(2) Grants. (a) From the appropriation under s. 20.435 (5) (fh), the department shall award $50,000 in each fiscal year as a grant to a community health center in a 1st class city and shall award $100,000
in each fiscal year as a grant to a nurse-managed community health center in a first class city.
(b) From the appropriation under s. 20.435 (5) (fh), the department shall award grants
totaling $3,500,000 in fiscal year 1999-2000 and totaling $4,000,000 in fiscal year 2000-01 and in each fiscal year
thereafter, to community health centers that receive federal grants under
42 USC 254b (e), (g) or (h). Each grant shall equal the amount that results from multiplying the total amount available for grants under this paragraph in the fiscal year in which the grants are to be awarded by the quotient obtained by dividing the amount that the community health center received under
42 USC 254b (e), (g) or (h) in the most recently concluded federal fiscal year in which those grants were made by the total amount of federal grants under
42 USC 254b (e), (g) and (h) made in that federal fiscal year to community health centers in this state.
(c) From the appropriation under s. 20.435 (5) (fh), the department shall award $25,000 in each fiscal year as a grant to HealthNet of Janesville, Inc.
9,2400qc
Section 2400qc. 251.02 (1) of the statutes is amended to read:
251.02 (1) In counties with a population of less than 500,000, the county board shall establish a county health department that meets the requirements of this chapter. The county health department shall serve all areas of the county that are not served by a city health department that was established prior to January 1, 1994, or by a town or village health department established under sub. (3m) or by a multiple local health department established under sub. (3r). No city health department may be established after that date January 1, 1994, but a city-county health department may be established after that date.
9,2400qd
Section 2400qd. 251.02 (3r) of the statutes is created to read:
251.02 (3r) In a county described in sub. (3m), in addition to the local health department required to be established under sub. (3m), the governing body of a city, village or town in that county may, in concert with the governing body of another city, village or town in that county, establish a multiple municipal local health department and elect a local health officer consistent with this chapter.
9,2400qe
Section 2400qe. 251.03 (4r) of the statutes is created to read:
251.03 (4r) Subsections (1) to (4m) do not apply to a city, village or town that establishes a multiple municipal local health department under s. 251.02 (3r). In establishing a multiple municipal local health department as described under s. 251.02 (3r), the relevant governing bodies shall agree on how many members of the local board of health are appointed by each governing body and how many of each governing body's appointees shall be members who are not elected officials or employes of the governing body. The members shall be appointed by the relevant governing bodies. A local board of health under this subsection shall elect a chairperson and clerk.
9,2400qf
Section 2400qf. 251.04 (1) of the statutes is amended to read:
251.04 (1) A city or county board of health shall govern each local health department other than a local health department as authorized in s. 251.02 (3m) and (3r) and a city or county board of health or a board of health for a local health department as authorized in s. 251.02 (3m) and (3r) shall assure the enforcement of state public health statutes and public health rules of the department as prescribed for a Level I local health department. A local board of health may contract or subcontract to provide public health services. The contractor's staff shall meet the appropriate qualifications for positions in a Level I local health department.
9,2400qg
Section 2400qg. 251.04 (2) of the statutes is amended to read:
251.04 (2) A city or county board of health or a board of health for a local health department as authorized in s. 251.02 (3m) or (3r) shall assure that its local health department is a Level I, Level II or Level III local health department, as specified in s. 251.05 (1).
9,2400qh
Section 2400qh. 251.04 (3) of the statutes is amended to read:
251.04 (3) A city or county board of health or a board of health for a local health department as authorized in s. 251.02 (3m) or (3r) may adopt those regulations, for its own guidance and for the governance of the local health department, that it considers necessary to protect and improve public health. The regulations may be no less stringent than, and may not conflict with, state statutes and rules of the department.
9,2400qi
Section 2400qi. 251.06 (1) (a) 2. of the statutes is amended to read:
251.06 (1) (a) 2. A local health officer of a village or town health department established under s. 251.02 (3m) or of a multiple municipal local health department established under s. 251.02 (3r) shall be either a physician or a registered nurse. The local health officer shall be a voting member of the local board of health and shall take an oath of office. With respect to the levels of services of a Level I local health department, as specified in s. 251.05 (2) (a), the local health officer shall be authorized to act by and be directed by the county health officer of the county specified under s. 251.02 (3m).
9,2400qim
Section 2400qim. 251.06 (2) (c) (intro.) of the statutes is amended to read:
251.06 (2) (c) (intro.) A local health officer of a local health department of a village or town established under s. 251.02 (3m) or a local health officer of a multiple municipal local health department established under s. 251.02 (3r) shall be one of the following:
9,2400qin
Section 2400qin. 251.06 (2) (c) 1. of the statutes is amended to read:
251.06 (2) (c) 1. An employe of the local health department of the village or town or an employe of the multiple municipal local health department.
9,2400qj
Section 2400qj. 251.06 (4) (c) of the statutes is amended to read:
251.06 (4) (c) A local health officer of a village or town health department established under s. 251.02 (3m) and a local health officer of a multiple municipal local health department established under s. 251.02 (3r) shall be appointed by the local board of health.
9,2400qk
Section 2400qk. 251.12 of the statutes is amended to read:
251.12 City health department, how financed. The common council shall appropriate funds for the operation of a city health department that is established as specified in s. 251.02 (1) and (2) and for the operation of a multiple municipal local health department that is established under s. 251.02 (3r) by the governing body of a city in concert with the governing body of another city or a village or town.
9,2400qL
Section 2400qL. 251.125 of the statutes is amended to read:
251.125 Village health department, how financed. If a village health department is established under s. 251.02 (2) or (3m) or if a multiple municipal local health department is established under s. 251.01 (3r) by the governing body of a village in concert with the governing body of another village or a city or town, the village board shall appropriate funds for the operation of the department.
9,2400qm
Section 2400qm. 251.127 of the statutes is amended to read:
251.127 Town health department, how financed. If a town health department is established under s. 251.02 (3m) or if a multiple municipal local health department is established under s. 251.02 (3r) by the governing body of a town in concert with the governing body of another town or a city or village, the town board shall appropriate funds for the operation of the department.
9,2400rf
Section 2400rf. 252.07 (1) of the statutes is renumbered 252.07 (1m) and amended to read:
252.07 (1m) Tuberculosis is a communicable disease caused by mycobacterium tuberculosis and is Infectious tuberculosis and suspect tuberculosis are subject to the reporting requirements specified in s. 252.05. Any laboratory that performs a test receives a specimen for tuberculosis testing shall report all positive results
obtained by any appropriate procedure, including a procedure performed by an out-of-state laboratory, to the local health officer and to the department.
9,2400rg
Section 2400rg. 252.07 (1g) of the statutes is created to read:
252.07 (1g) In this section:
(a) "Infectious tuberculosis" means tuberculosis disease of the respiratory tract, capable of producing infection or disease in others as demonstrated by the presence of acid-fast bacilli in the sputum or bronchial secretions or by chest radiograph and clinical findings.
(b) "Isolate" means a population of mycobacterium tuberculosis bacteria that has been obtained in pure culture medium.
(c) "Isolation" means the separation from other persons of a person with infectious tuberculosis in a place and under conditions that prevent the transmission of the infection.
(d) "Suspect tuberculosis" means an illness marked by symptoms and laboratory tests that may be indicative of tuberculosis, such as a prolonged cough, prolonged fever, hemoptysis, compatible roentgenographic findings or other appropriate medical imaging findings.
9,2400rh
Section 2400rh. 252.07 (1p) of the statutes is created to read:
252.07 (1p) Any laboratory that performs primary culture for mycobacteria shall also perform organism identification for mycobacterium tuberculosis complex using an approved rapid testing procedure specified by the department by rule.
9,2400ri
Section 2400ri. 252.07 (1t) of the statutes is created to read:
252.07 (1t) Any laboratory that identifies mycobacterium tuberculosis shall ensure that antimicrobial drug susceptibility tests are performed on the initial isolate. The laboratory shall report the results of these tests to the local health officer and the department.
9,2400rj
Section 2400rj. 252.07 (2) of the statutes is amended to read:
252.07 (2) The department shall identify groups at risk for contracting or transmitting mycobacterium tuberculosis and shall recommend the protocol for screening members of those groups. If necessary to prevent or control the transmission of mycobacterium tuberculosis, the department may promulgate rules that require screening of members of specific groups that are at risk for contracting or transmitting mycobacterium tuberculosis.
9,2400rk
Section 2400rk. 252.07 (4) of the statutes is repealed.
9,2400rL
Section 2400rL. 252.07 (5) of the statutes is amended to read:
252.07 (5) Upon report of any person under sub. (1) (1m) or (1t), the local health officer shall at once investigate and make and enforce the necessary orders. If any person does not voluntarily comply with any order made by the local health officer with respect to that person, the local health officer or the department may order a medical evaluation, directly observed therapy or home isolation of that person.
9,2400rm
Section 2400rm. 252.07 (7) of the statutes is repealed.
9,2400rn
Section 2400rn. 252.07 (8) of the statutes is created to read:
252.07 (8) (a) The department or a local health officer may order the confinement to a facility of an individual who has a confirmed diagnosis of infectious tuberculosis or suspect tuberculosis if all of the following conditions are met:
1. The department or local health officer notifies a court in writing of the confinement.
2. The department or local health officer provides to the court a written statement from a physician that the individual has infectious tuberculosis or suspect tuberculosis.
3. The department or local health officer provides to the court evidence that the individual has refused to follow a prescribed treatment regimen or, in the case of an individual with suspect tuberculosis, has refused to undergo a medical examination to confirm whether the individual has infectious tuberculosis.
4. In the case of an individual with a confirmed diagnosis of infectious tuberculosis, the department or local health officer determines that the individual poses an imminent and substantial threat to himself or herself or to the public health. The department or local health officer shall provide to the court a written statement of that determination.
(b) If the department or local health officer orders the confinement of an individual under this subsection, a law enforcement officer, or other person authorized by the local public health officer, shall transport the individual, if necessary, to a facility that the department or local health officer determines will meet the individual's need for medical evaluation, isolation and treatment.
(c) No individual may be confined under this subsection for more than 72 hours, excluding Saturdays, Sundays and legal holidays, without a court hearing under sub. (9) to determine whether the confinement should continue.
9,2400ro
Section 2400ro. 252.07 (9) of the statutes is created to read:
252.07 (9) (a) The department or a local health officer may petition any court for a hearing to determine whether an individual with infectious or suspect tuberculosis should be confined for longer than 72 hours in a facility where proper care and treatment will be provided and spread of the disease will be prevented. The department or local health officer shall include in the petition documentation that demonstrates all of the following:
1. That the individual named in the petition has infectious tuberculosis; that the individual has noninfectious tuberculosis but is at high risk of developing infectious tuberculosis; or that the individual has suspect tuberculosis.
2. That the individual has failed to comply with the prescribed treatment regimen or with any rules promulgated by the department under sub. (11); or that the disease is resistant to the medication prescribed to the individual.
3. That all other reasonable means of achieving voluntary compliance with treatment have been exhausted and no less restrictive alternative exists; or that no other medication to treat the resistant disease is available.
4. That the individual poses an imminent and substantial threat to himself or herself or to the public health.
(b) The department or local health officer shall give the individual written notice of a hearing at least 48 hours before a scheduled hearing is to be held. Notice of the hearing shall include all of the following information:
1. The date, time and place of the hearing.
2. The grounds, and underlying facts, upon which confinement of the individual is being sought.
3. An explanation of the individual's rights specified under par. (d).
4. The proposed actions to be taken and the reasons for each action.
(c) If the court orders confinement of an individual under this subsection, the individual shall remain confined until the department or local health officer, with the concurrence of a treating physician, determines that treatment is complete or that the individual is no longer a substantial threat to himself or herself or to the public health. If the individual is to be confined for more than 6 months, the court shall review the confinement every 6 months.
(d) An individual who is the subject of a petition for a hearing under this subsection has the right to appear at the hearing, the right to present evidence and cross-examine witnesses and the right to be represented by adversary counsel. At the time of the filing of the petition the court shall assure that the individual who is the subject of the petition is represented by adversary counsel. If the individual claims or appears to be indigent, the court shall refer the individual to the authority for indigency determinations specified under s. 977.07 (1). If the individual is a child, the court shall refer that child to the state public defender who shall appoint counsel for the child without a determination of indigency, as provided in s. 48.23 (4). Unless good cause is shown, a hearing under this subsection may be conducted by telephone or live audiovisual means, if available.
(e) An order issued by the court under this subsection may be appealed as a matter of right. An appeal shall be heard within 30 days after the appeal is filed. An appeal does not stay the order.
9,2400rp
Section 2400rp. 252.07 (11) of the statutes is created to read:
252.07 (11) The department may promulgate any rules necessary for the administration and enforcement of this section, including, if necessary to prevent or control the transmission of mycobacterium tuberculosis, rules that require screening of members of specific groups that are at risk for contracting or transmitting mycobacterium tuberculosis.
9,2400rq
Section 2400rq. 252.073 of the statutes is repealed.
9,2400rr
Section 2400rr. 252.076 of the statutes is repealed.
9,2400rs
Section 2400rs. 252.08 (1) of the statutes is repealed.
9,2400rt
Section 2400rt. 252.08 (2) of the statutes is repealed.
9,2400ru
Section 2400ru. 252.08 (3) of the statutes is renumbered 252.07 (10) and amended to read:
252.07 (10) Inpatient care for isolated pulmonary tuberculosis patients, and inpatient care exceeding 30 days for other pulmonary tuberculosis patients, who are not eligible for federal medicare benefits, for medical assistance under subch. V IV of ch. 49 or for health care services funded by a relief block grant under subch. II of ch. 49 may be reimbursed if provided by a facility contracted by the department. If the patient has private health insurance, the state shall pay the difference between health insurance payments and total charges.
9,2400rv
Section 2400rv. 252.08 (4) of the statutes is repealed.
9,2400rw
Section 2400rw. 252.08 (5) of the statutes is repealed.
9,2400rx
Section 2400rx. 252.08 (6) of the statutes is repealed.
9,2400ry
Section 2400ry. 252.09 of the statutes is repealed.
9,2421
Section
2421. 252.10 (1) of the statutes is amended to read:
252.10 (1) Counties with populations of more than 25,000 may establish and maintain public health dispensaries and, where necessary, branches of the dispensaries A local health department may request from the department certification to establish and maintain a public health dispensary for the diagnosis and treatment of persons suffering from or suspected of having mycobacterium tuberculosis or other pulmonary diseases. Two or more counties local health departments may jointly establish, operate and maintain public health dispensaries in order to serve a total population of not less than 25,000. Counties. The department shall certify a local health department to establish and maintain a public health dispensary if the local health department meets the standards established by the department by rule. The department of health and family services may withhold, suspend or revoke a certification if the local health department fails to comply with any rules promulgated by the department. The department shall provide the local health department with reasonable notice of the decision to withhold, suspend or revoke certification. The department shall offer the local health department an opportunity to comply with the rules and an opportunity for a fair hearing. Certified local health departments may contract with each other for public health dispensary services. The department and department of revenue shall be notified of the establishment of public health dispensaries and any contracts pertaining to the dispensaries. If the provider of those services fails to comply, the department may suspend or revoke the local health department's certification. The department may establish, operate and maintain public health dispensaries and branches in areas of the state where local authorities have not provided public health dispensaries.
9,2422
Section
2422. 252.10 (3) of the statutes is repealed.
9,2423
Section
2423. 252.10 (5) of the statutes is repealed.
9,2424
Section
2424. 252.10 (6) (a) of the statutes is amended to read:
252.10 (6) (a) The state shall credit or reimburse each dispensary on an annual or quarterly basis for the operation of public health dispensaries established and maintained in accordance with this section and rules promulgated by the department.
9,2425
Section
2425. 252.10 (6) (b) of the statutes is amended to read:
252.10 (6) (b) The state department shall determine by rule the reimbursement for each visit rate under par. (a) for services as ordered by a physician shall be $6 or a greater amount prescribed in rules promulgated by the department. If an X-ray is taken, an additional $6 or any greater amount prescribed in rules promulgated by the department will be credited. Any X-ray taken outside a facility under this section or outside a facility approved under s. 252.08 on individuals who have a significant reaction to a test for mycobacterium tuberculosis shall qualify for state aid in the same manner as an X-ray taken inside a facility, and the X-ray shall take the place of the first X-ray eligible for reimbursement as part of a case finding and preventive program under par. (e). The administration and reading of the test for mycobacterium tuberculosis for diagnostic purposes shall be considered one visit. Tests for mycobacterium tuberculosis given in school programs, employment health programs, community preventive and case finding programs are not reimbursable as a clinic visit.
