SECTION 11. 20.505 (8) (hm) 16m. of the statutes is created to read:
20.505 (8) (hm) 16m. The amount transferred to s. 20.410 (1) (ke) shall be the amount in the schedule under s. 20.410 (1) (ke).
SECTION 12. 20.505 (8) (hm) 16m. of the statutes, as created by 2005 Wisconsin Act .... (this act), is repealed.
SECTION 13. 20.505 (8) (hm) 18cm. of the statutes is created to read:
20.505 (8) (hm) 18cm. The amount transferred to s. 20.435 (7) (kh) shall be the amount in the schedule under s. 20.435 (7) (kh).
SECTION 14. 44.53 (1) (fm) of the statutes is created to read:
44.53 (1) (fm) Conduct a program identical to that described in par. (f), but only for American Indian individuals and groups. The program shall be funded from the appropriation under s. 20.215 ( 1) (km).
SECTION 15. 44.53 (2) (am) of the statutes is created to read:
44.53 (2) (am) Enter into contracts with American Indian individuals, organizations and institutions and American Indian tribal governments for services furthering the development of the arts and humanities.
SECTION 16. 46.03 (43) of the statutes is amended to read:
46.03 (43) COMPULSIVE GAMBLING AWARENESS CAMPAIGNS. From the appropriation account accounts under s. 20.435 (7) (kg) and ( kh), provide grants to one or more individuals or organizations in the private sector to conduct compulsive gambling awareness campaigns.
SECTION 17. 115.28 (47m) of the statutes is created to read:
115.28 (47m) GRANT TO BELOIT COLLEGE. Annually award the amount appropriated under s. 20.255 (2) (kn) to Beloit College to educate children and adults in southern Wisconsin about Native American cultures.
SECTION 18. 115.751 of the statutes is created to read:
115.751 Aid to alternative schools. (1) (a) Subject to the requirements of par. (b), each alternative school operating an American Indian language and culture education program under this subchapter shall receive state aid, from the appropriation under s. 20.255 (2) (km), in an amount equal to $200 for each pupil who has completed the fall semester in the program.
(b) No alternative school may receive state aid under this section unless the state superintendent:
1. Determines that the alternative school has adequate management and accounting capacity and that the school agrees that its accounts related to the program may be audited.
2. Certifies that the alternative school has met the requirements of ss. 115.73 and 115.735 and has submitted a report to the state superintendent which includes a description of all expenditures made in the prior year in connection with the program, a budget for the current year for the program, and the number of pupils who have completed the fall semester in the program.
(2) State aid under this section shall be paid in April of each year. In no case may such aid supplant federal aid received by the alternative school and utilized for American Indian language and culture education programs in the prior year.
(3) If the appropriation under s. 20.255 (2) (km) in any year is insufficient to pay the full amount of aid under this section, state aid payments shall be prorated among the alternative schools entitled to such aid.
SECTION 9409. Effective dates; corrections.
(1) JACKSON CORRECTIONAL INSTITUTION WASTEWATER TREATMENT FACILITY. The treatment of sections 20.410 (1) (ke) (by SECTION 6) and 20.505 (8) (hm) 16m. (by SECTION 12) of the statutes takes effect on July 1, 2007.
(End)
LRB-1649LRB-1649/10
DAK/PJK/RAC/MJL/JK:wlj&cjs:jf
2005 - 2006 LEGISLATURE
DOA:......Johnston, BB0423 - Health care quality improvement
For 2005-07 Budget -- Not Ready For Introduction
2005 BILL
AN ACT ...; relating to: the budget.
Analysis by the Legislative Reference Bureau
health and human services
Health
Under current law, DHFS must collect, analyze, and disseminate health care information from health care providers other than hospitals and ambulatory surgery centers; in addition, DOA must contract with an entity to collect, analyze, and disseminate health care information from hospitals and ambulatory surgery centers. Both DHFS and the entity under contract with DOA must, from the data collected, prepare certain reports that do not permit the identification of a patient, an employer, or a health care provider. The Board on Health Care Information, attached to DHFS, must advise DHFS on the collection, analysis, and dissemination of health care information; provide oversight on the reports issued by DHFS and the entity under contract with DOA; and develop overall strategy and direction for health care information collection activities. Activities of the Board on Health Care Information and DHFS are funded from fees for performance of certain work under contract and from assessments that are annually levied on health care providers other than hospitals and ambulatory surgery centers.
This bill eliminates the Board on Health Care Information as of October 1, 2005, and replaces it on that date with a nine-member Health Care Quality and Patient Safety Board (HCQPSB), attached to DOA, which assumes the duties and powers of the Board on Health Care Information. In addition, the HCQPSB must do all of the following:
1. By March 1, 2006, study and make recommendations concerning the feasibility of creating a centralized physician information database.
2. By October 1, 2006, study and make recommendations concerning rules required and authorized to be promulgated by DHFS concerning the collection, analysis, and dissemination of health care information; promote the collection and availability of certain health care information; and foster the evolution of certain partnerships and agreements and transparency of health care information.
3. By January 1, 2007, develop a plan and specific strategies to deploy health care information systems technology for health care quality, safety, and efficiency.
4. Annually report on its plans, activities, accomplishments, and recommendations.
5. Annually assess the extent to which automated information and decision support systems are used by health care providers in Wisconsin.
6. Annually assess options and develop a plan to achieve automation of all health care systems in Wisconsin by 2010.
7. Make grants or loans to clinics, health maintenance organizations, hospitals, or physicians for various projects.
The bill prohibits DHFS from enforcing rules promulgated before the effective date of this bill as an act that relate to the collection, from physicians, of workforce and practice information, health care plan affiliations, and hospital privileges and, from dentists, chiropractors, and podiatrists, of workforce and practice information. Beginning July 1, 2007, the bill also prohibits DHFS from enforcing rules promulgated before that date that relate to physician claims data. DHFS may only promulgate rules that relate to the collection and dissemination of health care information that are first approved by HCQPSB.
The bill creates the health care quality improvement fund, a segregated fund that consists of moneys transferred from the injured patients and families compensation fund, the net proceeds of certain revenue obligations, a portion of the annual assessments levied on health care providers other than hospitals and ambulatory surgery centers, the repayment of any loans made by the HCQPSB, and any moneys transferred by the secretary of administration. Funds of the health care quality improvement fund are, under the bill, appropriated for general program operations of the HCQPSB, for grants or loans made by the HCQPSB, and for benefits under the Medical Assistance (MA) program, including payments for direct graduate medical education, a major managed care supplement, a pediatric services supplement, rural hospital supplements, and an essential access city hospital.
Under the bill, before July 1, 2007, DHFS may promulgate only those rules relating to the collection, analysis, and dissemination of health care information that are first approved by the HCQPSB.
Other health and human services
Under current law, the Wisconsin Health and Educational Facilities Authority (WHEFA) provides financial assistance to private and public health facilities and hospitals. This bill prohibits WHEFA from providing such financial assistance unless the health facility or hospital demonstrates to the Health Care Quality and Patient Safety Board (HCQPSB) that the health facility or hospital is making progress to improve medical information systems technology.
insurance
Under current law, certain health care providers are required to carry health care liability insurance with liability limits of at least $1,000,000 for each occurrence and at least $3,000,000 for all occurrences in a policy year. Any portion of a medical malpractice claim against a health care provider subject to the health care liability insurance requirements that exceeds the policy limits of the health care provider's health care liability insurance is paid by the injured patients and families compensation fund. Moneys for the fund come from annual assessments paid by the health care providers who are subject to the health care liability insurance requirements. Current law provides that the fund is established to curb the rising costs of health care by financing part of the liability incurred by health care providers as a result of medical malpractice claims and that the fund is held in irrevocable trust for the sole benefit of providers and proper claimants and may not be used for any other purpose of the state.
This bill transfers $169,703,400 in fiscal year 2005-06 and $9,714,000 in fiscal year 2006-07 from the injured patients and families compensation fund to the health care quality improvement fund, as created in the bill. The bill also adds to the stated purposes of the injured patients and families compensation fund the purposes of ensuring the availability of health care providers in Wisconsin and of enabling the deployment of health care information systems technology for health care quality, safety, and efficiency, by the Health Care Quality and Patient Safety Board (HCQPSB), as created in the bill.
state government
State finance
This bill creates a program to issue revenue obligations to fund costs of the Medical Assistance program. Under the bill, funds for the program may not exceed $130,000,000. The bill provides that the principal and interest costs on the revenue obligations are to be paid from excise taxes that are currently imposed on the sale of liquor, fermented malt beverages, cigarettes, and tobacco products. These taxes are to be deposited into the excise tax fund, a fund under current law that can be used for any revenue obligations issued to pay the state's unfunded prior service liability under the Wisconsin Retirement System (WRS). To dedicate moneys in the excise tax fund for the payment of these grants, the bill eliminates the state's authority to issue revenue obligations secured by tax revenues derived from the sale of liquor, fermented malt beverages, cigarettes, and tobacco products for the payment of the state's unfunded prior liability under the WRS. Obligations for this purpose have already been issued under other current law authority.
For further information see the state and local 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:
SECTION 1. 15.07 (2) (b) of the statutes is repealed.
SECTION 2. 15.07 (2) (n) of the statutes is created to read:
15.07 (2) (n) The chairperson of the health care quality and patient safety board shall be designated biennially by the governor.
SECTION 3. 15.07 (3) (bm) 1. of the statutes is repealed.
SECTION 4. 15.105 (13) of the statutes is created to read:
15.105 (13) HEALTH CARE QUALITY AND PATIENT SAFETY BOARD. (a) Creation; membership. There is created a health care quality and patient safety board, attached to the department of administration under s. 15.03, consisting of the following members:
1. The secretary of health and family services, the secretary of employee trust funds, and the secretary of administration or their designees.
2. One physician, as defined in s. 448.01 (5).
3. One representative of hospitals.
4. One employer purchaser of health care.
5. One representative of the insurance industry.
6. One representative of health maintenance organizations, as defined in s. 609.01 (2).
7. One member who shall represent the public interest.
(b) Terms. The board members specified in par. (a) 2. to 7. shall be appointed for 4-year terms.
SECTION 5. 15.195 (6) of the statutes is repealed.
SECTION 6. 16.03 (3) of the statutes is amended to read:
16.03 (3) REPORT. The interagency coordinating council shall report at least twice annually to the health care quality and patient safety board on health care information in the department of health and family services administration, concerning the council's activities under this section.
SECTION 7. 16.526 (title) of the statutes is repealed and recreated to read:
16.526 (title) Revenue obligation program to fund costs of the Medical Assistance program.
SECTION 8. 16.526 (1) of the statutes is amended to read:
16.526 (1) For purposes of subch. II of ch. 18, the purposes of obtaining proceeds to pay the state's anticipated unfunded prior service liability under s. 40.05 (2) (b) and of paying the state's unfunded prior service liability under s. 40.05 (2) (b) and the state's unfunded liability under s. 40.05 (4) (b), (bc), and (bw) and subch. IX of ch. 40 fund costs of the Medical Assistance program is a special fund program, and the excise tax fund is a special fund. The legislature finds and determines that the excise tax fund is a segregated fund consisting of fees, penalties, or excise taxes and that financing the special Medical Assistance program to pay the state's unfunded prior service liability under s. 40.05 (2) (b) and the state's unfunded liability under s. 40.05 (4) (b), (bc), and (bw) and subch. IX of ch. 40 fund costs from the net proceeds of revenue obligations issued under this section is appropriate and will serve a public purpose by improving the quality of, and access of citizens of this state to, health care services.
SECTION 9. 16.526 (2) of the statutes is amended to read:
16.526 (2) The net proceeds of revenue obligations issued under subch. II of ch. 18, as authorized under this section, shall be deposited in a fund in the state treasury, or an account maintained by a trustee, created under s. 18.57 (1). The moneys shall be applied for ancillary payments and for the provision of reserves, as determined by the building commission, and for the payment of part or all of the state's unfunded prior service liability under s. 40.05 (2) (b) and the state's unfunded liability under s. 40.05 (4) (b), (bc), and (bw) and subch. IX of ch. 40, as determined by the department, costs of the Medical Assistance program, and any remainder shall be paid into a retirement liability an excise tax revenue obligation redemption fund created under 18.562 (3).
SECTION 10. 16.526 (5) (b) of the statutes is amended to read:
16.526 (5) (b) Except as otherwise provided in this paragraph, the secretary shall determine the requirements for funds to be obtained from revenue obligations issued under this section to pay the state's anticipated unfunded prior service liability under s. 40.05 (2) (b) and funds used for the payment of the state's unfunded prior service liability under s. 40.05 (2) (b) and the state's unfunded liability under s. 40.05 (4) (b), (bc), and (bw) and subch. IX of ch. 40, that are to be paid from revenue obligations issued under this section, shall be determined by the secretary costs of the Medical Assistance program. The sum amount of expenditures to be paid from revenue obligations issued under this section and appropriation obligations issued under s. 16.527, if any, excluding any appropriation revenue obligations that have been defeased under a cash optimization program administered by the building commission and any appropriation obligations issued pursuant to s. 16.527 (3) (b) 3., shall not exceed $1,500,000,000 $130,000,000.
SECTION 11. 16.526 (5) (c) of the statutes is created to read:
16.526 (5) (c) For the purpose of s. 18.58 (4), the department is carrying out program responsibilities for which the revenue obligations are authorized under this section.
SECTION 12. 16.527 (3) (b) 2. of the statutes is amended to read:
16.527 (3) (b) 2. The sum of appropriation obligations issued under this section, excluding any obligations that have been defeased under a cash optimization program administered by the building commission and any obligations issued pursuant to subd. 3., and revenue obligations issued under s. 16.526, if any, may not exceed $1,500,000,000.
SECTION 13. 18.55 (5) of the statutes is amended to read:
18.55 (5) EXERCISE OF AUTHORITY. Money may be borrowed and evidences of revenue obligation issued therefor pursuant to one or more authorizing resolutions, unless otherwise provided in the resolution or in this subchapter, at any time and from time to time, for any combination of purposes, in any specific amounts, at any rates of interest, for any term, payable at any intervals, at any place, in any manner and having any other terms or conditions deemed necessary or useful. Revenue obligation bonds may bear interest at variable or fixed rates, bear no interest or bear interest payable only at maturity or upon redemption prior to maturity. Unless sooner exercised or unless a shorter different period is provided in the resolution, every authorizing resolution, except as provided in s. 18.59 (1), shall expire one year after the date of its adoption.
SECTION 14. 18.61 (5) of the statutes is amended to read:
18.61 (5) The legislature may provide, with respect to any specific issue of revenue obligations, prior to their issuance, that if the special fund income or the enterprise or program income pledged to the payment of the principal and interest of the issue is insufficient for that purpose, or is insufficient to replenish a reserve fund, if applicable, it will consider supplying the deficiency by appropriation of funds, from time to time, out of the treasury. If the legislature so provides, the commission may make the necessary provisions therefor in the authorizing resolution and other proceedings of the issue. Thereafter, if the contingency occurs, recognizing its moral obligation to do so, the legislature hereby expresses its expectation and aspiration that it shall make such appropriation.
SECTION 15. 20.435 (4) (hg) of the statutes is renumbered 20.435 (1) (hg) and amended to read:
20.435 (1) (hg) General program operations; health care information. The amounts in the schedule to fund the activities of the department of health and family services and the board on health care information under ch. 153. The contract fees paid under s. 153.05 (6m) and assessments paid under s. 153.60, less $250,000 in assessments paid in each fiscal year, shall be credited to this appropriation account.
****NOTE: This is reconciled s. 20.435 (4) (hg). This SECTION has been affected by drafts with the following LRB numbers: LRB-0316/2 and LRB-1649/3.
SECTION 16. 20.435 (4) (r) of the statutes is created to read:
