Requirements to report cases of lead poisoning or lead exposure and the results of screening children under the age of 6 for lead poisoning or lead exposure are found in s. 254.13, Stats. Every physician who diagnoses lead poisoning or lead exposure, every person who screens a child under six years of age for lead poisoning or lead exposure, and any nurse, hospital administrator, director of a clinical laboratory or local health officer who has verified information of any person found to have or suspected of having lead poisoning or lead exposure is expected to report this information.
The reporting of all blood lead tests, as required by the rules, will serve the purposes stated in s. 254.13, Stats., and the broader purposes served by establishment of an adequate surveillance system authorized under s. 250.04(3), Stats.
The rules require that the results of all blood lead tests performed on blood samples taken from Wisconsin residents be reported to the Department or, at the request of a local health department and with agreement of the Department, to that local health department which then must forward the results to the Department. The way this will work is that whoever submits the sample of a person's blood to a laboratory for analysis to determine the amount of lead in the person's blood must send along with the sample specified information about the patient and how the sample was collected. That information will form part of the report to the Department or local health officer. Except in the case of an out-of-state laboratory or when a laboratory and health care provider agree in writing that the health care provider, after obtaining the test results from the laboratory, will report them to the Department, the laboratory is responsible for submitting the required report to the Department. The report will consist of the information submitted by the health care provider to the laboratory with the blood sample and information supplied by the laboratory that identifies the laboratory and states when the analysis was completed and the results of the blood lead test.
Contact Person
To find out more about the hearing or to request a copy of the proposed rules, write or phone:
Joseph Schirmer
Bureau of Environmental Health
1414 East Washington Ave.
Room 132
Madison, Wisconsin 53703
608-266-5885 or,
if you are hearing impaired,
1-800-947-3529
If you are hearing or visually impaired, do not speak English, or have other personal circumstances which might make communication at the hearing difficult and if you, therefore, require an interpreter, or a non-English, large-print or taped version of the hearing document, contact the person at the address or phone number above. A person requesting a non-English or sign language interpreter should make that request at least 10 days before the hearing. With less than 10 days notice, an interpreter may not be available.
Written comments on the proposed rules received at the above address no later than May 25, 1999 will be given the same consideration as testimony presented at a hearing.
Fiscal Estimate
These are rules for reporting to the Department and local health officers the results of tests performed to determine the amount of lead in human blood samples drawn for this purpose. Blood lead test reporting requirements are found in s. 254.13, Stats. These include requirements to be established by the Department. The Department has, in addition, broad responsibilities under s. 250.04(3), Stats., to establish, for public health protection purposes, surveillance systems relating to toxic substances.
Reporting of blood lead tests has been statutorily required since 1980. The rules are being promulgated at this time in part because s. 254.13(2), Stats., as created by 1993 Wisconsin Act 450, directs the Department to have rules that specify time periods for reporting and the form of the reports when blood lead screening is done for children under 6 years of age, and in part because there is a program need to clarify who is responsible for reporting and what information must be included in order for a report to be complete.
In the 1995-96 state fiscal year the Department and local health officers received reports on 72,500 blood lead tests. Reporting is mainly by clinical laboratories. Four of the 35 reporting laboratories are publicly owned, the State Laboratory of Hygiene, and the laboratories operated by the Milwaukee, Racine and Minneapolis Health Departments.
The rules will not affect the expenditures or revenues of state government or local governments. The State Laboratory of Hygiene already complies with the process set out in the rules, as do the Milwaukee, Racine and Minneapolis Health departments. Reporting by the Milwaukee City Health Department Laboratory is to the local health officer, which will continue under the rules.
Initial Regulatory Flexibility Analysis
About half of the 31 or so non-public laboratories that do blood lead testing for Wisconsin health care providers are small businesses as “small business" is defined in s. 227.114 (1) (a), Stats., as are many of the health care providers, in particular, physicians and nurses working independently or in a group practice who may obtain a blood sample or order that a blood sample be taken to measure the concentration of lead in blood.
Reporting to the Department or a local health officer the results of blood lead tests has been taking place under s. 254.13, Stat., for several years. It has not always been clear who is responsible for reporting, whether the health care provider or the clinical laboratory, and it has sometimes been difficult to get laboratories in particular to report everything that the Department wants reported. The rules make clear that the reporting responsibility is with the laboratories, unless a laboratory is out of state or the health care provider and the laboratory agree in writing that the health care provider will report, and make clear also what must be reported, by when and how.
The rules will not impose new requirements on laboratories or health care providers. No new professional skills are necessary for laboratories or health care providers to comply with the rules.
Notice of Hearing
Insurance, Commissioner of
Notice is hereby given that pursuant to the authority granted under s. 601.41 (3), Stats., and the procedure set forth in s. 227.18, Stats., the Office of the Commissioner of Insurance (OCI) will hold a public hearing to consider the adoption of the proposed rule-making order affecting ss. Ins 17.01 (3) (intro.), 17.275 and 17.28 (5) (c), (6) and (6a), Wis. Adm. Code, relating to annual patients compensation and mediation fund fees, open records law and exceptions applicable to fund records and imposing late fee for late or improper filing of certificates of insurance.
Analysis Prepared by the Office of the Commissioner of Insurance
Statutory authority: ss. 601.41 (3), 655.004, 655.27 (3) (b) and 655.61
Statutes interpreted: ss. 655.23 (3) (b) and (c) and 655.27 (3)
The Commissioner of Insurance, with the approval of the Board of Governors (Board) of the patients compensation fund (fund), is required to establish by administrative rule the annual fees which participating health care providers must pay to the fund. This rule establishes those fees for the fiscal year beginning July 1, 1999. These fees represent a 7% decrease compared with fees paid for the 1998-99 fiscal year. The Board approved these fees at its meeting on March 17, 1999, based on the recommendation of the Board's actuarial and underwriting committee.
The Board is also required to promulgate by rule the annual fees for the operation of the patients compensation mediation system, based on the recommendation of the Director of State Courts. This rule implements the Director's funding level recommendation by establishing mediation panel fees for the next fiscal year at $16.00 for physicians and $ 1.00 per occupied bed for hospitals, representing no increase from 1998-99 fiscal year mediation panel fees.
This rule provides that open records law and exceptions apply to fund records. This rule imposes a $100 late fee per week per certificate on insurers or self-insured providers who fail to comply with the format and filing date requirements of s. Ins 17.28 (5), Wis. Adm. Code. This late fee is intended to reduce the number of late filings and filings not in compliance with the format specified by the Commissioner.
Hearing Information
May 17, 1999 Room 23, OCI
Monday 121 East Wilson St.
10:00 a.m. Madison, WI
Written Comments
Written comments on the proposed rule will be accepted into the record and receive the same consideration as testimony presented at the hearing if they are received at OCI by 4:30 p.m. on the date of the hearing. Written comments should be addressed to:
Alice M. Shuman, OCI
P. O. Box 7873
Madison, WI 53707
Summary of Proposed Rule and Fiscal Estimate
For a summary of the rule see the analysis. There will be no state or local government fiscal effect.
Initial Regulatory Flexibility Analysis
This rule does not impose any additional requirements on small businesses.
Contact Person
A copy of the full text of the proposed rule changes and fiscal estimate may be obtained from the OCI internet WEB site at
http://www.state.wi.us/agencies/oci/rule.htm or by contacting Tammi Kuhl, Services Section, Office of the Commissioner of Insurance, at (608) 266-0110 or at 121 East Wilson Street, P. O. Box 7873, Madison, WI 53707-7873.
Notice of Hearings
Natural Resources
(Air Pollution Control, Chs. NR 400-)
Notice is hereby given that pursuant to ss. 227.11 (2) (a) and 285.11 (1), Stats., interpreting s. 285.11(6), Stats., and revising the State Implementation Plan (SIP) developed under that section, the Department of Natural Resources will hold public hearings on revisions to chs. NR 428 and 484, Wis. Adm. Code, relating to nitrogen oxides (NOx) emission reduction requirements.
Agency Analysis
The U.S. Environmental Protection Agency required states to adopt new regulations in response to its NOx SIP Call to Reduce Ozone Transport. The SIP call established a nitrogen oxides (NO
x) emissions budget for Wisconsin (and 21 other states) and gave the state some discretion as to how the reductions in NOx emissions would be achieved.
The proposed rule allocates a specified amount of NOx emissions during each ozone season (May 1 – September 30) to each affected source. The emission allocation or credits become tradeable across all sources affected by the reduction requirements which participate in a trading program such that the aggregate emission allocation is not exceeded with certain limitations in terms of allocation duration. Monitoring and reporting requirements ensure regional attainment of the reduction objectives. The trading structure allows facilities flexibility in the actual level of investment in controls versus acquisition of emission credits via the market of participating sources.
Initial Regulatory Flexibility Analysis
Notice is hereby further given that pursuant to s. 227.114, Stats., it is not anticipated that the proposed rule will have an economic impact on small businesses.
Environmental Assessment
Notice is hereby further given that the Department has made a preliminary determination that this action does not involve significant adverse environmental effects and does not need an environmental analysis under ch. NR 150, Wis. Adm. Code. However, based on the comments received, the Department may prepare an environmental analysis before proceeding with the proposal. This environmental review documents would summarize the Department's consideration of the impacts of the proposal and reasonable alternatives.
Hearing Information
Notice is hereby further given that the hearings will be held on:
Date & Time Location
May 17, 1999 Room 140-141
Monday DNR Southeast Region Office
at 1:00 p.m. 2300 N. Martin L. King, Jr. Dr.
MILWAUKEE, WI
May 18, 1999 Room 103 (Auditorium)
Tuesday Chippewa Valley Tech. College
at 1:00 p.m. 620 W. Clairemont Ave.
EAU CLAIRE, WI
(Parking is available in Lots P3
and P4 on the south side of
Clairemont Ave., and in P7
on the north side of
Clairemont Ave.)
