Amendment SA1-SSA1-SB40

SB40-SSA1-SA1,362,13 a. Department of administration.

SB40-SSA1-SA1,362,14 b. Department of agriculture, trade and consumer protection.

SB40-SSA1-SA1,362,15 c. Department of children and families.

SB40-SSA1-SA1,362,16 d. Department of commerce.

SB40-SSA1-SA1,362,17 e. Department of corrections.

SB40-SSA1-SA1,362,18 f. Department of employee trust funds.

SB40-SSA1-SA1,362,19 g. Department of financial institutions.

SB40-SSA1-SA1,362,20 h. Department of health and family services.

SB40-SSA1-SA1,362,21 j. Department of natural resources.

SB40-SSA1-SA1,362,22 L. Department of regulation and licensing.

SB40-SSA1-SA1,362,23 m. Department of revenue.

SB40-SSA1-SA1,362,24 n. Department of transportation.

SB40-SSA1-SA1,362,25 o. Department of veterans affairs.

SB40-SSA1-SA1,363,1 p. Department of workforce development.

SB40-SSA1-SA1,363,2 q. Office of the commissioner of insurance.

SB40-SSA1-SA1,363,3 (dm) Position increases and decreases.

SB40-SSA1-SA1,363,7 1. The authorized FTE positions for the department of agriculture, trade and consumer protection, funded from the appropriation under section 20.115 (1) (gb) of the statutes, as affected by this act, are decreased by 1.0 FTE position, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,363,11 1g. The authorized FTE positions for the department of agriculture, trade and consumer protection, funded from the appropriation under section 20.115 (7) (r) of the statutes, as affected by this act, are decreased by 1.0 FTE position, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,363,15 1r. The authorized FTE positions for the department of agriculture, trade and consumer protection, funded from the appropriation under section 20.115 (8) (a) of the statutes, as affected by this act, are decreased by 4.5 FTE positions, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,363,19 2. The authorized FTE positions for the department of commerce, funded from the appropriation under section 20.143 (3) (r) of the statutes, as affected by this act, are decreased by 0.5 FTE position, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,363,23 2m. The authorized FTE positions for the department of commerce, funded from the appropriation under section 20.143 (3) (w) of the statutes, as affected by this act, are decreased by 1.5 FTE positions, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,364,2 3. The authorized FTE positions for the department of financial institutions, funded from the appropriation under section 20.144 (1) (g) of the statutes, as affected by this act, are decreased by 5.0 FTE positions, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,364,6 4. The authorized FTE positions for the office of the commissioner of insurance, funded from the appropriation under section 20.145 (1) (g) of the statutes, as affected by this act, are decreased by 5.0 FTE positions, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,364,10 5. The authorized FTE positions for the department of regulation and licensing, funded from the appropriation under section 20.165 (1) (g) of the statutes, as affected by this act, are decreased by 28.0 FTE positions, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,364,14 5m. The authorized FTE positions for the department of regulation and licensing, funded from the appropriation under section 20.165 (1) (i) of the statutes, as affected by this act, are decreased by 1.0 FTE position, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,364,18 6. The authorized FTE positions for the department of natural resources, funded from the appropriation under section 20.370 (2) (gh) of the statutes, as affected by this act, are decreased by 0.5 FTE positions, for the purpose of transferring position under this section.

SB40-SSA1-SA1,364,22 6d. The authorized FTE positions for the department of natural resources, funded from the appropriation under section 20.370 (3) (mk) of the statutes, as affected by this act, are decreased by 0.5 FTE position, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,365,2 6h. The authorized FTE positions for the department of natural resources, funded from the appropriation under section 20.370 (8) (ma) of the statutes, as affected by this act, are decreased by 3.0 FTE positions, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,365,6 6k. The authorized FTE positions for the department of natural resources, funded from the appropriation under section 20.370 (8) (mq) of the statutes, as affected by this act, are decreased by 0.5 FTE position, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,365,10 6p. The authorized FTE positions for the department of natural resources, funded from the appropriation under section 20.370 (8) (mu) of the statutes, as affected by this act, are decreased by 6.0 FTE positions, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,365,14 6s. The authorized FTE positions for the department of natural resources, funded from the appropriation under section 20.370 (8) (mz) of the statutes, as affected by this act, are decreased by 6.0 FTE positions, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,365,18 7. The authorized FTE positions for the department of transportation, funded from the appropriation under section 20.395 (4) (aq) of the statutes, as affected by this act, are decreased by 10.0 FTE positions, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,365,22 8. The authorized FTE positions for the department of corrections, funded from the appropriation under section 20.410 (1) (a) of the statutes, as affected by this act, are decreased by 6.5 FTE positions, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,366,2 8m. The authorized FTE positions for the department of corrections, funded from the appropriation under section 20.410 (3) (hm) of the statutes, as affected by this act, are decreased by 0.3 FTE position, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,366,6 9. The authorized FTE positions for the department of health and family services, funded from the appropriation under section 20.435 (8) (a) of the statutes, as affected by this act, are decreased by 9.56 FTE positions, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,366,10 9m. The authorized FTE positions for the department of health and family services, funded from the appropriation under section 20.435 (8) (n) of the statutes, as affected by this act, are decreased by 8.94 FTE positions, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,366,14 10. The authorized FTE positions for the department of children and families, funded from the appropriation under section 20.437 (2) (a) of the statutes, as affected by this act are decreased by 0.08 FTE position, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,366,18 10g. The authorized FTE positions for the department of children and families, funded from the appropriation under section 20.437 (2) (mc) of the statutes, as affected by this act, are decreased by 0.37 FTE position, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,366,22 10m. The authorized FTE positions for the department of children and families, funded from the appropriation under section 20.437 (3) (a) of the statutes, as created by this act, are decreased by 2.55 FTE positions, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,367,2 10r. The authorized FTE positions for the department of children and families, funded from the appropriation under section 20.437 (3) (n) of the statutes, as created by this act, are decreased by 0.3 FTE position, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,367,6 11. The authorized FTE positions for the department of workforce development, funded from the appropriation under section 20.445 (1) (a) of the statutes, as affected by this act, are decreased by 0.55 FTE position, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,367,10 12. The authorized FTE positions for the department of veterans affairs, funded from the appropriation under section 20.485 (1) (gk) of the statutes, as affected by this act, are decreased by 0.1 FTE position, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,367,14 12g. The authorized FTE positions for the department of veterans affairs, funded from the appropriation under section 20.485 (2) (u) of the statutes, as affected by this act, are decreased by 0.4 FTE position, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,367,18 12r. The authorized FTE positions for the department of veterans affairs, funded from the appropriation under section 20.485 (3) (s) of the statutes, as affected by this act, are decreased by 1.5 FTE positions, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,367,22 13. The authorized FTE positions for the department of administration, funded from the appropriation under section 20.505 (1) (a) of the statutes, as affected by this act, are decreased by 2.0 FTE positions, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,368,2 13m. The authorized FTE positions for the department of administration, funded from the appropriation under section 20.505 (1) (v) of the statutes, as affected by this act, are decreased by 1.0 FTE position, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,368,6 14. The authorized FTE positions for the department of employee trust funds, funded from the appropriation under section 20.515 (1) (w) of the statutes, as affected by this act, are decreased by 1.0 FTE position, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,368,10 15. The authorized FTE positions for the office of state employment relations, funded from the appropriation under section 20.545 (1) (a) of the statutes, as affected by this act, are decreased by 1.0 FTE position, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,368,14 16. The authorized FTE positions for the department of revenue, funded from the appropriation under section 20.566 (3) (a) of the statutes, as affected by this act, are decreased by 15.05 FTE positions, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,368,18 16m. The authorized FTE positions for the department of revenue, funded from the appropriation under section 20.566 (8) (q) of the statutes, as affected by this act, are decreased by 0.7 FTE position, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,368,22 17. The authorized FTE positions for the department of administration, funded from the appropriation under section 20.505 (1) (kr) of the statutes, as created by this act, are increased by 125.90 FTE positions, for the purpose of transferring positions under this section.

SB40-SSA1-SA1,369,5 (e) Incumbents. All incumbent employees holding positions that are transferred under paragraphs (b) and (c) are transferred on the effective date of this paragraph to the department of administration. Employees transferred under these paragraphs have all the rights and the same status under subchapter V of chapter 111 and chapter 230 of the statutes in the department of administration that they enjoyed in their respective state agencies immediately before the transfer. Notwithstanding section 230.28 (4) of the statutes, no employee so transferred who has attained permanent status in class is required to serve a probationary period.

SB40-SSA1-SA1,369,10 (f) Materials. On the effective date of this paragraph, all equipment, supplies, and furniture required for the provision of legal services by employees transferred under paragraphs (b) and (c) are transferred to the department of administration. The secretary of administration shall identify the equipment, supplies, and furniture to be transferred.".

SB40-SSA1-SA1,369,11 681. Page 1643, line 21: after that line insert:

SB40-SSA1-SA1,369,18 "(3t) Levy limit exception; county charges to recovery unlawful property taxes. The limit otherwise applicable under section 66.0602 of the statutes does not apply to an amount that a municipality levied in 2006 as a county special charge to recover unlawful real estate taxes that were included on a municipality's statement of taxes for 2006 that was filed with the department of revenue if the special charge resulted from a 2005 tax amount that was rescinded due to an error, as that term is used in section 74.33 (1) of the statutes.".

SB40-SSA1-SA1,369,19 682. Page 1644, line 14: after that line insert:

SB40-SSA1-SA1,369,20 "(4c) Healthy Wisconsin Plan.

SB40-SSA1-SA1,369,23 (a) Legislative findings. In establishing the Healthy Wisconsin Plan under chapter 260 of the statutes, as created by this act, the legislature finds all of the following:

SB40-SSA1-SA1,370,6 1. `Costs.' Health care costs in Wisconsin are rising at an unsustainable rate making the need for comprehensive reform urgent. Rising costs are seriously threatening the ability of Wisconsin businesses to globally compete; farms to thrive; government to provide needed services; schools to educate; and local citizens to form new and successful business ventures. Some indicators of rising costs are the following:

SB40-SSA1-SA1,370,8 a. Total health care spending in Wisconsin in 2007 is projected to be $42.3 billion, and is projected to grow 82 percent, to $76.9 billion, in the next decade.

SB40-SSA1-SA1,370,11 b. The cost of employer-provided health care in Wisconsin increased by 9.3 percent in 2006, averaging $9,516 per employee. This figure is 26 percent more than the national average.

SB40-SSA1-SA1,370,13 c. Employee premium contributions and out-of-pocket costs are rising faster than wages.

SB40-SSA1-SA1,370,16 d. Rising costs have led to a decline in employer-provided health benefits. In 1979, 73 percent of private-sector Wisconsin workers had employer-based health insurance coverage; however, only 57 percent received health benefits in 2004.

SB40-SSA1-SA1,370,20 e. At least one-half of all personal bankruptcies in the United States are the result of medical expenses. Over 75.7 percent of this group had insurance at the onset of illness. In 2004, there were 13,454 medical bankruptcies in Wisconsin affecting 37,360 people.

SB40-SSA1-SA1,370,24 f. The costs of health services provided to individuals who are unable to pay are shifted to others. Of the $22 billion charged by hospitals in 2005, $736,000,000 was not collected. Those who bear the burden of this cost shift have an increasingly difficult time paying their own health care costs.

SB40-SSA1-SA1,371,4 2. `Access.' There is a large and increasing number of people who have no health insurance or who are underinsured. For this growing population, health care is unaffordable and, most often, not received in the most timely and effective manner. Some indicators of lack of access to health care are as follows:

SB40-SSA1-SA1,371,6 a. Over one 500,000 Wisconsin residents were uninsured at any given point during 2007.

SB40-SSA1-SA1,371,7 b. Over 65 percent of the uninsured in Wisconsin are employed.

SB40-SSA1-SA1,371,9 c. The uninsured are less likely to seek care and, thus, have poorer health outcomes compared to the insured population.

SB40-SSA1-SA1,371,13 d. In 2007, total spending on the uninsured in Wisconsin is projected to reach over $1,000,000,000. About 23.2 percent of this amount will be in the form of uncompensated care; 21.7 percent will be provided through public programs; and 37.5 percent will be paid by the uninsured individuals.

SB40-SSA1-SA1,371,15 3. `Inequity.' The health care system contains inequities. Some indicators of inequity are as follows:

SB40-SSA1-SA1,371,18 a. Wisconsin businesses are competing on an uneven playing field. The majority of Wisconsin businesses that do insure their workers are subsidizing those businesses that are not paying their fair share for health care.

SB40-SSA1-SA1,371,21 b. Our current system forces the sick and the aging to pay far higher premiums than the healthy and those covered under group plans, rather than spreading the risk across the broadest pool possible.

SB40-SSA1-SA1,371,23 c. The uninsured face medical charges by hospitals, doctors, and other health care providers that are 2.5 times what public and private health insurers pay.

SB40-SSA1-SA1,372,3 4. `Inefficiency.' Wisconsin does not have a clearly defined, integrated health care system. Our health care system is complex, fragmented, and disease-focused rather than health-focused, resulting in massive inefficiencies and placing inordinate administrative burdens on health care professionals. Some indicators of inefficiency are as follows:

SB40-SSA1-SA1,372,8 a. Health care financing is accomplished through a patchwork of public programs, private sector employer-sponsored self-insurance, commercial insurance, and individual payers. The most recent study for Wisconsin estimates that about 27 cents of every health care dollar is spent on marketing, overhead, and administration, leaving only 73 cents left to deliver medical care.

SB40-SSA1-SA1,372,11 b. This fragmentation and misaligned financial incentives lead, in some instances, to excessive or inadequate care and create barriers to coordination and accountability among health care professionals, payers, and patients.

SB40-SSA1-SA1,372,17 c. The Institute of Medicine estimates that between 30 cents and 40 cents of every health care dollar is spent on costs of poor quality — overuse, underuse, misuse, duplication, system failures, unnecessary repetition, poor communication, and inefficiency. Included in this inefficiency are an unacceptable number of adverse events attributable to medical errors. Patients receive appropriate care based on known "best practices" only about one-half of the time.

SB40-SSA1-SA1,372,20 d. The best care results from the conscientious, explicit, and judicious use of current best evidence and knowledge of patient values by well-trained, experienced clinicians.

SB40-SSA1-SA1,372,23 5. `Limitations on reform.' Federal laws and programs, such as Medicaid, Medicare, Tri-Care, and Champus, constrain Wisconsin's ability to establish immediately a fully integrated health care system.

SB40-SSA1-SA1,373,6 6. `Wisconsin as a laboratory for the nation.' Wisconsin is in a unique position to successfully implement major health care reform. Many providers are already organized into comprehensive delivery systems and have launched innovative pilot programs to improve both the quality and efficiency of their care. Wisconsin is at the forefront in developing systems for health information transparency. Organizations such as the Wisconsin Collaborative for Healthcare Quality, Wisconsin Health Information Organization, and the Wisconsin Hospital Association have launched ambitious projects to provide data on quality, safety, and pricing.

SB40-SSA1-SA1,373,10 (b) Initial terms of Healthy Wisconsin Authority board. Notwithstanding the lengths of terms of the members of the board of the Healthy Wisconsin Authority specified in section 260.05 (1) of the statutes, as created by this act, the initial members shall be appointed for the following terms:

SB40-SSA1-SA1,373,12 1. One member each from section 260.05 (1) (a), (b), and (g) of the statutes, as created by this act, for terms that expire on July 1, 2009.

SB40-SSA1-SA1,373,14 2. One member each from section 260.05 (1) (a), (b), and (e) of the statutes, as created by this act, for terms that expire on July 1, 2010.

SB40-SSA1-SA1,373,16 3. One member each from section 260.05 (1) (c), (e), and (g) of the statutes, as created by this act, for terms that expire on July 1, 2011.

SB40-SSA1-SA1,373,18 4. One member each from section 260.05 (1) (d), (f), and (g) of the statutes, as created by this act, for terms that expire on July 1, 2012.

SB40-SSA1-SA1,373,20 5. One member each from section 260.05 (1) (a) and (b) of the statutes, as created by this act, for terms that expire on July 1, 2013.

SB40-SSA1-SA1,373,22 6. One member each from section 260.05 (1) (a) and (b) of the statutes, as created by this act, for terms that expire on July 1, 2014.

SB40-SSA1-SA1,374,11 (c) Provisional appointments. Notwithstanding the requirement for senate confirmation of the appointment of the members of the board of the Healthy Wisconsin Authority under section 260.05 (1) of the statutes, as created by this act, the initial members may be provisionally appointed by the governor, subject to confirmation by the senate. Any such appointment shall be in full force until acted upon by the senate, and when confirmed by the senate shall continue for the remainder of the term, or until a successor is chosen and qualifies. A provisional appointee may exercise all of the powers and duties of the office to which such person is appointed during the time in which the appointee qualifies. Any appointment made under this subsection that is withdrawn or rejected by the senate shall lapse. When a provisional appointment lapses, a vacancy occurs. Whenever a new legislature is organized, any appointments then pending before the senate shall be referred by the president to the appropriate standing committee of the newly organized senate.