AB75-SSA1,1338,2020 _____ 16. SPECIAL INSTRUCTIONS:
AB75-SSA1,1338,2221 ON THE FOLLOWING LINES YOU MAY GIVE SPECIAL INSTRUCTIONS
22REGARDING THE POWERS GRANTED TO YOUR AGENT.
AB75-SSA1,1339,117 TO ESTABLISH WHEN, AND FOR HOW LONG, THE BASIC POWER OF
8ATTORNEY FOR FINANCES AND PROPERTY IS IN EFFECT, YOU MUST
9INITIAL ONLY ONE OF THE FOLLOWING 3 OPTIONS. IF YOU DO NOT
10INITIAL ONE, OR IF YOU INITIAL MORE THAN ONE, THIS BASIC POWER OF
11ATTORNEY FOR FINANCES AND PROPERTY WILL NOT TAKE EFFECT.
AB75-SSA1,1339,12 12Initials
AB75-SSA1,1339,1513 _____ This basic power of attorney for finances and property becomes effective
14when I sign it and will continue in effect as a durable power of attorney under section
15243.07, Wisconsin Statutes, if I become disabled or incapacitated.
AB75-SSA1,1339,1716 _____ This basic power of attorney for finances and property becomes effective
17only when both of the following apply:
AB75-SSA1,1339,1818 a. I have signed it; and
AB75-SSA1,1339,1919 b. I become disabled or incapacitated.
AB75-SSA1,1339,2220 _____ This basic power of attorney for finances and property becomes effective
21when I sign it but will cease to be effective if I become disabled
22or incapacitated
.
AB75-SSA1,1340,223 I agree that any 3rd party who receives a copy of this document may act under
24it. Revocation of this basic power of attorney is not effective as to a 3rd party until
25the 3rd party learns of the revocation. I agree to reimburse the 3rd party for any loss

1resulting from claims that arise against the 3rd party because of reliance on this
2basic power of attorney.
AB75-SSA1,1340,33 Signed this .... day of ...., (year)
AB75-SSA1,1340,55 (Your Signature)
AB75-SSA1,1340,88 (Your Social Security Number)
AB75-SSA1,1340,159 By signing as a witness, I am acknowledging the signature of the principal who
10signed in my presence and the presence of the other witness, and the fact that he or
11she has stated that this power of attorney reflects his or her wishes and is being
12executed voluntarily. I believe him or her to be of sound mind and capable of creating
13this power of attorney. I am not related to him or her by blood, marriage or adoption,
14and, to the best of my knowledge, I am not entitled to any portion of his or her estate
15under his or her will.
AB75-SSA1,1340,16 16Witness Witness
AB75-SSA1,1340,1717 Dated: ....   Dated: ....
AB75-SSA1,1340,1818 Signature: ....  Signature: ....
AB75-SSA1,1340,1919 Print Name: .... Print Name: ....
AB75-SSA1,1340,2020 Address: .... Address: ....
AB75-SSA1,1340,2121 State of ....
AB75-SSA1,1340,2222 County of ....
AB75-SSA1,1340,2423 This document was acknowledged before me on .... (date) by .... (name of
24principal).
AB75-SSA1,1341,22 (Signature of Notarial Officer)
AB75-SSA1,1341,33 (Seal, if any)
AB75-SSA1,1341,55 [My commission is permanent or expires: .... ]
AB75-SSA1,1341,86 BY ACCEPTING OR ACTING UNDER THE APPOINTMENT, THE AGENT
7ASSUMES THE FIDUCIARY AND OTHER LEGAL RESPONSIBILITIES AND
8LIABILITIES OF AN AGENT.
AB75-SSA1,1341,1010 (Name of Agent)
AB75-SSA1,1341,1313 (Signature of Agent)
AB75-SSA1,1341,1514 This document was drafted by .... (signature of person preparing the
15document).
AB75-SSA1, s. 2506 16Section 2506. 243.10 (7) (b) of the statutes is amended to read:
AB75-SSA1,1341,2517 243.10 (7) (b) A principal may revoke a Wisconsin basic power of attorney for
18finances and property and invalidate it at any time by destroying it, by directing
19another person to destroy it in the principal's presence or by signing a written and
20dated statement expressing the principal's intent to revoke. If the agent under the
21Wisconsin basic power of attorney for finances and property is the principal's spouse
22and the marriage is annulled, or the agent and principal are divorced, or the agent
23is the principal's domestic partner under ch. 770 and the domestic partnership is
24terminated under s. 770.12,
after signing the document, the Wisconsin basic power
25of attorney for finances and property is invalid.
AB75-SSA1, s. 2506r
1Section 2506r. 250.03 (3) (b) of the statutes is amended to read:
AB75-SSA1,1342,62 250.03 (3) (b) Biennially, after first consulting with the adjutant general, local
3health departments, health care providers, as defined in s. 146.81 (1) (a) to (p), and
4law enforcement agencies, as defined in s. 165.77 (1) (b), the department shall submit
5to the legislature under s. 13.172 (2) and to the governor a report on the preparedness
6of the public health system to address public health emergencies.
AB75-SSA1, s. 2507 7Section 2507. 250.10 (title) of the statutes is amended to read:
AB75-SSA1,1342,8 8250.10 (title) Grant for dental Dental services.
AB75-SSA1, s. 2508 9Section 2508. 250.10 (intro.) of the statutes is repealed.
AB75-SSA1, s. 2509 10Section 2509. 250.10 (1) of the statutes is renumbered 250.10 (1m) (a) and
11amended to read:
AB75-SSA1,1342,1912 250.10 (1m) (a) The department shall provide Provide funding in each fiscal
13year to the Marquette University School of Dentistry for clinical education of
14Marquette University School of Dentistry students through the provision of dental
15services by the students and faculty of the Marquette University School of Dentistry
16in underserved areas and to underserved populations in the state, as determined by
17the department in conjunction with the Marquette University School of Dentistry;
18to inmates of correctional centers in Milwaukee County; and in clinics in the city of
19Milwaukee.
AB75-SSA1, s. 2510 20Section 2510. 250.10 (1m) (intro.) of the statutes is created to read:
AB75-SSA1,1342,2121 250.10 (1m) (intro.) The department shall do all of the following:
AB75-SSA1, s. 2511 22Section 2511. 250.10 (2) of the statutes is renumbered 250.10 (1m) (b) and
23amended to read:
AB75-SSA1,1343,224 250.10 (1m) (b) The department shall distribute Award in each fiscal year to
25qualified applicants grants totaling $25,000 for fluoride supplements, $25,000 for a

1fluoride mouth-rinse program, and $120,000 for a school-based dental sealant
2program.
AB75-SSA1, s. 2512 3Section 2512. 250.15 (2) (intro.) of the statutes is created to read:
AB75-SSA1,1343,54 250.15 (2) (intro.) From the appropriation account under s. 20.435 (1) (fh), the
5department shall, in each fiscal year, award all of the following as grants:
AB75-SSA1, s. 2513 6Section 2513. 250.15 (2) (a) of the statutes is amended to read:
AB75-SSA1,1343,97 250.15 (2) (a) From the appropriation under s. 20.435 (5) (fh), the department
8shall award $50,000 in each fiscal year as a grant to
To a community health center
9in a 1st class city, $50,000.
AB75-SSA1, s. 2514 10Section 2514. 250.15 (2) (b) of the statutes is amended to read:
AB75-SSA1,1343,1911 250.15 (2) (b) From the appropriation under s. 20.435 (5) (fh), the department
12shall award grants in each fiscal year to
To community health centers that receive
13federal grants under 42 USC 254b (e), (g) or (h). Each grant shall equal the amount
14that results from multiplying the total amount available for grants under this
15paragraph in the fiscal year in which the grants are to be awarded by the quotient
16obtained by dividing the amount that the community health center received under
1742 USC 254b (e), (g) or (h) in the most recently concluded federal fiscal year in which
18those grants were made by the total amount of federal grants under 42 USC 254b (e),
19(g) and (h) made in that federal fiscal year to community health centers in this state.
AB75-SSA1, s. 2515 20Section 2515. 250.15 (2) (c) of the statutes is amended to read:
AB75-SSA1,1343,2321 250.15 (2) (c) From the appropriation under s. 20.435 (5) (fh), the department
22shall award $50,000 in each fiscal year as a grant to
To HealthNet of Janesville, Inc.,
23$50,000
.
AB75-SSA1, s. 2516 24Section 2516. 250.16 (1) of the statutes is amended to read:
AB75-SSA1,1344,7
1250.16 (1) The From the appropriation account under s. 20.435 (1) (gi), the
2department shall enter into an agreement with the Wisconsin Women's Health
3Foundation, Inc., to
make payments from the appropriation under s. 20.435 (5) (fi)
4to the Wisconsin Women's Health Foundation, Inc., to be used by the Wisconsin
5Women's Health Foundation, Inc., to fund its efforts to
provide women's health
6outreach and education programs and support for women's health research that
7improves the quality of life for women and families in this state.
AB75-SSA1, s. 2517 8Section 2517. 250.17 (1) of the statutes is amended to read:
AB75-SSA1,1344,179 250.17 (1) The From the appropriation account under s. 20.435 (1) (g), the
10department shall enter into an agreement with Donate Life Wisconsin to make
11payments from the appropriation under s. 20.435 (5) (g) to Donate Life Wisconsin,
12to be used to fund its efforts to encourage organ and tissue donation by providing
13educational programs, promoting or advancing research and patient services, and,
14at its the discretion of Donate Life Wisconsin, distributing portions of these
15payments to any other organ and tissue procurement and donation organization in
16this state that is exempt from taxation under section 501 (a) of the Internal Revenue
17Code, to be used for these same purposes.
AB75-SSA1, s. 2518 18Section 2518. 250.20 (3) of the statutes is amended to read:
AB75-SSA1,1345,219 250.20 (3) From the appropriation account under s. 20.435 (5) (1) (kb), the
20department shall annually award grants for activities to improve the health status
21of economically disadvantaged minority group members. A person may apply, in the
22manner specified by the department, for a grant of up to $50,000 in each fiscal year
23to conduct these activities. An awardee of a grant under this subsection shall
24provide, for at least 50% of the grant amount, matching funds that may consist of
25funding or an in-kind contribution. An applicant that is not a federally qualified

1health center, as defined under 42 CFR 405.2401 (b) shall receive priority for grants
2awarded under this subsection.
AB75-SSA1, s. 2519 3Section 2519. 250.20 (4) of the statutes is amended to read:
AB75-SSA1,1345,74 250.20 (4) From the appropriation account under s. 20.435 (5) (1) (kb), the
5department shall award a grant of up to $50,000 in each fiscal year to a private
6nonprofit corporation that applies, in the manner specified by the department, to
7conduct a public information campaign on minority health.
AB75-SSA1, s. 2520 8Section 2520. 250.20 (5) (intro.) of the statutes is amended to read:
AB75-SSA1,1345,159 250.20 (5) American Indian health project grants. (intro.) From the
10appropriation under s. 20.435 (5) (1) (ke), the department shall award grants for
11American Indian health projects in order to address specific problem areas in the
12field of American Indian health. A tribe, tribal agency, or inter-tribal organization
13may apply, in the manner specified by the department, for a grant of up to $10,000
14to conduct an American Indian health project that is designed to do any of the
15following:
AB75-SSA1, s. 2521n 16Section 2521n. 252.05 (1) of the statutes is amended to read:
AB75-SSA1,1345,2517 252.05 (1) Any health care provider, as defined in s. 146.81 (1) (a) to (p), who
18knows or has reason to believe that a person treated or visited by him or her has a
19communicable disease, or having a communicable disease, has died, shall report the
20appearance of the communicable disease or the death to the local health officer. The
21health agency of a federally recognized American Indian tribe or band may report
22this information to the local health officer. The local health officer shall report this
23information to the department or shall direct the person reporting to report to the
24department. Any person directed to report shall submit this information to the
25department.
AB75-SSA1, s. 2522
1Section 2522. 252.06 (10) (b) 4. of the statutes is repealed.
AB75-SSA1, s. 2523 2Section 2523. 252.07 (10) of the statutes is amended to read:
AB75-SSA1,1346,93 252.07 (10) Inpatient care for isolated pulmonary tuberculosis patients, and
4inpatient care exceeding 30 days for other pulmonary tuberculosis patients, who are
5not eligible for federal medicare benefits, or for medical assistance under subch. IV
6of ch. 49 or for health care services funded by a relief block grant under subch. II of
7ch. 49
may be reimbursed if provided by a facility contracted by the department. If
8the patient has private health insurance, the state shall pay the difference between
9health insurance payments and total charges.
AB75-SSA1, s. 2523d 10Section 2523d. 252.07 (12) of the statutes is created to read:
AB75-SSA1,1346,1311 252.07 (12) From the appropriation account under s. 20.435 (1) (e), the
12department may expend not more than $81,100 annually to fund targeted
13prevention activities for populations at high risk for tuberculosis infection.
AB75-SSA1, s. 2524 14Section 2524. 252.10 (6) (g) of the statutes is amended to read:
AB75-SSA1,1346,1715 252.10 (6) (g) The reimbursement by the state under pars. (a) and (b) shall
16apply only to funds that the department allocates for the reimbursement under the
17appropriation account under s. 20.435 (5) (1) (e).
AB75-SSA1, s. 2525 18Section 2525. 252.10 (7) of the statutes is amended to read:
AB75-SSA1,1346,2219 252.10 (7) Drugs necessary for the treatment of mycobacterium tuberculosis
20shall be purchased by the department from the appropriation account under s.
2120.435 (5) (1) (e) and dispensed to patients through the public health dispensaries,
22local health departments, physicians or advanced practice nurse prescribers.
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