RETIREMENT AND GROUP INSURANCE
Benefits for domestic partners
2017 Wisconsin Act 59, the 2017-19 biennial budget act, repealed certain benefits provided to domestic partners of public employees who receive benefits through the Wisconsin Retirement System (WRS), the Group Insurance Board (GIB), and the Deferred Compensation Program. The bill reestablishes those benefits. Specifically, Act 59 did all of the following: 1) for purposes of WRS, limited domestic partners to only those individuals who submitted an affidavit of domestic partnership to ETF before January 1, 2018; 2) prohibited GIB from covering an eligible employee’s domestic partner or stepchild under a domestic partnership in a group health insurance plan offered by GIB; 3) eliminated the option for a surviving domestic partner to purchase health insurance coverage under a group health insurance plan offered by GIB; and 4) for deaths occurring on or after January 1, 2018, provided that a surviving domestic partner is not a default beneficiary for purposes of a deferred compensation plan and is not eligible to receive duty disability survivorship benefits. The bill reverses, prospectively, those changes to those benefits.
WRS annuitants returning to work
Under current law, if a WRS annuitant, or a disability annuitant who has attained his or her normal retirement date, is appointed to a position with a WRS-participating employer or provides employee services to a WRS-participating employer in which he or she is expected to work at least two-thirds of what is considered full-time employment by ETF, the annuity must be suspended and no annuity payment is payable until after the participant again terminates covered employment.
The bill removes the requirement that an annuitant suspend his or her annuity and instead allows an annuitant to elect to suspend the annuity and again become a participating employee or elect to not suspend his or her annuity and not become a participating employee. In other words, the bill allows an annuitant who returns to work for a participating employer but elects not to become a participating employee for purposes of the WRS to continue to receive his or her annuity.
Under current law, a WRS participant who has applied to receive a retirement annuity must wait at least 75 days between terminating covered employment with a WRS employer and returning to covered employment again as a participating employee. The bill reduces that period to 30 days.
Waiting period for state employees
Under current law, most state employees, other than limited-term employees, may become covered under the state group health insurance plan on the first day of the first month after becoming employed with the state by filing an election within 30 days of being hired. However, most state employees are ineligible for an employer contribution towards the premiums for the health insurance for the first three months of employment. The bill changes the date to the first day of the second month for most state employees other than limited-term appointments hired on or after the effective date of the bill.
Income continuation insurance
Under current law, GIB must offer employees group income continuation insurance (ICI) coverage that pays for lost earnings as a result of injury or illness with separate provisions for short-term insurance with a benefit duration of no more than one year and long-term insurance covering injury or illness of indefinite duration.
The bill transfers oversight of the group ICI plan to the Employee Trust Funds Board (ETFB). The bill also provides that, as of January 1, 2025, ETFB must provide a group ICI plan, but ETFB is not required to provide separate short-term and long-term insurance or a particular benefit duration.
Under current law, an employee is eligible for benefits under the group ICI plan only after exhausting accumulated sick leave not to exceed 130 days. The bill eliminates that requirement and instead allows an employee to select among waiting periods determined by ETFB.
Employer and employee share of ICI premium payments
The bill changes how the employer and employee shares of premium payments for ICI are determined. Under current law, the employer pays part of an employee’s ICI premium, and the employee pays the remainder. The employer’s share is a certain percentage of the total premium cost that increases as an employee accumulates unused sick leave. For certain employees subject to collective bargaining agreements and for faculty and staff of the UW System, the employer and employee shares may be different from the prescribed formula that is based on the employee’s accumulation of sick leave.
Under the bill, beginning January 1, 2025, for all employees, including UW System faculty and staff, unless a collective bargaining agreement provides otherwise, the employer pays the premium for the longest waiting period available to the employee under the ICI contract. If an employee elects a shorter waiting period, the employee pays the difference in premium amounts between the longest waiting period and the waiting period selected by the employee.
Group long-term disability insurance plan
Under current law, ETFB may determine that GIB must establish a group insurance plan to provide certain disability annuity or death benefits. Under this authority, GIB currently oversees a group long-term disability insurance (LTDI) plan. The bill provides explicit statutory authority for ETFB to establish the LTDI plan and transfers oversight of the LTDI plan from GIB to ETFB.
Internal auditor
The bill creates an Office of Internal Audit attached to ETF. Under the bill, the office plans and conducts audits of activities and programs administered by ETF, among other responsibilities, while following policies, principles, and directives established by ETFB.
The bill requires the ETF board to appoint an internal auditor and internal audit staff within the classified service who report directly to the board. Currently, the internal auditor for ETF reports to the secretary of employee trust funds, and internal audit staff report to the internal auditor.
Trust funds earnings allocations
Under current law, investment gains and losses of the core and variable retirement investment trust funds are distributed in a ratio of each participating account’s average daily balance to the total average daily balance of all participating accounts. The State of Wisconsin Investment Board (SWIB) invests assets of the core and variable investment trust funds, which are commingled under current law, but all activity is not recorded on a daily basis for the separate participating accounts. SWIB provides certified annual earnings reports for the core and variable trust funds.
The bill provides that ETF must distribute the earnings to each participating account by calculating a simple average balance, which uses beginning and end-of-year balances for each participating account, and comparing that average balance to the total average balance of all participating accounts.
2025-27 budget request for pension administration system
The bill requires ETF to include in its 2025-27 biennial budget request a request for funding for modernization of ETF’s pension administration system.
SAFETY AND PROFESSIONAL SERVICES
Advanced practice registered nurses
Licensure of advanced practice registered nurses
Under current law, a person who wishes to practice professional nursing must be licensed by the Board of Nursing as a registered nurse (RN). The bill creates an additional system of licensure for advanced practice registered nurses (APRNs), to be administered by the board. Under the bill, in order to apply for an APRN license, a person must 1) hold an RN license; 2) have completed an accredited graduate-level or postgraduate-level education program preparing the person to practice as an APRN in one of four recognized roles and hold a current national certification approved by the board; 3) possess malpractice liability insurance as provided in the bill; 4) pay a fee determined by DSPS; and 5) satisfy certain other criteria specified in the bill. The bill also allows a person who has not completed an accredited education program described above to receive an APRN license if the person 1) on January 1, 2023, is both licensed as an RN in Wisconsin and practicing in one of the four recognized roles and 2) satisfies additional practice or education criteria established by the board. The bill also, however, automatically grants licenses to certain RNs, as further described below. The four recognized roles, as defined in the bill, are 1) certified nurse-midwife; 2) certified registered nurse anesthetist; 3) clinical nurse specialist; and 4) nurse practitioner. The bill requires the board, upon granting a person an APRN license, to also grant the person one or more specialty designations corresponding to the recognized role or roles for which the person qualifies.
Under the bill, all APRNs, except APRNs with a certified nurse-midwife specialty designation, must practice in collaboration with a physician or dentist. However, under the bill, an APRN may practice without being supervised by a physician or dentist if the Board of Nursing verifies that the APRN has completed 3,840 hours of professional nursing in a clinical setting and has completed 3,840 clinical hours of advanced practice registered nursing practice in his or her recognized role while working with a physician or dentist during those 3,840 hours of practice. APRNs may count additional hours practiced as an APRN in collaboration with a physician or dentist towards the 3,840 required hours of professional nursing. APRNs with a certified nurse-midwife specialty designation are instead required, if they offer to deliver babies outside of a hospital setting, to file and keep current with the board a proactive plan for involving a hospital or a physician who has admitting privileges at a hospital in the treatment of patients with higher acuity or emergency care needs, as further described below. Additionally, under the bill, an APRN may provide pain management services only while working in a collaborative relationship with a physician who specializes in pain management or, if the APRN has qualified to practice independently, in a hospital or clinic associated with a hospital.
The bill allows an APRN to delegate a task or order to another clinically trained health care worker if the task or order is within the scope of the APRN’s practice, the APRN is competent to perform the task or issue the order, and the APRN has reasonable evidence that the health care worker is minimally competent to perform the task or issue the order under the circumstances. The bill requires an APRN to adhere to professional standards when managing situations that are beyond the APRN’s expertise.
The holder of an APRN license may append the title “A.P.R.N.” to his or her name, as well as a title corresponding to whichever specialty designations that the person possesses. The bill prohibits any person from using the title “A.P.R.N.,” and from otherwise indicating that he or she is an APRN, unless the person is licensed by the board as an APRN. The bill also prohibits the use of titles and abbreviations corresponding to a recognized role unless the person has a specialty designation for that role.
Under the bill, when an APRN renews his or her APRN license, the board must grant the person the renewal of both the person’s RN license and the person’s APRN license. The bill requires all APRNs to complete continuing education requirements each biennium in clinical pharmacology or therapeutics relevant to the APRN’s area of practice and to satisfy certain other requirements when renewing a license.
Practice of nurse-midwifery
The bill repeals licensure and practice requirements specific to nurse-midwives and the practice of nurse-midwifery, including specific requirements to practice with an obstetrician. Under the bill, “certified nurse-midwife” is one of the four recognized roles for APRNs, and a person who is licensed as a nurse-midwife under current law is automatically granted an APRN license with a certified nurse-midwife specialty designation. The bill otherwise allows nurse-midwives to be licensed as APRNs if they satisfy the licensure requirements, except that the bill also requires that a person applying for a certified nurse-midwife specialty designation be certified by the American Midwifery Certification Board. The bill also requires an APRN with a specialty designation as a certified nurse-midwife to file with the Board of Nursing, and obtain the board’s approval of, a plan for ensuring appropriate care or care transitions in treating certain patients if the APRN offers to deliver babies outside of a hospital setting.
Prescribing authority
Under current law, a person licensed as an RN may apply to the Board of Nursing for a certificate to issue prescription orders if the person meets certain requirements established by the board. An RN holding a certificate is subject to various practice requirements and limitations established by the board and must possess malpractice liability insurance in an amount determined by the board.
The bill eliminates certificates to issue prescription orders and generally authorizes APRNs to issue prescription orders. A person who is certified to issue prescription orders under current law is automatically granted an APRN license with his or her appropriate specialty designation. RNs who are practicing in a recognized role on January 1, 2023, but who do not hold a certificate to issue prescription orders on that date and who are granted an APRN license under the bill may not issue prescription orders. As under current law, an APRN issuing prescription orders is subject to various practice requirements and limitations established by the board.
The bill repeals a provision concerning the ability of advanced practice nurses who are certified to issue prescription orders and who are required to work in collaboration with or under the supervision of a physician to obtain and practice under a federal waiver to dispense narcotic drugs to individuals for addiction treatment.
Malpractice liability insurance
The bill requires all APRNs to maintain malpractice liability insurance in coverage amounts specified under current law for physicians and nurse anesthetists. Additionally, the bill requires APRNs who have qualified to practice independently and who practice outside a collaborative or employment relationship, but not including those APRNs who only practice as a certified nurse-midwife, to participate in the Injured Patients and Families Compensation Fund. Under current law, only physicians and nurse anesthetists are mandatory participants in the Injured Patients and Families Compensation Fund. The Injured Patients and Families Compensation Fund provides excess medical malpractice coverage for health care providers who participate in the fund and meet all other participation requirements, which includes maintaining malpractice liability insurance in coverage amounts specified under current law.
Other changes
The bill directs DHS to require a hospital that provides emergency services to have sufficient qualified personnel available at all times to manage the number and severity of emergency department cases anticipated by the location. At a minimum, the bill directs DHS to require a hospital that provides emergency services to have on-site at least one physician who, through education, training, and experience, specializes in emergency medicine.
The bill makes numerous other changes throughout the statutes relating to APRNs, including various terminology changes.
Professional licensure
Licensure of dental therapists
The bill provides for the licensure of dental therapists, who are health care practitioners who may engage in the limited practice of dentistry.
Under current law, dentists and dental hygienists are licensed by the Dentistry Examining Board to practice dentistry and dental hygiene, respectively. The bill provides for the licensure of a third type of dental practitioner, dental therapists. Under the bill, the board must grant a dental therapist license to an individual who satisfies certain criteria, including completion of an approved dental therapy program and passage of required examinations.
Dental therapists may provide dental therapy services only under the supervision of a dentist with whom the dental therapist has a collaborative management agreement that addresses various aspects of the dental therapist’s practice. Dental therapists are, subject to the terms of a collaborative management agreement and what was covered in their dental therapy education program, limited to providing services, treatments, and procedures that are specified in the bill, as well as additional services, treatments, or procedures specified by the board by rule. Dental therapists may initially provide dental therapy services only under the direct or indirect supervision of a qualifying dentist. Once a dental therapist has provided dental therapy services for at least 2,000 hours, the dental therapist may provide services under the general supervision of a qualifying dentist. However, the level of supervision for a dental therapist may be further limited under the terms of a collaborative management agreement. Dental therapists must also, under the bill, either 1) limit their practice to federally defined dental shortage areas or 2) practice in settings where at least 50 percent of their patient base consists of certain specified populations. Dental therapists must complete 12 hours of continuing education each biennium.
The bill subjects dental therapists to, or covers dental therapists under, various other laws, including the health care records law, the volunteer health care provider program, the health care worker protection law, and the emergency volunteer health care practitioner law. The bill also provides for loan forgiveness for dental therapists under the health care provider loan assistance program.
Finally, the bill requires, effective when 50 individuals become licensed as a dental therapist in this state or five years after the bill is enacted, that, to the extent possible, one of the dental hygienist members on the board also be licensed as a dental therapist.
Professional licenses for certain noncitizens
Currently, federal law prohibits all but certain noncitizens from receiving any “state or local public benefit,” which is defined to include any “professional license, or commercial license provided by an agency of a state or local government.” However, federal law allows states to explicitly allow eligibility for certain public benefits. The bill allows certain individuals who are not U.S. citizens to receive any professional license issued in this state if they meet all other requirements or qualifications for the professional license. For purposes of the bill, “professional license” means a license, registration, certification, or other approval to perform certain work tasks, whether issued by the state or a local governmental entity.
DSPS renewal dates; continuing education; nursing workforce survey
Under current law, a two-year renewal period applies to many health and business credentials administered by DSPS or a credentialing board. The renewal date for each two-year period is specified by statute. In addition, the laws governing some professions specify continuing education requirements, either by statute or by rule, as part of credentialing renewal.
The bill eliminates statutory renewal dates for these credentials and instead allows DSPS, in consultation with the credentialing boards, to establish renewal dates. The bill makes various changes to continuing education requirements for various professions to account for the flexible renewal periods allowed in the bill, including allowing DSPS and the credentialing boards to adjust continuing education requirements and to establish interim continuing education or other reporting requirements as needed to align with changes to renewal cycles.
Under current law, in order to renew a registered nurse or licensed practical nurse license, a licensee must complete and submit to DSPS with the application for renewal of the license a nursing workforce survey developed by DWD, completed to the satisfaction of the Board of Nursing, along with a nursing workforce survey fee of $4. The bill modifies this requirement so that it no longer applies specifically as a condition of renewal of a nurse license.
Licensing fee revenue
Current law generally appropriates funding for the licensing, rule-making, and regulatory functions of DSPS for professional credentials and other approvals using 90 percent of revenues from the fees paid for those credentials and other approvals. The remaining 10 percent of these revenues are instead credited as GPR in the general fund.
The bill eliminates the exception whereby 10 percent of these revenues are credited as GPR and instead appropriates 100 percent of these revenues to DSPS for the purposes described above.
Reviews of criminal records
The bill requires DSPS, when conducting an investigation of the arrest or conviction record of a credential applicant, to review and obtain information to determine the circumstances of each case or offense, except that the bill allows DSPS, in its discretion, to complete its investigation of an arrest or conviction record without reviewing the circumstances of certain types of offenses specified in the bill. These offenses include certain first offense operating while intoxicated and related violations; certain underage alcohol violations; and minor, nonviolent ordinance violations, as determined by DSPS.
Rules; license portability
The bill provides that DSPS or a credentialing board in DSPS may promulgate administrative rules to facilitate enhanced license portability to help facilitate streamlined pathways to licensure for internationally trained professionals and increased reciprocity.
Trade exams administered by test service providers
Under the bill, DSPS is authorized to approve a test service provider to prepare, administer, and grade the examinations required for credentials to practice various trades, including for electricians, plumbers, fire sprinkler contractors and fitters, elevator mechanics, and blasters.
Buildings and safety
Use of vapor products in indoor locations
The bill specifies that the general prohibition under current law against smoking in indoor locations includes inhaling or exhaling vapor from a vapor product. Under the bill, a “vapor product” is a noncombustible product that produces vapor or aerosol for inhalation from the application of a heating element to a liquid or other substance. The prohibition applies to vapor products regardless of whether they contain nicotine.
Private on-site wastewater treatment system grants
The bill extends the grant program aiding certain persons and businesses served by failing private on-site wastewater treatment systems (POWTS), which are commonly known as septic tanks. Under current law, the program is repealed effective June 30, 2023. In addition, under the bill, a failing POWTS installed at least 33 years before the submission of a grant application is eligible to receive a grant. Current law authorizes grants only for failing POWTS that were installed before July 1, 1978.
Create appropriation for DSPS contractors
The bill creates an appropriation for payments received by DSPS contractors and vendors for services performed related to the regulation of industry, buildings, and safety.
SHARED REVENUE
Public safety, per capita, and aidable revenues allocations
Under current law, counties and municipalities annually receive county and municipal aid payments, commonly referred to as shared revenue. Generally, each county and municipality receives a payment equal to the payment it received in 2012.
The bill provides additional aid payments by creating a municipal and county shared revenue program and using a percentage of state sales tax revenue to make the payments. The total amount available to make the payments under the bill is an amount equal to 20 percent of the state sales tax revenue collected in each fiscal year, minus the amounts distributed for county and municipal aid, as state aid for exempt personal property, and as payments under the expenditure restraint program.
Beginning in 2024, each county and municipality will receive a public safety payment to be used for law enforcement, fire protection, and ambulance and emergency medical services and to pay the costs of prosecutorial and judicial functions. The amount that DOR will distribute for these payments is equal to 43.4 percent of the total amount allocated for all payments under the bill. The amount of the payments are determined on the basis of the most recent three-year average of the county’s or municipality’s expenditures for law enforcement, fire protection, or ambulance and emergency medical services.
Under the bill, each county and municipality will also receive a payment based on the county’s or municipality’s population. Seventy percent of this per capita distribution is paid to municipalities and 30 percent to counties.
Finally, each county and municipality receives a payment on the basis of its aidable revenues. The bill defines “aidable revenues” as the total of the three-year average of revenues from general property taxes, other taxes, payments in lieu of taxes, special assessments, licenses and permits, fines and forfeitures, public charges, intergovernmental revenues, and shared revenues, not including public utility aid payments. The total amount that DOR distributes for aidable revenues is the amount remaining after determining the amounts distributed as public safety payments or per capita payments. Generally, each county and municipality receives an aidable revenues payment, as adjusted by DOR, in proportion to the amount of its aidable revenues, compared to the aidable revenues for all counties or municipalities.
Nontaxable reservation property
The bill provides an additional county and municipal aid payment for certain towns and counties that will no longer be able to impose property taxes on property located within the boundaries of an American Indian reservation and owned by the tribe or tribal members. A federal court recently held that, pursuant to the 1854 Treaty of La Pointe, the state and its political subdivisions are prohibited from taxing all real property within the Bad River, Lac Courte Oreilles, Lac du Flambeau, and Red Cliff reservations if that property is owned by the tribe or by one or more tribal members, regardless of whether the property was previously owned by a person other than the tribe or a tribal member. See Lac Courte Oreilles Band of Lake Superior Chippewa Indians of Wisconsin v. Evers, 46 F.4th 552 (7th Cir. 2022).
Under the bill, DOA determines the amount of the payments to the affected towns and counties for the payments in 2024. In 2025, and in each year thereafter, the amount of the payment a town or county receives is the amount received in the previous year, less 10 percent. No payments are made under the bill after the distribution in 2033.
Energy storage facility
Under current law, counties and municipalities where power production plants are located receive public utility aid payments on the basis of the value or megawatt capacity of the plant. Generally, the amount of the payment to a county or municipality is determined by applying a mill rate to a specified amount of the license fees paid by the power production plant located in the county and municipality.
The bill provides utility aid payments to counties and municipalities where energy storage facilities are located. The bill defines an “energy storage facility” as property that receives electrical energy, stores the energy in a different form, and converts that other form of energy back to electrical energy for sale or to use to provide reliability or economic benefits to the electrical grid. The bill also defines an “energy storage facility” as property that is owned by a light, heat, and power company, electric cooperative, or municipal electric company and includes hydroelectric pumped storage, compressed air energy storage, regenerative fuel cells, batteries, and similar technologies.
