LRB-3384/2
TAY:jlg:jf
1999 - 2000 LEGISLATURE
November 5, 1999 - Introduced by Representatives Ladwig, Rhoades, Boyle,
Coggs, Freese, Gunderson, Hasenohrl, Kelso, Klusman, J. Lehman, M.
Lehman, Leibham, Musser, Pocan, Riley, Ryba, Seratti, Spillner, Staskunas,
Steinbrink, Stone, Sykora, Turner, Underheim, Vrakas, Wasserman
and
Young, cosponsored by Senators Plache, Darling, Baumgart, Breske,
Drzewiecki, Grobschmidt, Moore
and Roessler. Referred to Committee on
Children and Families.
AB579,1,3 1An Act to amend 146.82 (1) and 253.13 (2); to repeal and recreate 253.12; and
2to create 15.197 (12) of the statutes; relating to: birth defects prevention
3surveillance.
Analysis by the Legislative Reference Bureau
Under current law, the department of health and family services (DHFS)
administers the birth and developmental outcome monitoring program, commonly
referred to as BDOMP. Under that program, a report must be made to DHFS by a
physician who is the first physician to make a diagnosis or confirm a suspected
diagnosis that a child under the age of six has a condition resulting from a low birth
weight, a chronic condition possibly requiring long-term care, a birth defect or a
developmental disability or other severe disability. If no physician has treated the
child, a nurse who has visited with the child and who knows or suspects with
reasonable medical certainty that the child has such a condition must make the
report. DHFS is required to develop and implement a system for the collection,
updating and analysis of the information reported and to disseminate the
information. DHFS must also publish an annual report and submit the report
annually to the chief clerk of each house of the legislature and to counties on the
results of the information collected through the reports. DHFS must coordinate data
dissemination activities of the department with those of the division for learning
support, equity and advocacy in the department of public instruction with respect to
the information collected through the reports. Currently, information contained in
a report that specifically identifies the subject of the report is confidential and, with
certain exceptions, may not be released to any person.

This bill replaces BDOMP with a program that requires physicians, hospitals,
certain clinics and clinical laboratories to report birth defects identified in children
under the age of two to DHFS. Under the bill, a birth defect is defined as a structural
deformation, or a genetic, inherited or biochemical disease, that occurs prior to or at
birth and that requires medical or surgical intervention or interferes with normal
growth and development. The bill requires DHFS to establish and maintain a
registry that documents the diagnosis of a birth defect in a child under the age of two.
As under current law, personally identifying information that is contained in the
reports made to DHFS is confidential and, with certain exceptions, may not be
released to any person. Finally, the bill creates a council on birth defect prevention
and surveillance to advise DHFS regarding the registry and rules related to
reporting.
Also under current law, DHFS must contract with the state laboratory of
hygiene to perform tests on newborns to identify congenital and metabolic disorders.
DHFS must provide necessary diagnostic, special dietary treatment that is
prescribed by a physician for a patient with a congenital disorder and follow-up
counseling for the patient and his or her family. The state laboratory of hygiene is
required to impose a fee on behalf of DHFS that is sufficient to cover the cost of the
services provided.
This bill requires DHFS to provide medical services and counseling for
individuals and families at risk for preventable congenital disorders.
For further information see the state and local fiscal estimate, which will be
printed as an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB579, s. 1 1Section 1. 15.197 (12) of the statutes is created to read:
AB579,2,52 15.197 (12) Council on birth defect prevention and surveillance. There is
3created in the department of health and family services a council on birth defect
4prevention and surveillance. The council shall consist of the following members
5appointed for a 4-year term by the secretary of health and family services:
AB579,2,76 (a) A representative of the University of Wisconsin Medical School who has
7technical expertise in birth defects epidemiology.
AB579,2,98 (b) A representative from the Medical College of Wisconsin who has technical
9expertise in birth defects epidemiology.
AB579,3,2
1(c) A representative from the subunit of the department that is primarily
2responsible for the children with special health needs program.
AB579,3,43 (d) A representative from the subunit of the department that is primarily
4responsible for early intervention services.
AB579,3,65 (e) A representative from the subunit of the department that is primarily
6responsible for health statistics research and analysis.
AB579,3,77 (f) A representative of the State Medical Society of Wisconsin.
AB579,3,88 (g) A representative of the Wisconsin Health and Hospital Association.
AB579,3,109 (h) A representative of the American Academy of Pediatrics — Wisconsin
10Chapter.
AB579,3,1111 (i) A representative of the council on developmental disabilities.
AB579,3,1412 (j) A representative of a nonprofit organization that has as its primary purpose
13the prevention of birth defects and does not promote abortion as a method of
14prevention.
AB579,3,1515 (k) A parent or guardian of a child with a birth defect.
AB579,3,1716 (L) A representative of a local health department, as defined in s. 250.01 (4),
17who is not an employe of the department of health and family services.
AB579, s. 2 18Section 2. 146.82 (1) of the statutes is amended to read:
AB579,3,2419 146.82 (1) Confidentiality. All patient health care records shall remain
20confidential. Patient health care records may be released only to the persons
21designated in this section or to other persons with the informed consent of the patient
22or of a person authorized by the patient. This subsection does not prohibit reports
23made in compliance with s. 146.995, 253.12 (2) or 979.01 or testimony authorized
24under s. 905.04 (4) (h).
AB579, s. 3 25Section 3. 253.12 of the statutes is repealed and recreated to read:
AB579,4,2
1253.12 Birth defect prevention and surveillance system. (1)
2Definitions. In this section:
AB579,4,53 (a) "Birth defect" means any of the following conditions affecting an infant or
4child that occurs prior to or at birth and that requires medical or surgical
5intervention or interferes with normal growth and development:
AB579,4,66 1. A structural deformation, disruption or dysplasia.
AB579,4,77 2. A genetic, inherited or biochemical disease.
AB579,4,108 (b) "Pediatric specialty clinic" means a clinic the primary purpose of which is
9to provide pediatric specialty diagnostic, counseling and medical management
10services to persons with birth defects by physician subspecialist.
AB579,4,1111 (c) "Infant or child" means a human being from birth to the age of 2 years.
AB579,4,1212 (d) "Physician" has the meaning given in s. 448.01 (5).
AB579,4,15 13(2) Reporting. (a) Except as provided in par. (b), all of the following shall report
14in the manner prescribed by the department under sub. (3) (a) 3. a birth defect in an
15infant or child:
AB579,4,1716 1. A hospital or pediatric specialty clinic in which the birth defect is diagnosed
17in an infant or child or treatment for the birth defect is provided to the infant or child.
AB579,4,1918 2. A physician who diagnoses the birth defect or provides treatment to the
19infant or child for the birth defect.
AB579,4,2120 3. A clinical laboratory that identifies a birth defect in the infant or child as the
21result of laboratory analysis.
AB579,4,2522 (b) No person specified under par. (a) 1. to 3. need report under par. (a) if that
23person knows that another person specified under par. (a) 1. to 3. has already
24reported to the department the required information with respect to the same birth
25defect of the same infant or child.
AB579,5,6
1(c) If the department determines that there is a discrepancy in any data
2reported under this subsection, the department may request a physician, hospital or
3pediatric specialty clinic to provide to the department information contained in the
4medical records of patients who have a confirmed or suspected birth defect diagnosis.
5The physician, hospital or pediatric specialty clinic shall provide that information
6within 10 working days after the department requests it.
AB579,5,8 7(3) Department duties and powers. (a) The department shall do all of the
8following:
AB579,5,129 1. Establish and maintain an up-to-date registry that documents the
10diagnosis in this state of any infant or child who has a birth defect, regardless of the
11residence of the infant or child. The department shall include in the registry
12information that will facilitate all of the following:
AB579,5,1313 a. Identification of risk factors for birth defects.
AB579,5,1514 b. Investigation of the incidence, prevalence and trends of birth defects using
15epidemiological surveys.
AB579,5,1716 c. Development of primary preventive strategies to decrease the occurrence of
17birth defects without increasing abortions.
AB579,5,1818 d. Referrals for early intervention or other appropriate services.
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