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In this subsection, “crisis intervention services” means crisis intervention services for the treatment of mental illness, intellectual disability, substance abuse, and dementia that are provided by any of the following: 1. A crisis urgent care and observation facility certified under s. 51.036. 2. A crisis intervention program operated by, or under contract with, a county, if the county is certified as a medical assistance provider.
A crisis urgent care and observation facility certified under s. 51.036.
A crisis intervention program operated by, or under contract with, a county, if the county is certified as a medical assistance provider.
If a county elects to become certified as a provider of crisis intervention services under par. (a) 2., the county may provide crisis intervention services under this subsection in the county to medical assistance recipients through the medical assistance program. A county that elects to provide the services shall pay the amount of the allowable charges for the services under the medical assistance program that is not provided by the federal government. The department shall reimburse the county under this subsection only for the amount of the allowable charges for those services under the medical assistance program that is provided by the federal government.
Notwithstanding par. (b), if a county elects, pursuant to par. (a) 2., to deliver crisis intervention services under the Medical Assistance program on a regional basis according to criteria established by the department, all of the following apply: 1. After January 1, 2020, the department shall require the county to annually contribute for the crisis intervention services an amount equal to 75 percent of the annual average of the county’s expenditures for crisis intervention services under this subsection as determined by the department. 2. The department shall reimburse the provider of crisis intervention services in the county the amount of allowable charges for those services under the Medical Assistance program, including both the federal share and nonfederal share of those charges, that exceeds the amount of the county contribution required under subd. 1. 3. If a county submits a certified cost report under sub. (52) (b) to claim federal medical assistance funds, the claim based on certified costs made by a county for amounts under subd. 2. cannot include any part of the nonfederal share of the amount under subd. 2.
After January 1, 2020, the department shall require the county to annually contribute for the crisis intervention services an amount equal to 75 percent of the annual average of the county’s expenditures for crisis intervention services under this subsection as determined by the department.
The department shall reimburse the provider of crisis intervention services in the county the amount of allowable charges for those services under the Medical Assistance program, including both the federal share and nonfederal share of those charges, that exceeds the amount of the county contribution required under subd. 1.
If a county submits a certified cost report under sub. (52) (b) to claim federal medical assistance funds, the claim based on certified costs made by a county for amounts under subd. 2. cannot include any part of the nonfederal share of the amount under subd. 2.
The department shall, in accordance with all procedures set forth under s. 20.940, request a waiver under 42 USC 1315 or submit a Medical Assistance state plan amendment to the federal department of health and human services to obtain any necessary federal approval required to provide reimbursement to crisis urgent care and observation facilities certified under s. 51.036 for crisis intervention services under this subsection. If the department determines submission of a state plan amendment is appropriate, the department shall, notwithstanding whether the expected fiscal effect of the amendment is $7,500,000 or more, submit the amendment to the joint committee on finance for review in accordance with the procedures under sub. (2t). If federal approval is granted or no federal approval is required, the department shall provide reimbursement under s. 49.46 (2) (b) 15. If federal approval is necessary but is not granted, the department may not provide reimbursement for crisis intervention services provided by crisis urgent care and observation facilities.