate medical training consortium shall
	255	+	identify all of the partner rural hospitals and health systems in the consortium in its
	256	+	grant application.
	257	+	(5) GRANT NONRENEWAL. A graduate medical training consortium that receives
	258	+	a grant under sub. (2) (a) shall notify the department, in the manner determined by
	259	+	the department, if the consortium no longer satisfies the criteria established by the
	260	+	department under sub. (2) (b) or the eligibility requirement under sub. (3), the
	261	+	consortium is not accredited as a sponsoring institution by the Accreditation Council
	262	+	for Graduate Medical Education, or any successor organization, or another
	263	+	accrediting body as determined by the department, or the consortium no longer
	264	+	wishes to receive the grant.
	265	+	(6) ELIGIBILITY. A graduate medical training consortium may only receive a
	266	+	grant under this section if the graduate medical training consortium includes at least
	267	+	one partner rural hospital or health system.
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	291	+	24 - 7 -2023 - 2024 Legislature
	292	+	LRB-4860/1
	293	+	KMS:amn
	294	+	SECTION 11
	295	+	SENATE BILL 643
	296	+	(7) ACCREDITATION. A graduate medical training consortium shall, within 12
	297	+	months of receiving a grant under sub. (2) (a), obtain and maintain accreditation as
	298	+	a sponsoring institution by the Accreditation Council for Graduate Medical
	299	+	Education, or any successor organization, or another accrediting body as determined
	300	+	by the department.
	301	+	(8) EFFECT ON GRADUATE MEDICAL TRAINING EXPANSION GRANTS. The receipt of a
	302	+	grant under this section by a graduate medical training consortium does not affect
	303	+	the eligibility for a grant under s. 146.64 of any hospital that has an accredited
	304	+	graduate medical training program facilitated, organized, or implemented by the
	305	+	graduate medical training consortium.
	306	+	(END)
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