SB139,5,1311 2. On the form for a certificate of death prescribed by the state registrar under
12sub. (1) (b), the state registrar shall provide for a separate section for the indication
13of a therapeutic-related death as required under s. 979.01 (1n).
Note: Requires the state registrar of vital statistics to provide on the death
certificate form a separate section for indicating a therapeutic-related death. See
Section 12 of the bill.
SB139, s. 3 14Section 3. 146.365 of the statutes is created to read:
SB139,5,20 15146.365 Submission of reports to the medical examining board. Reports
16that are required to be submitted to the national practitioner data bank under 42
17USC 11131
and 11133 shall be submitted to the medical examining board in
18accordance with the time limits set forth in 45 CFR 60.5 (a) and (c). Any person who
19violates this section may be required to forfeit not more than $10,000 for each
20violation.
Note: Creates a requirement that information reported to the NPDB, established
by the Federal Health Care Quality Improvement Act of 1986, must also be reported to
the board. The requirement applies to reports on medical malpractice payments and on
certain professional review actions taken by health care entities. A person who violates

this requirement may be required to forfeit not more than $10,000 for each violation.
Note that "person" is broadly defined in s. 990.01 (26), stats.
SB139, s. 4 1Section 4 . 440.037 of the statutes is created to read:
SB139,6,3 2440.037 Duties of department regarding health care professional
3disciplinary process.
(1) Definitions. In this section:
SB139,6,44 (a) "Health care credentialing authority" means the:
SB139,6,55 1. Board of nursing.
SB139,6,66 2. Chiropractic examining board.
SB139,6,77 3. Dentistry examining board.
SB139,6,88 4. Dietitians affiliated credentialing board.
SB139,6,99 5. Hearing and speech examining board.
SB139,6,1110 6. Examining board of social workers, marriage and family therapists and
11professional counselors.
SB139,6,1212 7. Medical examining board.
SB139,6,1313 8. Optometry examining board.
SB139,6,1414 9. Pharmacy examining board.
SB139,6,1515 10. Physical therapists affiliated credentialing board.
SB139,6,1616 12. Psychology examining board.
SB139,6,1717 13. Podiatrists affiliated credentialing board.
SB139,6,1818 (b) "Health care professional" means:
SB139,6,2019 1. An individual who is licensed or certified by a health care credentialing
20authority.
SB139,6,2121 2. An acupuncturist certified by the department under s. 451.04.
Note: Health care professionals included in the definition are: acupuncturists;
audiologists; chiropractors; dental hygienists; dentists; dietitians; hearing instrument
specialists; advanced practice prescriber nurses; licensed practical nurses; registered
nurses; nurse midwives; occupational therapists; occupational therapy assistants;
optometrists; pharmacists; physical therapists; physicians; physician assistants;

podiatrists; private practice school psychologists; psychologists; respiratory care
practitioners; and speech-language pathologists.
SB139,7,12 1(2) Establishment of priority disciplinary cases. The department shall
2develop a system to establish the relative priority of disciplinary cases involving
3possible unprofessional conduct on the part of a health care professional. The
4prioritization system shall give highest priority to cases of unprofessional conduct
5that have the greatest potential to adversely affect the public health, safety, and
6welfare. In establishing the priorities, the department shall give particular
7consideration to cases of unprofessional conduct that may involve the death of a
8patient or client, serious injury to a patient or client, substantial damages incurred
9by a patient or client, or sexual abuse of a patient or client. The priority system shall
10be used to determine which cases receive priority of consideration and resources in
11order for the department and health care credentialing authorities to most
12effectively protect the public health, safety, and welfare.
Note: Generally reflects current practice of DORL.
SB139,7,16 13(3) Identification of health care professionals who may warrant evaluation.
14The department shall develop a system for identifying health care professionals who,
15even if not the subject of a specific allegation of, or specific information relating to,
16unprofessional conduct, may warrant further evaluation and possible investigation.
Note: Based on a recommendation contained in Evaluation of Quality of Care and
Maintenance of Competence, Federation of State Medical Boards of the United States,
Inc., 1998. The recommendation was included in a series of recommendations of the
Federation's Special Committee on the Evaluation of Quality of Care and Maintenance
of Competence, which were adopted as policy by the House of Delegates of the Federation
of State Medical Boards of the United States, Inc., in May 1998.
The recommendation on which the above provision is based suggests that state
medical boards develop a system of markers to identify licensees warranting evaluation.
Narrative comments to the recommendation note that historically the disciplinary
function of state medical boards may be characterized as reactive. The committee making
the recommendation suggests that measures to prevent, in contrast to only reacting to,
breaches of professional conduct and to improve physician practice will greatly enhance
public protection; the development of a system of markers is one means to identify
physicians, before a case of unprofessional conduct arises, who may be failing to maintain

acceptable standards in one or more areas of professional physician practice as well as
to identify opportunities to improve physician practice.
SB139,8,4 1(4) Notice to health care professionals, complainants, patients, and clients
2concerning disciplinary case.
(a) In this subsection, "complainant" means a person
3who has requested the department or a health care credentialing authority to
4investigate a health care professional for possible unprofessional conduct.
SB139,8,65 (b) The department shall notify a health care professional in writing within 30
6days after any of the following:
SB139,8,87 1. A case of possible unprofessional conduct by the health care professional is
8closed following screening for a possible investigation.
SB139,8,109 2. A case of possible unprofessional conduct by the health care professional has
10been opened for investigation.
SB139,8,1211 3. A case of possible unprofessional conduct by the health care professional is
12closed after an investigation.
SB139,8,1513 (c) The department shall make a reasonable attempt to provide the
14complainant with a copy of each notice made under par. (b) that relates to a
15disciplinary proceeding requested by the complainant.
SB139,8,1916 (d) If a case of possible unprofessional conduct by a health care professional
17involves conduct adversely affecting a patient or client of the health care professional
18and the patient or client is not a complainant, the department shall make a
19reasonable attempt to do one of the following:
SB139,8,2120 1. Provide the patient or client with a copy of each notice made under par. (b)
212. and 3. related to that case.
SB139,8,2322 2. Provide the spouse, child, sibling, parent, or legal guardian of the patient or
23client with a copy of each notice made under par. (b) 2. and 3. related to that case.
SB139,9,2
1(e) Failure to provide a notice under this subsection is not grounds for appeal
2or dismissal.
Note: Paragraph (b) generally reflects current practice of DORL, although notice
of the fact that a case of possible unprofessional conduct by a health care professional has
been opened for investigation may be delayed by DORL currently if there is concern that
such notice may adversely affect the investigation. The notice requirement of par. (b) only
addresses the early stages of the disciplinary process because it is assumed that if a
disciplinary case continues after an investigation is completed, the health care
professional will be well aware of the course of proceedings from that point on.
The requirement of par. (c) is new and assures that a person who has made the
effort to request an investigation for possible unprofessional conduct is given the same
notice that the health care professional receives regarding the status of the early stages
of the process.
The requirement of par. (d) is new. It recognizes that patients or clients are often
interested in the early stages of a disciplinary case. If a case proceeds beyond the
investigation stage, the patient or client and, in some cases, the family of the patient or
client and others, will be given the opportunity to confer with DORL regarding the
disposition of the case. See sub. (6) below.
SB139,9,6 3(5) Notice of pending complaint to health care professionals' place of
4practice.
(a) Within 30 days after a formal complaint alleging unprofessional
5conduct by a health care professional is filed, the department shall send written
6notice that a complaint has been filed to all of the following:
SB139,9,87 1. Each hospital where the health care professional has hospital staff
8privileges.
SB139,9,109 2. Each managed care plan, as defined in s. 609.01 (3c), for which the health
10care professional is a participating provider.
SB139,9,1311 3. Each employer, not included under subd. 1. or 2., that employs the health
12care professional to practice the health care profession for which the health care
13professional is credentialed.
SB139,9,1514 (b) If requested by the department, a health care professional shall provide
15information necessary for the department to comply with this subsection.
Note: New requirement. Because many health care professionals have multiple
places of practice or employment, notifying all places of a health care professional's
practice or employment will serve to alert them of the pending disciplinary action and
allow them to determine if any action on their part might be desirable.

Note that reference to "formal complaint" in the provision refers to the complaint
that is filed after a finding that there is probable cause to believe that the health care
professional is guilty of unprofessional conduct. See, generally, ss. RL 2.06 and 2.08, Wis.
Adm. Code.
SB139,10,2 1(6) Opportunity for patients and clients to confer concerning discipline.
2(a) In this subsection "patient" means any of the following:
SB139,10,53 1. A patient or client of a health care professional who has been adversely
4affected by conduct of the health care professional that is a subject of a disciplinary
5proceeding.
SB139,10,76 2. A parent, guardian, or legal custodian of a patient or client specified in subd.
71., if the patient or client is a child.
SB139,10,118 3. A person designated by a patient or client specified in subd. 1. or the spouse
9or a child, sibling, parent, or legal guardian of a patient or client specified in subd.
101., if the patient or client is physically or emotionally unable to confer as authorized
11in this subsection.
SB139,10,1212 4. If a patient or client specified in subd. 1. is deceased, any of the following:
SB139,10,1413 a. The spouse or a child, sibling, parent, or legal guardian of the deceased
14patient or client.
SB139,10,1515 b. A person who resided with the deceased patient or client.
SB139,10,1716 5. A guardian, appointed under ch. 880, of a patient or client specified in subd.
171., if the patient or client has been determined to be incompetent under ch. 880.
SB139,11,618 (b) Following an investigation of possible unprofessional conduct by a health
19care professional and before disciplinary action may be negotiated or imposed
20against the health care professional, a patient shall be provided an opportunity to
21confer with the department's prosecuting attorney concerning the disposition of the
22case and the economic, physical, and psychological effect on the patient of the
23unprofessional conduct. A prosecuting attorney may confer with a patient under this

1paragraph in person or by telephone or, if the patient agrees to the method, by any
2other method. The duty to confer under this paragraph does not limit the authority
3or obligation of the prosecuting attorney to exercise his or her discretion concerning
4the handling of a case of unprofessional conduct against the health care provider.
5Failure to provide an opportunity to confer under this paragraph is not grounds for
6appeal or dismissal of a disciplinary case against a health care professional.
Note: New requirement. The definition of "patient" is based on the definition of
"victim" currently found in s. 950.02 (4), stats., which defines the term for purposes of the
statutory chapter on rights of victims of crimes. Providing opportunity for involvement
in the health care professional disciplinary process will enhance the public's
understanding of and trust in that process. Further, the prospect of additional public
scrutiny may well accelerate the disciplinary process, rather than delay it. While a
patient's recommendations as to disposition are not determinative, the opportunity to be
heard and considered is appropriate for a patient adversely affected by the unprofessional
conduct that is a subject of the disciplinary proceeding.
SB139,11,15 7(7) Establishment of disciplinary procedure time guidelines. The
8department shall establish guidelines for the timely completion of each stage of the
9health care professional disciplinary process. Notwithstanding s. 227.10 (1), the
10guidelines need not be promulgated as rules under ch. 227. The guidelines may
11account for the type and complexity of the case. The guidelines shall promote the fair
12and efficient processing of cases of unprofessional conduct. The guidelines shall be
13for administrative purposes and shall permit the department to monitor the progress
14of cases and the performance of personnel handling the cases. Failure to comply with
15the guidelines is not grounds for appeal or dismissal.
Note: Reflects current practice of DORL. See also Section 15 of the bill and the
note thereto.
SB139,12,9 16(8) Panels of experts; alternative health care practitioners. If the
17department establishes a panel of health care experts to be used on a consulting basis
18by a health care credentialing authority, the department shall attempt to include a
19health care professional who practices alternative forms of health care on the panel.

1A health care professional who practices alternative health care and who
2participates on a panel shall be of the same profession as the professionals regulated
3by the health care credentialing authority utilizing the panel. The health care
4professional who practices alternative health care shall be available to assist in
5evaluating complaints filed with the department or health care credentialing
6authority against a health care professional who is alleged to have practiced health
7care in an unprofessional or negligent manner through the use of alternative forms
8of health care, the referral to an alternative health care provider, or the prescribing
9of alternative medical treatment.
Note: Provides for the inclusion of health care professionals who practice
alternative forms of health care on panels of expert consultants that may be assembled
by the department of regulation and licensing in reviewing complaints against health
care professionals. Health care professionals practicing alternative forms of health care
who are included on these panels must be of the same profession as the professionals
regulated by the health care credentialing authority with which the complaint is filed.
The purpose of including health care professionals who practice alternative forms of
health care is to assist in evaluating complaints against a health care professional that
may involve practice of health care in an unprofessional or negligent manner through the
use of alternative forms of health care, referral to an alternative health care provider, or
prescribing alternative medical treatment.
SB139,12,12 10(9) Advice of credentialing authorities. In carrying out its duties under this
11section, the department shall seek the advice of health care credentialing
12authorities.
SB139, s. 5 13Section 5. 448.02 (3) (c) of the statutes is amended to read:
SB139,13,714 448.02 (3) (c) Subject to par. (cm), after a disciplinary hearing, the board may,
15when it determines that a panel established under s. 655.02, 1983 stats., has
16unanimously found or a court has found that a person has been negligent in treating
17a patient or when it finds a person guilty of unprofessional conduct or negligence in
18treatment, do one or more of the following: warn or reprimand that person, assess
19a forfeiture against that person under par. (d),
or limit, suspend or revoke any license,

1certificate or limited permit granted by the board to that person. The board may
2condition the removal of limitations on a license, certificate or limited permit or the
3restoration of a suspended or revoked license, certificate or limited permit upon
4obtaining minimum results specified by the board on one or more physical, mental
5or professional competency examinations if the board believes that obtaining the
6minimum results is related to correcting one or more of the bases upon which the
7limitation, suspension or revocation was imposed.
SB139, s. 6 8Section 6. 448.02 (3) (d) of the statutes is created to read:
SB139,13,119 448.02 (3) (d) The board may, except in cases where the person is found guilty
10of negligence in treatment, assess a forfeiture of not more than $1,000 for each
11violation against a person who is found guilty of unprofessional conduct.
Note: Authorizes the board to assess a forfeiture, of not more than $1,000 for each
violation, against a credential holder who is found guilty of unprofessional conduct, not
including cases of negligence in treatment.
SB139, s. 7 12Section 7. 448.02 (4) and (9) (intro.) of the statutes are amended to read:
SB139,14,813 448.02 (4) Suspension pending hearing. The board may summarily suspend
14or limit any license, certificate or limited permit granted by the board for a period not
15to exceed 30 days pending hearing, when the board has in its possession evidence
16establishing probable cause to believe that the holder of the license, certificate or
17limited permit has violated the provisions of this subchapter and that it is necessary
18to suspend or limit the license, certificate or limited permit immediately to protect
19the public health, safety or welfare. The holder of the license, certificate or limited
20permit shall be granted an opportunity to be heard during the determination of
21probable cause. The board may designate any of its officers to exercise the authority
22granted by this subsection to suspend or limit summarily a license, certificate or
23limited permit, but such suspension or limitation shall be for a period of time not to

1exceed 72 hours. If a license, certificate or limited permit has been summarily
2suspended or limited by the board or any of its officers, the board may, while the
3hearing is in progress, extend the initial 30-day period of suspension or limitation
4for an additional 30 days. If the holder of the license, certificate or limited permit
5has caused a delay in the hearing process, the board may subsequently suspend or
6limit
the license, certificate or limited permit from the time the hearing is
7commenced until a final decision is issued or may delegate such authority to the
8hearing examiner.
Note: Authorizes the board to summarily limit the credential of a credential holder
when the board has probable cause to believe that the credential holder has violated a
provision of subch. II of ch. 448, stats., and that it is necessary to immediately limit the
credential to protect the public health, safety and welfare.
SB139,14,14 9(9) Judicial review. (intro.) No injunction, temporary injunction, stay,
10restraining order or other order may be issued by a court in any proceeding for review
11that suspends or stays an order of the board to discipline a physician under sub. (3)
12(c) or to suspend or limit a physician's license under sub. (4), except upon application
13to the court and a determination by the court that all of the following conditions are
14met:
SB139, s. 8 15Section 8. 979.01 (1) of the statutes is renumbered 979.01 (1) (intro.) and
16amended to read:
SB139,14,2217 979.01 (1) (intro.) All physicians, authorities of hospitals, sanatoriums, public
18and private institutions, convalescent homes, authorities of any institution of a like
19nature, and other persons having knowledge of the death of any person who has died
20under any of the following circumstances, shall immediately report the death to the
21sheriff, police chief, medical examiner or coroner of the county where the death took
22place.:

Note: This Section, together with Sections 9 and 10, clarify that a death under
any of the following circumstances must be reported:
"(a) All deaths in which there are unexplained, unusual, or suspicious
circumstances.
(b) All homicides.
(c) All suicides.
(d) All deaths following an abortion.
(e) All deaths due to poisoning, whether homicidal, suicidal, or accidental.
(f) All deaths following accidents, whether the injury is or is not the primary cause
of death.
(g) When there was no physician, or accredited practitioner of a bona fide religious
denomination relying upon prayer or spiritual means for healing in attendance within
30 days preceding death.
(h) When a physician refuses to sign the death certificate.
(i) When, after reasonable efforts, a physician cannot be obtained to sign the
medical certification as required under s. 69.18 (2) (b) or (c) within six days after the
pronouncement of death or sooner under circumstances which the coroner or medical
examiner determines to be an emergency.".
SB139, s. 9 1Section 9 . 979.01 (1g) (intro.) of the statutes is renumbered 979.01 (1g) and
2amended to read:
SB139,15,83 979.01 (1g) A sheriff or police chief shall, immediately upon notification of a
4death reported under sub. (1), notify the coroner or the medical examiner and the
5coroner or medical examiner
of the county where death took place , if. If the crime,
6injury or event occurred in another county, the coroner or medical examiner shall
7immediately report all of the following the death to the coroner or medical examiner
8of that county:.
SB139, s. 10 9Section 10 . 979.01 (1g) (a) to (i) of the statutes are renumbered 979.01 (1) (a)
10to (i).
SB139, s. 11 11Section 11. 979.01 (1m) of the statutes is amended to read:
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