SB306-AA6,2,1810 36.25 (49g) Cultural competency training. The board shall ensure that all
11students enrolled in the University of Wisconsin-Madison School of Medicine and
12Public Health, or in any program providing instruction for a health care or social
13work occupation, receive training in cultural competency to improve
14patient-centered care, which shall include evidence-based training related to
15implicit bias and emerging evidence related to cultural humility, in order to increase
16the students' cultural awareness and to improve the students' ability to
17communicate with, and effectively deliver health care to, patients from different
18racial and ethnic backgrounds.

SB306-AA6,3,220 38.04 (32) Cultural competency training. The board shall ensure that
21technical college students enrolled in health care occupation programs receive
22training in cultural competency to improve patient-centered care, which shall
23include evidence-based training related to implicit bias and emerging evidence
24related to cultural humility, in order to increase the students' cultural awareness and

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1to improve the students' ability to communicate with, and effectively deliver health
2care to, patients from different racial and ethnic backgrounds.

SB306-AA6,3,94 48.983 (4) (a) 4m. To reimburse a case management provider under s. 49.45 (25)
5(b) for the amount of the allowable charges under the Medical Assistance program
6that is not provided by the federal government for case management services
7provided to a Medical Assistance beneficiary described in s. 49.45 (25) (am) 9. who
8is a child and who is a member of a family that receives evidence-based home
9visitation program services under par. (b) 1.

SB306-AA6,4,1411 48.983 (4) (b) Home Evidence-based home visitation program services. 1. A
12county, private agency, or Indian tribe that is selected to participate in the program
13under this section shall offer all pregnant women in the county, the area in which
14that private agency is providing services, or the reservation of the tribe who are
15eligible for Medical Assistance under subch. IV of ch. 49 an opportunity to undergo
16an assessment through use of a risk assessment instrument to determine whether
17the person assessed presents risk factors for poor birth outcomes or for perpetrating
18child abuse or neglect. Persons who agree to be assessed shall be assessed during
19the prenatal period. The risk assessment instrument shall be developed by the
20department and shall be based on risk assessment instruments developed by the
21department for similar programs that are in operation. The department need not
22promulgate as rules under ch. 227 the risk assessment instrument developed under
23this subdivision. A person who is assessed to be at risk of poor birth outcomes or of
24abusing or neglecting his or her child shall be offered evidence-based home visitation
25program services that shall be commenced during the prenatal period. Home

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1Evidence-based home visitation program services may be provided to a family with
2a child identified as being at risk of child abuse or neglect until the identified child
3reaches 3 years of age. If a family has been receiving evidence-based home visitation
4program services continuously for not less than 12 months, those services may
5continue to be provided to the family until the identified child reaches 3 years of age,
6regardless of whether the child continues to be eligible for Medical Assistance under
7subch. IV of ch. 49. If risk factors for child abuse or neglect with respect to the
8identified child continue to be present when the child reaches 3 years of age,
9evidence-based home visitation program services may be provided until the
10identified child reaches 5 years of age. Home Evidence-based home visitation
11program services may not be provided to a person unless the person gives his or her
12written informed consent to receiving those services or, if the person is a child, unless
13the child's parent, guardian, or legal custodian gives his or her written informed
14consent for the child to receive those services.

SB306-AA6,4,1815 1m. No person who is required or permitted to report suspected or threatened
16abuse or neglect under s. 48.981 (2) may make or threaten to make such a report
17based on a refusal of a person to receive or to continue receiving evidence-based
18home visitation program services under subd. 1.

SB306-AA6,4,2219 3. A county, private agency, or Indian tribe that is providing evidence-based
20home visitation program services under subd. 1. shall provide to a person receiving
21those services the information relating to shaken baby syndrome and impacted
22babies required under s. 253.15 (6).

SB306-AA6,5,3

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148.983 (6) (a) (intro.) The part of an application, other than a renewal
2application, submitted by a county, private agency, or Indian tribe that relates to
3evidence-based home visitation programs shall include all of the following:

SB306-AA6,5,115 48.983 (6) (a) 1. Information on how the applicant's home visitation program
6is evidence-based, comprehensive, incorporates practice standards that have been
7developed for home visitation programs by entities concerned with the prevention of
8poor birth outcomes and child abuse and neglect and that are acceptable to the
9department, and incorporates practice standards and critical elements that have
10been developed for successful home visitation programs by a nationally recognized
11home visitation program model and that are acceptable to the department.

SB306-AA6,5,1813 48.983 (6) (a) 2. Documentation that the application was developed through
14collaboration among public and private organizations that provide services to
15children and families, especially children who are at risk of child abuse or neglect and
16families that are at risk of poor birth outcomes, or that are otherwise interested in
17child welfare and a description of how that collaboration effort will support a
18comprehensive, evidence-based home visitation program.

SB306-AA6,5,2420 48.983 (6) (a) 3. An identification of existing poor birth outcome and child abuse
21and neglect prevention services that are available to residents of the county, the area
22in which the private agency is providing services, or the reservation of the Indian
23tribe and a description of how those services and any additional needed services will
24support a comprehensive, evidence-based home visitation program.

SB306-AA6,6,4

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148.983 (6) (a) 4. An explanation of how the evidence-based home visitation
2program will build on existing poor birth outcome and child abuse and neglect
3prevention programs, including programs that provide support to families, and how
4the evidence-based home visitation program will coordinate with those programs.

SB306-AA6,6,86 48.983 (6) (a) 4m. An explanation of how the applicant will encourage private
7organizations to provide services under the applicant's evidence-based home
8visitation program.

SB306-AA6,6,1410 48.983 (6) (a) 6. An identification of how the evidence-based home visitation
11program is comprehensive and incorporates the practice standards and critical
12elements for successful home visitation programs referred to in subd. 1., including
13how services will vary in intensity levels depending on the needs and strengths of the
14participating family.

SB306-AA6,6,1816 48.983 (6) (a) 6m. An explanation of how the services to be provided under the
17evidence-based home visitation program, including the risk assessment under sub.
18(4) (b) 1., will be provided in a culturally competent manner.

SB306-AA6,7,520 48.983 (6) (b) 1. `Flexible fund for evidence-based home visitation programs.'
21The applicant demonstrates in the application that the applicant has established, or
22has plans to establish, if selected, a fund from which payments totaling not less than
23$250 per calendar year may be made for appropriate expenses of each family that is
24participating in the evidence-based home visitation program under sub. (4) (b) 1. or
25that is receiving home visitation services under s. 49.45 (44). The payments shall be

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1authorized by an individual designated by the applicant. If an applicant makes a
2payment to or on behalf of a family under this subdivision, one-half of the payment
3shall be from grant moneys received under this section and one-half of the payment
4shall be from moneys provided by the applicant from sources other than grant
5moneys received under this section.

SB306-AA6,7,127 48.983 (6) (c) Case management benefit. The applicant states in the grant
8application that it has elected, or, if selected, that it will elect, under s. 49.45 (25) (b),
9to make the case management benefit under s. 49.45 (25) available to the category
10of beneficiaries under s. 49.45 (25) (am) 9. who are children and who are members
11of families receiving evidence-based home visitation program services under sub. (4)
12(b) 1.

SB306-AA6,7,2314 48.983 (6g) (a) Except as permitted or required under s. 48.981 (2), no person
15may use or disclose any information concerning any individual who is selected for an
16assessment under sub. (4) (b), including an individual who declines to undergo the
17assessment, or concerning any individual who is offered services under a an
18evidence-based home visitation program funded under this section, including an
19individual who declines to receive those services, unless the use or disclosure is
20connected with the administration of the evidence-based home visitation program
21or the administration of the Medical Assistance program under ss. 49.43 to 49.497
22or unless the individual has given his or her written informed consent to the use or
23disclosure.

SB306-AA6,8,424 (b) A county, private agency, or Indian tribe that is selected to participate in the
25program under this section shall provide or shall designate an individual or entity

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1to provide an explanation of the confidentiality requirements under par. (a) to each
2individual who is offered an assessment under sub. (4) (b) or who is offered services
3under the evidence-based home visitation program of the county, private agency, or
4Indian tribe.

SB306-AA6,8,146 48.983 (6m) Notification of parent prior to making abuse or neglect report.
7If a person who is providing services under a an evidence-based home visitation
8program under sub. (4) (b) 1. determines that he or she is required or permitted to
9make a report under s. 48.981 (2) about a child in a family to which the person is
10providing those services, the person shall, prior to making the report under s. 48.981
11(2), make a reasonable effort to notify the child's parent that a report under s. 48.981
12(2) will be made and to encourage the parent to contact a county department to
13request assistance. The notification requirements under this subsection do not affect
14the reporting requirements under s. 48.981 (2).

SB306-AA6,8,2016 48.983 (6r) Home Evidence-based home visitation program informational
17materials. Any informational materials about a an evidence-based home visitation
18program under sub. (4) (b) 1. that are distributed to a person who is offered or who
19is receiving home visitation program services under that program shall state the
20sources of funding for the program.

SB306-AA6,9,223 48.983 (7) (title) Home Evidence-based home visitation program evaluation.
24(a) (intro.) The department shall conduct or shall select an evaluator to conduct an
25evaluation of the evidence-based home visitation program. The evaluation shall

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1measure all of the following criteria in families that have participated in the home
2visitation that program and that are selected for evaluation:

SB306-AA6,9,84 48.983 (7) (ag) The department shall evaluate the availability of
5evidence-based home visitation programs in the state and determine whether there
6are gaps in home visitation services in the state. The department shall cooperate
7with counties, private agencies, and Indian tribes providing evidence-based home
8visitation programs to address any gaps in services identified.

SB306-AA6,9,1410 48.983 (7) (ar) Each county, private agency, and Indian tribe providing a an
11evidence-based home visitation program shall collect and report data to the
12department, as required by the department. The department shall require each
13county, private agency, and Indian tribe providing a an evidence-based home
14visitation program to collect data using forms prescribed by the department.

SB306-AA6,9,1816 48.983 (7) (b) In the evaluation, the department shall determine the number
17of families who remained in the evidence-based home visitation program for the time
18recommended in the family's case plan.

SB306-AA6,9,2520 48.983 (7) (c) Each county, private agency, and Indian tribe providing a an
21evidence-based home visitation program shall develop a plan for evaluating the
22effectiveness of its program for approval by the department. The plan shall
23demonstrate how the county, private agency, or Indian tribe will use the evaluation
24of its program to improve the quality and outcomes of the program and to ensure
25continued compliance with the home visitation program criteria under sub. (6) (a).

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1The plan shall demonstrate how the outcomes will be tracked and measured. Under
2the plan, the extent to which all of the following outcomes are achieved shall be
3tracked and measured:

SB306-AA6,10,64 1. Parents receiving evidence-based home visitation services acquiring
5knowledge of early learning and child development and interacting with their
6children in ways that enhance the children's development and early learning.

SB306-AA6,10,77 2. Children receiving evidence-based home visitation services being healthy.

SB306-AA6,10,98 3. Children receiving evidence-based home visitation services living in a safe
9environment.

SB306-AA6,10,1110 4. Families receiving evidence-based home visitation services accessing formal
11and informal support networks.

SB306-AA6,10,1312 5. Children receiving evidence-based home visitation services achieving
13milestones in development and early learning.

SB306-AA6,10,1514 6. Children receiving evidence-based home visitation services who have
15developmental delays receiving appropriate intervention services.

SB306-AA6,10,2417 48.983 (8) Technical assistance and training. The department shall provide
18technical assistance and training to counties, private agencies, and Indian tribes
19that are selected to participate in the program under this section. The training may
20not be limited to a particular evidence-based home visitation model. The training
21shall include training in best practices regarding basic skills, uniform
22administration of screening and assessment tools, the issues and challenges that
23families face, and supervision and personnel skills for program managers. The
24training may also include training on data collection and reporting.

SB306-AA6,11,4

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148.983 (9) Memorandum of understanding. The department shall enter into
2a memorandum of understanding with the department of health services that
3provides for collaboration between those departments in carrying out
4evidence-based home visiting programs under sub. (4) (b) 1.

SB306-AA6,11,186 49.45 (24w) Services for pregnant women. (a) The department shall request
7a wavier of federal Medicaid law from the secretary of the federal department of
8health and human services to permit the department to provide services and support
9under medical assistance for pregnant women who face an increased risk of having
10a low-birth weight baby, a preterm birth, or other negative birth outcome because
11of medical or nonmedical factors, such as psychosocial, behavioral, environmental,
12educational, or nutritional factors. The department shall implement the programs
13and services authorized by this waiver in Milwaukee, Racine, Kenosha, Rock, and
14Dane counties, and in a rural multicounty region identified by the department in
15collaboration with the Great Lakes Intertribal Council. The multicounty region
16shall include counties experiencing the largest disparities in birth outcomes between
17Caucasian and Native American populations and shall be of sufficient size to enable
18meaningful implementation and evaluation of the programs and services.

SB306-AA6,11,2019 (b) The department shall consider including all of the following as covered
20services or programs in the waiver request under par. (a):

SB306-AA6,11,2321 1. Evidence-based social marketing of programs designed to reduce fetal and
22infant mortality, improve birth outcomes, and address needs of infants and their
23families.

SB306-AA6,11,2524 2. Evidence-based social-support programs, including fatherhood initiatives
25designed to reduce fetal and infant mortality and improve birth outcomes.

SB306-AA6,12,4

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13. Transportation services for persons who accompany a pregnant woman to
2prenatal appointments and transportation for the pregnant woman and her children
3to other destinations including social services' offices and locations where child care
4is provided for her children.

SB306-AA6,12,85 4. Data collection, including the pregnancy risk assessment and monitoring
6system, fetal and infant mortality review, vital statistics information, information
7from medical assistance data and chart reviews, and an assessment of nonmedical
8factors that may contribute to poor birth outcomes.

SB306-AA6,12,109 5. Full reimbursement for evidence-based group prenatal care, such as the
10Centering Pregnancy program.

SB306-AA6,12,1111 6. Mental health services.

SB306-AA6,12,1212 7. Smoking cessation services.

SB306-AA6,12,1513 8. Initiatives to increase the utilization of public health and other health care
14providers with similar racial and socioeconomic backgrounds as the pregnant women
15and families served by the health care provider.

SB306-AA6,12,2016 9. Coordinators to create social care plans for medical assistance recipients, to
17provide information and assistance regarding all programs that may impact
18low-income pregnant women, including programs regarding rental assistance, the
19earned income tax credit, available child care services for a pregnant woman's other
20children, and to provide breastfeeding support.

SB306-AA6,12,2321 10. Demonstration projects developed by the department, to evaluate the
22effectiveness of evidence-based programs designed to serve under-served
23populations.

SB306-AA6,13,3

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111. One or more initiatives, developed by the department, to increase the
2utilization of nurse-midwives licensed under s. 441.15 (3) and doulas in the delivery
3of care to underserved populations and to evaluate the outcomes of that care.

SB306-AA6,13,44 12. The establishment of freestanding birth centers.

SB306-AA6,13,85 13. Extension of the prenatal care coordination services that are available as
6a medical assistance benefit from the beginning of pregnancy to the first day of the
713th month after delivery and specifying that prenatal care coordination services are
8available to recipients' babies during that time period.

SB306-AA6,13,109 14. Expansion and full reimbursement of evidence-based, home-based
10prenatal care coordination services.

SB306-AA6,13,1511 15. Full reimbursement for home visits made by registered nurses who are
12public health nurses or who meet the qualifications of a public health nurse as
13specified in s. 250.06 (1), by social workers as defined in s. 252.15 (1) (er),
14nurse-midwives licensed under s. 441.15 (3), and by persons who receive the training
15established under s. 38.04 (32).

SB306-AA6,13,1716 16. Reimbursement of care provided through telemedicine visits on the same
17basis that reimbursement is provided for in-person visits.

SB306-AA6,13,1918 17. Reimbursement of the costs of providing banked human donor milk to
19newborns when medically indicated.

SB306-AA6,13,2220 (c) The department shall evaluate the programs and services implemented
21under the waiver and develop a plan to implement the programs and services
22statewide.

SB306-AA6,13,2523 (d) The department shall consider prohibiting reimbursement for elective
24induction of labor or cesarean sections if either procedure is performed before 39
25weeks gestation, unless medically indicated.

SB306-AA6,14,3 249.815 Statewide data management and information system. (1) The
3department of health services shall do all of the following:

SB306-AA6,14,94 (a) Expand the department's electronic application and information system
5that enables an individual to determine his or her eligibility for, and to apply for or
6renew, benefits under the Medical Assistance program or other public assistance
7benefits. The system shall include information regarding all programs designed to
8assist low-income individuals, including housing assistance, rental assistance, and
9temporary child care assistance.

SB306-AA6,14,1110 (b) Develop and implement a statewide, electronic data management and
11information system for public assistance programs that does all of the following:

SB306-AA6,14,1312 1. Determines a person's eligibility for multiple public assistance programs by
13means of a single registration or application.

SB306-AA6,14,1614 2. Allows administrators of public assistance programs to access data related
15to an individual that was previously collected in connection with a different public
16assistance program.

SB306-AA6,14,1817 3. Provides a single, automated care plan identifying a comprehensive array
18of service activities needed to address the assessed risks for an individual.

SB306-AA6,14,2119 4. Provides a scheduling or referral system that matches an individual's service
20needs with available health care, public assistance, or economic assistance
21providers.

SB306-AA6,14,25 22(2) The department of health services shall develop a detailed plan to
23implement an expanded system under sub. (1) (a) no later than 12 months after the
24effective date of this subsection .... [LRB inserts date]. The plan shall contain cost
25estimates and a proposed timeline for implementation.

SB306-AA6,15,4

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1(3) The department of health services shall collaborate with appropriate state
2agencies to expand the system under sub. (1) (a) and to develop and implement the
3system under sub. (1) (b). State agencies shall cooperate with the department on
4these projects.