LRB-4339/1
CTS:nwn:rs
2009 - 2010 LEGISLATURE
April 16, 2010 - Introduced by Senators Kreitlow, Taylor and Schultz,
cosponsored by Representatives
Schneider and Benedict. Referred to
Committee on Health, Health Insurance, Privacy, Property Tax Relief, and
Revenue.
SB698,1,10
1An Act to amend 50.09 (1) (a) (intro.), 50.09 (1) (f) 1., 50.09 (1) (h), 50.09 (1) (k),
250.49 (1) (b) (intro.), 70.47 (8) (intro.), 146.82 (3) (a), 252.07 (8) (a) 2., 252.07 (9)
3(c), 252.11 (2), 252.11 (4), 252.11 (5), 252.11 (7), 252.11 (10), 252.14 (1) (ar) 14.,
4252.15 (2) (a) 7. ak., 252.15 (5) (a) 11., 252.15 (5) (a) 12. b., 252.15 (5) (a) 14.,
5252.15 (5m) (a), 252.15 (5m) (b), 252.15 (5m) (c), 252.15 (7m) (intro.), 252.15
6(7m) (b), 252.16 (3) (c) (intro.), 252.17 (3) (c) (intro.), 252.18, 343.16 (5) (a),
7448.03 (5) (b), 448.56 (1), 448.56 (1m) (b), 448.67 (2), 450.11 (7) (b) and 450.11
8(8) (b); and
to create 50.01 (4p), 252.01 (5), 450.01 (15r), 450.01 (16) (h) 3. and
9450.13 (5) (c) of the statutes;
relating to: authorizing medically related actions
10by physician assistants.
Analysis by the Legislative Reference Bureau
Under current law, the Medical Examining Board grants physician assistant
licenses to individuals who meet training and examination requirements and any
other requirements established in rules promulgated by the Medical Examining
Board.
The following provisions under current law authorize physicians or other
health care professionals to act under specified circumstances and to affect
individuals by these authorized actions:
1. Unless medically contraindicated as documented by a nursing home or
community-based residential facility resident's physician in the resident's medical
record, the resident has the right to private and unrestricted communications with
his or her family, physician, attorney, and others; to share a room with his or her
spouse or domestic partner if the spouse or domestic partner is also a resident; to
participate in activities of social, religious, and community groups; and to be free
from chemical and physical restraints.
2. Home health services that are provided to an individual by a home health
agency must be those specified under a plan for furnishing the services that is
established and periodically reviewed by a physician.
3. For hearings before the local board of review concerning assessments of
property taxes, an ill or disabled person who presents to the board a letter from a
physician or osteopath confirming the illness or disability may present testimony by
telephone.
4. Under laws relating to confidentiality of patient health care records, a
physician who treats a patient whose physical or mental condition, in the physician's
judgment, affects his or her ability to exercise reasonable and ordinary control over
a motor vehicle may, without the patient's informed consent, report the patient's
name and other information to the Department of Transportation. Physicians are
exempted from civil liability for reporting, or not reporting, this information in good
faith.
5. Under laws relating to communicable diseases:
a. The Department of Health Services (DHS) may order an individual who has
a confirmed diagnosis of infectious tuberculosis or symptoms indicative of
tuberculosis confined to a facility if several conditions are met, including notifying
a court of the confinement and providing to the court a physician's written statement
affirming the tuberculosis or symptoms.
b. If a court orders confinement of an individual with infectious tuberculosis
or symptoms indicative of tuberculosis, the individual must remain confined until
DHS or a local health officer, with the concurrence of a treating physician,
determines that treatment is complete or that the individual is no longer a public
health threat.
c. If, following a request by an officer of DHS or a local health officer, a person
reasonably suspected of being infected with a sexually transmitted disease refuses
or neglects examination by a physician or treatment, the DHS officer or local health
officer may have the person committed to an institution for examination, treatment,
or observation.
d. If a person with a sexually transmitted disease ceases or refuses treatment
before reaching what is in a physician's opinion the noncommunicable stage, the
physician must notify DHS and the person may be committed by a court for
examination or treatment.
e. If a physician has reported to DHS a case of sexually transmitted disease,
information regarding the disease and its treatment is not privileged before a court.
f. The State Laboratory of Hygiene must examine specimens for the diagnosis
of sexually transmitted disease for any physician or local health officer and must
report positive results to the local health officer and DHS.
g. If certain individuals, including emergency medical technicians, fire
fighters, state patrol officers, jailers, emergency care givers, and coroners, receive a
significant exposure (sustain a contact that has a potential for transmission of HIV),
the person to whom they are significantly exposed may be compelled to be tested for
the presence of HIV, and the test results may be provided to the affected individual.
One prerequisite for compulsory testing is a written determination and certification
by a physician that the individual has been significantly exposed.
h. If a test administered to a corpse indicates the presence of HIV, the deceased
person's physician may provide the results of the test to persons whom the physician
knows have had sexual contact or shared intravenous drug use paraphernalia with
the deceased person; to emergency caregivers; and to funeral directors, coroners, and
medical examiners who prepare a corpse for burial or who are significantly exposed
to HIV in the course of performing an autopsy.
i. If a local health officer or DHS officer requires it, a person who is employed
in the handling of food products or is suspected of having a disease in a form that is
communicable by food handling must submit to an examination by the officer or by
a physician.
j. Certain individuals are eligible to receive premium subsidies for health
insurance or medical leave premiums if a physician certifies that the individual has
been infected with HIV.
6. Under occupational regulation laws relating to physical therapists, a
physical therapist may practice only on the written referral of a physician,
chiropractor, dentist, or podiatrist, except under certain conditions, including
providing services to an individual for a previously diagnosed medical condition after
informing the individual's physician, chiropractor, dentist, or podiatrist.
7. Under occupational regulation laws relating to podiatrists, a podiatrist who
renders chargeable services to, among others, a patient or physician, must render a
statement of the charge directly to the person served.
8. Under laws relating to the practice of pharmacy, current law does the
following:
a. Defines the term "practice of pharmacy" to include making therapeutic
alternate drug selections in accordance with written guidelines or procedures
approved by a hospital and by a physician for his or her patients for a hospital stay.
b. Provides that information communicated to a physician in an effort
unlawfully to procure a prescription drug is not privileged communication.
c. Requires the enforcement of prescription drug laws that apply to physicians
to be the responsibility of the Department of Regulation and Licensing and the
Medical Examining Board.
d. Exempts pharmacists from requirements that they provide certain
information when dispensing a drug product equivalent, if the patient is in a hospital
and the drug product equivalent is dispensed in accordance with guidelines
approved by, among others, the patient's physician.
Currently, an advanced practice nurse prescriber may act in the same manner
physicians may act in the instances specified above.
This bill expands the current laws described above that authorize physicians
to act under specified circumstances and to affect individuals by these authorized
actions, by similarly authorizing individuals licensed as physician assistants.
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:
SB698, s. 1
1Section
1. 50.01 (4p) of the statutes is created to read:
SB698,4,22
50.01
(4p) "Physician assistant" has the meaning given in s. 448.01 (6).
SB698, s. 2
3Section
2. 50.09 (1) (a) (intro.) of the statutes is amended to read:
SB698,4,104
50.09
(1) (a) (intro.) Private and unrestricted communications with the
5resident's family, physician,
physician assistant, advanced practice nurse prescriber,
6attorney, and any other person, unless medically contraindicated as documented by
7the resident's physician
, physician assistant, or advanced practice nurse prescriber
8in the resident's medical record, except that communications with public officials or
9with the resident's attorney shall not be restricted in any event. The right to private
10and unrestricted communications shall include, but is not limited to, the right to:
SB698,4,1713
50.09
(1) (f) 1. Privacy for visits by spouse or domestic partner. If both spouses
14or both domestic partners under ch.770 are residents of the same facility, the spouses
15or domestic partners shall be permitted to share a room unless medically
16contraindicated as documented by the resident's physician
, physician assistant, or
17advanced practice nurse prescriber in the resident's medical record.
SB698, s. 4
1Section
4. 50.09 (1) (h) of the statutes is amended to read:
SB698,5,52
50.09
(1) (h) Meet with, and participate in activities of social, religious, and
3community groups at the resident's discretion, unless medically contraindicated as
4documented by the resident's physician
, physician assistant, or advanced practice
5nurse prescriber in the resident's medical record.
SB698, s. 5
6Section
5. 50.09 (1) (k) of the statutes is amended to read:
SB698,5,187
50.09
(1) (k) Be free from mental and physical abuse, and be free from chemical
8and physical restraints except as authorized in writing by a physician
, physician
9assistant, or advanced practice nurse prescriber for a specified and limited period of
10time and documented in the resident's medical record. Physical restraints may be
11used in an emergency when necessary to protect the resident from injury to himself
12or herself or others or to property. However, authorization for continuing use of the
13physical restraints shall be secured from a physician
, physician assistant, or
14advanced practice nurse prescriber within 12 hours. Any use of physical restraints
15shall be noted in the resident's medical records. "Physical restraints" includes, but
16is not limited to, any article, device, or garment that interferes with the free
17movement of the resident and that the resident is unable to remove easily, and
18confinement in a locked room.
SB698, s. 6
19Section
6. 50.49 (1) (b) (intro.) of the statutes is amended to read:
SB698,6,220
50.49
(1) (b) (intro.) "Home health services" means the following items and
21services that are furnished to an individual, who is under the care of a physician
,
22physician assistant, or advanced practice nurse prescriber, by a home health agency,
23or by others under arrangements made by the home health agency, that are under
24a plan for furnishing those items and services to the individual that is established
25and periodically reviewed by a physician
, physician assistant, or advanced practice
1nurse prescriber and that are, except as provided in subd. 6., provided on a visiting
2basis in a place of residence used as the individual's home:
SB698, s. 7
3Section
7. 70.47 (8) (intro.) of the statutes is amended to read:
SB698,6,94
70.47
(8) Hearing. (intro.) The board shall hear upon oath all persons who
5appear before it in relation to the assessment. The board shall hear upon oath, by
6telephone, all ill or disabled persons who present to the board a letter from a
7physician, osteopath,
physician assistant, as defined in s. 448.01 (6), or advanced
8practice nurse prescriber certified under s. 441.16 (2) that confirms their illness or
9disability. The board at such hearing shall proceed as follows:
