Comparison with federal regulations
To the fund board's and OCI's knowledge there is no existing or proposed federal regulation that is intended to address patient compensation fund rates, administration or activities.
Comparison of rules in adjacent states
To the fund board's and OCI's knowledge there are no similar rules in the adjacent states to compare this rule to as none of these states have a patients compensation fund created by statute where rates are directed to be established yearly by rule as is true in Wisconsin.
Summary of factual data and analytical methodologies
None. This rule establishes annual fund fees pursuant to the requirements of the above-noted Wisconsin statutes.
Analysis and supporting documentation used to determine rule's effect on small businesses
This increase in fund fees and mediation panel fees will have an affect on some small businesses in Wisconsin; particularly those that employ physicians and other health care professionals. The mediation panel fee is assessed only on physicians and hospitals, not on corporations or other health care entities. These increases will affect only those small businesses that pay the fund fees and mediation panel fees on behalf of their employed physicians. However, these increases will not have a significant effect nor should it negatively affect the small business's ability to compete with other providers.
Small Business Impact
This rule will have little or no effect on small businesses. The increase contained in the proposed rule will require providers to pay an increased fund fee and mediation panel fee which will increase the operational expenses for the providers. However, this increase is not considered to be significant and will have no effect on the provider's competitive abilities.
Small business regulatory coordinator
The OCI small business coordinator is Eileen Mallow and may be reached at phone number (608) 266-7843 or at email address
eileen.mallow@wisconsin.gov
Fiscal Estimate
Summary
The Injured Patients and Families Compensation Fund (IPFCF or Fund) is a segregated fund. Annual Fund fees are established to become effective each July 1 based on actuarial estimates of the Fund's needs for payment of medical malpractice claims. The proposed fees were approved by the Fund's Board of Governors at its December 17, 2008 meeting.
The Fund is a unique fund; there are no other funds like it in the country. The Fund provides unlimited liability coverage and participation is mandatory. These two features make this Fund unique compared to funds in other states. The only persons who will be affected by this rule change are the Fund participants themselves as the IPFCF is fully funded through assessments paid by Fund participants.
There is no effect on GPR.
State fiscal effect
None.
Local government fiscal effect
None.
Fiscal effect on private sector
The increase in fees promulgated by this rule does not result in a significant fiscal effect on the private sector. Although a health care provider may pass this increase on to its patients, there will not be a significant fiscal effect on the private sector as a result of this proposed rule.
Fund sources affected
SEG.
Long-range fiscal implications
None.
Notice of Hearing
Medical Examining Board
NOTICE IS HEREBY GIVEN that pursuant to authority vested in the Medical Examining Board in ss.
15.08 (5) (b)
,
227.11 (2)
and
448.04 (1) (i) 3.
, Stats., the Medical Examining Board will hold a public hearing at the time and place indicated below to consider an order to amend s.
Med 20.05
(title), and to create s.
Med 20.055
, relating to temporary certificates for respiratory care practitioners who are certified in other jurisdictions.
Hearing Information
Date:
March 18, 2009
Time:
8:30 a.m.
Location:
1400 East Washington Avenue
(Enter at 55 North Dickinson Street)
Room 121A
Madison, Wisconsin
Appearances at the Hearing and Submission of Written Comments
Interested persons are invited to present information at the hearing. Persons appearing may make an oral presentation but are urged to submit facts, opinions and argument in writing as well. Facts, opinions and argument may also be submitted in writing without a personal appearance by mail addressed to Pamela Haack, Paralegal, Department of Regulation and Licensing, Office of Legal Counsel, 1400 East Washington Avenue, Room 152, P.O. Box 8935, Madison, Wisconsin 53708, email at
pamela.haack@wisconsin.gov
. Comments must be received on or before March 30, 2009, to be included in the record of rule-making proceedings.
Copies of Proposed Rule
Copies of this proposed rule are available upon request to Pamela Haack, Paralegal, Department of Regulation and Licensing, Office of Legal Counsel, 1400 East Washington Avenue, P.O. Box 8935, Madison, Wisconsin 53708, or by email at
pamela.haack@wisconsin.gov
.
Analysis prepared by the Department of Regulation and Licensing.
Statutes interpreted
Statutory authority
Explanation of agency authority
The Medical Examining Board has the authority under s.
448.40
, Stats., to promulgate rules establishing minimum standards for the practice of respiratory care, including the issuance of temporary certificates for respiratory care practitioners.
Related statute or rule
Plain language analysis
This proposed rule-making will conform ch.
Med 20
, relating to respiratory care practitioners, to the provisions enacted by
2007 Wisconsin Act 54
, which created a temporary certificate for the practice of respiratory care. The temporary certificate to practice respiratory care authorized by this Act is available to a limited category of applicants who have passed the national examination and are licensed in another state. The Act allows for a maximum of three months of practice under the temporary certificate, which cannot be renewed. The proposed rule addresses the high demand for health care professionals such as respiratory care practitioners and makes its easier for hospitals, especially those along Wisconsin's borders, to recruit and hire qualified applicants that are licensed in neighboring states in a timely manner. Currently, the temporary certificate is only available to graduates who have not passed the national examination.
SECTION 2 creates s.
Med 20.055
relating to the requirements for issuance of a temporary certificate for applicants who are certified to practice in another jurisdiction.
Comparison with federal regulations
There is no existing or proposed federal regulation.
Comparison with rules in adjacent states
Iowa:
None.
Illinois:
There is a six month temporary license available for pending applicants until the next available examination is taken.
Michigan:
A temporary license is available for up to four years if the applicant has practiced as a full-time respiratory care practitioner for four years immediately preceding the date of application in certain, specified settings. A letter of recommendation from a Medical Director is also required.
Minnesota:
A temporary permit is issued and is valid until the board meets to decide on the application. A temporary permit is also available until the next available examination.
Summary of factual data and analytical methodologies
Analysis and supporting documents used to determine effect on small business
The Medical Examining Board did not consult supporting documents other than
2005 Wisconsin Act 195
. It is merely updating its rules based on the legislative change.
Section
227.137
, Stats., requires an "agency" to prepare an economic impact report before submitting the proposed rule-making order to the Wisconsin Legislative Council. The Department of Regulation and Licensing is not included as an "agency" in this section.
Small Business Impact
These proposed rules will have no significant economic impact on a substantial number of small businesses, as defined in s.
227.114 (1)
, Stats.
The Department's Regulatory Review Coordinator may be contacted by email at
larry.martin@wisconsin.gov
, or by calling 608-266-8608.
Fiscal Estimate
The department estimates that this rule will require staff time in the Office of Legal Counsel, Division of Management Services, and the Division of Professional Credentialing. The total one-time salary and fringe costs are estimated at $3,500. The total on-going salary and fringe costs are estimated at $600.
Anticipated costs incurred by private sector
The department finds that this rule has no significant fiscal effect on the private sector.
Agency Contact Person
Pamela Haack, Paralegal, Department of Regulation and Licensing, Office of Legal Counsel, 1400 East Washington Avenue, Room 152, P.O. Box 8935, Madison, Wisconsin 53708; telephone 608-266-0495; email at
pamela.haack@ wisconsin.gov
.
Notice of Hearing
Medical Examining Board
NOTICE IS HEREBY GIVEN that pursuant to authority vested in the Medical Examining Board in ss.
15.08 (5) (b)
,
227.11 (2)
,
448.05 (5)
and
448.40
, Stats., the Medical Examining Board will hold a public hearing at the time and place indicated below to consider an order to revise ss.
Med 8.08
and
8.10 (3)
, relating to prescribing limitations for physician assistants.
Hearing Information
Date:
March 18, 2009
Time:
8:40 a.m.
Location:
1400 East Washington Avenue
(Enter at 55 North Dickinson Street)
Room 121A
Madison, Wisconsin
Appearances at the Hearing and Submission of Written Comments
Interested persons are invited to present information at the hearing. Persons appearing may make an oral presentation but are urged to submit facts, opinions and argument in writing as well. Facts, opinions and argument may also be submitted in writing without a personal appearance by mail addressed to Pamela Haack, Paralegal, Department of Regulation and Licensing, Office of Legal Counsel, 1400 East Washington Avenue, Room 152, P.O. Box 8935, Madison, Wisconsin 53708, email at
pamela.haack@wisconsin.gov
. Comments must be received on or before March 30, 2009, to be included in the record of rule-making proceedings.
Copies of Proposed Rule
Copies of this proposed rule are available upon request to Pamela Haack, Paralegal, Department of Regulation and Licensing, Office of Legal Counsel, 1400 East Washington Avenue, P.O. Box 8935, Madison, Wisconsin 53708, or by email at
pamela.haack@wisconsin.gov
.
Analysis Prepared by the Department of Regulation and Licensing
Statutes interpreted
Statutory authority
Explanation of agency authority
The Medical Examining Board is granted the authority under s.
448.40
, Stats., to promulgate rules establishing licensing and practice standards for physician assistants for the purpose of protecting the public health, safety and welfare.
Related statutes or rules
Plain language analysis
This proposed rule-making will change the countersignature requirement of the physician assistant prescribing rule which currently provides that the supervising physician must countersign the prescription or patient record within 72 hours or one week, depending on the practice site. Based on the advances in physician assistants' licensure and prescriptive authority, including a record of safe prescribing, co-signature of every prescription is no longer needed. The proposed rule will allow for more flexibility between the physician and physician assistant by allowing the supervising physician to determine the method and frequency of the review based upon the prescriptive practice, the experience of the physician assistant and the patients' needs. In addition, the proposed rule re-conceptualizes the required written guidelines for prescribing to include the categories of drugs for which prescriptive authority has been authorized and the technological advancement in electronic communications and recordkeeping.
SECTION 1 amends rules to reflect the prescribing or dispensing of a drug pursuant to written guidelines for supervised prescriptive practice.
SECTION 2 repeals rules which currently provide that the supervising physician must countersign the prescription or patient record within 72 hours or one week, based on the advances in physician assistant licensure and prescriptive authority.
SECTION 3 creates rules to allow for more flexibility between the physician and physician assistant by allowing the supervising physician to determine the method and frequency of the review based upon prescriptive practice, experience of the physician assistant, and patient needs.
SECTION 4 amends rules to incorporate the technological advancement in electronic communications.
Comparison with federal regulations
There is no existing or proposed federal regulation.
Comparison with rules in adjacent states
Iowa:
Physician assistants may prescribe non-controlled and controlled substances (except schedule II depressants). They may dispense under certain conditions. Physician assistants who prescribe controlled medications must register with the DEA.
Supervision: A physician need not be physically present, but must be readily available by telecommunication.
Illinois:
A physician may delegate prescriptive authority for non-controlled and schedules III-V medications to physician assistants, with periodic review by the supervising physician. A physician must file notice of delegation of prescriptive authority to the physician assistant with the Department of Professional Regulation. The physician and physician assistant adopt written guidelines for prescribing. Physician assistants who prescribe controlled substances must register with state controlled substance authority and the DEA.
Supervision: Physical presence of a physician is not required. The physician must be able to consult by radio, telephone, or telecommunications. The supervising physician may designate an alternate supervising physician in accordance with statutes. Physicians within a practice group of the supervising physician may supervise the physician assistant with respect to their patients without being deemed an alternate supervising physician.
Michigan:
Physician assistants may prescribe non-controlled and schedules III-V medications as delegated by a supervising physician. Physician assistants may prescribe a 7-day supply of schedule II drugs as discharge medications. Supervising physicians' and physician assistants' names must be indicated on the prescription. Physician assistant prescribers of controlled medications must register with the DEA.
Supervision: A physician must be continuously available for direct communication in person or by radio, telephone, or telecommunication and must regularly review the physician assistant's performance and patient records, consult, and educate.
Minnesota:
Physician assistants may prescribe controlled (schedules II-V) and non-controlled drugs. The physician reviews prescribing by the physician assistant weekly. Physician assistants authorized to prescribe controlled medications must register with the DEA.
Supervision: Physical presence of a physician is not required. The physician assistant and supervising physician must be able to be in touch via telecommunication.
Summary of factual data and analytical methodologies
The Wisconsin Council on Physician Assistants initiated this rule by a request to the Medical Examining Board. The board's attorney drafted the rule in accordance with instructions from the Council. Council members sought the collaborative support of several groups and individuals interested in the rules governing prescribing by physician assistants and discussed the rule thoroughly at Council meetings. The Council examined the experience of other states, particularly that of Minnesota.
Analysis and supporting documents used to determine effect on small business
It is anticipated that the impact on small businesses will be positive because of the additional flexibility built into the supervisory relationship. The guidelines, which govern the relationship between the physician and the physician assistant, remain in place though the form will change slightly to include a section outlining the categories of drugs the physician assistant may prescribe.
Section
227.137
, Stats., requires an "agency" to prepare an economic impact report before submitting the proposed rule-making order to the Wisconsin Legislative Council. The Department of Regulation and Licensing is not included as an "agency" in this section.
Small Business Impact
These proposed rules will have no significant economic impact on a substantial number of small businesses, as defined in s.
227.114 (1)
, Stats.
The Department's Regulatory Review Coordinator may be contacted by email at
larry.martin@wisconsin.gov
, or by calling 608-266-8608.
Fiscal Estimate
The department estimates that this rule will require staff time in the Office of Legal Counsel. The total one-time salary and fringe costs are estimated at $4,300. The total on-going salary and fringe costs are estimated at $2,400.
Anticipated costs incurred by private sector
The department finds that this rule has no significant fiscal effect on the private sector.
Agency Contact Person
Pamela Haack, Paralegal, Department of Regulation and Licensing, Office of Legal Counsel, 1400 East Washington Avenue, Room 152, P.O. Box 8935, Madison, Wisconsin 53708; telephone 608-266-0495; email at
pamela.haack@ wisconsin.gov
.
Notice of Hearing
Regulation and Licensing
NOTICE IS HEREBY GIVEN that pursuant to authority vested in the Department of Regulation and Licensing in ss.
227.11 (2)
,
461.02 (7)
and
461.06
, Stats., the Department of Regulation and Licensing will hold a public hearing at the time and place indicated below to consider an order to create Chapter
RL 186
, relating to the registration and regulation of professional employer organizations and groups.
Hearing Information
Date:
March 2, 2009
Time:
10:00 a.m.
Location:
1400 East Washington Avenue
(Enter at 55 North Dickinson Street)
Room 121A
Madison, Wisconsin
Appearances at the Hearing and Submission of Written Comments
Interested persons are invited to present information at the hearing. Persons appearing may make an oral presentation but are urged to submit facts, opinions and argument in writing as well. Facts, opinions and argument may also be submitted in writing without a personal appearance by mail addressed to Pamela Haack, Paralegal, Department of Regulation and Licensing, Office of Legal Counsel, 1400 East Washington Avenue, Room 152, P.O. Box 8935, Madison, Wisconsin 53708, email at
pamela.haack@wisconsin.gov
. Comments must be received by March 20, 2009, to be included in the record of rule-making proceedings.
Copies of Proposed Rule
Copies of this proposed rule are available upon request to Pamela Haack, Paralegal, Department of Regulation and Licensing, Office of Legal Counsel, 1400 East Washington Avenue, P.O. Box 8935, Madison, Wisconsin 53708, or by email at
pamela.haack@wisconsin.gov
.
Analysis Prepared by the Department of Regulation and Licensing.
Statutes interpreted
Statutory authority
Explanation of agency authority
The Department of Regulation and Licensing is required under
2007 Wisconsin Act 189
to promulgate rules to implement the requirements under ch.
461
, Stats., relating to the registration of professional employer organizations and groups.
Related statute or rule
There are no other statutes or rules other than those listed above.
Plain language analysis
This proposed rule-making order creates new rules relating to the registration of professional employer organizations and groups. The rules contain provisions for the application and renewal of registrations and grounds for discipline of registrants.
SECTION 1 creates the following provisions:
1. Definitions for the terms "applicant," "client," "controlling person," "department," "electronic record," "electronic signature," "professional employer group," "professional employer organization" and "registrant."
2. Application requirements for initial and renewal registrations, including requirements for limited and alternative registrations and verification of the financial capability of applicants.
3. Grounds for discipline of professional employer organizations and groups.
Comparison with federal regulations
There is no existing or proposed federal regulation that relates to the regulation of professional employer organizations or groups.
Comparison with rules in adjacent states
Iowa:
Iowa has no specific professional employer organization license required.
Illinois:
A license is required from the Division of Insurance to operate a professional employer organization under the Employee Leasing Company Act s215.113 (ILCS). Professional employer organizations are known as employee leasing companies.
Michigan:
Michigan has no specific professional employer organization license required.
Minnesota:
Professional employer organizations must register with the Department of Commerce relating to their ability to sponsor workers' compensation insurance policies under s79.255 (MN Stats.).
Summary of factual data and analytical methodologies
Small and medium sized businesses outsource to professional employer organizations everything from administering the payroll and paying employment related taxes, to risk management, recruiting, providing health benefits and securing workers' compensation coverage according to the National Association of Professional Employer Organizations (NAPEO), the leading trade association for the profession, who also report that about 700 professional employer organizations are operating in 50 states; the average client of NAPEO members is a small business with an average of 19 employees; and larger businesses are signing up more and more.
Analysis and supporting documents used to determine effect on small business
According to statistics provided by NAPEO, between 1980 and 2000, the number of labor laws and regulations grew by almost two-thirds according to the federal Small Business Administration, which also estimated that owners of small and mid-sized businesses spent up to 25% of their time on employment-related paperwork. Professional employer organizations assume much of that responsibility and helps companies comply with all the related regulations. Additional statistics indicate that professional employer organizations provided enhanced access to employee benefits for 2-3 million working Americans because of the savings and benefits they provide to small businesses. Further, because the average client of NAPEO's member professional employer organizations has only 19 worksite employees, without professional employer organization relationships, NAPEO member employees would not have protection under COBRA, ADA or the FMLA. NAPEO also reports that professional employer organizations help tens of thousands of companies provide benefits such as health care plans, 401K tax-free savings accounts and other perks to working Americans. An estimated 95 percent of workers in a professional employer organization arrangement have access to a pension plan, and workers with access to a 401K dropped from 28 percent to 19 percent. Lastly, NAPEO indicates that professional employer organizations help improve the work environment and make it safer in that they focus on workplace risk management, safety programs and good human resources practices. Professional employer organizations arrange coverage for workers' compensation with major insurance carriers and manage the claims as well.
Small Business Impact
These proposed rules will have no significant economic impact on a substantial number of small businesses, as defined in s.
227.114 (1)
, Stats.
The Department's Regulatory Review Coordinator may be contacted by email at
larry.martin@ wisconsin.gov
, or by calling 608-266-8608.
Fiscal Estimate
The department estimates that this rule will require staff time in the Office of Legal Counsel, Division of Management Services, Division of Board Services, and the Division of Professional Credentialing. The total one-time salary and fringe costs are estimated at $45,466. The total on-going salary and fringe costs are estimated at $29,340 with supplies and services costs of $12,500.
Anticipated costs incurred by private sector
The department finds that this rule has no significant fiscal effect on the private sector.
Agency Contact Person
Pamela Haack, Paralegal, Department of Regulation and Licensing, Office of Legal Counsel, 1400 East Washington Avenue, Room 152, P.O. Box 8935, Madison, Wisconsin 53708; telephone 608-266-0495; email at
pamela.haack@ wisconsin.gov
.
Notice of Hearing
University of Wisconsin System
NOTICE IS HEREBY GIVEN that pursuant to ss.
36.11 (1)
,
(2)
, and
(8)
, and
36.35
, Stats., the Board of Regents of the University of Wisconsin System will hold a public hearing to consider the proposed revision to Chapter
UWS 18
, relating to student nonacademic misconduct, and conduct on land under the control of the Board of Regents.
Hearing Information
Date:
March 5, 2009
(Thursday)
Time:
7:00 P.M.
Location:
Room 280, Zelazo Center
UW-Milwaukee campus
2419 E. Kenwood Boulevard
Milwaukee, Wisconsin
Persons with disabilities requesting an accommodation to attend are asked to contact Judith Temby in advance of the hearing at (608) 262-2324.
Copies of Proposed Rule
Copies of the text of the rule may be obtained at no charge from the Office of the Board of Regents, 1860 Van Hise Hall, 1220 Linden Drive, Madison, Wisconsin 53706 or on the internet at
http://www.wisconsin.edu/admincode
.
Submission of Written Comments
Comments may be submitted to: Jane S. Radue, Assistant Director, UW System Office of Operations Review and Audit; 780 Regent Street, Suite 210, Madison, WI 53715, E-mail:
jradue@uwsa.edu
. The deadline for written comments is 4:30 p.m. on March 13, 2009
.
Analysis Prepared by the Board of Regents of the University of Wisconsin System
Statutes interpreted
Statutory authority
Explanation of agency authority
Sections
36.11(1)
,
(2)
, and
(8)
give the Board of Regents police power over all property owned by the Board, and authority to adopt rules regulating conduct and parking on university lands. Section
36.35
, Stats., authorizes the Board and its designees to discipline students for misconduct, and directs the Board to promulgate rules governing student conduct and procedures for the administration of violations.
Related statutes or rules
None.
Plain language analysis
As a result of a recent review of ch.
UWS 17
, relating to student nonacademic misconduct, the board is considering changes in the rules to address issues on campuses and in the broader university community that have arisen since the rules were last significantly revised in May 1996. Specifically, some conduct, such as hazing, falsification of ID cards, and illegal use of alcohol or controlled substances, is not adequately addressed in the current rule. The availability of electronic communications may improve and streamline notice and communication during the disciplinary process by allowing certain notifications to occur electronically rather than by personal delivery or first-class mail as currently provided. In addition, it is also desirable to clarify at this time certain terms in the provisions relating to disciplinary sanctions for nonacademic misconduct, including situations in which the misconduct occurs away from the campus but which adversely affects a substantial university interest. The proposed rule also seeks to improve the effectiveness of the disciplinary hearing process, while preserving and protecting students' due process rights.
Chapter
UWS 18
addresses operation of motor vehicles, parking, and other conduct on land under the control of the Board of Regents. The board proposes several amendments to better organize the chapter, and to clarify the scope of prohibitions related to particular kinds of conduct on campus, such as bicycle riding, selling and soliciting goods and services, smoking within 25 feet of residence halls, using sound-amplifying equipment, and using computers. In the proposed rule, prohibitions on certain types of conduct are grouped according to categories that will make the rule easier to read and understand.
Comparison with federal regulations
There is no existing or proposed federal regulation for summary and comparison.
Comparison with rules in adjacent states
Public universities in Illinois, Iowa, Michigan, and Minnesota each have administrative policies relating to student non-academic misconduct and conduct on property under the control of the university.
Summary of factual data and analytical methodologies
There were no factual data or analytical methodologies used to develop the proposed rules.
Analysis and supporting documents used to determine effect on small business
The proposed rules affect only faculty, staff, and students of the University of Wisconsin System, and other persons using University of Wisconsin lands. They have no effect on small business.
Small Business Impact
The proposed rules will have no effect on small business.
Fiscal Estimate
The proposed rules will have no fiscal effect.
Agency Contact Persons
Anne E. Bilder, Senior System Legal Counsel
UW System Administration - 1850 Van Hise Hall
1220 Linden Drive
Madison, Wisconsin 53706
Telephone: (608) 265-3094
Jane S. Radue, Assistant Director
Office of Operations Review and Audit
UW System Administration
780 Regent Street — Suite 210
Madison, Wisconsin 53715
Telephone: (608) 263-4396
