Register January 2009 No. 637
Chapter DHS 181
REPORTING OF BLOOD LEAD TEST RESULTS
DHS 181.01   Authority and purpose.
DHS 181.02   Applicability.
DHS 181.03   Definitions.
DHS 181.04   Reporting responsibility and test result access.
DHS 181.05   Timetable for reporting.
DHS 181.06   Contents of report.
DHS 181.07   Form of report submitted to the department.
DHS 181.08   Enforcement, penalties and immunity from liability.
Ch. DHS 181 Note Note: Chapter HFS 181 was renumbered chapter DHS 181 under s. 13.92 (4) (b) 1., Stats., and corrections made under s. 13.92 (4) (b) 7., Stats., Register January 2009 No. 637.
DHS 181.01 DHS 181.01Authority and purpose. This chapter is promulgated under the authority of ss. 250.04 (7) and 254.13, Stats., to ensure timely reporting to the department of the results of all tests made to determine the concentration of lead in a person's blood. The chapter establishes a foundation for a surveillance system that will identify, evaluate and provide a basis for controlling the prevalence of lead poisoning or lead exposure. When blood lead test results are properly reported, the department and local health departments are able to carry out their public health responsibilities to identify individuals with lead poisoning, identify and evaluate trends, patterns and risk factors for lead poisoning, identify sources of lead in the environment, educate the public and prevent exposure to lead.
DHS 181.01 History History: Cr. Register, May, 2000, No. 533, eff. 6-1-00.
DHS 181.02 DHS 181.02Applicability. This chapter applies to any physician, nurse, hospital administrator, director of a blood drawing site or local health officer who obtains a person's blood sample or orders that a blood sample be taken from a Wisconsin resident for the purpose of measuring the concentration of lead in the blood and to directors of clinical laboratories that analyze human blood samples to determine the concentration of lead in blood.
DHS 181.02 History History: Cr. Register, May, 2000, No. 533, eff. 6-1-00.
DHS 181.03 DHS 181.03Definitions. In this chapter:
DHS 181.03(1) (1) “Blood lead test" means the determination by a clinical laboratory of the amount of lead in a blood sample.
DHS 181.03(2) (2) “Blood sample" means any human blood sample, venous or capillary, drawn for analysis of the concentration of lead in the blood.
DHS 181.03(3) (3) “Clinical laboratory" means a laboratory which analyzes human blood samples to determine the concentration of lead in blood and which meets the standards of the clinical laboratory improvement amendments.
DHS 181.03(4) (4) “Clinical laboratory improvement amendments" means the federal clinical laboratory improvement amendments of 1988, as amended, 42 USC 263a and 42 CFR Part 493.
DHS 181.03(5) (5) “Department" means the Wisconsin department of health services.
DHS 181.03(6) (6) “Director of a blood drawing site" means a person responsible for a location where blood samples are obtained or drawn to determine the concentration of lead in the blood.
DHS 181.03(7) (7) “Health care provider" means a physician, nurse, hospital administrator, local health officer or director of a blood drawing site.
DHS 181.03(8) (8) “Local health department" has the meaning specified under s. 250.01 (4), Stats.
DHS 181.03(9) (9) “Local health officer" means the person in charge of a local health department.
DHS 181.03(10) (10) “Lead poisoning or lead exposure" means a concentration of lead in the blood of 10 micrograms or more of lead per 100 milliliters of human blood.
DHS 181.03(11) (11) “Medical assistance" means the assistance program under ss. 49.43 to 49.497, Stats., and chs. DHS 101 to 108.
DHS 181.03(12) (12) “Screens" means taking a sample of blood from a person and sending the blood sample to a clinical laboratory for determination of the concentration of lead in the person's blood.
DHS 181.03(13) (13) “Person who screens for lead poisoning or lead exposure" means a physician, nurse, hospital administrator, local health officer, director of a clinical laboratory or director of a blood drawing site who screens blood samples for determination of the concentration in the blood.
DHS 181.03 History History: Cr. Register, May, 2000, No. 533, eff. 6-1-00; corrections in (5) and (11) made under s. 13.92 (4) (b) 6. and 7., Stats., Register January 2009 No. 637.
DHS 181.04 DHS 181.04Reporting responsibility and test result access.
DHS 181.04(1)(1) The results of all blood lead tests performed on blood samples taken from Wisconsin residents shall be reported to the department.
DHS 181.04(2) (2) When a health care provider sends a blood sample to a clinical laboratory for determination of the concentration of lead in the blood, the health care provider shall include with the blood sample all the information required under s. DHS 181.06 (1).
DHS 181.04(3)(a)(a) Except as provided in par. (b), directors of clinical laboratories shall report to the department the results of all blood lead tests and the other information as described in s. DHS 181.06 for each blood lead test regardless of the concentration of lead in the blood.
DHS 181.04(3)(b) (b) If there is a written agreement between the health care provider and the clinical laboratory, the health care provider may report the blood lead test results and the other information described in s. DHS 181.06 to the department.
DHS 181.04(3)(c) (c) If the health care provider sends blood samples to a clinical laboratory outside of Wisconsin, the health care provider shall report the blood lead test results and other information described in s. DHS 181.06 to the department.
DHS 181.04(4) (4) A health care provider shall be considered to have met the requirement under s. 254.13 (1), Stats., to report results to the department if the health care provider submits the information required under s. DHS 181.06 (1) in writing with the blood sample when sending the blood sample to a clinical laboratory for determination of the concentration of lead in blood except as indicated in sub. (3) (c).
DHS 181.04(5) (5) Blood sample test results shall be accessible to health care providers treating the person tested. If the blood sample test results indicate lead poisoning or lead exposure, the department shall transmit results of the test to the local health department in the area in which the person tested resides.
DHS 181.04(6) (6) At the direction of the department and at the request of the local health department, a laboratory director or a health care provider under sub. (3) (b) shall report results of blood lead tests directly to the local health department in the area in which the person tested resides. The local health department shall transmit results of blood lead tests and the other information required by s. DHS 181.06 at least quarterly to the department in a format acceptable to the department.
DHS 181.04(7) (7) Failure to report blood lead results is a violation of this chapter and therefore the person responsible is subject to prosecution under s. DHS 181.08.
DHS 181.04 Note Note: To obtain information about reporting or to send blood test results and other patient information, write or call the Lead Poisoning Prevention Program, Division of Public Health, P.O. Box 2659, Madison, WI 53701-2659, telephone (608) 266-5817.
DHS 181.04 History History: Cr. Register, May, 2000, No. 533, eff. 6-1-00; CR 04-040: r. and recr. (5) Register November 2004 No. 587, eff. 12-1-04.
DHS 181.05 DHS 181.05Timetable for reporting.
DHS 181.05(1)(a) (a) Blood lead concentrations of 45 micrograms or more of lead per 100 milliliters of blood shall be reported to the department within 24 hours from the time the analysis is completed.
DHS 181.05 Note Note: For patients with blood lead results of 45 micrograms lead per 100 milliliters of blood or more, report to the Department blood lead test results and other patient information by telephoning or faxing: Lead Poisoning Prevention Program, Division of Public Health, P.O. Box 2659, Madison, WI 53701-2659; telephone (608) 266-5817; fax (608) 267-0402.
DHS 181.05(1)(b) (b) Blood lead concentrations of 10 micrograms or more of lead but less than 45 micrograms of lead per 100 milliliters of blood shall be reported to the department within 48 hours from the time the analysis is completed.
DHS 181.05(1)(c) (c) Blood lead concentrations of less than 10 micrograms of lead per 100 milliliters of blood shall be reported to the department within 30 days from the time the analysis is completed.
DHS 181.05(2) (2) Failure to report blood lead test results in the timeframe identified in this section is a violation of this chapter and therefore the person responsible is subject to prosecution under s. DHS 181.08.
DHS 181.05 History History: Cr. Register, May, 2000, No. 533, eff. 6-1-00.
DHS 181.06 DHS 181.06Contents of report.
DHS 181.06(1) (1)Information to accompany blood sample for laboratory analysis. Any health care provider who submits a human blood sample to a clinical laboratory for a determination of the lead concentration in the blood shall include all of the following information with the blood sample:
DHS 181.06(1)(a) (a) The patient's first name, middle initial and last name.
DHS 181.06(1)(b) (b) The patient's month, day and year of birth.
DHS 181.06(1)(c) (c) The patient's gender, male or female.
DHS 181.06(1)(d) (d) The patient's race: Z=Unknown, W=White, B=Black, A=Asian, N=Native American, O=Other.
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Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date the chapter was last published.