AB366: Bill Text

Analysis by the Legislative Reference Bureau

This bill 1) prohibits individuals, including medical examiners but not including coroners, from performing or assisting with a death investigation without a state-issued license; 2) establishes a Medicolegal Investigation Examining Board to administer the licensure provisions and provide training and education to licensees; 3) makes certain changes relating to the duties of coroners and medical examiners regarding death notifications; 4) creates provisions regarding the handling of personal property by a coroner or medical examiner at a death scene; 5) modifies provisions regarding the disposition and disinterment of bodies; and 6) provides coroners and medical examiners access to mental health treatment records without informed consent for certain purposes.

Current law overview

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.

The bill

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.

Notifications

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.

Handling of personal property

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

Authorization to embalm or dispose of a body. The bill requires an authorization from the coroner or medical examiner to embalm 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 a body.

Cremation 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 permit. The bill further requires that a coroner or medical examiner must specify on a cremation permit the earliest date and time that cremation may occur.

Authorization to disinter and reinter. 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. 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 may 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. 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.

Mental health treatment records

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. 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.

The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:

AB366,1 Section 1. 15.405 (18) of the statutes is created to read:

AB366,5,5 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:

AB366,5,7 (a) Two individuals, each of whom is a coroner, chief deputy coroner, or deputy coroner.

AB366,6,4 (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).

AB366,6,6 (b) Two individuals, each of whom is an accredited medical examiner, as defined in s. 465.01 (1g).

AB366,6,7 (c) One member of the Wisconsin District Attorneys' Association.

AB366,6,8 (d) One member of the Badger State Sheriffs Association.

AB366,6,9 (e) One member of the Wisconsin Chiefs of Police Association.

AB366,6,10 (g) The attorney general or his or her designee.

AB366,6,11 (i) One public member.

AB366,2 Section 2. 20.165 (1) (g) of the statutes is amended to read:

AB366,6,21 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.

AB366,3 Section 3. 20.165 (1) (hr) of the statutes is created to read:

AB366,7,2 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.

AB366,4 Section 4. 51.30 (4) (b) 29. of the statutes is created to read:

AB366,7,13 51.30 (4) (b) 29. Following the death of a patient, to a coroner, deputy coroner, medical examiner or medical examiner's assistant, for the purpose of completing a medical certificate under s. 69.18 (2) or investigating a death under s. 979.01 or 979.10. The health care provider may release information by initiating contact with the office of the coroner or medical examiner without receiving a request for release of the information and shall release information upon receipt of an oral or written request for the information from the coroner, deputy coroner, medical examiner or medical examiner's assistant. 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.

AB366,5 Section 5. 69.01 (12) of the statutes is amended to read:

AB366,7,19 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.

AB366,6 Section 6. 69.18 (2) (d) 1. of the statutes is amended to read:

AB366,8,4 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.

AB366,7 Section 7. 69.18 (2) (d) 2. of the statutes is amended to read:

AB366,8,12 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.

AB366,8 Section 8. 69.18 (2) (d) 3. of the statutes is amended to read:

AB366,8,20 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.

AB366,9 Section 9. 69.18 (3) (a) of the statutes is amended to read:

AB366,9,6 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 if the death is subject to investigation under s. 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.

AB366,10 Section 10. 69.18 (3) (b) of the statutes is amended to read:

AB366,9,12 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) or an authorization to embalm a body under s. 979.105.

AB366,11 Section 11. 69.18 (3) (d) of the statutes is amended to read:

AB366,9,21 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 or an authorization to embalm 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.

AB366,12 Section 12. 69.18 (4) (a) (intro.) of the statutes is renumbered 69.18 (4) (c) and amended to read:

AB366,9,25 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:.

AB366,13 Section 13. 69.18 (4) (a) 1g. to 6. of the statutes are renumbered 69.18 (4) (am) 1g. to 6.

AB366,14 Section 14. 69.18 (4) (am) (intro.) of the statutes is created to read:

AB366,10,13 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:

AB366,15 Section 15. 69.18 (4) (b) of the statutes is created to read:

AB366,10,17 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).

AB366,16 Section 16. 69.18 (4) (bm) of the statutes is repealed.

AB366,17 Section 17. 69.18 (4) (d) of the statutes is created to read:

AB366,10,24 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:

AB366,11,2 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.

AB366,11,4 2. The coroner or medical examiner does not have actual notice that the decedent would have opposed the disinterment.

AB366,11,7 3. The coroner or medical examiner does not have actual notice of opposition to disinterment by a representative of the decedent who is a member of the same or a prior class under par. (am) as the applicant.

AB366,11,9 4. The applicant provides proof of intent to cremate the decedent's corpse or to lawfully inter the decedent's corpse in a specified burial place.

AB366,18 Section 18. 69.18 (4) (e) of the statutes is created to read:

AB366,11,12 69.18 (4) (e) No person may cremate a corpse disinterred under this subsection without obtaining a cremation permit under s. 979.10 (1) (ag).

AB366,19 Section 19. 69.18 (4) (f) of the statutes is created to read:

AB366,11,16 69.18 (4) (f) Except as provided in s. 157.112 (3), no person may disinter a decedent's cremated remains from a cemetery unless all of the following conditions are satisfied:

AB366,11,17 1. The cemetery authority, or its designee, consents to disinterment.

AB366,11,20 2. A representative of the decedent consents to disinterment and no other representative of the decedent who is a member of the same or a prior class under par. (am) objects to disinterment.

AB366,20 Section 20. 69.20 (2) (a) 2. of the statutes is amended to read:

AB366,11,24 69.20 (2) (a) 2. For a certificate of death, any of the persons specified under s. 69.18 (4) (a) (am) 1g. to 6. or an individual who is authorized in writing by one of the persons.