2025 - 2026 LEGISLATURE
LRB-2329/1
SWB:skw
2025 ASSEMBLY BILL 115
March 11, 2025 - Introduced by JOINT LEGISLATIVE COUNCIL. Referred to
Committee on Mental Health and Substance Abuse Prevention.
***AUTHORS SUBJECT TO CHANGE***
AN ACT to create 49.45 (29t) and 49.46 (2) (b) 14r. of the statutes; relating to:
authorizing youth behavioral health program under the Medical Assistance
program and granting rule-making authority.
Analysis by the Legislative Reference Bureau
This bill is explained in the NOTES provided by the Joint Legislative Council in
the bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
JOINT LEGISLATIVE COUNCIL PREFATORY NOTE: This bill was prepared for the
Joint Legislative Council Study Committee on Emergency Detention and Civil
Commitment of Minors.
The bill authorizes the Department of Health Services (DHS) to create a new
youth behavioral health Medical Assistance (MA) program. The program is expected to
coordinate access and services across programs for children and youth under age 21
who are experiencing complex behavioral health needs, particularly in multiple systems
of care.
To accomplish this, the bill directs DHS to collaborate with the Departments of
Children and Families and Public Instruction, Office of Children[s Mental Health,
DHS[s XChildren Come FirstY advisory committee, and county human or social services
agencies, to create the new MA program. DHS must also seek feedback from county
1
2
3 2025 - 2026 Legislature
ASSEMBLY BILL 115
- 2 - LRB-2329/1
SWB:skw
SECTION 1
human or social services agencies on the operability of the proposed funding structure
under the MA program. DHS may submit an MA waiver or state plan amendment to
the U.S. Department of Health and Human Services to provide reimbursement for the
services, and implementation of the program is contingent on that approval.
The bill specifies that the goal of the new program is to keep families supported
in the community and to prevent institutionalization and out of home care placement.
In furtherance of that goal, the bill directs DHS to design the program to provide
services that include any of the following: mobile response and stabilization services,
intensive home-based treatment, behavioral health services (including inpatient
behavioral health services), psychiatric residential treatment facilities, substance use
disorder services, psychiatry services, outpatient services, and developmental
disabilities services. DHS must ensure that care management is delivered according to
the child[s or youth[s and the family[s needs.
Care coordination under the program must be provided on a regional basis (as
determined by DHS), by community-based organizations or county human or social
services agencies. DHS may procure a single, statewide managed care plan that is
responsible for building a sufficient provider network to ensure access to behavioral
health services, including residential treatment services and home and community-
based services, in order to offer a full continuum of behavioral health care. DHS or a
managed care organization may manage administrative care coordination, utilization
management, and quality improvement efforts.
Lastly, the bill specifies that DHS may promulgate rules to implement the
program, may establish standards and enforce staffing, network adequacy, and
complaint and grievance requirements, and is authorized to add one full-time
equivalent project position for the purpose of developing and implementing the
program.
SECTION 1. 49.45 (29t) of the statutes is created to read:
49.45 (29t) YOUTH BEHAVIORAL HEALTH PROGRAM. (a) In this subsection,
XprogramY means the youth behavioral health program described under par. (b).
(b) The department shall collaborate with the department of children and
families, the department of public instruction, the office of children[s mental health
in the department of health services, the state advisory committee under s. 46.56
(14) (a), and county human or social services agencies to create, under the Medical
Assistance program, a program that coordinates access and services across
programs for individuals under the age of 21 who are experiencing complex
behavioral health needs. The department shall seek feedback from county human
or social services agencies on the operability of the proposed funding structure
under the Medical Assistance program.
1
2
3
4
5
6
7
8
9
10
11
12 2025 - 2026 Legislature
ASSEMBLY BILL 115
- 3 - LRB-2329/1
SWB:skw
SECTION 1
(c) The department shall ensure that the program addresses the behavioral
health needs of individuals under the age of 21 who have complex, multisystem
needs, with the goal of keeping families supported in the community and
preventing institutionalization and out-of-home care placement. The department
shall ensure that care management under the program is delivered according to the
needs of the child or youth and of the family of the child or youth.
(d) The department shall design the program to provide services, including
any of the following:
1. Mobile response and stabilization services.
2. Intensive home-based treatment.
3. Behavioral health services, including inpatient behavioral health services.
4. Psychiatric residential treatment facilities.
5. Substance use disorder services.
6. Psychiatry services.
7. Outpatient services.
8. Developmental disabilities services.
(e) Care coordination through the program shall be provided on a regional
basis, as determined by the department, by community-based organizations or
county human or social services agencies. The department may procure a single,
statewide managed care plan that builds a sufficient provider network to ensure
access to behavioral health services, including residential treatment services and
home and community-based services, in order to offer a full continuum of
behavioral health care. The department or a managed care organization may
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23 2025 - 2026 Legislature
ASSEMBLY BILL 115
- 4 - LRB-2329/1
SWB:skw
SECTION 1
manage administrative care coordination, utilization management, and quality
improvement efforts under this paragraph.
(f) The department may promulgate rules to implement the program and may
establish standards and enforce staffing, network adequacy, and complaint and
grievance requirements.
(g) The department may submit to the federal department of health and
human services any request for a state plan amendment, waiver, or other federal
approval necessary to provide reimbursement for services under s. 49.46 (2) (b) 14r.
The department may implement the program under this subsection and provide
reimbursement under s. 49.46 (2) (b) 14r. only if any necessary federal approval
from the federal department of health and human services under this paragraph is
granted or if no federal approval is required. If federal approval is necessary but is
not granted, the department may not provide reimbursement for services under s.
49.46 (2) (b) 14r.
SECTION 2. 49.46 (2) (b) 14r. of the statutes is created to read:
49.46 (2) (b) 14r. Youth behavioral health services, as specified under s. 49.45
(29t).
SECTION 3. Nonstatutory provisions.
(1) POSITION AUTHORIZATION FOR THE DEPARTMENT OF HEALTH SERVICES. The
authorized FTE positions for the department of health services are increased by 1.0
GPR project position, to be funded from the appropriation under s. 20.435 (4) (b), for
the purpose of developing and, subject to the approval requirements of s. 49.45 (29t)
(g), implementing the youth behavioral health program under s. 49.45 (29t).
(END)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24