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2005 - 2006 LEGISLATURE
SENATE SUBSTITUTE AMENDMENT 2,
TO 2005 SENATE BILL 221
October 17, 2005 - Offered by Senator Lassa.
SB221-SSA2,1,9 1An Act to amend 48.67, 49.155 (1d) (a) and 49.45 (44) (intro.); and to create
220.433 (1) (e), 46.515 (4) (b) 3., 121.02 (1) (L) 6. and 253.15 of the statutes;
3relating to: the provision of information regarding shaken baby syndrome and
4impacted babies to the parents of newborn infants, training regarding shaken
5baby syndrome and impacted babies for day care providers, and instruction
6regarding shaken baby syndrome and impacted babies for middle school and
7high school pupils; the identification of, and documentation of certain
8information concerning, shaken and impacted babies; granting rule-making
9authority; and making an appropriation.
Analysis by the Legislative Reference Bureau
Under current law, the Department of Health and Family Services (DHFS) is
required to prepare printed informational materials relating to sudden infant death
syndrome and to distribute those materials so as to maximize their availability to
parents. DHFS is also required to promulgate rules requiring day care center
licensees who are licensed to provide care and supervision for children under one

year of age and the employees and volunteers of those licensees to receive training
in sudden infant death syndrome before the license is issued or the employment or
volunteer work commences. The Department of Workforce Development (DWD) is
required to promulgate similar rules for day care providers who are certified to
receive reimbursement under the Wisconsin Works (W-2) program and for the
employees and volunteers of those providers. In addition, the Child Abuse and
Neglect Prevention Board (CANPB) awards grants and administers statewide
projects for the prevention of child abuse and neglect.
This substitute amendment creates similar requirements relating to shaken
baby syndrome, which is defined in the substitute amendment as a severe form of
brain injury that occurs when an infant or young child is shaken forcibly enough to
cause the brain to rebound against his or her skull and requirements relating to
impacted babies, which is defined as babies that suffer death or great bodily harm
as a result of being thrown against a surface, hard or soft. Specifically, the substitute
amendment requires the CANPB to purchase or prepare, or to arrange with a
nonprofit organization that is dedicated to the prevention of shaken baby syndrome
and impacted babies and the support of families affected by shaken baby syndrome
or an impacted baby (nonprofit organization) to prepare, printed and audiovisual
materials relating to shaken baby syndrome and impacted babies that include:
information regarding the identification and prevention of shaken baby syndrome
and impacted babies; the grave effects of shaking or throwing an infant or young
child; appropriate ways to manage crying, fussing, or other causes that can lead a
person to shake or throw an infant or young child; and a discussion of ways to reduce
the risks that can lead a person to shake or throw an infant or young child.
The substitute amendment requires the parents of a newborn infant to be
provided with a copy of those written materials as follows:
1. In the case of an infant born at or on route to a hospital or maternity home,
by the attending physician, attending nurse-midwife, or a trained, designated staff
member of the hospital or maternity home before the infant is discharged from the
hospital or maternity home. That person is also required to inform the parents of the
availability of those audiovisual materials and to make those audiovisual materials
available for the parents to view.
2. In the case of an infant born elsewhere than at or on route to a hospital or
maternity home, by the attending physician, attending nurse-midwife, or a trained,
designated birth attendant within seven days after the birth of the infant. That
person is also required to inform the parents of the availability of those audiovisual
materials.
The substitute amendment also requires the person who provides those written
materials to provide those parents with a form that includes all of the following:
1. A statement that the parent has been advised as to the grave effects of
shaking or throwing on an infant or young child and of appropriate ways to manage
crying, fussing, or other causes that can lead a person to shake or throw an infant
or young child.
2. A telephone number that the parent may call to obtain assistance on how to
care for an infant or young child.

3. A statement that the parent will share that information with all persons who
provide care for the infant.
In addition, under the substitute amendment:
1. Before an individual may obtain a license to operate a day care center for
children under five years of age or enter into a contract with a school board to provide
a day care program for children under five years of age, the individual must receive
training relating to shaken baby syndrome and impacted babies that is approved or
provided by DHFS or that is provided by a nonprofit organization contracted by
DHFS to provide that training.
2. Before an individual may be certified as a day care provider for children
under five years of age under the W-2 program, the individual must receive training
relating to shaken baby syndrome and impacted babies that is approved or provided
by a county department of human services or social services (county department) or
that is provided by a nonprofit organization contracted by that county department
to provide the training.
3. Before an employee or volunteer of a day care center, of a day care provider,
or of a day care program may provide care and supervision for children under five
years of age, the employee or volunteer must receive training relating to shaken baby
syndrome and impacted babies that is approved or provided by DHFS or the
certifying county department or that is provided by a nonprofit organization
contracted by DHFS or county department to provide that training.
The training must be provided by no later than the continuation date of the
license or the renewal date of the certification or contract, whichever is applicable,
or by two years after the effective date of the substitute amendment, whichever is
sooner, for an individual who on the day before the initial applicability date of the
substitute amendment: 1) already holds or has applied for a license to operate a day
care center; 2) is already certified as a day care provider or has applied for that
certification; 3) is already providing a day care program under a contract with a
school board; or 4) is already an employee or volunteer of such a licensee, provider,
or program.
In addition, the substitute amendment requires each school board to provide
or arrange with a nonprofit organization or health care provider to provide
age-appropriate instruction relating to shaken baby syndrome and impacted babies
for pupils in one of grades 5 to 8 and in one of grades 10 to 12. The substitute
amendment permits the person providing the instruction to provide to each pupil
receiving the instruction a copy of the written materials purchased or prepared by
the CANPB or prepared by the nonprofit organization, a presentation of the
audiovisual materials purchased or prepared by the CANPB or prepared by the
nonprofit organization, and an oral explanation of those written and audiovisual
materials.
Moreover, the substitute amendment requires a county department or an
Indian tribe that is providing home visitation services under DHFS's Child Abuse
and Neglect Prevention Program or that is a provider of prenatal, postpartum, and
young child care coordination services in Milwaukee County under the Medical
Assistance program to provide to a recipient of those services, without cost, a copy

of the written materials relating to shaken baby syndrome and impacted babies
purchased or prepared by the CANPB or prepared by the nonprofit organization and
an oral explanation of those materials.
Finally, the substitute amendment requires DHFS to identify all infants and
young children who have shaken baby syndrome or who are impacted babies and all
infants and young children who have died as a result of being shaken or thrown by
using the statewide automated child welfare information system (commonly referred
to as "WISACWIS") and child fatality information compiled by the Department of
Justice. For each infant or young child so identified, DHFS must document the age,
sex, and other characteristics of the child that are relevant to the prevention of
shaken baby syndrome and impacted babies and, if known, the age, sex, employment
status, and residence of the person who shook or threw the infant or young child, the
relationship of that person to the child, and any other characteristics of that person
that are relevant to the prevention of shaken baby syndrome and impacted babies.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SB221-SSA2, s. 1 1Section 1. 20.005 (3) (schedule) of the statutes: at the appropriate place, insert
2the following amounts for the purposes indicated: - See PDF for table PDF
SB221-SSA2, s. 2 3Section 2. 20.433 (1) (e) of the statutes is created to read:
SB221-SSA2,4,64 20.433 (1) (e) Shaken baby syndrome and impacted babies prevention. The
5amounts in the schedule for shaken baby syndrome and impacted babies prevention
6activities under s. 253.15.
SB221-SSA2, s. 3 7Section 3. 46.515 (4) (b) 3. of the statutes is created to read:
SB221-SSA2,5,4
146.515 (4) (b) 3. A county or Indian tribe that is providing home visitation
2program services under subd. 1. or 2. shall provide to a person receiving those
3services the information relating to shaken baby syndrome and impacted babies
4required under s. 253.15 (6).
SB221-SSA2, s. 4 5Section 4. 48.67 of the statutes is amended to read:
SB221-SSA2,6,2 648.67 Rules governing child welfare agencies, day care centers, foster
7homes, treatment foster homes, group homes, shelter care facilities
, and
8county departments.
The department shall promulgate rules establishing
9minimum requirements for the issuance of licenses to, and establishing standards
10for the operation of, child welfare agencies, day care centers, foster homes, treatment
11foster homes, group homes, shelter care facilities, and county departments. These
12Those rules shall be designed to protect and promote the health, safety, and welfare
13of the children in the care of all licensees. The department shall consult with the
14department of commerce and, the department of public instruction, and the child
15abuse and neglect prevention board
before promulgating these those rules. In
16establishing the minimum requirements for the issuance of licenses to day care
17centers that provide care and supervision for children under one year of age, the
18department shall include a requirement that all licensees who are individuals and
19all employees and volunteers of a licensee who provide care and supervision for
20children receive, before the date on which the license is issued or the employment or
21volunteer work commences, whichever is applicable, training in the most current
22medically accepted methods of preventing sudden infant death syndrome , if the
23licensee, employee, or volunteer provides care and supervision for children under one
24year of age, and the training relating to shaken baby syndrome and impacted babies

1required under s. 253.15 (4), if the licensee, employee, or volunteer provides care and
2supervision for children under 5 years of age
.
SB221-SSA2, s. 5 3Section 5. 49.155 (1d) (a) of the statutes is amended to read:
SB221-SSA2,6,194 49.155 (1d) (a) The department shall promulgate rules establishing standards
5for the certification of child care providers under s. 48.651. The department shall
6consult with the child abuse and neglect prevention board before promulgating those
7rules.
In establishing the requirements for certification under this paragraph of a
8child care provider who provides care and supervision for children under one year
9of age
, the department shall include a requirement that all providers and all
10employees and volunteers of a provider who provide care and supervision for children
11receive, before the date on which the provider is certified or the employment or
12volunteer work commences, whichever is applicable, training in the most current
13medically accepted methods of preventing sudden infant death syndrome , if the
14provider, employee, or volunteer provides care and supervision for children under
15one year of age, and the training relating to shaken baby syndrome and impacted
16babies required under s. 253.15 (4), if the provider, employee, or volunteer provides
17care and supervision for children under 5 years of age
. In establishing the
18requirements for certification as a Level II certified family day care provider, the
19department may not include any other requirement for training for providers.
SB221-SSA2, s. 6 20Section 6. 49.45 (44) (intro.) of the statutes is amended to read:
SB221-SSA2,7,421 49.45 (44) Prenatal, postpartum and young child care coordination. (intro.)
22Providers in Milwaukee County that are certified to provide care coordination
23services under s. 49.46 (2) (b) 12. may be certified to provide to medical assistance
24recipients prenatal and postpartum care coordination services and care coordination
25services for children who have not attained the age of 7. A provider of those care

1coordination services shall provide to a person receiving those services the
2information relating to shaken baby syndrome and impacted babies required under
3s. 253.15 (6).
The department shall provide reimbursement for these those care
4coordination services only if at least one of the following conditions is met:
SB221-SSA2, s. 7 5Section 7. 121.02 (1) (L) 6. of the statutes is created to read:
SB221-SSA2,7,86 121.02 (1) (L) 6. In one of grades 5 to 8 and in one of grades 10 to 12, provide
7pupils with the instruction on shaken baby syndrome and impacted babies described
8in s. 253.15 (5).
SB221-SSA2, s. 8 9Section 8. 253.15 of the statutes is created to read:
SB221-SSA2,7,11 10253.15 Shaken baby syndrome and impacted babies. (1) Definitions.
11In this section:
SB221-SSA2,7,1212 (a) "Board" means the child abuse and neglect prevention board.
SB221-SSA2,7,1413 (b) "County department" means a county department of human services or
14social services under s. 46.215, 46.22, or 46.23.
SB221-SSA2,7,1715 (c) "Health care provider" means any person who is licensed, registered,
16permitted, or certified by the department of health and family services or the
17department of regulation and licensing to provide health care services in this state.
SB221-SSA2,7,1918 (d) "Impacted baby" means an infant or young child who suffers death or great
19bodily harm as a result of being thrown against a surface, hard or soft.
SB221-SSA2,7,2320 (e) "Nonprofit organization" means an organization described in section 501 (c)
21(3) of the Internal Revenue Code that is dedicated to the prevention of shaken baby
22syndrome and impacted babies and the support of families affected by shaken baby
23syndrome or an impacted baby.
SB221-SSA2,8,3
1(f) "Shaken baby syndrome" means a severe form of brain injury that occurs
2when an infant or young child is shaken forcibly enough to cause the brain to rebound
3against his or her skull.
SB221-SSA2,9,2 4(2) Informational materials. The board shall purchase or prepare or arrange
5with a nonprofit organization to prepare printed and audiovisual materials relating
6to shaken baby syndrome and impacted babies. The materials shall include
7information regarding the identification and prevention of shaken baby syndrome
8and impacted babies, the grave effects of shaking or throwing on an infant or young
9child, appropriate ways to manage crying, fussing, or other causes that can lead a
10person to shake or throw an infant or young child, and a discussion of ways to reduce
11the risks that can lead a person to shake or throw an infant or young child. The
12materials shall be prepared in English, Spanish, and other languages spoken by a
13significant number of state residents, as determined by the board. The board shall
14make those written and audiovisual materials available to all hospitals, maternity
15homes, and nurse-midwives licensed under s. 441.15 that are required to provide or
16make available materials to parents under sub. (3) (a) 1., to the department and to
17all county departments and nonprofit organizations that are required to provide the
18materials to day care providers under sub. (4), and to all school boards and nonprofit
19organizations that are permitted to provide the materials to pupils in one of grades
205 to 8 and in one of grades 10 to 12 under sub. (5). The board shall also make those
21written materials available to all county departments and Indian tribes that are
22providing home visitation services under s. 46.515 (4) (b) 1. or 2. and to all providers
23of prenatal, postpartum, and young child care coordination services under s. 49.45
24(44). The board may make available the materials required under this subsection

1to be made available by making those materials available at no charge on the board's
2Internet site.
SB221-SSA2,9,10 3(3) Information to parents. (a) 1. Before an infant who is born at or on route
4to a hospital or maternity home is discharged from the hospital or maternity home,
5the attending physician, the attending nurse midwife, or another trained,
6designated staff member of the hospital or maternity home shall provide to the
7parents of the infant, without cost to those parents, a copy of the written materials
8purchased or prepared under sub. (2), shall inform those parents of the availability
9of the audiovisual materials purchased or prepared under sub. (2), and shall make
10those audiovisual materials available for those parents to view.
SB221-SSA2,9,1711 2. Within 7 days after the birth of an infant who is born elsewhere than at or
12on route to a hospital or maternity home, the attending physician, the attending
13nurse-midwife, or a trained, designated birth attendant who attended the birth of
14the child shall provide to the parents of the infant, without cost to those parents, a
15copy of the written materials purchased or prepared under sub. (2) and shall inform
16those parents of the availability of the audiovisual materials purchased or prepared
17under sub. (2).
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