Under current law, payment for medical services received by residents of this
state is made from a combination of federal moneys (such as under the medicare,
medicaid, and various block grant programs), general purpose revenues (such as the
"state share" of the joint federal-state medical assistance program, the BadgerCare
program, state contributions to relief block grants for health care services, and
moneys appropriated for specific medical purposes, such as cancer control grants),
local moneys (such as funding for medical relief health care services and county
nursing homes and hospitals), private health insurance coverage purchased by
individuals or provided, in part, as employee benefits, and out-of-pocket payments
by health care consumers.
This bill establishes a universal health plan for Wisconsin, under which,
beginning July 1, 2004, each state resident, with certain specified exceptions, shall

receive reasonable medical services necessary to maintain health, enable diagnosis,
or provide treatment or rehabilitation for an injury, disability, or disease. Specified
persons who are excepted from the July 1, 2004, beginning date are phased in for
eligibility that begins July 1, 2005.
To administer the universal health plan, the bill creates a department of health
planning and finance (DHPF), with six regional offices, that is directed and
supervised by an 11-member health policy board that is also created in the bill. The
health policy board appoints the secretary of health planning and finance and is
required to review that appointment after 36 months. The bill also creates six
regional health councils that are attached to DHPF and that report at least twice a
year to the health policy board on the health care needs, problems, and concerns of
the region. The bill requires appropriation of general purpose revenues to DHPF for
operation of the health policy board for the 2001-03 fiscal biennium and requires
that the health policy board consider numerous specified issues related to the
formation of a universal health plan in this state.
Under the bill, by July 1, 2003, DHPF must begin implementation of processes,
in light of policies determined by the health policy board, to effect numerous matters,
including specifying the amounts and sources of funds to finance payment to
providers under the universal health plan, applying for waivers to federal medicaid
statutes and rules, and establishing a listing of approved medicinal substances and
formulae. The secretary of health planning and finance and the secretary of
administration must, until September 1, 2003, meet at least semimonthly to
formulate decisions on issues concerning the universal health plan and DHPF and
how the scope and functions of DHPF affect the scope and functions of the
department of health and family services, the office of the commissioner of insurance,
the board on aging and long-term care, and the duties or powers of any other state
agency. The health policy board must convey the decisions to the legislative
reference bureau for drafting of necessary proposed legislation for introduction in
the legislature in 2004. The legislative reference bureau must prepare, in proper
form for introduction, the proposed legislation that relates to the decisions.
For further information see the state and local 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:
SB133, s. 1 1Section 1. 15.01 (4) of the statutes is amended to read:
SB133,3,72 15.01 (4) "Council" means a part-time body appointed to function on a
3continuing basis for the study, and recommendation of solutions and policy
4alternatives, of the problems arising in a specified functional area of state
5government, except the Wisconsin land council has the powers specified in s. 16.965

1(3) and (5) and the powers granted to agencies under ch. 227, the Milwaukee River
2revitalization council has the powers and duties specified in s. 23.18, the council on
3physical disabilities has the powers and duties specified in s. 46.29 (1) and (2), the
4state council on alcohol and other drug abuse has the powers and duties specified in
5s. 14.24, the regional health councils have the powers and duties specified in s. 152.30
6(1),
and, before January 1, 2001, the council on health care fraud and abuse has the
7powers and duties specified in s. 146.36.
SB133, s. 2 8Section 2. 15.01 (4) of the statutes, as affected by 1999 Wisconsin Act 9, section
912n, and 2001 Wisconsin Act .... (this act), is repealed and recreated to read:
SB133,3,1910 15.01 (4) "Council" means a part-time body appointed to function on a
11continuing basis for the study, and recommendation of solutions and policy
12alternatives, of the problems arising in a specified functional area of state
13government, except the Milwaukee River revitalization council has the powers and
14duties specified in s. 23.18, the council on physical disabilities has the powers and
15duties specified in s. 46.29 (1) and (2), the state council on alcohol and other drug
16abuse has the powers and duties specified in s. 14.24, the regional health councils
17have the powers and duties specified in s. 152.30 (1), and, before January 1, 2001,
18the council on health care fraud and abuse has the powers and duties specified in s.
19146.36.
SB133, s. 3 20Section 3. 15.07 (1) (a) 8. of the statutes is created to read:
SB133,3,2221 15.07 (1) (a) 8. Members of the health policy board elected under s. 15.20 (1)
22shall be elected as provided in that section.
SB133, s. 4 23Section 4. 15.07 (2) (L) of the statutes is created to read:
SB133,3,2524 15.07 (2) (L) The chairperson of the health policy board shall serve for a period
25of 3 years and may be reelected for 2 additional successive terms.
SB133, s. 5
1Section 5. 15.07 (5) (z) of the statutes is created to read:
SB133,4,22 15.07 (5) (z) Members of the health policy board, $50 per day.
SB133, s. 6 3Section 6. 15.07 (5m) (c) of the statutes is created to read:
SB133,4,74 15.07 (5m) (c) Health policy board. Members of the health policy board may
5be reimbursed for lost wages if required by their employers to use leave without pay
6in order to attend meetings of the health policy board, and they may be reimbursed
7for actual and necessary child care expenses without proof of financial hardship.
SB133, s. 7 8Section 7. 15.20 of the statutes is created to read:
SB133,4,15 915.20 Department of health planning and finance. There is created a
10department of health planning and finance under the direction and supervision of
11the health policy board. The health policy board shall consist of the following
12members, each of whom is to serve for a 6-year term and, if reelected or reappointed,
13for an additional 6-year term and none of whom may be a health care provider, as
14defined in s. 152.01 (6), an administrator or owner of a health care facility or
15organization, or an elected public official:
SB133,4,17 16(1) One member elected by and from the current membership of each of the 6
17regional health councils specified under s. 15.207 (1) (b).
SB133,4,21 18(2) Five members, nominated by the governor and with the advice and consent
19of the senate appointed, who reflect as much as possible a balance of gender, race,
20age, sexual orientation, ethnicity, religion, geographic areas, and the interests of
21management, labor, and individuals with disabilities.
SB133, s. 8 22Section 8. 15.207 of the statutes is created to read:
SB133,5,2 2315.207 Same; councils. (1) Regional health councils. (a) There are created
246 regional health councils that are attached to the department of health planning

1and finance under s. 15.03, one of which is established in each of the following areas
2of this state:
SB133,5,53 1. The northern region, consisting of Ashland, Bayfield, Douglas, Florence,
4Forest, Iron, Langlade, Lincoln, Marathon, Oneida, Portage, Price, Sawyer, Taylor,
5Vilas, and Wood counties.
SB133,5,86 2. The southern region, consisting of Adams, Columbia, Crawford, Dane,
7Dodge, Grant, Green, Iowa, Jefferson, Juneau, Lafayette, Richland, Rock, Sauk, and
8Vernon counties.
SB133,5,119 3. The western region, consisting of Barron, Burnett, Buffalo, Chippewa,
10Clark, Dunn, Eau Claire, Jackson, La Crosse, Monroe, Pepin, Pierce, Polk, Rusk, St.
11Croix, Trempealeau, and Washburn counties.
SB133,5,1412 4. The northeastern region, consisting of Brown, Calumet, Door, Fond du Lac,
13Green Lake, Kewaunee, Manitowoc, Marinette, Marquette, Menominee, Oconto,
14Outagamie, Shawano, Sheboygan, Waupaca, Waushara, and Winnebago counties.
SB133,5,1615 5. The southeastern region, consisting of Kenosha, Ozaukee, Walworth,
16Washington, Waukesha, and Racine counties.
SB133,5,1717 6. The area within Milwaukee County.
SB133,5,2118 (b) Each regional health council shall consist of the following members, none
19of whom may be a health care provider, as defined in s. 152.01 (6), an administrator
20or owner of a health care facility or organization, or an elected public official, to serve
21for no more than 3 3-year terms:
SB133,5,2422 1. In the northern region, a total of 16 members, consisting of one member from
23each county in that region. The county board of supervisors of each county in that
24region shall appoint one person from that county.
SB133,6,3
12. In the southern region, a total of 15 members, consisting of one member from
2each county in that region. The county board of supervisors of each county in that
3region shall appoint one person from that county.
SB133,6,64 3. In the western region, a total of 17 members, consisting of one member from
5each county in that region. The county board of supervisors of each county in that
6region shall appoint one person from that county.
SB133,6,97 4. In the northeastern region, a total of 17 members, consisting of one member
8from each county in that region. The county board of supervisors of each county in
9that region shall appoint one person from that county.
SB133,6,1210 5. In the southeastern region, a total of 12 members, consisting of 2 members
11from each county in that region. The county board of supervisors of each county in
12that region shall appoint 2 persons from that county.
SB133,6,1713 6. In the area within Milwaukee County, a total of 12 members, consisting of
146 persons who are residents of the city of Milwaukee and are appointed by the mayor
15of the city of Milwaukee, and 6 persons who are residents of Milwaukee County but
16are not residents of the city of Milwaukee and are appointed by the county executive
17of Milwaukee County.
SB133, s. 9 18Section 9. 20.005 (3) (schedule) of the statutes: at the appropriate place, insert
19the following amounts for the purposes indicated: - See PDF for table PDF
SB133, s. 10
1Section 10. 20.430 of the statutes is created to read:
SB133,7,4 220.430 Health planning and finance, department of. There is
3appropriated to the department of health planning and finance for the following
4program:
SB133,7,7 5(1) Health planning and finance. (a) General program operations. The
6amounts in the schedule for the general program operations of the department of
7health planning and finance.
SB133,7,98 (b) Universal health plan services and benefits. The amounts in the schedule
9for health care services and benefits provided under s. 152.10 (4).
SB133,7,1110 (i) Gifts and grants. All moneys received from gifts, grants, bequests, and
11devises to carry out the purposes for which made.
SB133,7,1412 (m) Federal funds; state operations. All moneys received from the federal
13government, as authorized by the governor under s. 16.54, for the purposes for which
14made and received.
SB133, s. 11 15Section 11. 59.17 (2) (c) of the statutes is amended to read:
SB133,7,2016 59.17 (2) (c) Appoint the members of all boards and, commissions, and councils
17where appointments are required and where the statutes provide that the
18appointments are made by the county board or, by the chairperson of the county
19board, or by the county executive. All appointments to boards and, commissions, and
20councils
by the county executive are subject to confirmation by the county board.
SB133, s. 12 21Section 12. 59.53 (24) of the statutes is created to read:
SB133,7,2322 59.53 (24) Regional health council. The board shall appoint members of a
23regional health council, as specified in s. 15.207 (1) (b) 1. to 5.
SB133, s. 13 24Section 13. 62.09 (8) (cm) of the statutes is created to read:
SB133,8,3
162.09 (8) (cm) The mayor of the city of Milwaukee shall, with the advice and
2consent of the common council of that city, appoint 6 members of a regional health
3council, as specified under s. 15.207 (1) (b) 6.
SB133, s. 14 4Section 14. Chapter 152 of the statutes is created to read:
SB133,8,65 Chapter 152
6 Universal health plan
SB133,8,7 7152.01 Definitions. In this chapter:
SB133,8,8 8(1) "Block grant" has the meaning given in s. 16.54 (2) (a) 3.
SB133,8,9 9(2) "Board" means the health policy board.
SB133,8,10 10(3) "Department" means the department of health planning and finance.
SB133,8,11 11(4) "Disability insurance policy" has the meaning given in s. 632.895 (1) (a).
SB133,8,20 12(5) "Health care facility" means a facility, as defined in s. 647.01 (4), or any
13hospital, nursing home, community-based residential facility, county home, county
14infirmary, county hospital, county mental health center, community health center,
15primary health center, tuberculosis sanatorium, adult family home, assisted living
16facility, rural medical center, hospice, or other place licensed, certified, or approved
17by the department under s. 49.70, 49.71, 49.72, 50.02, 50.03, 50.032, 50.033, 50.034,
1850.35, 50.52, 50.92 (2), 51.08, or 51.09 or a facility under s. 45.365, 51.05, 51.06, or
19252.10 or ch. 233, or licensed or certified by a county department under s. 50.032 or
2050.033.
SB133,8,22 21(6) "Health care provider" means a provider of health care services or other
22benefits in this state that are specified under s. 152.10 (4).
SB133,8,24 23(7) "Medicare" means coverage under part A or part B of Title XVIII of the
24federal Social Security Act, 42 USC 1395 to 1395ddd.
SB133,9,2
1(8) "Reimbursement" means payment for the provision of services and other
2benefits that are specified under s. 152.10 (4).
SB133,9,3 3(9) "Secretary" means the secretary of health planning and finance.
SB133,9,4 4(10) "Veteran" has the meaning given in 38 USC 101 (2).
SB133,9,12 5152.10 Universal health plan. (1) There is created a universal health plan
6in this state, under which, beginning on July 1, 2004, each eligible person shall
7receive reasonable medical service necessary to maintain health, enable diagnosis,
8or provide treatment or rehabilitation for an injury, condition, disability, or disease,
9for which reimbursement shall be made by the department, except that no coverage
10is provided for orthodontia or for the performance of reconstructive or cosmetic
11surgery that is not determined to be medically necessary under criteria that are
12promulgated as rules by the department.
SB133,9,17 13(2) Each individual in this state who meets requirements of residency, under
14criteria promulgated as rules by the department, is eligible for coverage, except as
15provided in sub. (5), under the universal health plan, except that all of the following
16may be phased in for eligibility under this subsection, beginning no later than July
171, 2005:
SB133,9,1918 (a) Individuals, other than those specified in par. (b), who have no coverage
19under disability insurance policies.
SB133,9,2320 (b) Individuals who have no coverage under disability insurance policies and
21who receive health care, treatment for nervous or mental disorders, or treatment or
22prevention services for alcohol and other drug abuse that are funded by state or local
23funding.
SB133,9,2524 (c) Individuals who are employees of the state or any county, city, village, or
25town, and who, as a benefit of the employment, have coverage for themselves and

1family members under provisions of group disability insurance policies or under
2self-insured health plans.
SB133,10,53 (d) Individuals, other than those specified in par. (c) or (h), who, by reason of
4their employment or as family members of individuals who are employed, have
5coverage under group disability insurance policies.
SB133,10,76 (e) Individuals who have coverage under individual disability insurance
7policies.
SB133,10,98 (f) Individuals who have coverage under the health insurance risk-sharing
9plan under ch. 149.
SB133,10,1110 (g) Individuals who are eligible for benefits or services under s. 49.46, 49.468,
1149.47, or 49.665, medicare, or block grants that provide health care services.
SB133,10,1412 (h) Individuals who are employees of self-insured employers, other than those
13specified in par. (c), and who receive health care benefits for themselves and family
14members under self-insured health plans.
SB133,10,1515 (i) Individuals who receive medical benefits under worker's compensation.
SB133,10,1816(j) Veterans who receive medical benefits under s. 45.351 (1j) or 38 USC 1701
17to 1774, or both, and the children of veterans who receive medical benefits under 38
18USC 1801
to 1806.
SB133,10,1919(k) Indians who receive health and other services under 25 USC 1651 to 1683.
SB133,10,22 20(3) (a) Any individual who is eligible under sub. (2) may receive services that
21are available under the universal health plan from any participating health care
22provider in this state.
SB133,10,2523 (b) No individual who is eligible under sub. (2) may under this section be
24required to pay an amount as a deductible or copayment as a condition for receipt of
25services under this section from a health care facility or health care provider.
SB133,11,4
1(c) An individual's state residency is presumed unless rebutted by clear and
2convincing evidence. If the presumption is so rebutted, any reimbursement paid
3under the universal health plan for health care services rendered to the individual
4is a liability of the individual.
SB133,11,6 5(4) Health care services and other benefits provided under the universal health
6plan shall include all of the following:
SB133,11,87 (a) Services of all persons licensed, certified, registered, or permitted to treat
8the sick under chs. 441, 446, 447, 448, 449, 450, 451, 455, 457, and 459.
SB133,11,109 (b) Health care services that are provided by health care facilities and the
10offices and clinics of persons under par. (a).
SB133,11,1211 (c) Preventive health care services and health promotional programs, including
12well-child care, immunizations, screening, outreach, and education.
SB133,11,1513 (d) Medical or surgical supplies and durable medical or surgical equipment,
14supplies and appliances, including valves, pacemakers, prostheses, eyeglasses, and
15hearing aids.
SB133,11,1716 (e) Prescription drugs specified in the state formulary under the requirements
17of s. 152.40 (4) (n) and any other drugs specified by the department by rule.
SB133,11,1818 (f) Blood and blood products.
SB133,11,2319 (g) Long-term care services that are necessary for the physical health, mental
20and emotional well-being, and social and personal needs of individuals who have
21limited self-care capabilities, including services of health care facilities; home
22health care; hospice care; home-based and community-based services, including
23personal assistance and attendant care; and periodic needs assessments.
SB133,11,2524 (h) Mental health treatment and services, including substance abuse and brain
25injury treatment.
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