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2017 Wisconsin Act 59, the 2017-19 biennial budget act, repealed certain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.
Under the bill, DOA annually distributes to each county and municipality in
which an energy storage facility is located an amount calculated by multiplying the
facility's megawatt capacity by $2,000 and then multiplying the product of that
calculation by three mills for a county and by six mills for a municipality. However,
if the energy storage facility is located in a town, the town receives a payment equal
to multiplying the product of that calculation by three mills and the county where
the town is located receives a payment equal to multiplying the product of that
calculation by six mills.
