AB867: Bill Text

LRB-4377/1

TJD&MED:wlj&amn

2015 - 2016 LEGISLATURE

2015 Assembly BILL 867

February 4, 2016 - Introduced by Representatives Schraa, Shankland, Loudenbeck, Kitchens, Kleefisch, Tittl, R. Brooks, Skowronski, Quinn, Krug, Wachs, Kuglitsch, Kahl, Kolste, Kessler, Mursau, VanderMeer, Spiros, Born, Thiesfeldt, Rohrkaste, Swearingen, Meyers and Murphy, cosponsored by Senators Gudex and Lassa. Referred to Committee on State Affairs and Government Operations.

AB867,2,9 An Act to repeal 69.18 (4) (bm), 979.01 (3), 979.01 (3m), 979.03 and 979.10 (3); to renumber 69.18 (4) (a) 1g. to 6.; to renumber and amend 69.18 (4) (a) (intro.), 157.02 (1), (2), (3), (4) and (5), 979.01 (1m), 979.01 (2), 979.01 (4), 979.02, 979.10 (1) (a) 1., 2. and 3. and 979.10 (1) (c); to amend 20.165 (1) (g), 20.435 (1) (gm), 69.01 (12), 69.18 (2) (d) 1., 69.18 (2) (d) 2., 69.18 (2) (d) 3., 69.18 (3) (a), 69.18 (3) (b), 69.18 (3) (d), 69.20 (2) (a) 2., 157.03 (1), 157.03 (2), 157.055 (2) (intro.), 157.112 (3) (intro.), 157.70 (3) (a), 346.71 (1), 346.71 (2), 440.03 (9) (a) (intro.), 440.05 (intro.), 440.78 (1) (b), 979.01 (title), 979.01 (1r), 979.015, 979.02 (title), 979.025 (2), 979.025 (3), 979.09, 979.10 (1) (a) (intro.), 979.10 (1) (b), 979.10 (2), 979.10 (4) and 979.22; to repeal and recreate 20.435 (1) (gm), 979.01 (1) and 979.01 (1g); and to create 15.405 (18), 20.165 (1) (hr), 20.165 (1) (kd), 51.30 (4) (b) 29., 69.18 (4) (am) (intro.), 69.18 (4) (b), 69.18 (4) (d), 69.18 (4) (e), 69.18 (4) (f), 157.02 (1m) (title), 157.02 (2m), 440.03 (9) (bm), 440.03 (13) (b) 38d., 440.08 (2) (a) 46t., chapter 465, 979.001, 979.01 (1d), 979.01 (1i), 979.01 (1k), 979.01 (1m) (b), 979.01 (1p), 979.01 (2) (b), 979.017, 979.02 (2) to (7), 979.027, 979.032, 979.034, 979.036, 979.10 (1) (a) 1m. and 2m., 979.10 (1) (d), 979.10 (5) and 979.10 (6) of the statutes; relating to: reporting deaths; death investigations and other duties of coroners and medical examiners; disposition of bodies; creating a medicolegal investigation examining board; licensure of medical examiners and medicolegal investigation staff members; extending the time limit for emergency rule procedures; providing an exemption from emergency rule procedures; granting rule-making authority; making an appropriation; and providing criminal 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 medical examiners, medicolegal investigators, and others

The bill establishes a prohibition against performing a death investigation or performing the functions of 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, except that the bill exempts coroners and certain accredited medical examiners 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 nonaccredited medical examiner or medicolegal investigation staff member in this state on the bill's effective date. The bill also allows an individual who is serving as coroner on the bill's effective date to elect to receive such a license. The bill requires each such individual to complete, prior to the next license renewal date, 40 hours of education, 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 appointed as a nonaccredited 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 requires such an individual to complete a 40-hour death investigation training course within 18 months of initial licensure.

Finally, the bill allows an individual who is not serving as a 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, 2019, 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 24 hours of education, subject to certain exemptions for initial renewals.

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.