Date of enactment:
2023 Senate Bill 643 Date of publication*:
2023 WISCONSIN ACT
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
(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)
(a) 2., 146.64 (3m) and 146.645 of the statutes; relating to: expanding graduate medical training grants and making
an appropriation.
The people of the state of Wisconsin, represented in
senate and assembly, do enact as follows:
SECTION 1. 20.435 (4) (bf) of the statutes is amended
to read:
20.435 (4) (bf) Graduate medical training support
grants. As a continuing appropriation, the amounts in the
schedule to award grants to rural hospitals under s.
146.63, and to support graduate medical training pro-
grams under s. 146.64, and to support graduate medical
training consortia under s. 146.645.
SECTION 2. 146.63 (6) (intro.) of the statutes is
renumbered 146.63 (6) and amended to read:
146.63 (6) ELIGIBILITY. A rural hospital or group of
rural hospitals may only receive a grant under sub. (3) if
the plan to use the funds involves developing an accred-
ited graduate medical training program in a specialty,
including any of the following:.
SECTION 3. 146.63 (6) (a) to (e) of the statutes are
repealed.
SECTION 4. 146.64 (2) (a) of the statutes is renum-
bered 146.64 (2) (a) (intro.) and amended to read:
146.64 (2) (a) (intro.) Subject to par. (c) and sub. (4),
the department shall distribute grants to hospitals to fund
the addition of positions to existing accredited graduate
medical training programs. The department shall distrib-
ute the grants under this paragraph to hospitals all of the
following:
1. Hospitals that apply to receive a grant under sub.
(3) and that satisfy the criteria established by the depart-
ment under par. (b) and the eligibility requirement under
sub. (4).
SECTION 5. 146.64 (2) (a) 2. of the statutes is created
to read:
146.64 (2) (a) 2. Hospitals that received a grant under
this paragraph in the immediately preceding fiscal year,
unless the hospital no longer satisfies the criteria estab-
lished by the department under par. (b), the hospital no
longer has an accredited graduate medical training pro-
gram, or the hospital has notified the department that the
hospital no longer wishes to receive the grant. The
department may not require a hospital under this subdivi-
sion to apply for a grant under this paragraph.
SECTION 6. 146.64 (2) (c) 1. of the statutes is
amended to read:
146.64 (2) (c) 1. The department shall distribute
funds for grants under par. (a) from the appropriation
under s. 20.435 (4) (bf). The department may not distrib-
ute more than $225,000 from the appropriation under s.
20.435 (4) (bf) to a particular hospital in a given state fis-
cal year and may not distribute more than $75,000 from
* 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
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
the appropriation under s. 20.435 (4) (bf) to fund a given
position in a graduate medical training program in a
given state fiscal year.
SECTION 7. 146.64 (3) of the statutes is amended to
read:
146.64 (3) GRANT APPLICATION. A Except as pro-
vided in sub. (2) (a) 2., a hospital may apply, in the form
and manner determined by the department, to receive a
grant under sub. (2) (a).
SECTION 8. 146.64 (3m) of the statutes is created to
read:
146.64 (3m) GRANT NONRENEWAL. A hospital that
receives a grant under sub. (2) (a) shall notify the depart-
ment, in the manner determined by the department, if the
hospital no longer satisfies the criteria established by the
department under sub. (2) (b), the hospital no longer has
an accredited graduate medical training program, or the
hospital no longer wishes to receive the grant.
SECTION 9. 146.64 (4) (intro.) of the statutes is
renumbered 146.64 (4) and amended to read:
146.64 (4) ELIGIBILITY. A hospital that has an accred-
ited graduate medical training program in a specialty,
including any of the following, may apply to receive a
grant under sub. (3):.
SECTION 10. 146.64 (4) (a) to (e) of the statutes are
repealed.
SECTION 11. 146.645 of the statutes is created to read:
146.645 Grants to support the establishment or
operation of graduate medical training consortia. (1)
DEFINITIONS. In this section:
(a) “Graduate medical training consortium” means
an independent, nonprofit organization formed by 2 or
more entities to operate as a sponsoring institution for
accredited graduate medical training programs at rural
hospitals in this state.
(b) “Rural hospital” has the meaning given in s.
146.63 (1).
(c) “Sponsoring institution” means an entity that
oversees, supports, and administers one or more accred-
ited graduate medical training programs.
(2) DEPARTMENTAL DUTIES. (a) The department shall
distribute grants from the appropriation under s. 20.435
(4) (bf) to support the operational expenses of graduate
medical training consortia. Subject to par. (c) and sub.
(3), the department shall distribute grants to all of the fol-
lowing:
1. Graduate medical training consortia that apply to
receive a grant under sub. (4) and that satisfy the criteria
established by the department under par. (b) and the eligi-
bility requirement under sub. (3).
2. A graduate medical training consortium that
received a grant under this paragraph in the immediately
preceding fiscal year, unless the graduate medical train-
ing consortium no longer satisfies the criteria established
by the department under par. (b) or the eligibility require-
ment under sub. (3), the consortium is not accredited as
a sponsoring institution by the Accreditation Council for
Graduate Medical Education, or any successor organiza-
tion, or another accrediting body as determined by the
department, or the consortium has notified the depart-
ment that the consortium no longer wishes to receive the
grant.
(b) The department shall establish criteria for
approving and distributing grants under par. (a). The
department may not require a consortium under par. (a)
2. to apply for a grant under that subdivision.
(c) 1. The department shall distribute up to $375,000
in annual grants under par. (a) from the appropriation
under s. 20.435 (4) (bf).
2. If the department receives matching federal Medi-
cal Assistance funds, the department shall distribute
those funds for grants under par. (a) in addition to any
funds distributed under subd. 1.
(d) In awarding grants under par. (a), the department
shall give preference to graduate medical training con-
sortia that are the sponsoring institutions for graduate
medical training programs in rural hospitals that have
limited or no direct access to graduate medical training
funding from the federal centers for medicare and medic-
aid services or have reached the maximum available
amount of graduate medical training funding from the
federal centers for medicare and medicaid services.
(3) ELIGIBILITY. A graduate medical training consor-
tium may only receive a grant under this section if the
graduate medical training consortium includes at least
one partner rural hospital or health system.
(4) GRANT APPLICATION. Except as provided in sub.
(2) (a) 2., a graduate medical training consortium may
apply, in the manner determined by the department, to
receive a grant under sub. (2) (a). A graduate medical
training consortium shall identify all of the partner rural
hospitals and health systems in the consortium in its grant
application.
(5) GRANT NONRENEWAL. A graduate medical train-
ing consortium that receives a grant under sub. (2) (a)
shall notify the department, in the manner determined by
the department, if the consortium no longer satisfies the
criteria established by the department under sub. (2) (b)
or the eligibility requirement under sub. (3), the consor-
tium is not accredited as a sponsoring institution by the
Accreditation Council for Graduate Medical Education,
or any successor organization, or another accrediting
body as determined by the department, or the consortium
no longer wishes to receive the grant.
(6) ACCREDITATION. A graduate medical training
consortium shall, within 12 months of receiving a grant
under sub. (2) (a), obtain and maintain accreditation as a
sponsoring institution by the Accreditation Council for
Graduate Medical Education, or any successor organiza-
tion, or another accrediting body as determined by the
department. − 3 − 2023 Wisconsin Act 2023 Senate Bill 643
(7) EFFECT ON GRADUATE MEDICAL TRAINING EXPAN-
SION GRANTS. The receipt of a grant under this section by
a graduate medical training consortium does not affect
the eligibility for a grant under s. 146.64 of any hospital
that has an accredited graduate medical training program
facilitated, organized, or implemented by the graduate
medical training consortium.