AB924: Bill Text

2001 Assembly BILL 924

March 14, 2002 - Introduced by Representatives Johnsrud, J. Lehman, Loeffelholz, Urban, Hines, Bies and Kedzie, cosponsored by Senator Moen. Referred to Committee on Health.

AB924,1,11 An Act to repeal 456.04 (4); to renumber and amend 15.405 (7m); to amend 15.08 (1m) (b), 46.21 (1m) (am), 50.04 (2) (a), 59.79 (10), chapter 456 (title), 456.01 (1), 456.01 (4), 456.01 (5), 456.02 (1), 456.02 (4), 456.02 (5), 456.02 (6), 456.03, 456.04 (intro.), 456.05 (intro.), 456.05 (1), 456.05 (2), 456.05 (3), 456.07 (1), 456.07 (2), 456.07 (3), 456.07 (4), 456.08, 456.09 (1) (b), 456.09 (1) (c), 456.09 (1) (d), 456.09 (1) (e), 456.10 (1) (intro.), 456.10 (1) (bm), 456.10 (1) (c), 456.10 (1) (d) and 456.10 (2); and to create 14.405 (7m) (c), 15.405 (7m) (a) 2., 440.08 (2) (a) 38k., 456.01 (1g), 456.01 (1r), 456.01 (3m), 456.01 (5m), 456.04 (5), 456.04 (6), 456.05 (4), 456.07 (2m), 456.07 (6), 456.072, 456.078 and 456.12 of the statutes; relating to: licensing hospital administrators and granting rule-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, 2008, 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:

AB924, s. 1 Section 1. 14.405 (7m) (c) of the statutes is created to read:

AB924,3,4 14.405 (7m) (c) One of the members appointed under par. (a) 4. must be employed in a nursing home and the other member appointed under par. (a) 4. must be employed in a hospital.

AB924, s. 2 Section 2. 15.08 (1m) (b) of the statutes is amended to read:

AB924,4,10 15.08 (1m) (b) The public members of the chiropractic examining board, the dentistry examining board, the hearing and speech examining board, the medical examining board, the respiratory care practitioners examining council and, the council on physician assistants, the board of nursing, the hospital and nursing home administrator examining board, the veterinary examining board, the optometry examining board, the pharmacy examining board, the examining board of social workers, marriage and family therapists and professional counselors , and the psychology examining board shall not be engaged in any profession or occupation concerned with the delivery of physical or mental health care.

AB924, s. 3 Section 3. 15.405 (7m) of the statutes is renumbered 15.405 (7m) (a) (intro.) and amended to read:

AB924,4,18 15.405 (7m) (a) (intro.) Nursing Hospital and nursing home administrator examining board. There is created a hospital and nursing home administrator examining board in the department of regulation and licensing consisting of 9 members appointed for staggered 4-year terms and the secretary of health and family services or a designee, who shall serve as a nonvoting member . Five, and the following members appointed for 4-year terms:

AB924,4,20 1. Three members shall be who are nursing home administrators licensed in this state under ch. 456.

AB924,4,21 3. One member shall be who is a physician. One member shall be a nurse

AB924,4,22 4. Two members who are nurses licensed under ch. 441.

AB924,4,23 5. Two public members shall be public members.

AB924,4,25 (b) No more than 2 members appointed under par. (a) 1. to 5. may be officials or full-time employees of this state.

AB924, s. 4 Section 4. 15.405 (7m) (a) 2. of the statutes is created to read:

AB924,5,3 15.405 (7m) (a) 2. Three members who are hospital administrators licensed under ch. 456.

AB924, s. 5 Section 5. 46.21 (1m) (am) of the statutes is amended to read:

AB924,5,16 46.21 (1m) (am) The county executive shall appoint under ss. 63.01 to 63.17 an administrator of the county hospital. The appointment shall be made on the basis of recognized and demonstrated public interest in and knowledge of the problems of delivery of medical care and treatment, and with due regard to training, experience, executive and administrative ability and efficiency, and general qualifications and fitness for performing the duties of the office. An administrator may not be appointed under this paragraph unless he or she is licensed as a hospital administrator under ch. 456. The administrator shall file an official oath and bond in the amount determined by the county board of supervisors. The county board of supervisors may create positions to assist the administrator. The administrator shall be appointed by the county executive in the unclassified civil service, and the appointment is subject to confirmation by the county board of supervisors under s. 59.17 (2) (bm).

AB924, s. 6 Section 6. 50.04 (2) (a) of the statutes is amended to read:

AB924,6,3 50.04 (2) (a) No nursing home within the state may operate except under the supervision of an administrator licensed under ch. 456 by the hospital and nursing home administrators administrator examining board. If the holder of a nursing home license is unable to secure a new administrator because of the departure of an administrator, such license holder may, upon written notice to the department and upon the showing of a good faith effort to secure a licensed administrator, place the nursing home in the charge of an unlicensed individual subject to conditions and time limitations established by the department, with advice from the hospital and nursing home administrator examining board. An unlicensed individual who administers a nursing home as authorized under this subsection is not subject to the penalty provided under s. 456.09.

AB924, s. 7 Section 7. 59.79 (10) of the statutes is amended to read:

AB924,6,16 59.79 (10) County hospital. Determine policy for the operation, maintenance, and improvement of the county hospital under s. 49.71 (2) and, notwithstanding the powers and duties specified under s. 46.21 (2) (k), (3r), and (6) with respect to the county hospital and the administrator and specified under s. 46.21 (2) (b), (L), (m), (n), (nm), (o), (p), and (q) and (3g), provide for the management of the county hospital as the board considers appropriate, except that the employee positions at the hospital will be county employee positions and except that the board may not employ a person as a hospital administrator unless he or she is licensed as such under ch. 456. If the board acts under this subsection, the board may not discontinue operation, maintenance, and improvement of the county hospital under s. 49.71 (2) and shall exercise the duties under s. 46.21 (4m). This subsection does not apply if the board acts under s. 46.21 with respect to the county hospital under s. 49.71 (2).

AB924, s. 8 Section 8. 440.08 (2) (a) 38k. of the statutes is created to read:

AB924,6,19 440.08 (2) (a) 38k. Hospital administrator: July 1 of each even-numbered year; $53.

AB924, s. 9 Section 9. Chapter 456 (title) of the statutes is amended to read:

AB924,6,23 CHAPTER 456 hospital and nursing home administrator examining board

AB924, s. 10 Section 10. 456.01 (1) of the statutes is amended to read:

AB924,7,2 456.01 (1) "Examining board" means the hospital and nursing home administrator examining board.

AB924, s. 11 Section 11. 456.01 (1g) of the statutes is created to read:

AB924,7,4 456.01 (1g) "Hospital" has the meaning given in s. 50.33 (2).

AB924, s. 12 Section 12. 456.01 (1r) of the statutes is created to read:

AB924,7,9 456.01 (1r) "Hospital administrator" means any individual responsible for planning, organizing, directing, and controlling the operation of a hospital, or who in fact performs such functions, whether or not such functions are shared by one or more other persons.

AB924, s. 13 Section 13. 456.01 (3m) of the statutes is created to read:

AB924,7,12 456.01 (3m) "Practice of hospital administration" means the planning, organizing, directing, and controlling of the operation of a hospital.

AB924, s. 14 Section 14. 456.01 (4) of the statutes is amended to read:

AB924,7,15 456.01 (4) "Practice of nursing home administration" means the planning, organizing, directing, and control controlling of the operation of a nursing home.

AB924, s. 15 Section 15. 456.01 (5) of the statutes is amended to read:

AB924,7,18 456.01 (5) "Provisional license" is a temporary license issued to a provisional hospital or nursing home administrator under this chapter.

AB924, s. 16 Section 16. 456.01 (5m) of the statutes is created to read:

AB924,7,21 456.01 (5m) "Provisional hospital administrator" means an individual who has been licensed as such under this chapter.

AB924, s. 17 Section 17. 456.02 (1) of the statutes is amended to read:

AB924,8,3 456.02 (1) Develop, impose, and enforce standards which must be met by individuals in order to receive a license as a hospital or nursing home administrator, which standards shall be designed to insure that hospital or nursing home administrators will be individuals who are of good character and are otherwise suitable, and who, by training or experience in the field of institutional administration, are qualified to serve as hospital or nursing home administrators;

AB924, s. 18 Section 18. 456.02 (4) of the statutes is amended to read:

AB924,8,7 456.02 (4) Establish and carry out procedures designed to insure that individuals licensed as hospital or nursing home administrators will, during any period that they serve as such, comply with the requirements of such standards;

AB924, s. 19 Section 19. 456.02 (5) of the statutes is amended to read:

AB924,8,13 456.02 (5) Subject to the rules promulgated under s. 440.03 (1), receive, investigate, and take appropriate action with respect to, any charge or complaint filed with the examining board to the effect that any individual licensed as a hospital or nursing home administrator has failed to comply with the requirements of such standards;

AB924, s. 20 Section 20. 456.02 (6) of the statutes is amended to read:

AB924,8,20 456.02 (6) In cooperation with other agencies and appropriate organizations, conduct a continuing study of the practice of hospital and nursing home administration within the state with a view to the improvement of the standards imposed for the licensing of such administrators and of procedures and methods for the enforcement of such standards with respect to administrators of hospitals or nursing homes who have been licensed as such;.

AB924, s. 21 Section 21. 456.03 of the statutes is amended to read:

AB924,9,3 456.03 Licenses. An applicant for a license as a hospital or nursing home administrator who has successfully complied with the requirements for licensure under this chapter and passed the examination shall be granted a license by the examining board, certifying that the applicant, depending on the license granted, has met the requirements of the laws and rules entitling the applicant to serve, act, practice, and otherwise hold himself or herself out as a duly licensed hospital or nursing home administrator.

AB924, s. 22 Section 22. 456.04 (intro.) of the statutes is amended to read:

AB924,9,7 456.04 Examination requirements. (intro.) The examining board shall allow any person to take the examination for licensure as a hospital or nursing home administrator who satisfies all of the following requirements:

AB924, s. 23 Section 23. 456.04 (4) of the statutes is repealed.

AB924, s. 24 Section 24. 456.04 (5) of the statutes is created to read:

AB924,9,13 456.04 (5) For licensure as a nursing home administrator, received a bachelor's degree in nursing home administration or has completed an educational program that the examining board determines is substantially equivalent to receiving a bachelor's degree in nursing home administration.

AB924, s. 25 Section 25. 456.04 (6) of the statutes is created to read:

AB924,9,19 456.04 (6) Except as provided in s. 456.072 (1), for licensure as a hospital administrator, received a bachelor's degree in administration of health care facilities or programs or has completed an educational program that the examining board determines is substantially equivalent to receiving a bachelor's degree in administration of health care facilities or programs.

AB924, s. 26 Section 26. 456.05 (intro.) of the statutes is amended to read:

AB924,9,25 456.05 Examinations. (intro.) The examining board shall determine the subjects of examination for applicants for licensure as hospital or nursing home administrators, and the scope, content, and format of such examinations. The Depending on the license applied for, the examinations shall include examination of the applicant's knowledge of each of the following:

AB924, s. 27 Section 27. 456.05 (1) of the statutes is amended to read:

AB924,10,4 456.05 (1) The laws governing the operation of hospitals or long-term care facilities and the protection of the interests, safety, and well-being of the patients or residents therein; and.

AB924, s. 28 Section 28. 456.05 (2) of the statutes is amended to read:

AB924,10,7 456.05 (2) The elements of proper and effective administration of hospitals or long-term care facilities; and.

AB924, s. 29 Section 29. 456.05 (3) of the statutes is amended to read:

AB924,10,10 456.05 (3) The psychological, physical, medical, and social needs of persons served in such hospitals or long-term care facilities.

AB924, s. 30 Section 30. 456.05 (4) of the statutes is created to read:

AB924,10,13 456.05 (4) The requirements and procedures of federal and state health care reimbursement programs.

AB924, s. 31 Section 31. 456.07 (1) of the statutes is amended to read:

AB924,10,18 456.07 (1) Every individual who holds a license as a hospital or nursing home administrator issued by the department shall biennially apply to the examining board for a new certificate of registration and report any facts requested by the examining board on forms provided for such purpose.

AB924, s. 32 Section 32. 456.07 (2) of the statutes is amended to read: