Amendment AA2-ASA1-AB133

AB133-ASA1-AA2, s. 2400qf Section 2400qf. 251.04 (1) of the statutes is amended to read:

AB133-ASA1-AA2,417,18 251.04 (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 a city or county board of health or a board of health for a local health department as authorized in s. 251.02 (3m) 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.

AB133-ASA1-AA2, s. 2400qg Section 2400qg. 251.04 (2) of the statutes is amended to read:

AB133-ASA1-AA2,417,23 251.04 (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) 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).

AB133-ASA1-AA2, s. 2400qh Section 2400qh. 251.04 (3) of the statutes is amended to read:

AB133-ASA1-AA2,418,5 251.04 (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) 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.

AB133-ASA1-AA2, s. 2400qi Section 2400qi. 251.06 (1) (a) 2. of the statutes is amended to read:

AB133-ASA1-AA2,418,13 251.06 (1) (a) 2. A local health officer of a village or town multiple municipal local health department established under s. 251.02 (3m) 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).

AB133-ASA1-AA2, s. 2400qim Section 2400qim. 251.06 (2) (c) (intro.) of the statutes is amended to read:

AB133-ASA1-AA2,418,17 251.06 (2) (c) (intro.) A local health officer of a multiple municipal local health department of a village or town established under s. 251.02 (3m) shall be one of the following:

AB133-ASA1-AA2, s. 2400qin Section 2400qin. 251.06 (2) (c) 1. of the statutes is amended to read:

AB133-ASA1-AA2,418,20 251.06 (2) (c) 1. An employe of the multiple municipal local health department of the village or town.

AB133-ASA1-AA2, s. 2400qj Section 2400qj. 251.06 (4) (c) of the statutes is amended to read:

AB133-ASA1-AA2,418,24 251.06 (4) (c) A local health officer of a village or town multiple municipal local health department established under s. 251.02 (3m) shall be appointed by the local board of health.

AB133-ASA1-AA2, s. 2400qk Section 2400qk. 251.12 of the statutes is amended to read:

AB133-ASA1-AA2,419,5 251.12 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 (3m) by the governing body of a city in concert with the governing body of another city or a village or town.

AB133-ASA1-AA2, s. 2400qL Section 2400qL. 251.125 of the statutes is amended to read:

AB133-ASA1-AA2,419,11 251.125 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 (3m) 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.

AB133-ASA1-AA2, s. 2400qm Section 2400qm. 251.127 of the statutes is amended to read:

AB133-ASA1-AA2,419,17 251.127 Town health department, how financed. If a town multiple municipal local health department is established under s. 251.02 (3m) 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.".

AB133-ASA1-AA2,419,18 915. Page 1211, line 18: after that line insert:

AB133-ASA1-AA2,419,20 " Section 2400mf. 252.07 (1) of the statutes is renumbered 252.07 (1m) and amended to read:

AB133-ASA1-AA2,420,2 252.07 (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.

AB133-ASA1-AA2, s. 2400mg Section 2400mg. 252.07 (1g) of the statutes is created to read:

AB133-ASA1-AA2,420,4 252.07 (1g) In this section:

AB133-ASA1-AA2,420,8 (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.

AB133-ASA1-AA2,420,10 (b) "Isolate" means a population of mycobacterium tuberculosis bacteria that has been obtained in pure culture medium.

AB133-ASA1-AA2,420,13 (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.

AB133-ASA1-AA2,420,17 (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.

AB133-ASA1-AA2, s. 2400mh Section 2400mh. 252.07 (1p) of the statutes is created to read:

AB133-ASA1-AA2,420,21 252.07 (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.

AB133-ASA1-AA2, s. 2400mi Section 2400mi. 252.07 (1t) of the statutes is created to read:

AB133-ASA1-AA2,421,2 252.07 (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.

AB133-ASA1-AA2, s. 2400mj Section 2400mj. 252.07 (2) of the statutes is amended to read:

AB133-ASA1-AA2,421,9 252.07 (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.

AB133-ASA1-AA2, s. 2400mk Section 2400mk. 252.07 (4) of the statutes is repealed.

AB133-ASA1-AA2, s. 2400mL Section 2400mL. 252.07 (5) of the statutes is amended to read:

AB133-ASA1-AA2,421,16 252.07 (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.

AB133-ASA1-AA2, s. 2400mm Section 2400mm. 252.07 (7) of the statutes is repealed.

AB133-ASA1-AA2, s. 2400mn Section 2400mn. 252.07 (8) of the statutes is created to read:

AB133-ASA1-AA2,421,21 252.07 (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:

AB133-ASA1-AA2,421,23 1. The department or local health officer notifies a court in writing of the confinement.

AB133-ASA1-AA2,422,3 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.

AB133-ASA1-AA2,422,7 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.

AB133-ASA1-AA2,422,12 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.

AB133-ASA1-AA2,422,17 (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.

AB133-ASA1-AA2,422,20 (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.

AB133-ASA1-AA2, s. 2400mo Section 2400mo. 252.07 (9) of the statutes is created to read:

AB133-ASA1-AA2,423,2 252.07 (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:

AB133-ASA1-AA2,423,5 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.

AB133-ASA1-AA2,423,8 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.

AB133-ASA1-AA2,423,11 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.

AB133-ASA1-AA2,423,13 4. That the individual poses an imminent and substantial threat to himself or herself or to the public health.

AB133-ASA1-AA2,423,16 (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:

AB133-ASA1-AA2,423,17 1. The date, time and place of the hearing.

AB133-ASA1-AA2,423,19 2. The grounds, and underlying facts, upon which confinement of the individual is being sought.

AB133-ASA1-AA2,423,20 3. An explanation of the individual's rights specified under par. (d).

AB133-ASA1-AA2,423,21 4. The proposed actions to be taken and the reasons for each action.

AB133-ASA1-AA2,424,2 (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.

AB133-ASA1-AA2,424,13 (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.

AB133-ASA1-AA2,424,16 (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.

AB133-ASA1-AA2, s. 2400mp Section 2400mp. 252.07 (11) of the statutes is created to read:

AB133-ASA1-AA2,424,22 252.07 (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.

AB133-ASA1-AA2, s. 2400mq Section 2400mq. 252.073 of the statutes is repealed.

AB133-ASA1-AA2, s. 2400mr Section 2400mr. 252.076 of the statutes is repealed.

AB133-ASA1-AA2, s. 2400ms Section 2400ms. 252.08 (1) of the statutes is repealed.

AB133-ASA1-AA2, s. 2400mt Section 2400mt. 252.08 (2) of the statutes is repealed.

AB133-ASA1-AA2, s. 2400mu Section 2400mu. 252.08 (3) of the statutes is renumbered 252.07 (10) and amended to read:

AB133-ASA1-AA2,425,10 252.07 (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.

AB133-ASA1-AA2, s. 2400mv Section 2400mv. 252.08 (4) of the statutes is repealed.

AB133-ASA1-AA2, s. 2400mw Section 2400mw. 252.08 (5) of the statutes is repealed.

AB133-ASA1-AA2, s. 2400mx Section 2400mx. 252.08 (6) of the statutes is repealed.

AB133-ASA1-AA2, s. 2400my Section 2400my. 252.09 of the statutes is repealed.".

AB133-ASA1-AA2,425,15 916. Page 1213, line 22: after that line insert:

AB133-ASA1-AA2,425,17 " Section 2430L. 252.10 (7) of the statutes, as affected by 1997 Wisconsin Act 156, is amended to read:

AB133-ASA1-AA2,426,3 252.10 (7) Drugs necessary for the treatment of mycobacterium tuberculosis shall be purchased by the department from the appropriation under s. 20.435 (5) (e) and dispensed to patients through the public health dispensaries or through health care providers, as defined in s. 146.81 (1), other than massage therapists or bodyworkers issued a license of registration under subch. X of ch. 440, social workers, marriage and family therapists or professional counselors certified under ch. 457, speech-language pathologists or audiologists licensed under subch. II of ch. 459, speech and language pathologists licensed by the department of public instruction or dietitians certified under subch. V of ch. 448, local health departments, physicians or advanced practice nurse prescribers.".

AB133-ASA1-AA2,426,4 917. Page 1214, line 4: after that line insert:

AB133-ASA1-AA2,426,5 " Section 2432d. 252.12 (2) (a) 3. (intro.) of the statutes is amended to read:

AB133-ASA1-AA2,426,15 252.12 (2) (a) 3. `Statewide public education campaign.' (intro.) The department shall promote public awareness of the risk of contracting acquired immunodeficiency syndrome and measures for acquired immunodeficiency syndrome protection by development and distribution of information through clinics providing family planning services, as defined in s. 253.07 (1) (b) 49.001 (1s), offices of physicians and clinics for sexually transmitted diseases and by newsletters, public presentations or other releases of information to newspapers, periodicals, radio and television stations and other public information resources. The information would be targeted at individuals whose behavior puts them at risk of contracting acquired immunodeficiency syndrome and would encompass the following topics:".

AB133-ASA1-AA2,426,16 918. Page 1214, line 7: delete "$1,994,900" and substitute "$1,933,600".

AB133-ASA1-AA2,426,17 919. Page 1215, line 4: after that line insert:

AB133-ASA1-AA2,426,18 " Section 2432r. 252.14 (1) (ar) 4q. of the statutes is created to read:

AB133-ASA1-AA2,426,19 252.14 (1) (ar) 4q. An athletic trainer licensed under subch. VI of ch. 448.".

AB133-ASA1-AA2,426,20 920. Page 1215, line 4: after that line insert:

AB133-ASA1-AA2,426,21 " Section 2435d. 253.02 (2) (a) of the statutes is repealed.

AB133-ASA1-AA2, s. 2435e Section 2435e. 253.02 (2) (g) of the statutes is amended to read:

AB133-ASA1-AA2,427,3 253.02 (2) (g) Maternal and child health system coordination services that promote coordination of public and private sector activities in areas of the maternal and child health program described in pars. (a) (b) to (f).".

AB133-ASA1-AA2,427,4 921. Page 1215, line 4: after that line insert:

AB133-ASA1-AA2,427,5 " Section 2434d. 252.15 (1) (ab) of the statutes is amended to read: