Effective date note
NOTE: Par. (hm) is shown as amended eff. 1-1-96 by
1995 Wis. Act 27, s.
9145 (1). The treatment by Act 27 was held unconstitutional and declared void by the Supreme Court in Thompson v. Craney, case no.
95-2168-OA. Prior to 1-1-96, s. 9145 (1), it read:
Effective date text
(hm) A speech-language pathologist or audiologist licensed under subch. II of ch. 459 or a speech and language pathologist licensed by the department of public instruction.
146.81(1)(j)
(j) A corporation or limited liability company of any providers specified under
pars. (a) to
(hm) that provides health care services.
146.81(1)(k)
(k) An operational cooperative sickness care plan organized under
ss. 185.981 to
185.985 that directly provides services through salaried employes in its own facility.
146.81(2)
(2) "Informed consent" means written consent to the disclosure of information from patient health care records to an individual, agency or organization that includes all of the following:
146.81(2)(a)
(a) The name of the patient whose record is being disclosed.
146.81(2)(c)
(c) The types of health care providers making the disclosure.
146.81(2)(d)
(d) The purpose of the disclosure such as whether the disclosure is for further medical care, for an application for insurance, to obtain payment of an insurance claim, for a disability determination, for a vocational rehabilitation evaluation, for a legal investigation or for other specified purposes.
146.81(2)(e)
(e) The individual, agency or organization to which disclosure may be made.
146.81(2)(f)
(f) The signature of the patient or the person authorized by the patient and, if signed by a person authorized by the patient, the relationship of that person to the patient or the authority of the person.
146.81(2)(h)
(h) The time period during which the consent is effective.
146.81(3)
(3) "Patient" means a person who receives health care services from a health care provider.
146.81(4)
(4) "Patient health care records" means all records related to the health of a patient prepared by or under the supervision of a health care provider, including the records required under
s. 146.82 (2) (d) and
(3) (c), but not those records subject to
s. 51.30, reports collected under
s. 69.186, records of tests administered under
s. 252.15 (2) (a) 7.,
343.305,
938.296 (4) or
968.38 (4), fetal monitor tracings, as defined under
s. 146.817 (1), or a pupil's physical health records maintained by a school under
s. 118.125.
146.81(5)
(5) "Person authorized by the patient" means the parent, guardian or legal custodian of a minor patient, as defined in
s. 48.02 (8) and
(11), the person vested with supervision of the child under
s. 938.183 or
938.34 (4d),
(4h),
(4m) or
(4n), the guardian of a patient adjudged incompetent, as defined in
s. 880.01 (3) and
(4), the personal representative or spouse of a deceased patient, any person authorized in writing by the patient or a health care agent designated by the patient as a principal under
ch. 155 if the patient has been found to be incapacitated under
s. 155.05 (2), except as limited by the power of attorney for health care instrument. If no spouse survives a deceased patient, "person authorized by the patient" also means an adult member of the deceased patient's immediate family, as defined in
s. 632.895 (1) (d). A court may appoint a temporary guardian for a patient believed incompetent to consent to the release of records under this section as the person authorized by the patient to decide upon the release of records, if no guardian has been appointed for the patient.
146.81 History
History: 1979 c. 221;
1981 c. 39 s.
22;
1983 a. 27;
1983 a. 189 s.
329 (1);
1983 a. 535;
1985 a. 315;
1987 a. 27,
70,
264;
1987 a. 399 ss.
403br,
491r;
1987 a. 403;
1989 a. 31,
168,
199,
200,
229,
316,
359;
1991 a. 39,
160,
269;
1993 a. 27,
32,
105,
112,
183,
385,
443,
496;
1995 a. 27 s.
9145 (1);
1995 a. 77,
98,
352.
146.815
146.815
Contents of certain patient health care records. 146.815(1)(1) Patient health care records maintained for hospital inpatients shall include, if obtainable, the inpatient's occupation and the industry in which the inpatient is employed at the time of admission, plus the inpatient's usual occupation.
146.815(2)(a)(a) If a hospital inpatient's health problems may be related to the inpatient's occupation or past occupations, the inpatient's physician shall ensure that the inpatient's health care record contains available information from the patient or family about these occupations and any potential health hazards related to these occupations.
146.815(2)(b)
(b) If a hospital inpatient's health problems may be related to the occupation or past occupations of the inpatient's parents, the inpatient's physician shall ensure that the inpatient's health care record contains available information from the patient or family about these occupations and any potential health hazards related to these occupations.
146.815(3)
(3) The department shall provide forms that may be used to record information specified under
sub. (2) and shall provide guidelines for determining whether to prepare the occupational history required under
sub. (2). Nothing in this section shall be construed to require a hospital or physician to collect information required in this section from or about a patient who chooses not to divulge such information.
146.815 History
History: 1981 c. 214.
146.817
146.817
Preservation of fetal monitor tracings and microfilm copies. 146.817(1)(1) In this section, "fetal monitor tracing" means documentation of the heart tones of a fetus during labor and delivery of the mother of the fetus that are recorded from an electronic fetal monitor machine.
146.817(2)(a)(a) Unless a health care provider has first made and preserved a microfilm copy of a patient's fetal monitor tracing, the health care provider may delete or destroy part or all of the patient's fetal monitor tracing only if 35 days prior to the deletion or destruction the health care provider provides written notice to the patient.
146.817(2)(b)
(b) If a health care provider has made and preserved a microfilm copy of a patient's fetal monitor tracing and if the health care provider has deleted or destroyed part or all of the patient's fetal monitor tracing, the health care provider may delete or destroy part or all of the microfilm copy of the patient's fetal monitor tracing only if 35 days prior to the deletion or destruction the health care provider provides written notice to the patient.
146.817(2)(c)
(c) The notice specified in
pars. (a) and
(b) shall be sent to the patient's last-known address and shall inform the patient of the imminent deletion or destruction of the fetal monitor tracing or of the microfilm copy of the fetal monitor tracing and of the patient's right, within 30 days after receipt of notice, to obtain the fetal monitor tracing or the microfilm copy of the fetal monitor tracing from the health care provider.
146.817(2)(d)
(d) The notice requirements under this subsection do not apply after 5 years after a fetal monitor tracing was first made.
146.817 History
History: 1987 a. 27,
399,
403.
146.819
146.819
Preservation or destruction of patient health care records. 146.819(1)(1) Except as provided in
sub. (4), any health care provider who ceases practice or business as a health care provider or the personal representative of a deceased health care provider who was an independent practitioner shall do one of the following for all patient health care records in the possession of the health care provider when the health care provider ceased business or practice or died:
146.819(1)(a)
(a) Provide for the maintenance of the patient health care records by a person who states, in writing, that the records will be maintained in compliance with
ss. 146.81 to
146.835.
146.819(1)(b)
(b) Provide for the deletion or destruction of the patient health care records.
146.819(1)(c)
(c) Provide for the maintenance of some of the patient health care records, as specified in
par. (a), and for the deletion or destruction of some of the records, as specified in
par. (b).
146.819(2)
(2) If the health care provider or personal representative provides for the maintenance of any of the patient health care records under
sub. (1), the health care provider or personal representative shall also do at least one of the following:
146.819(2)(a)
(a) Provide written notice, by 1st class mail, to each patient or person authorized by the patient whose records will be maintained, at the last-known address of the patient or person, describing where and by whom the records shall be maintained.
146.819(2)(b)
(b) Publish, under
ch. 985, a class 3 notice in a newspaper that is published in the county in which the health care provider's or decedent's health care practice was located, specifying where and by whom the patient health care records shall be maintained.
146.819(3)
(3) If the health care provider or personal representative provides for the deletion or destruction of any of the patient health care records under
sub. (1), the health care provider or personal representative shall also do at least one of the following:
146.819(3)(a)
(a) Provide notice to each patient or person authorized by the patient whose records will be deleted or destroyed, that the records pertaining to the patient will be deleted or destroyed. The notice shall be provided at least 35 days prior to deleting or destroying the records, shall be in writing and shall be sent, by 1st class mail, to the last-known address of the patient to whom the records pertain or the last-known address of the person authorized by the patient. The notice shall inform the patient or person authorized by the patient of the date on which the records will be deleted or destroyed, unless the patient or person retrieves them before that date, and the location where, and the dates and times when, the records may be retrieved by the patient or person.
146.819(3)(b)
(b) Publish, under
ch. 985, a class 3 notice in a newspaper that is published in the county in which the health care provider's or decedent's health care practice was located, specifying the date on which the records will be deleted or destroyed, unless the patient or person authorized by the patient retrieves them before that date, and the location where, and the dates and times when, the records may be retrieved by the patient or person.
146.819(4)
(4) This section does not apply to a health care provider that is any of the following:
146.819(4)(a)
(a) A community-based residential facility or nursing home licensed under
s. 50.03.
146.819(4)(f)
(f) A local health department, as defined in
s. 250.01 (4), that ceases practice or business and transfers the patient health care records in its possession to a successor local health department.
146.819 History
History: 1991 a. 269;
1993 a. 27.
146.82
146.82
Confidentiality of patient health care records. 146.82(1)(1)
Confidentiality. All patient health care records shall remain confidential. Patient health care records may be released only to the persons designated in this section or to other persons with the informed consent of the patient or of a person authorized by the patient. This subsection does not prohibit reports made in compliance with
s. 146.995 or testimony authorized under
s. 905.04 (4) (h).
146.82(2)
(2) Access without informed consent. 146.82(2)(a)(a) Notwithstanding
sub. (1), patient health care records shall be released upon request without informed consent in the following circumstances:
146.82(2)(a)1.
1. To health care facility staff committees, or accreditation or health care services review organizations for the purposes of conducting management audits, financial audits, program monitoring and evaluation, health care services reviews or accreditation.
146.82(2)(a)2.
2. To the extent that performance of their duties requires access to the records, to a health care provider or any person acting under the supervision of a health care provider or to a person licensed under
s. 146.50, including but not limited to medical staff members, employes or persons serving in training programs or participating in volunteer programs and affiliated with the health care provider, if:
146.82(2)(a)2.b.
b. The person is being consulted regarding the health of the patient; or
146.82(2)(a)2.c.
c. The life or health of the patient appears to be in danger and the information contained in the patient health care records may aid the person in rendering assistance.
146.82(2)(a)2.d.
d. The person prepares or stores records, for the purposes of the preparation or storage of those records.
146.82(2)(a)3.
3. To the extent that the records are needed for billing, collection or payment of claims.
146.82(2)(a)5.
5. In response to a written request by any federal or state governmental agency to perform a legally authorized function, including but not limited to management audits, financial audits, program monitoring and evaluation, facility licensure or certification or individual licensure or certification. The private pay patient, except if a resident of a nursing home, may deny access granted under this subdivision by annually submitting to a health care provider, other than a nursing home, a signed, written request on a form provided by the department. The provider, if a hospital, shall submit a copy of the signed form to the patient's physician.
146.82(2)(a)6.
6. For purposes of research if the researcher is affiliated with the health care provider and provides written assurances to the custodian of the patient health care records that the information will be used only for the purposes for which it is provided to the researcher, the information will not be released to a person not connected with the study, and the final product of the research will not reveal information that may serve to identify the patient whose records are being released under this paragraph without the informed consent of the patient. The private pay patient may deny access granted under this subdivision by annually submitting to the health care provider a signed, written request on a form provided by the department.
146.82(2)(a)7.
7. To a county agency designated under
s. 46.90 (2) or other investigating agency under
s. 46.90 for purposes of
s. 46.90 (4) (a) and
(5) or to the county protective services agency designated under
s. 55.02 for purposes of
s. 55.043. The health care provider may release information by initiating contact with the county agency or county protective services agency without receiving a request for release of the information from the county agency or county protective services agency.
146.82(2)(a)8.
8. To the department under
s. 255.04. The release of a patient health care record under this subdivision shall be limited to the information prescribed by the department under
s. 255.04 (2).
146.82(2)(a)9.a.a. In this subdivision, "abuse" has the meaning given in
s. 51.62 (1) (ag); "neglect" has the meaning given in
s. 51.62 (1) (br); and "parent" has the meaning given in
s. 48.02 (13), except that "parent" does not include the parent of a minor whose custody is transferred to a legal custodian, as defined in
s. 48.02 (11), or for whom a guardian is appointed under
s. 880.33.
146.82(2)(a)9.b.
b. Except as provided in
subd. 9. c. and
d., to staff members of the protection and advocacy agency designated under
s. 51.62 (2) or to staff members of the private, nonprofit corporation with which the agency has contracted under
s. 51.62 (3) (a) 3., if any, for the purpose of protecting and advocating the rights of a person with development disabilities, as defined under
s. 51.62 (1) (am), who resides in or who is receiving services from an inpatient health care facility, as defined under
s. 51.62 (1) (b), or a person with mental illness, as defined under
s. 51.62 (1) (bm).
146.82(2)(a)9.c.
c. If the patient, regardless of age, has a guardian appointed under
s. 880.33, or if the patient is a minor with developmental disability, as defined in
s. 51.01 (5) (a), who has a parent or has a guardian appointed under
s. 48.831 and does not have a guardian appointed under
s. 880.33, information concerning the patient that is obtainable by staff members of the agency or nonprofit corporation with which the agency has contracted is limited, except as provided in
subd. 9. e., to the nature of an alleged rights violation, if any; the name, birth date and county of residence of the patient; information regarding whether the patient was voluntarily admitted, involuntarily committed or protectively placed and the date and place of admission, placement or commitment; and the name, address and telephone number of the guardian of the patient and the date and place of the guardian's appointment or, if the patient is a minor with developmental disability who has a parent or has a guardian appointed under
s. 48.831 and does not have a guardian appointed under
s. 880.33, the name, address and telephone number of the parent or guardian appointed under
s. 48.831 of the patient.
146.82(2)(a)9.d.
d. Except as provided in
subd. 9. e., any staff member who wishes to obtain additional information about a patient described in
subd. 9. c. shall notify the patient's guardian or, if applicable, parent in writing of the request and of the guardian's or parent's right to object. The staff member shall send the notice by mail to the guardian's or, if applicable, parent's address. If the guardian or parent does not object in writing within 15 days after the notice is mailed, the staff member may obtain the additional information. If the guardian or parent objects in writing within 15 days after the notice is mailed, the staff member may not obtain the additional information.
146.82(2)(a)9.e.
e. The restrictions on information that is obtainable by staff members of the protection and advocacy agency or private, nonprofit corporation that are specified in
subd. 9. c. and
d. do not apply if the custodian of the record fails to promptly provide the name and address of the parent or guardian; if a complaint is received by the agency or nonprofit corporation about a patient, or if the agency or nonprofit corporation determines that there is probable cause to believe that the health or safety of the patient is in serious and immediate jeopardy, the agency or nonprofit corporation has made a good-faith effort to contact the parent or guardian upon receiving the name and address of the parent or guardian, the agency or nonprofit corporation has either been unable to contact the parent or guardian or has offered assistance to the parent or guardian to resolve the situation and the parent or guardian has failed or refused to act on behalf of the patient; if a complaint is received by the agency or nonprofit corporation about a patient or there is otherwise probable cause to believe that the patient has been subject to abuse or neglect by a parent or guardian; or if the patient is a minor whose custody has been transferred to a legal custodian, as defined in
s. 48.02 (11) or for whom a guardian that is an agency of the state or a county has been appointed.
146.82(2)(a)11.
11. To a county department, as defined under
s. 48.02 (2g), a sheriff or police department or a district attorney for purposes of investigation of threatened or suspected child abuse or neglect or prosecution of alleged child abuse or neglect if the person conducting the investigation or prosecution identifies the subject of the record by name. The health care provider may release information by initiating contact with a county department, sheriff or police department or district attorney without receiving a request for release of the information. A person to whom a report or record is disclosed under this subdivision may not further disclose it, except to the persons, for the purposes and under the conditions specified in
s. 48.981 (7).
146.82(2)(a)12.
12. To a school district employe or agent, with regard to patient health care records maintained by the school district by which he or she is employed or is an agent, if any of the following apply:
146.82(2)(a)12.a.
a. The employe or agent has responsibility for preparation or storage of patient health care records.
146.82(2)(a)12.b.
b. Access to the patient health care records is necessary to comply with a requirement in federal or state law.
146.82(2)(a)16.
16. To a designated representative of the long-term care ombudsman under
s. 16.009 (4), for the purpose of protecting and advocating the rights of an individual 60 years of age or older who resides in a long-term care facility, as specified in
s. 16.009 (4) (b).
146.82(2)(b)
(b) Unless authorized by a court of record, the recipient of any information under
par. (a) shall keep the information confidential and may not disclose identifying information about the patient whose patient health care records are released.
