Wisconsin 2025-2026 Regular Session

Wisconsin Assembly Bill AB115 Compare Versions

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

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1	1	2025 - 2026 LEGISLATURE
2	2	LRB-2329/1
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4	4	2025 ASSEMBLY BILL 115
5	5	March 11, 2025 - Introduced by JOINT LEGISLATIVE COUNCIL. Referred to
6	6	Committee on Mental Health and Substance Abuse Prevention.
7	7
8	8	*AUTHORS SUBJECT TO CHANGE*
9	9	AN ACT to create 49.45 (29t) and 49.46 (2) (b) 14r. of the statutes; relating to:
10	10	authorizing youth behavioral health program under the Medical Assistance
11	11	program and granting rule-making authority.
12	12	Analysis by the Legislative Reference Bureau
13	13	This bill is explained in the NOTES provided by the Joint Legislative Council in
14	14	the bill.
15	15	The people of the state of Wisconsin, represented in senate and assembly, do
16	16	enact as follows:
17	17	JOINT LEGISLATIVE COUNCIL PREFATORY NOTE: This bill was prepared for the
18	18	Joint Legislative Council Study Committee on Emergency Detention and Civil
19	19	Commitment of Minors.
20	20	The bill authorizes the Department of Health Services (DHS) to create a new
21	21	youth behavioral health Medical Assistance (MA) program. The program is expected to
22	22	coordinate access and services across programs for children and youth under age 21
23	23	who are experiencing complex behavioral health needs, particularly in multiple systems
24	24	of care.
25	25	To accomplish this, the bill directs DHS to collaborate with the Departments of
26	26	Children and Families and Public Instruction, Office of Children[s Mental Health,
27	27	DHS[s XChildren Come FirstY advisory committee, and county human or social services
28	28	agencies, to create the new MA program. DHS must also seek feedback from county
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31	31	3 2025 - 2026 Legislature
32	32	ASSEMBLY BILL 115
33	33	- 2 - LRB-2329/1
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35	35	SECTION 1
36	36	human or social services agencies on the operability of the proposed funding structure
37	37	under the MA program. DHS may submit an MA waiver or state plan amendment to
38	38	the U.S. Department of Health and Human Services to provide reimbursement for the
39	39	services, and implementation of the program is contingent on that approval.
40	40	The bill specifies that the goal of the new program is to keep families supported
41	41	in the community and to prevent institutionalization and out of home care placement.
42	42	In furtherance of that goal, the bill directs DHS to design the program to provide
43	43	services that include any of the following: mobile response and stabilization services,
44	44	intensive home-based treatment, behavioral health services (including inpatient
45	45	behavioral health services), psychiatric residential treatment facilities, substance use
46	46	disorder services, psychiatry services, outpatient services, and developmental
47	47	disabilities services. DHS must ensure that care management is delivered according to
48	48	the child[s or youth[s and the family[s needs.
49	49	Care coordination under the program must be provided on a regional basis (as
50	50	determined by DHS), by community-based organizations or county human or social
51	51	services agencies. DHS may procure a single, statewide managed care plan that is
52	52	responsible for building a sufficient provider network to ensure access to behavioral
53	53	health services, including residential treatment services and home and community-
54	54	based services, in order to offer a full continuum of behavioral health care. DHS or a
55	55	managed care organization may manage administrative care coordination, utilization
56	56	management, and quality improvement efforts.
57	57	Lastly, the bill specifies that DHS may promulgate rules to implement the
58	58	program, may establish standards and enforce staffing, network adequacy, and
59	59	complaint and grievance requirements, and is authorized to add one full-time
60	60	equivalent project position for the purpose of developing and implementing the
61	61	program.
62	62	SECTION 1. 49.45 (29t) of the statutes is created to read:
63	63	49.45 (29t) YOUTH BEHAVIORAL HEALTH PROGRAM. (a) In this subsection,
64	64	XprogramY means the youth behavioral health program described under par. (b).
65	65	(b) The department shall collaborate with the department of children and
66	66	families, the department of public instruction, the office of children[s mental health
67	67	in the department of health services, the state advisory committee under s. 46.56
68	68	(14) (a), and county human or social services agencies to create, under the Medical
69	69	Assistance program, a program that coordinates access and services across
70	70	programs for individuals under the age of 21 who are experiencing complex
71	71	behavioral health needs. The department shall seek feedback from county human
72	72	or social services agencies on the operability of the proposed funding structure
73	73	under the Medical Assistance program.
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86	86	ASSEMBLY BILL 115
87	87	- 3 - LRB-2329/1
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89	89	SECTION 1
90	90	(c) The department shall ensure that the program addresses the behavioral
91	91	health needs of individuals under the age of 21 who have complex, multisystem
92	92	needs, with the goal of keeping families supported in the community and
93	93	preventing institutionalization and out-of-home care placement. The department
94	94	shall ensure that care management under the program is delivered according to the
95	95	needs of the child or youth and of the family of the child or youth.
96	96	(d) The department shall design the program to provide services, including
97	97	any of the following:
98	98	1. Mobile response and stabilization services.
99	99	2. Intensive home-based treatment.
100	100	3. Behavioral health services, including inpatient behavioral health services.
101	101	4. Psychiatric residential treatment facilities.
102	102	5. Substance use disorder services.
103	103	6. Psychiatry services.
104	104	7. Outpatient services.
105	105	8. Developmental disabilities services.
106	106	(e) Care coordination through the program shall be provided on a regional
107	107	basis, as determined by the department, by community-based organizations or
108	108	county human or social services agencies. The department may procure a single,
109	109	statewide managed care plan that builds a sufficient provider network to ensure
110	110	access to behavioral health services, including residential treatment services and
111	111	home and community-based services, in order to offer a full continuum of
112	112	behavioral health care. The department or a managed care organization may
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135	135	23 2025 - 2026 Legislature
136	136	ASSEMBLY BILL 115
137	137	- 4 - LRB-2329/1
138	138	SWB:skw
139	139	SECTION 1
140	140	manage administrative care coordination, utilization management, and quality
141	141	improvement efforts under this paragraph.
142	142	(f) The department may promulgate rules to implement the program and may
143	143	establish standards and enforce staffing, network adequacy, and complaint and
144	144	grievance requirements.
145	145	(g) The department may submit to the federal department of health and
146	146	human services any request for a state plan amendment, waiver, or other federal
147	147	approval necessary to provide reimbursement for services under s. 49.46 (2) (b) 14r.
148	148	The department may implement the program under this subsection and provide
149	149	reimbursement under s. 49.46 (2) (b) 14r. only if any necessary federal approval
150	150	from the federal department of health and human services under this paragraph is
151	151	granted or if no federal approval is required. If federal approval is necessary but is
152	152	not granted, the department may not provide reimbursement for services under s.
153	153	49.46 (2) (b) 14r.
154	154	SECTION 2. 49.46 (2) (b) 14r. of the statutes is created to read:
155	155	49.46 (2) (b) 14r. Youth behavioral health services, as specified under s. 49.45
156	156	(29t).
157	157	SECTION 3. Nonstatutory provisions.
158	158	(1) POSITION AUTHORIZATION FOR THE DEPARTMENT OF HEALTH SERVICES. The
159	159	authorized FTE positions for the department of health services are increased by 1.0
160	160	GPR project position, to be funded from the appropriation under s. 20.435 (4) (b), for
161	161	the purpose of developing and, subject to the approval requirements of s. 49.45 (29t)
162	162	(g), implementing the youth behavioral health program under s. 49.45 (29t).
163	163	(END)
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