AB849: Bill Text

DAK/RPN/RLR/MDK:hmh:pg

2001 - 2002 LEGISLATURE

2001 Assembly BILL 849

February 25, 2002 - Introduced by Representatives Underheim, Huber and Miller, cosponsored by Senators Moen and Rosenzweig. Referred to Committee on Public Health.

AB849,1,9 An Act to renumber 95.22 and 252.06 (4); to amend 166.03 (1) (b) 1., 252.02 (title), 252.05 (1), 252.06 (1) and 252.06 (10) (a); and to create 20.435 (1) (e), 95.22 (2), 157.055, 166.02 (1p), 166.02 (1r), 166.02 (1t), 166.02 (7), 166.02 (8), 166.03 (1) (b) 8., 166.03 (2) (a) 6., 250.01 (6g), 250.01 (6r), 250.03 (3), 250.042, 251.05 (3) (e), 252.02 (7), 252.041, 252.06 (4) (b), 252.06 (10) (b) 5., 252.06 (10) (b) 6., 440.142, 895.46 (5) (c) and 979.012 of the statutes; relating to: authorizing a declaration of and actions under a state of emergency related to public health, requiring the exercise of rule-making authority, making an appropriation, and providing a penalty.

Analysis by the Legislative Reference Bureau

Under current law, the governor may proclaim a state of emergency for any portion of the state or the whole state if the governor determines that an emergency resulting from enemy action or a natural or man-made disaster exists. The state of emergency may not exceed 60 days for an emergency resulting from enemy action or 30 days from disasters, unless extended by a joint resolution of the legislature. The department of military affairs, through the division of emergency government, is the lead state agency to respond to the emergency. This bill allows the governor to proclaim a state of emergency related to public health and designate the department of health and family services (DHFS) as the lead state agency if the governor determines that a public health emergency exists. The bill defines a public health emergency as the occurrence or threat of a health condition that is caused by bioterrorism or a novel or previously controlled biological agent and that poses a high probability of a large number of deaths or serious injury and a high probability of widespread exposure to a biological, chemical, or radiological agent that creates a significant risk of harm to a large number of people. Under the bill, during a state of emergency related to public health, the governor may suspend any administrative rule that would hinder necessary actions to respond to the emergency and increase the health threat to the population.

Current law relating to the duties of funeral directors prohibits a public officer, an employee or officer of a public institution, or a physician from sending the corpse of a person to a funeral director without having first made inquiry as to the desires of the next of kin or others who may be chargeable with the funeral expenses. No person who is not licensed as a funeral director by the funeral directors examining board may engage in the business of a funeral director. Further, no person may cremate a corpse without first obtaining a cremation permit from the appropriate county coroner or medical examiner. If a corpse is the subject of a coroner's or medical examiner's investigation concerning cause of death, no person may embalm or conduct an autopsy on the corpse without authorization from the appropriate coroner or medical examiner.

Under current law, DHFS must carry out a statewide immunization program to eliminate mumps, measles, German measles, diphtheria, whooping cough, poliomyelitis and other diseases that DHFS specifies by rule and to protect against tetanus. Any registered nurse, licensed practical nurse, nurse midwife, physician, physician assistant, respirator care practitioner, physician therapist, podiatrist, dietitian, athletic trainer, or occupational therapist who knows or has reason to know that a person treated or visited by him or her has a communicable disease or, having a communicable disease, has died, must report the appearance of the disease or the death to the local health officer; the local health officer must report, or require the person reporting, to report to DHFS. DHFS has broad authority to implement emergency measures necessary to control communicable diseases, that are diseases specified by DHFS by rule. DHFS or local health officers of local health departments may require isolation of a patient, quarantine of contacts, disinfection, or modified forms of these procedures. If a local health officer has a reasonable belief in the existence of a communicable disease or receives a diagnostic report of a physician or notification or a confirming report from a parent or caretaker, the local health officer must immediately quarantine, isolate, and impose restrictions on persons or take other communicable disease control measures. If DHFS or a local health officer determines it necessary for a particular communicable disease, no persons except the local health officer, his or her representative, the attending physicians and nurses, members of the clergy, members of a patient's immediate family, and other persons with a special permit from the local health officer may be in direct contact with the patient. Expenses for necessary medical care, food, and other articles necessary for the care of an infected person must be charged to the person or whoever is liable for his or her support.

This bill requires DHFS to act as the public health authority during the period of a state of emergency related to public health, if the governor declares the state of emergency and designates the department as the lead state agency. During the state of emergency, the secretary of DHFS may designate a local health department as an agent of DHFS and confer upon the local health department, acting under that agency, the powers and duties of the public health authority.

Under the bill, as the public health authority, DHFS must inform state residents when a state of emergency related to public health has been declared or is terminated, how to protect themselves, and what actions the public health authority is taking to control a public health emergency. This information must be provided by all available and reasonable means calculated to inform the general public. From a sum sufficient appropriation of general purpose revenues created in the bill, DHFS may purchase, store, or distribute antitoxins, serums, vaccines, immunizing agents, antibiotics, and other pharmaceutical agents or medical supplies that DHFS determines are advisable to control a public health emergency. DHFS also may order any individual to receive a vaccination unless a vaccination is reasonably likely to lead to serious harm to the individual, and may isolate or quarantine any individual who is unable or unwilling for reasons of health, religion, or conscience to receive the vaccination. Further, the bill creates provisions relating to visitation during isolation or quarantine under a state of emergency related to public health to establish a penalty for any person, other than a person authorized by the public health authority or agent of the public health authority, who enters an isolation or quarantine premises. In addition, a person, whether authorized or not, who enters an isolation or quarantine premises may be subject to quarantine or isolation. A county or municipality is made liable for the expense of providing a reasonable means of communication for a person who is isolated or quarantined and for expenses for necessary medical care, food, and other articles needed for the care and treatment of an infected person who is quarantined or isolated in a place other than his or her residence or a family member's residence, unless third-party payment is available for these expenses. All health care providers who know or have reason to know that a person treated or visited by them has a communicable disease, or, having a communicable disease, has died, must report the communicable disease or death to the local health officer.

The bill also permits a public health authority, during a period of a state of emergency relating to public health, to do all of the following:

1. Issue and enforce orders that are reasonable and necessary to provide for the safe disposal of human remains, including by embalming, burial, cremation, interment, disinterment, transportation, and other disposal.

2. Take possession and control of any human remains.

3. Order the disposal, through burial or cremation, of any human remains of an individual who has died of a communicable disease, within 24 hours after the individual's death.

4. If reasonable and necessary for emergency response, compel a funeral establishment, as a condition of its permit, to accept human remains or provide the use of its business to the public health authority for the period of the state of emergency.

5. Require the labeling of all human remains before disposal with all available identifying information and information concerning the circumstances of death, and require the tagging of the human remains of an individual with a communicable disease.

6. Maintain or require maintenance of a written or electronic record of all human remains that are disposed of and, if it is impossible to identify the human remains, require that fingerprints, photographs, or identifying dental information be obtained and a specimen of deoxyribonucleic acid be collected.

7. Authorize a county medical examiner or county coroner to appoint assistants or deputies, if necessary to perform the duties of the medical examiner or the coroner.

The bill requires a pharmacist or pharmacy to report to DHFS all of the following:

1. An unusual increase in the number of prescriptions dispensed or nonprescription drug products sold for the treatment of medical conditions, as specified by DHFS by rule.

2. An unusual increase in the number of antibiotic drug prescriptions dispensed.

3. Prescriptions dispensed for treatment of a disease that is relatively uncommon or may be associated with bioterrorism.

The bill also requires a coroner or medical examiner to report to DHFS any illness or health condition of a deceased that is caused by bioterrorism or by a novel or previously controlled or eradicated biological agent.

Lastly, beginning on July 1, 2002, after first consulting with the adjutant general, local health departments, health care providers, and law enforcement agencies, the bill requires DHFS to report biennially to the governor and to the legislature on the preparedness of the public health system to address public health emergencies. In addition, no later than 90 days after a state of emergency relating to public health is declared and the lead state agency is designated to respond to that emergency and no later than 90 days after the termination of this state of emergency, the lead state agency, either DHFS or the department of military affairs, must submit to the legislature and to the governor a report on the emergency powers used and the expenses incurred by the department and its agents.

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:

AB849, s. 1 Section 1. 20.435 (1) (e) of the statutes is created to read:

AB849,5,5 20.435 (1) (e) Public health emergency. A sum sufficient to defray all expenditures necessary to respond to a state of emergency related to public health only if the governor declares such an emergency and designates the department of health and family services as the lead state agency to respond to the emergency under s. 166.03 (1) (b) 1.

AB849, s. 2 Section 2. 95.22 of the statutes is renumbered 95.22 (1).

AB849, s. 3 Section 3. 95.22 (2) of the statutes is created to read:

AB849,5,9 95.22 (2) The department shall provide the reports of any communicable diseases under sub. (1) to the department of health and family services.

AB849, s. 4 Section 4. 157.055 of the statutes is created to read:

AB849,5,12 157.055 Disposal of human remains during state of emergency relating to public health. (1) In this section:

AB849,5,13 (a) "Funeral establishment" has the meaning given in s. 445.01 (6).

AB849,5,14 (b) "Public health authority" has the meaning given in s. 250.01 (6g).

AB849,5,18 (2) Notwithstanding ss. 69.18 (4), 445.04 (2), 445.14, 979.01 (3), (3m), and (4), 979.02, and 979.10, during a period of a state of emergency related to public health declared by the governor under s. 166.03 (1) (b) 1., a public health authority may do all of the following:

AB849,5,21 (a) Issue and enforce orders that are reasonable and necessary to provide for the safe disposal of human remains, including by embalming, burial, cremation, interment, disinterment, transportation, and other disposal.

AB849,5,22 (b) Take possession and control of any human remains.

AB849,6,2 (c) Order the disposal, through burial or cremation, of any human remains of an individual who has died of a communicable disease, within 24 hours after the individual's death and consider, to the extent feasible, the religious, cultural, or individual beliefs of the deceased individual or his or her family in disposing of the remains.

AB849,6,7 (d) If reasonable and necessary for emergency response, compel a funeral establishment, as a condition of its permit under s. 445.105 (1), to accept human remains or provide the use of its business or facility, including by transferring the management and supervision of the funeral establishment to the public health authority, for a period of time not to exceed the period of the state of emergency.

AB849,6,12 (e) Require the labeling of all human remains before disposal with all available identifying information and information concerning the circumstances of death and, in addition, require that the human remains of an individual with a communicable disease be clearly tagged to indicate that remains contain a communicable disease and, if known, the specific communicable disease.

AB849,6,19 (f) Maintain or require the maintenance of a written or electronic record of all human remains that are disposed of, including all available identifying information and information concerning the circumstances of death and disposal. If it is impossible to identify human remains prior to disposal, the public health authority may require that a qualified person obtain any fingerprints, photographs, or identifying dental information, and collect a specimen of deoxyribonucleic acid from the human remains and transmit this information to the public health authority.

AB849,7,6 (g) Notwithstanding s. 59.34 (1) or 59.35 (1), authorize a county medical examiner or a county coroner to appoint emergency assistant medical examiners or emergency deputy coroners, whichever is applicable, if necessary to perform the duties of the office of medical examiner or coroner, and to prescribe the duties of the emergency assistant medical examiners or emergency deputy coroners. The term of any emergency appointment authorized under this paragraph may not exceed the period of the state of emergency. A county medical examiner or county coroner may terminate an emergency appointment before the end of the period of the state of emergency, if termination of the appointment will not impede the performance of the duties of his or her office. From the appropriation under s. 20.435 (1) (e), the department shall reimburse counties for the cost of any emergency medical examiners or emergency deputy coroners appointed under this paragraph.

AB849, s. 5 Section 5. 166.02 (1p) of the statutes is created to read:

AB849,7,8 166.02 (1p) "Biological agent" means any of the following:

AB849,7,10 (a) A select agent that is a virus, bacterium, rickettsia, fungus, or toxin that is specified under 42 CFR 72, Appendix A.

AB849,7,13 (b) A genetically modified microorganism or genetic element from an organism under par. (a) that is shown to produce or encode for a factor associated with a disease.

AB849,7,15 (c) A genetically modified microorganism or genetic element that contains nucleic acid sequences coding for a toxin under par. (a) or its toxic subunit.

AB849, s. 6 Section 6. 166.02 (1r) of the statutes is created to read:

AB849,7,20 166.02 (1r) "Bioterrorism" means the intentional use of any biological, chemical, or radiological agent to cause death, disease, or biological malfunction in a human, animal, plant, or other living organism in order to influence the policy of a governmental unit or to intimidate or coerce the civilian population.

AB849, s. 7 Section 7. 166.02 (1t) of the statutes is created to read:

AB849,7,23 166.02 (1t) "Chemical agent" means a substance that has chemical properties that produce lethal or serious effects in plants or animals.

AB849, s. 8 Section 8. 166.02 (7) of the statutes is created to read:

AB849,8,2 166.02 (7) "Public health emergency" means the occurrence or imminent threat of an illness or health condition that meets all of the following criteria:

AB849,8,4 (a) Is believed to be caused by bioterrorism or a novel or previously controlled or eradicated biological agent.

AB849,8,5 (b) Poses a high probability of any of the following:

AB849,8,6 1. A large number of deaths or serious or long-term disabilities among humans.

AB849,8,9 2. A high probability of widespread exposure to a biological, chemical, or radiological agent that creates a significant risk of substantial future harm to a large number of people.

AB849, s. 9 Section 9. 166.02 (8) of the statutes is created to read:

AB849,8,12 166.02 (8) "Radiological agent" means radiation or radioactive material at a level that is dangerous to human health.

AB849, s. 10 Section 10. 166.03 (1) (b) 1. of the statutes is amended to read:

AB849,8,25 166.03 (1) (b) 1. Proclaim a state of emergency for the state or any portion thereof of the state if he or she determines that an emergency resulting from enemy action or natural or man-made disaster exists. If the governor determines that a public health emergency exists, he or she may declare a state of emergency related to public health and may designate the department of health and family services as the lead state agency to respond to that emergency. The duration of such state of emergency shall not exceed 60 days as to emergencies resulting from enemy action or 30 days as to emergencies resulting from natural or man-made disaster, unless either is extended by joint resolution of the legislature. A copy of the proclamation shall be filed with the secretary of state. The proclamation may be revoked at the discretion of either the governor by written order or the legislature by joint resolution.

AB849, s. 11 Section 11. 166.03 (1) (b) 8. of the statutes is created to read:

AB849,9,5 166.03 (1) (b) 8. During a state of emergency related to public health, suspend the provisions of any administrative rule if the strict compliance with that rule would prevent, hinder, or delay necessary actions to respond to the emergency and increase the health threat to the population.

AB849, s. 12 Section 12. 166.03 (2) (a) 6. of the statutes is created to read:

AB849,9,11 166.03 (2) (a) 6. No later than 90 days after a state of emergency relating to public health is declared and the department is designated under s. 166.03 (1) (b) 1. as the lead state agency to respond to that emergency and no later than 90 days after the termination of this state of emergency relating to public health, submit to the legislature under s. 13.172 (2) and to the governor a report on all of the following:

AB849,9,13 a. The emergency powers used by the department of military affairs or its agents.

AB849,9,15 b. The expenses incurred by the department of military affairs and its agents in acting under the state of emergency related to public health.

AB849, s. 13 Section 13. 250.01 (6g) of the statutes is created to read:

AB849,9,19 250.01 (6g) "Public health authority" means the department, if the governor declares under s. 166.03 (1) (b) 1. a state of emergency related to public health and designates the department as the lead state agency to respond to that emergency.

AB849, s. 14 Section 14. 250.01 (6r) of the statutes is created to read:

AB849,9,21 250.01 (6r) "Public health emergency" has the meaning given in s. 166.02 (7).

AB849, s. 15 Section 15. 250.03 (3) of the statutes is created to read:

AB849,9,25 250.03 (3) (a) No later than 90 days after a state of emergency relating to public health is declared and the department is designated under s. 166.03 (1) (b) 1. as the lead state agency to respond to that emergency and no later than 90 days after the termination of this state of emergency relating to public health, the department shall submit to the legislature under s. 13.172 (2) and to the governor a report on all of the following:

AB849,10,4 1. The emergency powers used by the public health authority or its agents.

AB849,10,6 2. The expenses incurred by the public health authority and its agents in acting under the state of emergency related to public health.

AB849,10,12 (b) Biennially, beginning on July 1, 2002, after first consulting with the adjutant general, local health departments, health care providers, as defined in s. 146.81 (1), and law enforcement agencies, as defined in s. 165.77 (1) (b), the department shall submit to the legislature under s. 13.172 (2) and to the governor a report on the preparedness of the public health system to address public health emergencies.

AB849, s. 16 Section 16. 250.042 of the statutes is created to read:

AB849,10,21 250.042 Powers and duties of the department as public health authority. (1) If the governor declares a state of emergency related to public health under s. 166.03 (1) (b) 1. and designates the department as the lead state agency, the department shall act as the public health authority during the period of the state of emergency. During the period of the state of emergency, the secretary may designate a local health department as an agent of the department and confer upon the local health department, acting under that agency, the powers and duties of the public health authority.