LRB-2433/1
MDK:wlj:jf
2003 - 2004 LEGISLATURE
May 8, 2003 - Introduced by Representatives Johnsrud, Hines and Ott. Referred
to Committee on Health.
AB314,1,11
1An Act to repeal 456.04 (4);
to renumber and amend 15.405 (7m);
to amend
215.08 (1m) (b), 46.21 (1m) (am), 50.04 (2) (a), 59.79 (10), chapter 456 (title),
3456.01 (1), 456.01 (4), 456.01 (5), 456.02 (1), 456.02 (4), 456.02 (5), 456.02 (6),
4456.03, 456.04 (intro.), 456.05 (intro.), 456.05 (1), 456.05 (2), 456.05 (3), 456.07
5(1), 456.07 (2), 456.07 (3), 456.07 (4), 456.08, 456.09 (1) (b), 456.09 (1) (c), 456.09
6(1) (d), 456.09 (1) (e), 456.10 (1) (intro.), 456.10 (1) (bm), 456.10 (1) (c), 456.10
7(1) (d) and 456.10 (2); and
to create 15.405 (7m) (a) 2., 15.405 (7m) (c), 440.08
8(2) (a) 38k., 456.01 (1g), 456.01 (1r), 456.01 (3m), 456.01 (4m), 456.04 (5), 456.04
9(6), 456.05 (4), 456.07 (2m), 456.07 (6), 456.072, 456.078 and 456.12 of the
10statutes;
relating to: licensing hospital administrators and granting
11rule-making authority.
Analysis by the Legislative Reference Bureau
Under current law, a person may not practice as a nursing home administrator,
or use such a title, unless he or she is granted a license by the Nursing Home
Administrator Examining Board (board). To obtain a license, a person must pass an
examination regarding the laws governing long-term care facilities, the
administration of such facilities, and the needs of persons served by the facilities.
A person may not take the examination unless he or she satisfies educational
requirements that the board considers are adequate preparation for nursing home
administration. In addition, a person may not take the examination if he or she has
an arrest or conviction record the circumstances of which substantially relate to
nursing home administration.
Also under current law, a nursing home administrator license expires on July
1 of each even-numbered year, unless the license is renewed. To renew a license, a
person must apply to the board for a certificate of registration. In addition, the board
may take disciplinary action against a person who is licensed, including suspending
or revoking a license, if he or she engages in specified prohibited conduct. For
example, the board may take disciplinary action if a person is incompetent or acts
in a manner inconsistent with the health and safety of the residents of a nursing
home, or if the nursing home that he or she administers has a pattern of serious
violations of federal or state laws.
This bill requires the board to also grant licenses to hospital administrators and
changes the name of the board to the Hospital and Nursing Home Administrator
Examining Board. Under the bill, except for a hospital administrator employed by
the federal government, a person may not practice as a hospital administrator, or use
such a title, unless he or she is licensed as a hospital administrator by the board. The
requirements for obtaining and renewing a hospital administrator license are
similar to the requirements for a nursing home administrator license. For example,
a person must pass an examination regarding the laws governing hospitals, the
administration of hospitals, and the needs of patients served by hospitals. In
addition, the bill requires both the hospital and nursing home administrator
examinations to test knowledge of federal and state health care reimbursement
programs.
The bill also imposes similar requirements that a person must satisfy to take
the hospital administrator examination. Like the nursing home administrator
examination, a person may not take the hospital administrator examination if he or
she has an arrest or conviction record the circumstances of which substantially relate
to hospital administration. In addition, a person may not take the hospital
administrator examination unless he or she has received a bachelor's degree in
administration of health care facilities or programs or has completed an educational
program that the board determines is substantially equivalent to receiving such a
degree. For a limited time, the board must waive this educational requirement for
a person who is primarily employed as a hospital administrator on the effective date
of the bill. Until five years after the bill goes into effect, such a person may take the
examination even if he or she does not satisfy the educational requirement.
However, when a person who receives a waiver applies to renew his or her license
that expires on July 1, 2010, the person must submit evidence that he or she satisfies
the educational requirement. If the person does not satisfy the educational
requirement by that date, his or her license may not be renewed, and he or she may
not continue to practice as a hospital administrator.
Also, the bill changes the educational requirements for a nursing home
administrator license. Under the bill, a person may not take the examination for that
license unless he or she has received a bachelor's degree in nursing home
administration or has completed an educational program that the board determines
is substantially equivalent to receiving such a degree.
In addition, the bill makes the following changes:
1. The bill requires a person who applies to renew a hospital administrator
license to submit evidence that he or she completed at least 24 hours of continuing
education during the preceding two-year period. Although current law requires a
nursing home administrator to complete continuing education requirements,
current law does not specify a minimum number of hours.
2. The bill requires the board to promulgate rules establishing a code of ethics
governing the professional conduct of hospital and nursing home administrators.
The rules may establish separate codes for each profession.
3. The bill allows the board to grant hospital administrator licenses to persons
licensed as hospital administrators in other states. The board has similar authority
under current law with respect to nursing home administrator licenses.
4. The board's authority to take disciplinary action is expanded so that the
board may also take such action against persons licensed as hospital administrators.
Therefore, for example, the board may take disciplinary action if a hospital
administrator is incompetent or acts in a manner inconsistent with the health and
safety of the patients in a hospital, or if the hospital that he or she administers has
a pattern of serious violations of federal or state laws.
5. The bill changes the membership of the board, which consists of the following
members under current law: five nursing home administrators, two public members,
one physician, one nurse, and, as a nonvoting member, the secretary of health and
family services or his or her designee. This bill eliminates two of the nursing home
administrators and replaces them with three hospital administrators. In addition,
the bill adds another nurse member to the board and requires one of the nurse
members to be employed in a nursing home and the other nurse member to be
employed in a hospital.
For further information see the state fiscal estimate, which will be printed as
an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB314, s. 1
1Section
1. 15.08 (1m) (b) of the statutes is amended to read:
AB314,4,72
15.08
(1m) (b) The public members of the chiropractic examining board, the
3dentistry examining board, the hearing and speech examining board, the medical
4examining board,
the perfusionists examining council,
the respiratory care
1practitioners examining council
and, the council on physician assistants, the board
2of nursing, the
hospital and nursing home administrator examining board, the
3veterinary examining board, the optometry examining board, the pharmacy
4examining board, the marriage and family therapy, professional counseling, and
5social work examining board, and the psychology examining board shall not be
6engaged in any profession or occupation concerned with the delivery of physical or
7mental health care.
AB314, s. 2
8Section
2. 15.405 (7m) of the statutes is renumbered 15.405 (7m) (a) (intro.)
9and amended to read:
AB314,4,1510
15.405
(7m) (a) (intro.)
Nursing Hospital and nursing home administrator
11examining board. There is created a
hospital and nursing home administrator
12examining board in the department of regulation and licensing consisting of
9
13members appointed for staggered 4-year terms and the secretary of health and
14family services or a designee, who shall serve as a nonvoting member
. Five, and the
15following members appointed for 4-year terms:
AB314,4,17
161. Three members
shall be who are nursing home administrators licensed
in
17this state under ch. 456.
AB314,4,18
183. One member
shall be who is a physician.
One member shall be a nurse
AB314,4,19
194. Two members who are nurses licensed under ch. 441.
AB314,4,20
205. Two
public members
shall be public members.
AB314,4,22
21(b) No more than 2 members
appointed under par. (a) 1. to 5. may be officials
22or full-time employees of this state.
AB314, s. 3
23Section
3. 15.405 (7m) (a) 2. of the statutes is created to read:
AB314,4,2524
15.405
(7m) (a) 2. Three members who are hospital administrators licensed
25under ch. 456.
AB314, s. 4
1Section
4. 15.405 (7m) (c) of the statutes is created to read:
AB314,5,42
15.405
(7m) (c) One of the members appointed under par. (a) 4. must be
3employed in a nursing home and the other member appointed under par. (a) 4. must
4be employed in a hospital.
AB314, s. 5
5Section
5. 46.21 (1m) (am) of the statutes is amended to read:
AB314,5,176
46.21
(1m) (am) The county executive shall appoint under ss. 63.01 to 63.17
7an administrator of the county hospital. The appointment shall be made on the basis
8of recognized and demonstrated public interest in and knowledge of the problems of
9delivery of medical care and treatment, and with due regard to training, experience,
10executive and administrative ability and efficiency, and general qualifications and
11fitness for performing the duties of the office.
An administrator may not be appointed
12under this paragraph unless he or she is licensed as a hospital administrator under
13ch. 456. The administrator shall file an official oath and bond in the amount
14determined by the county board of supervisors. The county board of supervisors may
15create positions to assist the administrator. The administrator shall be appointed
16by the county executive in the unclassified civil service
, and the appointment is
17subject to confirmation by the county board of supervisors under s. 59.17 (2) (bm).
AB314, s. 6
18Section
6. 50.04 (2) (a) of the statutes is amended to read:
AB314,6,419
50.04
(2) (a) No nursing home within the state may operate except under the
20supervision of an administrator licensed under ch. 456 by the
hospital and nursing
21home
administrators administrator examining board. If the holder of a nursing
22home license is unable to secure a new administrator because of the departure of an
23administrator, such license holder may, upon written notice to the department and
24upon the showing of a good faith effort to secure a licensed administrator, place the
25nursing home in the charge of an unlicensed individual subject to conditions and
1time limitations established by the department, with advice from the
hospital and 2nursing home administrator examining board. An unlicensed individual who
3administers a nursing home as authorized under this subsection is not subject to the
4penalty provided under s. 456.09.
AB314, s. 7
5Section
7. 59.79 (10) of the statutes is amended to read:
AB314,6,176
59.79
(10) County hospital. Determine policy for the operation, maintenance
, 7and improvement of the county hospital under s. 49.71 (2) and, notwithstanding the
8powers and duties specified under s. 46.21 (2) (k), (3r)
, and (6) with respect to the
9county hospital and the administrator and specified under s. 46.21 (2) (b), (L), (m),
10(n), (nm), (o), (p)
, and (q) and (3g), provide for the management of the county hospital
11as the board considers appropriate, except that the employee positions at the
12hospital will be county employee positions
and except that the board may not employ
13a person as a hospital administrator unless he or she is licensed as such under ch.
14456. If the board acts under this subsection, the board may not discontinue
15operation, maintenance
, and improvement of the county hospital under s. 49.71 (2)
16and shall exercise the duties under s. 46.21 (4m). This subsection does not apply if
17the board acts under s. 46.21 with respect to the county hospital under s. 49.71 (2).
AB314, s. 8
18Section
8. 440.08 (2) (a) 38k. of the statutes is created to read:
AB314,6,2019
440.08
(2) (a) 38k. Hospital administrator: July 1 of each even-numbered year;
20$53.
AB314, s. 9
21Section
9. Chapter 456 (title) of the statutes is amended to read:
AB314,6,2422
CHAPTER 456
23hospital and nursing home
24
administrator examining board
AB314, s. 10
25Section
10. 456.01 (1) of the statutes is amended to read:
AB314,7,2
1456.01
(1) "Examining board" means the
hospital and nursing home
2administrator examining board.
AB314, s. 11
3Section
11. 456.01 (1g) of the statutes is created to read:
AB314,7,44
456.01
(1g) "Hospital" has the meaning given in s. 50.33 (2).
AB314, s. 12
5Section
12. 456.01 (1r) of the statutes is created to read:
AB314,7,96
456.01
(1r) "Hospital administrator" means any individual responsible for
7planning, organizing, directing, and controlling the operation of a hospital, or who
8in fact performs such functions, whether or not such functions are shared by one or
9more other persons.
AB314, s. 13
10Section
13. 456.01 (3m) of the statutes is created to read:
AB314,7,1211
456.01
(3m) "Practice of hospital administration" means the planning,
12organizing, directing, and controlling of the operation of a hospital.
AB314, s. 14
13Section
14. 456.01 (4) of the statutes is amended to read:
AB314,7,1514
456.01
(4) "Practice of nursing home administration" means the planning,
15organizing, directing
, and
control
controlling of the operation of a nursing home.
AB314, s. 15
16Section
15. 456.01 (4m) of the statutes is created to read:
AB314,7,1817
456.01
(4m) "Provisional hospital administrator" means an individual who has
18been licensed as such under this chapter.
AB314, s. 16
19Section
16. 456.01 (5) of the statutes is amended to read:
AB314,7,2120
456.01
(5) "Provisional license" is a temporary license issued to a provisional
21hospital or nursing home administrator under this chapter.
AB314, s. 17
22Section
17. 456.02 (1) of the statutes is amended to read:
AB314,8,323
456.02
(1) Develop, impose
, and enforce standards which must be met by
24individuals
in order to receive a license as a
hospital or nursing home administrator,
25which standards shall be designed to insure that
hospital or nursing home
1administrators will be individuals who are of good character and are otherwise
2suitable, and who, by training or experience in the field of institutional
3administration, are qualified to serve as
hospital or nursing home administrators;
AB314, s. 18
4Section
18. 456.02 (4) of the statutes is amended to read:
AB314,8,75
456.02
(4) Establish and carry out procedures designed to insure that
6individuals licensed as
hospital or nursing home administrators will, during any
7period that they serve as such, comply with the requirements of such standards;