LRB-3587/1
MDK:cjs:rs
2001 - 2002 LEGISLATURE
December 7, 2001 - Introduced by
Joint Legislative Council. Referred to
Committee on Health.
AB672,1,4
1An Act to amend 448.02 (3) (a); and
to create 115.357 and 448.35 of the statutes;
2relating to: requiring physicians to provide certain information when issuing
3prescription orders to treat children with attention deficit hyperactivity
4disorder.
Analysis by the Legislative Reference Bureau
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:
Prefatory note: This bill was prepared for the joint legislative council's special
committee on use of prescription drugs for children.
REQUIREMENT FOR A PHYSICIAN ISSUING A PRESCRIPTION ORDER
FOR A CHILD FOR TREATMENT OF ATTENTION DEFICIT HYPERACTIVITY
DISORDER TO PROVIDE CERTAIN INFORMATION
Treatment of Attention Deficit Hyperactivity Disorder With a Prescription
Drug
The bill requires any physician who diagnoses a child (any person less than 18
years old) with attention deficit hyperactivity disorder (ADHD) and issues a prescription
order for treatment of the disorder to provide certain information to the parent or
guardian of the child or to an adult who is with the child at the time the prescription order
is issued, if any. If the child is 14 years of age or older, the physician must also provide
the information to the child.
If a physician treats a child for ADHD with a prescription drug on a long-term
basis, the physician must provide the information when issuing the initial prescription
order and at least once every 2 years thereafter. A physician is not required to provide
the information in an emergency or if the physician reasonably believes that another
physician has issued a prescription order for the child for the same prescription drug
within the past year.
Under the circumstances described above, a physician must provide all of the
following information:
1. An explanation of the method of diagnosis used, including the results of any tests
or evaluations.
2. Information on alternative modes of treatment, as provided in s. 448.30, stats.,
which provides as follows:
"448.30 Information on alternate modes of treatment. Any physician who
treats a patient shall inform the patient about the availability of all alternate, viable
medical modes of treatment and about the benefits and risks of these treatments. The
physician's duty to inform the patient under this section does not require disclosure of:
(1) Information beyond what a reasonably well-qualified physician in a similar
medical classification would know.
(2) Detailed technical information that in all probability a patient would not
understand.
(3) Risks apparent or known to the patient.
(4) Extremely remote possibilities that might falsely or detrimentally alarm the
patient.
(5) Information in emergencies where failure to provide treatment would be more
harmful to the patient than treatment.
(6) Information in cases where the patient is incapable of consenting.".
3. A printed copy of the informational materials pertaining to the assessment and
treatment of ADHD prepared by the department of health and family services (DHFS).
The requirement for DHFS to prepare those materials is described below.
Treatment of ADHD With a Schedule II Controlled Substance
In addition to providing the materials described above, a physician who diagnoses
a child with ADHD and prescribes a Schedule II controlled substance for treatment of the
disorder must provide a printed copy of any materials pertaining to the substance which
have been prepared by DHFS.
A physician who is required to provide any of the information (as described above)
must obtain certification in writing from the parent or guardian of the child or the adult
to whom the information is provided, if any, that the physician has provided all of the
required information.
Penalty for Failure to Provide Information; Exemption
Under current law, a physician who, after investigation and a hearing, is found
guilty of unprofessional conduct is subject to disciplinary action by the medical examining
board. The bill provides that an allegation that a physician has failed to provide the
required information or obtain the required certification is an allegation of
unprofessional conduct. However, the bill provides that it is not unprofessional conduct
for a physician to fail to provide the informational materials prepared by DHFS, if the
physician made a reasonably diligent effort to obtain the materials from DHFS and
DHFS did not make materials available at the time the physician was required to provide
them.
PREPARATION OF INFORMATIONAL MATERIALS BY DHFS
Materials Pertaining to the Assessment and Treatment of ADHD
The bill requires DHFS to prepare informational materials on the assessment and
treatment of ADHD. These are the materials which must be provided by a physician who
prescribes any prescription drug for the treatment of ADHD in a child. The materials
must contain the following:
1. A summary of the practice parameters for the assessment and treatment of
children and adolescents with ADHD published by the American Academy of Child and
Adolescent Psychiatry.
2. A statement that a parent or guardian may seek treatment other than
prescription drugs for a child with ADHD.
Materials Pertaining to Schedule II Controlled Substances
In addition to the materials above, the bill requires DHFS to prepare informational
materials on certain Schedule II controlled substances. These are the additional
materials that must be provided by a physician who prescribes any Schedule II controlled
substance for treatment of ADHD in a child. DHFS must, in consultation with the State
Medical Society of Wisconsin, determine which Schedule II controlled substances are
routinely prescribed by physicians in this state to treat ADHD in children. For each of
these substances, DHFS must prepare materials containing the following information:
1. A statement that the substance is a Schedule II controlled substance under s.
961.16.
2. A summary of information included in the labeling of the substance required by
federal law pertaining to the safety and effectiveness of the substance when used to treat
ADHD in children, including any information relating to the potential for abuse or
development of dependence upon the drug.
3. A statement that use of a the Schedule II controlled substance to treat ADHD
may affect a person's eligibility to serve in the U.S. armed forces, if the DHFS so finds.
4. A statement that the use of a Schedule II controlled substance to treat ADHD
may affect the cost of a person's health insurance.
DHFS must prepare all of the informational materials within approximately 5
months after the effective date of the bill. Physicians are first required to provide the
required information beginning approximately 9 months after the effective date of the
bill.
Dissemination of Materials by the Department of Public Instruction
The bill requires the department of public instruction (DPI) to disseminate the
informational materials prepared by DHFS to appropriate public school staff.
AB672, s. 1
1Section
1. 115.357 of the statutes is created to read:
AB672,3,6
2115.357 Information on attention deficit hyperactivity disorder. The
3department shall disseminate to appropriate public school staff the information
4regarding the diagnosis and treatment of attention deficit hyperactivity disorder and
5prescription drugs used to treat the disorder prepared by the department of health
6and family services under s. 448.35 (2).
Note: Requires the DPI to distribute the informational materials prepared by
DHFS to appropriate public school staff.
AB672, s. 2
7Section
2. 448.02 (3) (a) of the statutes is amended to read:
AB672,4,19
1448.02
(3) (a) The board shall investigate allegations of unprofessional conduct
2and negligence in treatment by persons holding a license, certificate or limited
3permit granted by the board. An allegation that a physician has violated s. 253.10
4(3), 448.30
, 448.35 (3), or 450.13 (2) or has failed to mail or present a medical
5certification required under s. 69.18 (2) within 21 days after the pronouncement of
6death of the person who is the subject of the required certificate or that a physician
7has failed at least 6 times within a 6-month period to mail or present a medical
8certificate required under s. 69.18 (2) within 6 days after the pronouncement of death
9of the person who is the subject of the required certificate is an allegation of
10unprofessional conduct. Information contained in reports filed with the board under
11s. 49.45 (2) (a) 12r., 50.36 (3) (b), 609.17 or 632.715, or under
42 CFR 1001.2005, shall
12be investigated by the board. Information contained in a report filed with the board
13under s. 655.045 (1), as created by
1985 Wisconsin Act 29, which is not a finding of
14negligence or in a report filed with the board under s. 50.36 (3) (c) may, within the
15discretion of the board, be used as the basis of an investigation of a person named in
16the report. The board may require a person holding a license, certificate or limited
17permit to undergo and may consider the results of one or more physical, mental or
18professional competency examinations if the board believes that the results of any
19such examinations may be useful to the board in conducting its investigation.
Note: Amends the statute which authorizes the medical examining board to
investigate allegations of unprofessional conduct and impose penalties against a
physician who is found guilty of unprofessional conduct. Specifically, provides that an
allegation that a physician violated s. 448.35 (3), stats., requiring physicians to provide
certain informational materials, as created in Section 3 of the bill, is an allegation of
unprofessional conduct. Section 3 of the bill also creates an exemption which provides
that a physician is not guilty of unprofessional conduct for failure to provide the
informational materials prepared by DHFS if the physician made a reasonably diligent
effort to obtain the materials from DHFS and DHFS did not make the materials available.
AB672, s. 3
20Section
3. 448.35 of the statutes is created to read:
AB672,5,2
1448.35 Attention deficit hyperactivity disorder. (1) Definitions. In this
2section:
AB672,5,33
(a) "Child" means a person under 18 years of age.
AB672,5,44
(b) "Department" means the department of health and family services.
AB672,5,55
(c) "Prescription drug" has the meaning given in s. 450.01 (20).
AB672,5,66
(d) "Prescription order" has the meaning given in s. 450.01 (21).
AB672,5,87
(e) "Schedule II controlled substance" means any substance included under s.
8961.16.