LRB-1449/1
TJD&MED:sac&eev:ev
2013 - 2014 LEGISLATURE
November 25, 2013 - Introduced by Representatives Vruwink, Kleefisch,
Loudenbeck, Goyke, Bies, Kahl, Berceau, Pope, Ohnstad and Wachs,
cosponsored by Senator Lassa. Referred to Committee on State Affairs and
Government Operations.
AB530,2,8
1An Act to repeal 69.18 (4) (bm), 979.01 (3), 979.01 (3m), 979.03 and 979.10 (3);
2to renumber 69.18 (4) (a) 1g. to 6.;
to renumber and amend 69.18 (4) (a)
3(intro.), 157.02 (1), (2), (3), (4) and (5), 979.01 (1m), 979.01 (2), 979.01 (4),
4979.02, 979.10 (1) (a) 1., 2. and 3. and 979.10 (1) (c);
to amend 20.165 (1) (g),
569.01 (12), 69.18 (1) (a) 3., 69.18 (2) (d) 1., 69.18 (2) (d) 2., 69.18 (2) (d) 3., 69.18
6(3) (a), 69.18 (3) (b), 69.18 (3) (d), 69.20 (2) (a) 2., 157.03 (1), 157.03 (2), 157.055
7(2) (intro.), 157.112 (3) (intro.), 157.70 (3) (a), 346.71 (1), 346.71 (2), 440.03 (9)
8(a) (intro.), 440.05 (intro.), 440.78 (1) (b), 979.01 (title), 979.01 (1r), 979.015,
9979.02 (title), 979.025 (title), 979.025 (1), 979.025 (2), 979.025 (3), 979.09,
10979.10 (1) (a) (intro.), 979.10 (1) (b), 979.10 (2), 979.10 (4) and 979.22;
to repeal
11and recreate 979.01 (1) and 979.01 (1g); and
to create 15.405 (18), 20.165 (1)
12(b), 20.165 (1) (hr), 51.30 (4) (b) 29., 69.18 (4) (am) (intro.), 69.18 (4) (b), 69.18
13(4) (d), 69.18 (4) (e), 69.18 (4) (f), 157.02 (1m) (title), 157.02 (2m), 440.03 (9) (bm),
14440.03 (13) (b) 38m., 440.08 (2) (a) 46t., chapter 463, 979.001, 979.01 (1d),
1979.01 (1i), 979.01 (1k), 979.01 (1m) (b), 979.01 (1p), 979.01 (2) (b), 979.017,
2979.02 (2) to (7), 979.027, 979.032, 979.034, 979.036, 979.10 (1) (a) 1m. and 2m.,
3979.10 (1) (d), 979.10 (5) and 979.10 (6) of the statutes;
relating to: reporting
4deaths; death investigations and other duties of coroners and medical
5examiners; disposition of bodies; creating a medicolegal investigation
6examining board; licensure of coroners, medical examiners, and medicolegal
7investigation staff members; granting rule-making authority; making an
8appropriation; and providing penalties.
Analysis by the Legislative Reference Bureau
Under current law, coroners or medical examiners investigate certain deaths
and have various duties and powers specified by law related to deaths occurring in
this state, including receiving reports of deaths, participating in inquest
proceedings, determining causes of death, ordering autopsies, administering
provisions related to making anatomical gifts, and issuing cremation permits.
Current law provides for the election of coroners for four-year terms by the electors
of each county or of more than one county in certain cases, except that a county with
a population of 500,000 or more must, and a county with a population of less than
500,000 may, abolish the office of coroner and establish a medical examiner system.
Under the medical examiner system, a medical examiner is appointed by the county
board or, in populous counties, by the county executive. Current law does not
otherwise specify any particular requirements that an individual must fulfill in
order to hold the office of coroner or to be appointed as a medical examiner.
Licensure of coroners, medical examiners, medicolegal investigators, and
others
The bill establishes a prohibition against performing a death investigation or
performing the functions of a coroner, a medical examiner, or a person who assists
a coroner or medical examiner with a death investigation (medicolegal investigation
staff member) without a license in medicolegal investigation issued by the
Medicolegal Investigation Examining Board (board), except that the bill exempts
medical examiners who are physicians licensed by the Medical Examining Board
from this requirement. Any person who violates the prohibition may be subject to
a fine of not more than $1,000 and imprisonment of up to 90 days.
The bill requires the board to issue an initial license in medicolegal
investigation, at no charge, to every individual who is serving as a coroner,
nonphysician medical examiner, and medicolegal investigation staff member in this
state on the bill's effective date. The bill requires each such individual to complete,
prior to the next license renewal date, 40 hours of training, except that the bill allows
an individual who holds a credential, in good standing, from a nationally recognized
accreditation organization specializing in death investigation education to receive a
waiver from completing 16 of those 40 hours. The bill requires the board to provide,
at no cost, the required hours of training to these individuals.
The bill also requires the board to issue a license in medicolegal investigation
to any individual who is elected as a coroner, is appointed to fill a vacancy as a
coroner, is appointed as a nonphysician medical examiner, or is hired to serve as a
medicolegal investigation staff member after the bill's effective date, if the individual
pays any initial license fee imposed by the board. The bill generally requires such
an individual to complete 40 hours of training, but similarly allows for a waiver of
16 hours of this training and provides that an individual who was issued his or her
initial license with less than one year remaining before the next renewal date need
not complete the 40 hours of training until the following renewal. The bill allows the
board to impose a fee for the provision of this training for individuals elected,
appointed, or hired after the bill's effective date.
Finally, the bill allows an individual who is not serving as a coroner, medical
examiner, or medicolegal investigator to obtain a license in medicolegal investigation
from the board if he or she first completes 40 hours of training and pays any licensure
fee established by the board.
The bill provides that the renewal date for any license in medicolegal
investigation is January 1, 2015, and every four years thereafter. In order to renew
a license, a license holder must pay any renewal fee imposed by the board and
complete any required training or, for subsequent renewals, complete 24 hours of
education.
Medicolegal Investigation Examining Board; powers and duties
The bill provides for the creation of the 11-member board in the Department
of Safety and Professional Services, to be composed of a coroner; a medical examiner;
a forensic pathologist; a funeral director; members of three specified law
enforcement organizations; a member of the Wisconsin Counties Association; the
attorney general or his or her designee; the state public defender or his or her
designee; and one public member, appointed for six-year terms. The bill requires the
board to do all of the following:
1. Promulgate rules specifying standards and curricula for training and
education requirements for individuals holding a license in medicolegal
investigation issued by the board.
2. Coordinate and provide, on a regional basis, training and education for
holders of licenses issued by the board.
3. Monitor compliance with the licensure requirements created by the bill.
The bill also requires the board, if a license is not renewed for any reason, to do
any of the following that applies to the license holder:
1. If the license holder is a coroner, send a statement to the governor
recommending removal of the coroner from office because of the coroner's failure to
renew the license.
2. If the license holder is a medical examiner who is not a licensed physician,
send a statement to the county board or county executive, if applicable, of any county
in which the license holder serves, recommending dismissal of the nonphysician
medical examiner because of the nonphysician medical examiner's failure to renew
the license.
3. If the license holder is a medicolegal investigation staff member, send a
notice to the office in which the individual works notifying the coroner or medical
examiner of the staff member's failure to renew the license.
4. Provide the required training and education to license holders. The bill
allows the board to impose fees for licenses issued after the bill's effective date and
for license renewals, and to impose fees for providing training to those licensed after
the bill's effective date and for providing the education required to renew a license.
The bill requires an individual who is elected as a coroner, is appointed to fill
a vacancy as a coroner, is appointed as a nonphysician medical examiner, or is hired
to serve as a medicolegal investigation staff member, and who leaves his or her
position as a coroner, medical examiner, or medicolegal investigation staff member,
to so inform the board.
The bill appropriates to the board all moneys received from training, education,
and licensure fees and appropriates additional GPR funding to the board for the
purpose of carrying out its functions.
Reporting deaths
Under current law, any person who has knowledge of certain deaths must
report the death to the sheriff, police chief, or medical examiner or coroner for the
locality in which the death occurred. The following types of deaths must be reported:
a death that involves unexplained, unusual, or suspicious circumstances; a homicide
or suicide; a death following an accident; a death that is due to poisoning; a death
following an abortion; a death for which a physician or spiritual advisor did not
attend the deceased within 30 days before death; and a death for which a physician
refuses to sign the death certificate or for which a physician cannot timely be
obtained to sign the medical certification that is required for a death certificate. A
sheriff or police chief who is notified of such a death must notify the coroner or
medical examiner of the death, and the coroner or medical examiner must notify the
district attorney. In addition, current law requires a parent, stepparent, guardian,
or legal custodian of a child to report to law enforcement the death of the child if it
occurs under certain circumstances.
This bill requires that, if a death must be reported, any person who has
knowledge of the death must report it to the coroner or medical examiner and may,
in addition, report it to a law enforcement officer.
The bill requires that a law enforcement officer, health care provider, or funeral
director who has knowledge of a death that occurs outside of a hospital, nursing
home, hospice, or physician's office and any person who discovers the body or remains
of a deceased individual outside of a hospital, nursing home, hospice, or physician's
office must report the death to the coroner or medical examiner in the county where
the death occurred or where the body or remains were located. The bill also includes
specific reporting requirements for deaths that occur in hospitals, nursing homes,
hospices, or physician's offices. First, a health care provider must report each death
that occurs in a physician's office. Second, a hospice must report deaths that occur
while a person is receiving care from hospice in accordance with the coroner or
medical examiner's written policy. Third, a hospital or nursing home must report
each death that occurs at the hospital or nursing home and that did not result from
a natural disease process. Fourth, a hospital must report each death that occurs in
the emergency department of the hospital.
Currently, the penalty for failure to report a death for which reporting is
required is a fine not to exceed $1,000 or imprisonment for not more than 90 days.
The bill increases the maximum fine to $10,000 for a partnership, association,
organization, institution, or body politic or corporate that fails to report a death for
which reporting is required.
Jurisdiction to investigate death and notifications
Currently, a sheriff or police chief to whom a death is reported must notify a
coroner or medical examiner, and the coroner or medical examiner must notify the
district attorney.
The bill assigns jurisdiction to investigate a death to the coroner or medical
examiner in the county in which occurred the crime, injury, or other event that
caused the death. However, if it cannot be determined where the event that caused
the death occurred, or if the death occurred outside the state, the coroner or medical
examiner in the county in which death was pronounced has jurisdiction to
investigate. The bill provides that the coroner or medical examiner who has
jurisdiction to investigate a death has custody of the deceased's body and prohibits
any person from moving the body at or from a death scene without authorization from
the coroner or medical examiner. The bill requires a coroner or medical examiner
who receives notice of a death to notify the deceased's next of kin. The bill provides
that a coroner or medical examiner need not notify the district attorney of certain
types of reported deaths if the district attorney has waived notice in writing.
Autopsies and other diagnostic procedures
Currently, a coroner, medical examiner, or district attorney may order an
autopsy conducted on a body if there is reason to believe that the death resulted from
a homicide or certain other crimes or suicide, or occurred under unexplained or
suspicious circumstances. A coroner or medical examiner must order an autopsy on
any person who dies while confined in a correctional facility in this state. If a child
who is under two years of age dies unexpectedly or under circumstances indicating
sudden infant death syndrome, the coroner or medical examiner must order an
autopsy unless the parent or guardian requests in writing that an autopsy not be
performed. If the autopsy reveals that sudden infant death syndrome is the cause
of death, that cause shall be stated in the autopsy report. No person may perform
an autopsy on the body of a person whose death must be reported without obtaining
written authorization from the coroner or medical examiner.
Under current law, if an autopsy is not performed in connection with a death
that must be reported, the coroner or medical examiner may take specimens from the
body for analysis to assist in determining the cause of death. The coroner or medical
examiner must take specimens for analysis in such cases if requested to do so by the
spouse, parent, child, or sibling of the deceased.
The bill requires a coroner or medical examiner to order an autopsy for the
following deaths: a death that likely resulted from a crime; a death of a person under
two years of age under circumstances indicating sudden infant death syndrome; a
death of a person under 18 years of age that is unusual or unexplained; a death of
a person who is in the custody of a law enforcement officer or under active pursuit
by a law enforcement officer, or that otherwise involves a law enforcement officer; a
death of a person who is confined in federal prison or confined in a jail or otherwise
confined by a sheriff; and a death of a person who is detained or institutionalized in
connection with a civil commitment, preliminary proceedings for civil commitment,
or criminal trial competency proceedings. The bill allows a district attorney to order
an autopsy. The bill repeals the requirement that a coroner or medical examiner, in
cases where a death must be reported, must take specimens from a deceased's body
upon request of the deceased's spouse, parent, child, or sibling. Under the bill, if a
coroner or medical examiner does not order an autopsy for a death that must be
reported and a representative of the deceased inquires about performance of an
autopsy, the coroner or medical examiner must inform the representative that the
representative may independently contract for pathology-related services. Finally,
the bill repeals the requirement that, when applicable, coroners and medical
examiners cite sudden infant death syndrome as the cause of death in an autopsy
report.
Investigation records and handling of personal property
The bill requires that each coroner or medical examiner keep records of each
death investigation and specifies the contents of the records. The bill further
requires that the coroner or medical examiner keep death investigation records in
an office that is owned or leased by the county and designated as the office of the
coroner or medical examiner.
The bill provides that records of autopsies and other diagnostic procedures are
confidential. Under the bill, a coroner or medical examiner may release such records
only to persons who have authority to access the deceased's health care records
without informed consent, to a representative of the deceased, or for educational
purposes. The bill requires that a coroner or medical examiner keep all confidential
records that are gathered for an investigation, such as health care records,
confidential with certain exceptions. At the request of a law enforcement agency
investigating a death, a coroner or medical examiner must keep death investigation
records and information related to an investigation confidential during the course
of the investigation. The bill also requires that each coroner or medical examiner
maintain written policies regarding access to death investigation records.
The bill requires a coroner or medical examiner to maintain an inventory of
personal property that the coroner or medical examiner takes from a death scene or
from a deceased. The bill specifies that the coroner or medical examiner must
destroy, in accordance with applicable county evidence retention policies and
standards for disposal of medications, or donate to a drug repository program any
prescription medications that the coroner or medical examiner collects in an
investigation and does not provide to a law enforcement agency.
Disposition of bodies
Under current law, the coroner's or medical examiner's authorization is
required for various activities related to the disposition of bodies.
Authorization to embalm or dispose of a body. Under current law, a coroner's
or medical examiner's authorization is required to embalm or perform an autopsy on
the body of a person whose death must be reported. A coroner or medical examiner
must issue the authorization within 12 hours of receiving notice of the death or as
soon thereafter as possible in the event of unexplained, unusual, or suspicious
circumstances.
The bill requires an authorization from the coroner or medical examiner to
embalm, bury, entomb, cremate, or deliver for research purposes the body of a person
whose death must be reported. The bill specifies certain information that a coroner
or medical examiner must include on an authorization to embalm or dispose of a body,
eliminates the general 12-hour deadline for issuing an authorization to embalm, and
provides that a coroner or medical examiner must issue an authorization to embalm
or dispose of a body as soon as possible after being notified of a death.
Cremation permit. Under current law, a cremation permit issued by a coroner
or medical examiner is required for cremation of the body of any deceased person.
Currently, a person may not cremate a body within 48 hours of death, or discovery
of death, unless the death was caused by a contagious or infectious disease. A coroner
or medical examiner must view a body and make inquiry into the cause and manner
of death before issuing a cremation permit. Finally, a cremation permit for the body
of a person who died outside the state may be used only in the county in which it is
issued.
The bill calls the authorization required for cremation a release rather than a
permit. The bill provides that even when a death is caused by a contagious or
infectious disease, the body may not be cremated within 48 hours of the
pronouncement of death unless the body must be cremated immediately to
effectively contain the disease or a public health authority orders the sooner disposal
of the body during a state of emergency that is related to public health. The bill
requires that, if the medical certification of the cause and manner of death on a death
certificate is completed by a physician, the coroner or medical examiner must review
the medical certification before issuing a cremation release. The bill further requires
that a coroner or medical examiner must specify on a cremation release the earliest
date and time that cremation may occur. Finally, the bill requires that a person who
receives a body for medical research or education must request a cremation release
before receiving the body.
Authorization to disinter and reinter. Under current law, a coroner or medical
examiner must issue an authorization to disinter and reinter a body upon an order
of the court or at the request of various next of kin of the deceased or another person
who has authority to dispose of the body.
The bill clarifies that no person, other than a cemetery, may disinter a body or
human remains without authorization from the coroner or medical examiner. The
bill adds, as a condition for obtaining a coroner's or medical examiner's authorization
for disinterment without a court order, that the person requesting authorization
provide proof of intent to cremate or bury the disinterred remains.
Disposition of unidentified or unclaimed bodies. Under current law, if an
inmate of a state, county, or municipal institution dies, and a relative or friend of the
deceased does not claim the body and a medical or mortuary school does not take the
body, the superintendent of the institution must bury the body.
This bill provides that, if a person other than the superintendent of a state,
county, or municipal institution has an unidentified or unclaimed body, the person
shall notify the coroner or medical examiner in the county of residence of the
deceased, who must bury or cremate the body. Under the bill, if a coroner or medical
examiner buries or cremates the body, the county must pay the costs of burial or
cremation with funds other than funds appropriated for the operation of the
coroner's or medical examiner's office. The bill further provides that, if the coroner
or medical examiner makes reasonable efforts to identify a body and notify the
deceased's representative of disposal of the body, the coroner or medical examiner is
immune from civil liability for his or her choice of method for disposing of the body.
Mental health treatment records
Under current law, a coroner or medical examiner may obtain a deceased's
health care records without informed consent for the purpose of completing a medical
certification on a certificate of death or for conducting a death investigation. This
bill provides a coroner or medical examiner access to a deceased's mental health
treatment records without informed consent for the purpose of completing a medical
certification on a certificate of death or for conducting a death investigation.
Because this bill creates a new crime or revises a penalty for an existing crime,
the Joint Review Committee on Criminal Penalties may be requested to prepare a
report concerning the proposed penalty and the costs or savings that are likely to
result if the bill is enacted.
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: