An immunization program under sub. (8)
shall be supervised by a physician, selected by the school district or local health department, who shall issue written orders for the administration of immunizations that are in accordance with written protocols issued by the department.
If the physician under par. (a)
is not an employe of the county, city, village or school district, receives no compensation for his or her services under par. (a)
and acts under par. (a)
in accordance with written protocols issued by the department, he or she is a state agent of the department for the purposes of ss. 165.25 (6)
, 893.82 (3)
The department may disapprove the selection made under par. (a)
or may require the removal of a physician selected.
The department shall, by rule, prescribe the mechanisms for implementing and monitoring compliance with this section. The department shall prescribe, by rule, the form that any person immunizing a student shall provide to the student under sub. (1)
Annually, by July 1, the department shall submit a report to the legislature under s. 13.172 (3)
on the success of the statewide immunization program under this section.
History: 1993 a. 27
; 1995 a. 32
Reports of cases. 252.05(1)(1)
Any person licensed, permitted, registered or certified under ch. 441
knowing or having reason to know that a person treated or visited by him or her has a communicable disease, or having a communicable disease, has died, shall report the appearance of the communicable disease or the death to the local health officer. The local health officer shall report this information to the department or shall direct the person reporting to report to the department. Any person directed to report shall submit this information to the department.
Each laboratory shall report as prescribed by the department those specimen results that the department finds necessary for the surveillance, control, diagnosis and prevention of communicable diseases.
Anyone having knowledge or reason to believe that any person has a communicable disease shall report the facts to the local health officer.
Reports under subs. (1)
shall state so far as known the name, sex, age and residence of the person, the communicable disease and other facts the department or local health officer requires. Report forms may be furnished by the department and distributed by the local health officer.
All reports shall be made within 24 hours, unless otherwise specified by the department, by telephone, telegraph, mail or electronic means or by deposit at the office of the local health officer.
Any local health officer, upon receiving a report, shall cause a permanent record of the report to be made and upon demand of the department transmit the original or a copy to the department, together with other information the department requires. The department may store these records as paper or electronic records and shall treat them as patient health care records under ss. 146.81
When an outbreak or epidemic occurs, the local health officer shall immediately report to the department, and shall at all times keep the department informed of the prevalence of the communicable diseases in the locality in the manner and with the facts the department requires.
The department shall print and distribute, without charge, to all local health departments and, upon request, to health care providers and facilities a chart that provides information about communicable diseases.
Any person licensed, permitted, registered or certified under ch. 441
shall use ordinary skill in determining the presence of communicable diseases. If there is a dispute regarding disease determination, if the disease may have potential public health significance or if more extensive laboratory tests will aid in the investigation, the local health officer shall order the tests made by the state laboratory of hygiene or by a laboratory certified under 42 USC 263a
If a violation of this section is reported to a district attorney by a local health officer or by the department, the district attorney shall forthwith prosecute the proper action, and upon request of the department, the attorney general shall assist.
History: 1971 c. 164
; 1981 c. 291
; 1993 a. 16
; 1993 a. 27
; Stats. 1993 s. 252.05; 1993 a. 183
Isolation and quarantine. 252.06(1)
The department or the local health officer acting on behalf of the department may require isolation of the patient, quarantine of contacts, concurrent and terminal disinfection, or modified forms of these procedures as may be necessary and which are determined by the department by rule.
If a local health officer suspects or is informed of the existence of any communicable disease, the officer shall at once investigate and make or cause such examinations to be made as are necessary. The diagnostic report of a physician, the notification or confirmatory report of a parent or caretaker of the patient, or a reasonable belief in the existence of a communicable disease shall require the local health officer immediately to quarantine, isolate, require restrictions or take other communicable disease control measures in the manner, upon the persons and for the time specified in rules promulgated by the department. If the local health officer is not a physician, he or she shall consult a physician as speedily as possible where there is reasonable doubt or disagreement in diagnosis and where advice is needed. The local health officer shall investigate evasion of the laws and rules concerning communicable disease and shall act to protect the public.
If deemed necessary by the department or a local health officer for a particular communicable disease, all persons except the local health officer, his or her representative, attending physicians and nurses, members of the clergy, the members of the immediate family and any other person having a special written permit from the local health officer are forbidden to be in direct contact with the patient.
The local health officer shall employ as many persons as are necessary to execute his or her orders and properly guard any place if quarantine or other restrictions on communicable disease are violated or intent to violate is manifested. These persons shall be sworn in as quarantine guards, shall have police powers, and may use all necessary means to enforce the state laws for the prevention and control of communicable diseases, or the orders and rules of the department or any local health officer.
When the local health officer deems it necessary that a person be quarantined or otherwise restricted in a separate place, the officer shall remove the person, if it can be done without danger to the person's health, to this place.
When a person confined in a jail, state prison, mental health institute or other public place of detention has a disease which the local health officer or the director of health at the institution deems dangerous to the health of other residents or the neighborhood, the local health officer or the director of health at the institution shall order in writing the removal of the person to a hospital or other place of safety, there to be provided for and securely kept. Upon recovery the person shall be returned; and if the person was committed by a court or under process the removal order or a copy shall be returned by the local health officer to the committing court officer.
Expenses for necessary medical care, food and other articles needed for the care of the infected person shall be charged against the person or whoever is liable for the person's support.
The county or municipality in which a person with a communicable disease resides is liable for the following costs accruing under this section, unless the costs are payable through 3rd-party liability or through any benefit system:
The expense of maintaining quarantine and enforcing isolation of the quarantined area.
The expense of conducting examinations and tests for disease carriers made under the direction of the local health officer.
History: 1981 c. 291
; 1983 a. 189
s. 329 (19)
; 1993 a. 27
; Stats. 1993 s. 252.06.
Tuberculosis is a communicable disease caused by mycobacterium tuberculosis and is subject to the reporting requirements specified in s. 252.05
. Any laboratory that performs a test for tuberculosis shall report all positive results to the local health officer and to the department.
The department shall identify groups at risk for contracting or transmitting mycobacterium tuberculosis and shall recommend the protocol for screening members of those groups. If necessary to prevent or control the transmission of mycobacterium tuberculosis, the department may promulgate rules that require screening of members of specific groups that are at risk for contracting or transmitting mycobacterium tuberculosis.
Any court of record may commit a person infected with mycobacterium tuberculosis to a place that will provide proper care and prevent the spread of the disease if the disease is diagnosed by a medical, laboratory or X-ray examination and if the person fails to comply with this chapter or with rules of the department concerning tuberculosis. If the local health officer or any resident of the municipality in which an alleged violation of this subsection occurs petitions the court and states the facts of the alleged violation, the court shall summon the person infected with tuberculosis to appear in court on a date at least 48 hours, but not more than 96 hours, after service of the summons. The court may order the person discharged. If the administrative officer of the institution has good cause to believe that a person who is committed may leave without a court order, the officer may restrain the person from leaving. The administrative officer may segregate any person who is committed, as needed.
Upon report of any person under sub. (1)
, the local health officer shall at once investigate and make and enforce the necessary orders.
For the purpose of this section persons in charge of common carriers shall have police powers.
County tuberculosis sanatoriums. 252.073(1)
Every county may, under this section, establish a county tuberculosis sanatorium. In counties with a population of 500,000 or more the institution shall be governed under s. 46.21
. In all other counties it shall be governed under ss. 46.18
, except as otherwise provided in this chapter.
The superintendent shall be either a registered nurse with a graduate degree in nursing or a physician. If the superintendent is a registered nurse, the trustees shall appoint and fix the compensation of a visiting physician, and may appoint and fix the compensation of a business manager other than the superintendent, and a director of occupational therapy. The director of occupational therapy may be employed on a part-time basis jointly with other county or state institutions.
(3) Compensation of trustees.
The trustees of the sanatorium shall receive compensation as determined under the provisions of s. 59.22
(4) Site and building regulations.
The department shall fix reasonable standards for the construction and repair of county tuberculosis sanatoriums with respect to their adequacy and fitness for the needs of the community which they are to serve. Purchase of sites shall be subject to the approval of the department.
(5) Approval of plans for sanatorium.
The plans and specifications for such sanatorium buildings must be approved by the department as conforming with said standards and all the requirements of this chapter before any building is constructed.
(6) Trustees of county sanatorium.
The county sanatorium shall be controlled and managed, subject to regulations approved by the county board, by 3 trustees (electors of the county) elected by the county board in the manner, at the times, for the terms, and subject to the limitations and conditions provided in s. 46.18
(7) Report of trustees to department.
On each July 1 the trustees shall prepare a detailed financial report, as specified in s. 46.18 (7)
, for the preceding fiscal year and shall transmit one copy to the department, one copy to the county clerk and keep one copy on file at the sanatorium. Such report shall be accompanied by an inventory of all properties on hand at the end of the fiscal year, an estimate of the receipts and expenses of the current year and the reports of the superintendent and visiting physicians. A copy of this report shall be on file in the department not later than August 15 following the close of the fiscal year.
(8) Semiannual inspection of buildings.
Before the occupancy of any such building, and semiannually thereafter, the department shall cause such building to be inspected with respect to its safety, sanitation, adequacy and fitness, and report to the authorities conducting said institution any deficiency found, stating the nature of the deficiency, in whole or in part, and ordering the necessary work to correct it or that a new building shall be provided. If within 6 months thereafter such work be not commenced, or not completed within a reasonable period thereafter, to the satisfaction of the department, it shall suspend the allowance of any state aid for, and prohibit the use of such building for the purposes of said institution until said order shall have been complied with.
History: 1975 c. 413
; Stats. 1975 s. 149.01; 1977 c. 29
; 1983 a. 27
; 1991 a. 274
; 1993 a. 27
; Stats. 1993 s. 252.073; 1995 a. 201
Joint county home and county tuberculosis sanatorium. 252.076(1)(1)
Such portions of the buildings, grounds and facilities of an established county tuberculosis sanatorium not needed for hospitalization or treatment of tuberculosis patients and such improvements and additions as the county board of supervisors may make in connection therewith may be established and used as a county home for the aged or a unit thereof when the board of supervisors of the county by a majority vote of its members so determines and makes provision therefor in accordance with this section.
No county home or unit thereof so established shall be used or occupied for such purpose unless and until:
The facilities used as a county home for the aged are separated from the remaining facilities used as a tuberculosis sanatorium in a manner designed to prevent the spread of tuberculosis and approved by the department.
The buildings thereof are disinfected in a manner approved by the department; and
Adequate provision is made for sanitation of dishes and tableware and precaution is taken to prevent food contamination and introduction of a source of infection to the county home unit, in accordance with such methods and standards as the department may prescribe.
Management of the 2 jointly housed units shall be separate and distinct. The county home unit shall for all purposes be deemed part of, and managed and operated by the same authorities as any previously established and existing county home of the county. Except as otherwise provided by statute and so far as applicable, this section and ss. 252.073
shall continue to apply to a jointly housed county tuberculosis sanatorium and ss. 49.70
shall apply to a jointly housed county home or a unit of a jointly housed county home.
When separate facilities for any such services are not provided for each institution the trustees of the county tuberculosis sanatorium shall hold and manage, employ necessary employes to operate and do the purchasing for the operation of a common kitchen, laundry, heating plant, power plant, water supply or other joint facilities, for the use and benefit of both institutions.
This section shall not apply to counties having a population of 500,000 or more.
History: 1975 c. 413
; Stats. 1975 s. 149.02; 1977 c. 29
; 1983 a. 27
; 1993 a. 27
; Stats. 1993 s. 252.076; 1995 a. 27
Tuberculosis acute treatment centers; maintenance charges; liability of relatives. 252.08(1)
Hospitals as defined in s. 50.33
, tuberculosis sanatoriums under ss. 252.073 (1)
and 252.076 (1)
and private tuberculosis sanatoriums under s. 58.06
may submit a request to the department for a certificate of approval as a tuberculosis acute treatment center. The department shall issue a certificate of approval if the hospital or sanatorium meets the standards under 42 USC 1396
and the rules promulgated and standards established by the department. The certification is to be renewed by the department as provided under ss. 50.32
. The certificate of approval shall apply only for the premises, persons and services named in the application and may not be transferred or assigned. The department may not withhold, suspend or revoke a certificate of approval unless the hospital or sanatorium substantially fails to comply with ss. 50.32
, the standards under 42 USC 1396
or the rules promulgated and standards established by the department, after having been given a reasonable notice, a fair hearing and an opportunity to comply. The rules and standards for the operation of the hospital or sanatoriums providing care for patients with active tuberculosis shall be promulgated and established by the department.
Community-based residential facilities under ch. 50
shall request a certificate of approval from the department in order to provide care for patients suffering from tuberculosis based on rules promulgated and standards established by the department.
Inpatient care for isolated pulmonary tuberculosis patients, and inpatient care exceeding 30 days for other pulmonary tuberculosis patients, who are not eligible for federal medicare benefits, for medical assistance under subch. V of ch. 49
or for health care services funded by a relief block grant under subch. II of ch. 49
may be reimbursed if provided by a facility contracted by the department. If the patient has private health insurance, the state shall pay the difference between health insurance payments and total charges.
The state shall also assume the charges not collected from insurance, medicaid, and other benefits for:
Care of patients transferred to facilities approved under this section from state institutions or from state penal institutions under s. 304.115
Care of any minor committed to the department in an approved facility under this section.
The department shall ensure that charges to the state for care in facilities approved under this section reflect reasonable and accurate expenses in providing the care.
The records and accounts of all facilities approved under this section shall be available to the department upon request and shall comply with accepted accounting practices.
Whenever a person is admitted to a tuberculosis hospital or sanatorium and the expense of maintenance in the tuberculosis hospital or sanatorium is chargeable to the state or any subdivision of the state or both, the relative of the person, if the person is dependent as described in s. 49.90
, shall be liable to the state or any subdivision of the state in the manner and to the extent provided in s. 49.90
. The district attorney of any county in which the relative resides shall, at the request of the circuit judge or the governing body of the institution, take all necessary procedures to enforce the provisions of this section.
General supervision and inspection of tuberculosis hospitals; charges. 252.09(1)(a)
Investigate and supervise all of the tuberculosis hospitals and sanatoriums of every county and other municipality, and become familiar with all of the circumstances affecting their management and usefulness.
Visit each of the tuberculosis hospitals and sanatoriums and inquire into their methods of treatment, instruction, government and management of their patients; the official conduct of their trustees, managers, directors, superintendents and other officers and employes; the condition of the buildings, grounds and all other property pertaining to the tuberculosis hospitals and sanatoriums, and all other matters pertaining to their usefulness and management; and recommend to the officers in charge the changes and additional provisions that the department considers proper.
Inspect each tuberculosis hospital and sanatorium annually, or oftener if necessary and, if directed by the governor, investigate the past or present management, or anything connected with the management, and report to the governor the testimony taken, facts found and conclusions made.
Inform the governor, and the district attorney of the county in which the tuberculosis hospital and sanatorium is located, of any violation of law disclosed in any investigation of the tuberculosis hospital and sanatorium.
All trustees, managers, directors, superintendents and other officers or employes of a tuberculosis hospital and sanatorium shall at all times afford, to the department or its agents, inspection of and free access to all parts of the buildings and grounds and to all books and papers of the tuberculosis hospital and sanatorium and shall give, either verbally or in writing, information that the department requires. Any person violating this subsection shall forfeit not less than $10 nor more than $100. The department may administer oaths and take testimony and may cause depositions to be taken. All expenses of the investigations, including fees of officers and witnesses, shall be paid from the appropriation under s. 20.435 (1) (a)
History: 1973 c. 90
; 1975 c. 39
; 1975 c. 413
; Stats. 1975 s. 149.07; 1983 a. 192
s. 303 (7)
; 1987 a. 399
; 1993 a. 27
; Stats. 1993 s. 252.09; 1993 a. 213
Public health dispensaries. 252.10(1)
Counties with populations of more than 25,000 may establish and maintain public health dispensaries and, where necessary, branches of the dispensaries for the diagnosis and treatment of persons suffering from or suspected of having mycobacterium tuberculosis or other pulmonary diseases. Two or more counties may jointly establish, operate and maintain public health dispensaries in order to serve a total population of not less than 25,000. Counties may contract with each other for public health dispensary services. The department and department of revenue shall be notified of the establishment of public health dispensaries and any contracts pertaining to the dispensaries. The department may establish, operate and maintain public health dispensaries and branches in areas of the state where local authorities have not provided public health dispensaries.
A county or counties jointly, and the department, may contract with other agencies, hospitals and individuals for the use of necessary space, equipment, facilities and personnel to operate a public health dispensary or for provision of medical consultation.
Fees may but need not be charged for services rendered in public health dispensaries operated by one or more counties or the department. A schedule of fees shall be established by the respective operating agencies and shall be based upon reasonable costs. A copy of such schedule and any subsequent changes shall be forwarded to the department and the department of revenue. Fees received by the department shall be used as a nonlapsing appropriation for the maintenance and operation of its public health dispensaries together with other funds received for this purpose.
The state shall credit or reimburse each dispensary on an annual or quarterly basis for the operation of public health dispensaries established and maintained in accordance with this section.
The state reimbursement for each visit for services as ordered by a physician shall be $6 or a greater amount prescribed in rules promulgated by the department. If an X-ray is taken, an additional $6 or any greater amount prescribed in rules promulgated by the department will be credited. Any X-ray taken outside a facility under this section or outside a facility approved under s. 252.08
on individuals who have a significant reaction to a test for mycobacterium tuberculosis shall qualify for state aid in the same manner as an X-ray taken inside a facility, and the X-ray shall take the place of the first X-ray eligible for reimbursement as part of a case finding and preventive program under par. (e)
. The administration and reading of the test for mycobacterium tuberculosis for diagnostic purposes shall be considered one visit. Tests for mycobacterium tuberculosis given in school programs, employment health programs, community preventive and case finding programs are not reimbursable as a clinic visit.