AB867: Bill Text

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 two individuals who are coroners, chief deputy coroners, or deputy coroners; two individuals who are nonaccredited medical examiners or medicolegal investigation staff members; two accredited medical examiners; a member of the Wisconsin District Attorneys' Association; members of two specified law enforcement organizations; the attorney general 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 at no cost to those license holders.

3. Monitor compliance with the licensure requirements created by the bill.

4. Revoke the license of a license holder who fails to complete the required death investigation course.

5. 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.

The bill also requires the board, if a license is revoked or not renewed for any reason, to do any of the following that applies to the license holder:

1. If the license holder is a nonaccredited medical examiner, send a statement to the county board or county executive, if applicable, for any county in which the license holder serves, recommending dismissal of the nonaccredited medical examiner because of the revocation or failure to renew the license.

2. 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 revocation or failure to renew the license.

The bill requires an individual who is appointed as a nonaccredited medical examiner or is hired to serve as a medicolegal investigation staff member, and who leaves his or her position as a medical examiner or medicolegal investigation staff member, to so inform the board.

The bill appropriates to the board all moneys received from licensure fees for medicolegal investigators licensed by the board and moneys received by the Department of Health Services for the issuance of death certificates.

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.

The bill requires that a law enforcement officer, health care provider, or funeral director who has knowledge of a death that occurs outside a hospital, nursing home, hospice, or physician's office must immediately report the death to the appropriate law enforcement agency and the coroner or medical examiner in the county where the death occurred or where the body or remains were located. Any person who discovers a body or the remains of a deceased individual outside a hospital, nursing home, hospice, or physician's office must also immediately report the death, if the death is of a type that must be reported, to law enforcement in the county where the death occurred or where the body or remains were located and may also report the death to the coroner or medical examiner. If the discovery of the body or remains is not reported to the coroner or medical examiner, law enforcement must report the discovery to the coroner or medical examiner. 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

The bill assigns jurisdiction to investigate the cause and manner of 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 after any crime scene investigation the coroner or medical examiner who has jurisdiction to investigate cause and manner of 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 law enforcement agency investigating the death and 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. 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.

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:

AB867,1 Section 1. 15.405 (18) of the statutes is created to read:

AB867,8,5 15.405 (18) Medicolegal investigation examining board. There is created a medicolegal investigation examining board in the department of safety and professional services that shall consist of the following members appointed for 6-year terms:

AB867,8,7 (a) Two individuals, each of whom is a coroner, chief deputy coroner, or deputy coroner.

AB867,8,11 (am) Two individuals, each of whom is a nonaccredited medical examiner, as defined in s. 465.01 (4), or a medicolegal investigation staff member, as defined in s. 465.01 (3), other than a medicolegal investigation staff member included under par. (a).

AB867,8,13 (b) Two individuals, each of whom is an accredited medical examiner, as defined in s. 465.01 (1g).

AB867,9,1 (c) One member of the Wisconsin District Attorneys' Association.

AB867,9,2 (d) One member of the Badger State Sheriffs Association.

AB867,9,3 (e) One member of the Wisconsin Chiefs of Police Association.

AB867,9,4 (g) The attorney general or his or her designee.

AB867,9,5 (i) One public member.

AB867,2 Section 2. 20.165 (1) (g) of the statutes is amended to read:

AB867,9,15 20.165 (1) (g) General program operations. The amounts in the schedule for the licensing, rule making, and regulatory functions of the department, other than the licensing, rule-making, and credentialing functions of the medical examining board and the affiliated credentialing boards attached to the medical examining board and except for preparing, administering, and grading examinations. Ninety percent of all moneys received under chs. 440 to 480, except ch. chs. 448 and 465 and ss. 440.03 (13), and 440.05 (1) (b), and, less $10 of each renewal fee received under s. 452.12 (5); all moneys transferred from the appropriation under par. (i); and all moneys received under s. 440.055 (2), shall be credited to this appropriation.

AB867,3 Section 3. 20.165 (1) (hr) of the statutes is created to read:

AB867,9,20 20.165 (1) (hr) Medicolegal investigation examining board; program revenues. All moneys received from fees imposed for licenses issued under s. 465.10 to provide training and education to individuals licensed under s. 465.10 and to support the medicolegal investigation examining board in performing its duties and functions.

AB867,4 Section 4. 20.165 (1) (kd) of the statutes is created to read:

AB867,9,25 20.165 (1) (kd) Medicolegal investigation examining board. All moneys transferred from the appropriation account under s. 20.435 (1) (gm) to provide training and education to individuals licensed under s. 465.10 and to support the medicolegal investigation examining board in performing its duties and functions.

AB867,5 Section 5. 20.435 (1) (gm) of the statutes, as affected by 2015 Wisconsin Act 55, section 669, is amended to read:

AB867,10,13 20.435 (1) (gm) Licensing, review and certifying activities; fees; supplies and services. The amounts in the schedule for the purposes specified in ss. 253.12, 254.176, 254.178, 254.179, 254.20 (5) and (8), 254.31 to 254.39, 254.41, 254.47, 254.61 to 254.88, and 256.15 (8), ch. 69, for the purchase and distribution of medical supplies, and to analyze and provide data under s. 250.04. All moneys received under ss. 250.04 (3m), 254.176, 254.178, 254.181, 254.20 (5) and (8), 254.31 to 254.39, 254.41, 254.47, 254.61 to 254.88, and 256.15 (5) (f) and (8) (d) and ch. 69, other than s. 69.22 (1m), and as reimbursement for medical supplies shall be credited to this appropriation account, except that all moneys received under s. 69.22 for copies of death certificates shall be transferred to the appropriation account under s. 20.165 (1) (kd).

AB867,6 Section 6. 20.435 (1) (gm) of the statutes, as affected by 2015 Wisconsin Acts 55, section 670, and .... (this act), is repealed and recreated to read:

AB867,10,25 20.435 (1) (gm) Licensing, review and certifying activities; fees; supplies and services. The amounts in the schedule for the purposes specified in ss. 253.12, 254.176, 254.178, 254.179, 254.20 (5) and (8), 254.31 to 254.39, 254.41, and 256.15 (8), ch. 69, for the purchase and distribution of medical supplies, and to analyze and provide data under s. 250.04. All moneys received under ss. 250.04 (3m), 254.176, 254.178, 254.181, 254.20 (5) and (8), 254.31 to 254.39, 254.41, and 256.15 (5) (f) and (8) (d) and ch. 69, other than s. 69.22 (1m), and as reimbursement for medical supplies shall be credited to this appropriation account, except that all moneys received under s. 69.22 for copies of death certificates shall be transferred to the appropriation account under s. 20.165 (1) (kd).

AB867,7 Section 7. 51.30 (4) (b) 29. of the statutes is created to read:

AB867,11,11 51.30 (4) (b) 29. To a medical examiner, assistant medical examiner, coroner, or deputy coroner upon an oral or written request from that person, if the individual's treatment records are relevant to completion of a medical certification for the individual's death under s. 69.18 (2) or to an investigation of the cause or manner of the individual's death under s. 979.01 or 979.10. A custodian of treatment records may initiate contact with a coroner or medical examiner to inform him or her of treatment records of a deceased individual that may be relevant to the completion of a medical certification or the investigation of a death. The recipient of any information under this subdivision shall keep the information confidential except as necessary to comply with s. 69.18, 979.01, or 979.10.

AB867,8 Section 8. 69.01 (12) of the statutes is amended to read:

AB867,11,17 69.01 (12) "Final disposition" means the disposition of a corpse or stillbirth by burial, interment, entombment, cremation, delivery to a university or school under s. 157.02 (3) (1m) (c), or delivery to a medical or dental school anatomy department under s. 157.06. "Final disposition" does not include disposition of the ashes produced by cremation of a corpse or stillbirth.

AB867,9 Section 9. 69.18 (2) (d) 1. of the statutes is amended to read:

AB867,12,2 69.18 (2) (d) 1. Except as provided under par. (e), if a the manner of death is not natural and is the subject of a coroner's or medical examiner's determination investigated by a coroner or medical examiner under s. 979.01 or 979.03, the coroner or medical examiner or a physician supervised by a coroner or medical examiner in the county where the event which caused the death occurred shall complete and sign the medical certification for the death and mail the death certificate within 5 days after the pronouncement of death or present the certificate to the person responsible for filing the death certificate under sub. (1) within 6 days after the pronouncement of death.

AB867,10 Section 10. 69.18 (2) (d) 2. of the statutes is amended to read:

AB867,12,10 69.18 (2) (d) 2. Except as provided under par. (e), if the decedent was not under the care of a physician for the illness or condition from which the person died, the coroner or medical examiner, or a physician supervised by a coroner or medical examiner, in the county of the place of death shall complete and sign the medical certification for the death and mail the death certificate within 5 days after the pronouncement of death or present the certificate to the person responsible for filing the death certificate under sub. (1) within 6 days after the pronouncement of death.

AB867,11 Section 11. 69.18 (2) (d) 3. of the statutes is amended to read:

AB867,12,18 69.18 (2) (d) 3. For a medical certification under this paragraph, except a medical certification of the cause of death of an indigent, a coroner or medical examiner may charge a fee established by the county board, not to exceed an amount reasonably related to the actual and necessary cost of providing the medical certification. The coroner or medical examiner, or the physician employed by the coroner or medical examiner, shall mail or present complete and sign a medical certification as required under subd. 1., whether or not the fee has been paid.

AB867,12 Section 12. 69.18 (3) (a) of the statutes is amended to read:

AB867,13,3 69.18 (3) (a) Except as provided under par. (c) or (e), the person who has moved a corpse under sub. (1) (a) shall complete a report for final disposition, on a form supplied by the state registrar, and, within 24 hours after being notified of the death, mail or present a copy of the report to the coroner or medical examiner in the county of the place of death and mail or present a copy to the local registrar in the registration district of the place of death. If the cause of death is subject to an investigation must be reported to a coroner or medical examiner under s. 979.01 or 979.03, the report for final disposition shall be submitted to the coroner or medical examiner in the county in which the event which caused the death occurred.

AB867,13 Section 13. 69.18 (3) (b) of the statutes is amended to read:

AB867,13,9 69.18 (3) (b) If a medical certification for a corpse is required under sub. (2) (d), no person may embalm the corpse or effect its final disposition without satisfying the requirements for a report under par. (a) and without obtaining the written permission of the person required to complete the medical certification under sub. (2) (d) an authorization to embalm or dispose of a body under s. 979.105.

AB867,14 Section 14. 69.18 (3) (d) of the statutes is amended to read:

AB867,13,18 69.18 (3) (d) No person may remove a corpse from this state if the place of death was in this state unless the corpse is accompanied by a copy of the report for final disposition. If a medical certification is required for the corpse under sub. (2) (d), the corpse must be accompanied by the report and the written permission of the coroner or medical examiner to embalm and effect final disposition an authorization to embalm or dispose of a body under s. 979.105. No person may remove a stillbirth from this state if the delivery of the stillbirth was in this state unless the stillbirth is accompanied by a report for final disposition.

AB867,15 Section 15. 69.18 (4) (a) (intro.) of the statutes is renumbered 69.18 (4) (c) and amended to read:

AB867,14,4 69.18 (4) (c) Subject to s. 157.111, the coroner or medical examiner of the county in which a decedent's corpse is interred shall issue an authorization a permit for disinterment and reinterment upon receipt of an order of a court of competent jurisdiction or upon receipt of a written application for disinterment and reinterment signed by the person in charge of the disinterment and by any of the following persons, in order of priority stated, when persons in prior classes are not available at the time of application, and in the absence of actual notice of contrary indications by the decedent or actual notice of opposition by a member of the same or a prior class:.

AB867,16 Section 16. 69.18 (4) (a) 1g. to 6. of the statutes are renumbered 69.18 (4) (am) 1g. to 6.

AB867,17 Section 17. 69.18 (4) (am) (intro.) of the statutes is created to read:

AB867,14,10 69.18 (4) (am) (intro.) In this subsection, "representative of the decedent" means any member of the following classes of individuals, in the order of priority listed:

AB867,18 Section 18. 69.18 (4) (b) of the statutes is created to read:

AB867,14,14 69.18 (4) (b) Except as provided in s. 157.112 (3), no person may disinter a human corpse from a grave or tomb without first obtaining a disinterment permit under par. (c) or (d).

AB867,19 Section 19. 69.18 (4) (bm) of the statutes is repealed.

AB867,20 Section 20. 69.18 (4) (d) of the statutes is created to read:

AB867,14,21 69.18 (4) (d) Subject to s. 157.111, the coroner or medical examiner of the county in which a decedent's corpse is interred shall issue a disinterment permit upon receipt of a written application for disinterment that is made and signed by a representative of the decedent and signed by the person in charge of disinterment if all of the following apply:

AB867,14,23 1. No representative of the decedent who is a member of a prior class under par. (am) is available at the time the application is made.