SB488: Bill Text

DAK&TNF:cmh:hmh

1999 - 2000 LEGISLATURE

1999 Senate BILL 488

March 21, 2000 - Introduced by Senators Rosenzweig, Robson, Roessler, Grobschmidt, Risser, Plache and Farrow, cosponsored by Representatives Wasserman, Kaufert, Jeskewitz, Bock, Vrakas, Ladwig, Riley, Ryba, Albers, Steinbrink, Huebsch, Walker, Plale, Balow, Musser, La Fave, Ainsworth, Schooff, Kreuser, Plouff, Gronemus, J. Lehman, Hahn and Turner. Referred to Committee on Health, Utilities, Veterans and Military Affairs.

SB488,2,2 An Act to renumber 343.14 (6); to renumber and amend 157.06 (1) (c) 2. and 157.06 (2) (f) 5. b.; to amend 20.435 (1) (bm), 146.71, 155.30 (3), 157.06 (2) (b), 157.06 (2) (f) 1., 157.06 (2) (f) 1m., 157.06 (2) (f) 4., 157.06 (2) (i) 1., 157.06 (2) (i) 2. b., 157.06 (2) (i) 3., 157.06 (10m) (a) 1., 157.06 (10r) (a), 343.17 (3) (b), 343.175 (1), 343.175 (2) (a), 343.175 (2) (ag), 343.175 (2) (ar), 343.175 (2) (b), 343.20 (2m), 343.50 (3) and 343.50 (4m) (a); and to create 15.195 (2), 20.435 (1) (bm), 155.30 (3m), 157.06 (1) (em), 157.06 (1) (km), 157.06 (2) (L), 157.06 (10m), 157.06 (10r), 343.14 (2) (g) 2m., 343.14 (6) (b), 343.235 (3) (c), 343.24 (4) (c) 3. and 343.50 (4m) (c) of the statutes; relating to: creating a donor registry board, creating a Wisconsin donor registry, the definition of "document of gift", modifying the form for the power of attorney for health care, requiring a study, providing an exemption from emergency rule procedures, granting rule-making authority and making an appropriation.

Analysis by the Legislative Reference Bureau

Under current law, a person who is 18 or older may make a donation of all or a part of his or her body to a hospital, physician or an organ procurement organization; to an accredited medical or dental school, college or university; or to a designated individual. This anatomical gift may be made only if the donor signs a document of gift, which may be a card, a statement attached to or imprinted on a driver's license or identification card issued by the department of transportation (DOT), a will or another writing, such as a power of attorney for health care, that is used to make such a gift. The department of health and family services (DHFS) is required to prepare and provide copies of a power of attorney for health care instrument for distribution to the public; the form for the power of attorney for health care instrument that DHFS must prepare is specified in the statutes.

This bill creates a donor registry board that is attached to DHFS, composed of 11 voting and two nonvoting members. The donor registry board must review requests for proposals and award one or more contracts from general purpose revenues, as appropriated under the bill, to establish, operate and maintain a Wisconsin donor registry. The Wisconsin donor registry shall include names of and pertinent information about persons who have signed enrollment forms indicating their desires to make anatomical gifts. The bill authorizes the signing of an enrollment form to be an additional means of making a document of gift. This information is not subject to open records requirements and may be released by the registry only to organ procurement organizations, eye banks, tissue banks, the donor registry board and any successor contractors. Before the Wisconsin donor registry is implemented, the donor registry board must promulgate rules that ensure the confidentiality of registry enrollees and may promulgate the rules as emergency rules without making a finding of emergency. The entity that operates the registry must operate also a toll-free telephone number and may maintain an Internet Web site to provide information about making an anatomical gift and about enrollment in and disenrollment from the registry. The donor registry board must study the effectiveness of the registry and, by March 1, 2003, report the study results to the governor and the legislature.

The bill also modifies the power of attorney for health care form, to indicate that, since many institutions have certain conditions that must be met before receiving a donated body, if the principal intends to donate his or her whole body to an institution, the principal will attempt to contact the institution to which the donation is intended to be made. In addition, the bill authorizes DHFS to modify the form with respect to making an anatomical gift, to include the toll-free telephone number to obtain information on the Wisconsin donor registry.

Under current law, DOT is required to inquire whether an applicant for a driver's license or identification card (ID card) desires to be an organ donor. DOT must record the applicant's response in its file on the person. The bill requires DOT to forward to the Wisconsin donor registry, at least quarterly, a list of the names and addresses of those applicants whose response to this inquiry was affirmative. The bill also requires DOT to print the toll-free telephone number to obtain information on the Wisconsin donor registry on the reverse side of every driver's license and ID card. Finally, DOT must disseminate the enrollment form to all applicants for a driver's license or ID card.

Lastly, the bill requests that the entity that operates and maintains the Wisconsin donor registry study and, by January 1, 2002, report to the donor registry board on the means by which names and information may be purged from the registry after a period of time.

For further information see the state 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:

SB488, s. 1 Section 1. 15.195 (2) of the statutes is created to read:

SB488,3,6 15.195 (2) Donor registry board. There is created a donor registry board, attached to the department of health and family services under s. 15.03. The donor registry board shall consist of the secretary of health and family services and the secretary of transportation, or their designees, as nonvoting members, and shall consist of the following voting members appointed for 3-year terms:

SB488,3,7 (a) One representative of each of 2 organ procurement organizations.

SB488,3,8 (b) Two representatives of repositories for donated human tissue and bone.

SB488,3,10 (c) One representative of a repository for donated human eyes or portions of eyes.

SB488,3,11 (d) One recipient of organ or tissue donation or his or her family member.

SB488,3,12 (e) One organ or tissue donor or his or her family member.

SB488,3,14 (f) One member nominated by the Wisconsin Health and Hospital Association, Inc.

SB488,3,15 (g) One member nominated by the Wisconsin Nurses Association, Inc.

SB488,4,1 (h) One member nominated by the State Medical Society of Wisconsin.

SB488,4,2 (i) One member nominated by the State Bar of Wisconsin.

SB488, s. 2 Section 2. 20.005 (3) (schedule) of the statutes: at the appropriate place, insert the following amounts for the purposes indicated: - See PDF for table

SB488, s. 3 Section 3. 20.435 (1) (bm) of the statutes is created to read:

SB488,4,9 20.435 (1) (bm) Wisconsin donor registry. As a continuing appropriation, the amounts in the schedule for permanent property, supplies, services and staff support for the establishment, operation, maintenance and monitoring of the Wisconsin donor registry.

SB488, s. 4 Section 4. 20.435 (1) (bm) of the statutes, as created by 1999 Wisconsin Act .... (this act), is amended to read:

SB488,4,15 20.435 (1) (bm) Wisconsin donor registry. As a continuing appropriation, the amounts in the schedule for permanent property, supplies, services and staff support for the establishment, operation, maintenance and monitoring of the Wisconsin donor registry.

SB488, s. 5 Section 5. 146.71 of the statutes is amended to read:

SB488,5,5 146.71 Determination of death. An individual who has sustained either irreversible cessation of circulatory and respiratory functions or irreversible cessation of all functions of the entire brain, including the brain stem, is dead. A determination of death shall be made in accordance with accepted medical standards. A physician who acts in accordance with this section in making a determination of death or attempts in good faith to do so is not liable for that act in a civil action or criminal proceeding.

SB488, s. 6 Section 6. 155.30 (3) of the statutes is amended to read:

SB488,5,20 155.30 (3) The department shall prepare and provide copies of a power of attorney for health care instrument and accompanying information for distribution in quantities to health care professionals, hospitals, nursing homes, multipurpose senior centers, county clerks and local bar associations and individually to private persons. The department shall include, in information accompanying the copy of the instrument, at least the statutory definitions of terms used in the instrument, statutory restrictions on who may be witnesses to a valid instrument, a statement explaining that valid witnesses acting in good faith are statutorily immune from civil or criminal liability and a statement explaining that an instrument may, but need not, be filed with the register in probate of the principal's county of residence. The department may charge a reasonable fee for the cost of preparation and distribution. The power of attorney for health care instrument distributed by the department shall include the notice specified in sub. (1) and shall, except as provided in sub. (3m), be in the following form:

SB488,5,21 POWER OF ATTORNEY

SB488,5,22 FOR HEALTH CARE

SB488,5,23 Document made this.... day of.... (month),.... (year).

SB488,5,24 CREATION OF POWER OF

SB488,5,25 ATTORNEY FOR HEALTH CARE

SB488,6,8 I,.... (print name, address and date of birth), being of sound mind, intend by this document to create a power of attorney for health care. My executing this power of attorney for health care is voluntary. Despite the creation of this power of attorney for health care, I expect to be fully informed about and allowed to participate in any health care decision for me, to the extent that I am able. For the purposes of this document, "health care decision" means an informed decision to accept, maintain, discontinue or refuse any care, treatment, service or procedure to maintain, diagnose or treat my physical or mental condition.

SB488,6,10 In addition, I may, by this document, specify my wishes with respect to making an anatomical gift upon my death.

SB488,6,11 DESIGNATION OF HEALTH CARE AGENT

SB488,7,2 If I am no longer able to make health care decisions for myself, due to my incapacity, I hereby designate.... (print name, address and telephone number) to be my health care agent for the purpose of making health care decisions on my behalf. If he or she is ever unable or unwilling to do so, I hereby designate.... (print name, address and telephone number) to be my alternate health care agent for the purpose of making health care decisions on my behalf. Neither my health care agent nor my alternate health care agent whom I have designated is my health care provider, an employe of my health care provider, an employe of a health care facility in which I am a patient or a spouse of any of those persons, unless he or she is also my relative. For purposes of this document, "incapacity" exists if 2 physicians or a physician and a psychologist who have personally examined me sign a statement that specifically expresses their opinion that I have a condition that means that I am unable to receive and evaluate information effectively or to communicate decisions to such an extent that I lack the capacity to manage my health care decisions. A copy of that statement must be attached to this document.

SB488,7,3 GENERAL STATEMENT OF

SB488,7,4 AUTHORITY GRANTED

SB488,7,11 Unless I have specified otherwise in this document, if I ever have incapacity I instruct my health care provider to obtain the health care decision of my health care agent, if I need treatment, for all of my health care and treatment. I have discussed my desires thoroughly with my health care agent and believe that he or she understands my philosophy regarding the health care decisions I would make if I were able. I desire that my wishes be carried out through the authority given to my health care agent under this document.

SB488,7,20 If I am unable, due to my incapacity, to make a health care decision, my health care agent is instructed to make the health care decision for me, but my health care agent should try to discuss with me any specific proposed health care if I am able to communicate in any manner, including by blinking my eyes. If this communication cannot be made, my health care agent shall base his or her decision on any health care choices that I have expressed prior to the time of the decision. If I have not expressed a health care choice about the health care in question and communication cannot be made, my health care agent shall base his or her health care decision on what he or she believes to be in my best interest.

SB488,7,21 LIMITATIONS ON

SB488,7,22 MENTAL HEALTH TREATMENT

SB488,8,2 My health care agent may not admit or commit me on an inpatient basis to an institution for mental diseases, an intermediate care facility for the mentally retarded, a state treatment facility or a treatment facility. My health care agent may not consent to experimental mental health research or psychosurgery, electroconvulsive treatment or drastic mental health treatment procedures for me.

SB488,8,4 ADMISSION TO NURSING HOMES OR COMMUNITY-BASED RESIDENTIAL FACILITIES

SB488,8,6 My health care agent may admit me to a nursing home or community-based residential facility for short-term stays for recuperative care or respite care.

SB488,8,9 If I have checked "Yes" to the following, my health care agent may admit me for a purpose other than recuperative care or respite care, but if I have checked "No" to the following, my health care agent may not so admit me:

SB488,8,10 1. A nursing home — Yes.... No....

SB488,8,11 2. A community-based residential facility — Yes.... No....

SB488,8,13 If I have not checked either "Yes" or "No" immediately above, my health care agent may admit me only for short-term stays for recuperative care or respite care.

SB488,8,14 PROVISION OF A FEEDING TUBE

SB488,8,19 If I have checked "Yes" to the following, my health care agent may have a feeding tube withheld or withdrawn from me, unless my physician has advised that, in his or her professional judgment, this will cause me pain or will reduce my comfort. If I have checked "No" to the following, my health care agent may not have a feeding tube withheld or withdrawn from me.

SB488,8,22 My health care agent may not have orally ingested nutrition or hydration withheld or withdrawn from me unless provision of the nutrition or hydration is medically contraindicated.

SB488,8,23 Withhold or withdraw a feeding tube — Yes.... No....

SB488,8,25 If I have not checked either "Yes" or "No" immediately above, my health care agent may not have a feeding tube withdrawn from me.

SB488,9,1 HEALTH CARE DECISIONS

SB488,9,2 FOR PREGNANT WOMEN

SB488,9,6 If I have checked "Yes" to the following, my health care agent may make health care decisions for me even if my agent knows I am pregnant. If I have checked "No" to the following, my health care agent may not make health care decisions for me if my health care agent knows I am pregnant.

SB488,9,7 Health care decision if I am pregnant — Yes.... No....

SB488,9,10 If I have not checked either "Yes" or "No" immediately above, my health care agent may not make health care decisions for me if my health care agent knows I am pregnant.

SB488,9,11 STATEMENT OF DESIRES, SPECIAL

SB488,9,12 PROVISIONS OR LIMITATIONS

SB488,9,16 In exercising authority under this document, my health care agent shall act consistently with my following stated desires, if any, and is subject to any special provisions or limitations that I specify. The following are specific desires, provisions or limitations that I wish to state (add more items if needed):

SB488,9,17 1) -

SB488,9,18 2) -

SB488,9,19 3) -

SB488,9,20 INSPECTION AND DISCLOSURE OF INFORMATION

SB488,9,21 RELATING TO MY PHYSICAL OR MENTAL HEALTH

SB488,9,23 Subject to any limitations in this document, my health care agent has the authority to do all of the following:

SB488,9,25 (a) Request, review and receive any information, oral or written, regarding my physical or mental health, including medical and hospital records.

SB488,10,2 (b) Execute on my behalf any documents that may be required in order to obtain this information.

SB488,10,3 (c) Consent to the disclosure of this information.

SB488,10,4 (The principal and the witnesses all must sign the document at the same time.)

SB488,10,5 SIGNATURE OF PRINCIPAL