51.22(5)
(5) The board to which a patient is committed shall provide the least restrictive treatment alternative appropriate to the patient's needs, and movement through all appropriate and necessary treatment components to assure continuity of care.
51.22 Annotation
The standard for determining whether the state has adequately protected a patient's rights is whether professional judgment was in fact exercised. Youngberg v. Romeo,
457 U.S. 307 (1982).
51.30(1)(1)
Definitions. In this section:
51.30(1)(a)
(a) "Registration records" include all the records of the department, county departments under
s. 51.42 or
51.437, treatment facilities, and other persons providing services to the department, county departments or facilities which identify individuals who are receiving or who at any time have received services for mental illness, developmental disabilities, alcoholism or drug dependence.
51.30(1)(b)
(b) "Treatment records" include the registration and all other records concerning individuals who are receiving or who at any time have received services for mental illness, developmental disabilities, alcoholism, or drug dependence which are maintained by the department, by county departments under
s. 51.42 or
51.437 and their staffs, and by treatment facilities. Such records do not include notes or records maintained for personal use by an individual providing treatment services for the department, a county department under
s. 51.42 or
51.437, or a treatment facility if such notes or records are not available to others.
51.30(2)
(2) Informed consent. An informed consent for disclosure of information from court or treatment records to an individual, agency, or organization must be in writing and must contain the following: the name of the individual, agency, or organization to which the disclosure is to be made; the name of the subject individual whose treatment record is being disclosed; the purpose or need for the disclosure; the specific type of information to be disclosed; the time period during which the consent is effective; the date on which the consent is signed; and the signature of the individual or person legally authorized to give consent for the individual.
51.30(3)(a)(a) Except as provided in
pars. (b) and
(c), the files and records of the court proceedings under this chapter shall be closed but shall be accessible to any individual who is the subject of a petition filed under this chapter.
51.30(3)(b)
(b) An individual's attorney or guardian ad litem and the corporation counsel shall have access to the files and records of the court proceedings under this chapter without the individual's consent and without modification of the records in order to prepare for involuntary commitment or recommitment proceedings, reexaminations, appeals, or other actions relating to detention, admission, or commitment under this chapter or
ch. 971 or
975.
51.30(3)(c)
(c) The files and records of court proceedings under this chapter may be released to other persons with the informed written consent of the individual, pursuant to lawful order of the court which maintains the records or under
s. 51.20 (13) (cv) 4. or
(16) (gm).
51.30(3)(d)
(d) The department of corrections shall have access to the files and records of court proceedings under this chapter concerning an individual required to register under
s. 301.45. The department of corrections may disclose information that it obtains under this paragraph as provided under
s. 301.46.
51.30(4)
(4) Access to registration and treatment records. 51.30(4)(a)(a) Confidentiality of records. Except as otherwise provided in this chapter and
ss. 118.125 (4),
610.70 (3) and
(5),
905.03 and
905.04, all treatment records shall remain confidential and are privileged to the subject individual. Such records may be released only to the persons designated in this chapter or
ss. 118.125 (4),
610.70 (3) and
(5),
905.03 and
905.04, or to other designated persons with the informed written consent of the subject individual as provided in this section. This restriction applies to elected officials and to members of boards appointed under
s. 51.42 (4) (a) or
51.437 (7) (a).
51.30(4)(b)
(b)
Access without informed written consent. Notwithstanding
par. (a), treatment records of an individual may be released without informed written consent in the following circumstances, except as restricted under
par. (c):
51.30(4)(b)1.
1. To an individual, organization or agency designated by the department or as required by law for the purposes of management audits, financial audits, or program monitoring and evaluation. Information obtained under this paragraph shall remain confidential and shall not be used in any way that discloses the names or other identifying information about the individual whose records are being released. The department shall promulgate rules to assure the confidentiality of such information.
51.30(4)(b)2.
2. To the department, the director of a county department under
s. 51.42 or
51.437, or a qualified staff member designated by the director as is necessary for, and only to be used for, billing or collection purposes. Such information shall remain confidential. The department and county departments shall develop procedures to assure the confidentiality of such information.
51.30(4)(b)3.
3. For purposes of research as permitted in
s. 51.61 (1) (j) and
(4) if the research project has been approved by the department and the researcher has provided assurances that the information will be used only for the purposes for which it was provided to the researcher, the information will not be released to a person not connected with the study under consideration, and the final product of the research will not reveal information that may serve to identify the individual whose treatment records are being released under this subsection without the informed written consent of the individual. Such information shall remain confidential. In approving research projects under this subsection, the department shall impose any additional safeguards needed to prevent unwarranted disclosure of information.
51.30(4)(b)5.
5. To qualified staff members of the department, to the director of the county department under
s. 51.42 or
51.437 which is responsible for serving a subject individual or to qualified staff members designated by the director as is necessary to determine progress and adequacy of treatment, to determine whether the person should be transferred to a less restrictive or more appropriate treatment modality or facility or for the purposes of
s. 51.14. Such information shall remain confidential. The department and county departments under
s. 51.42 or
51.437 shall develop procedures to assure the confidentiality of such information.
51.30(4)(b)6.
6. Within the treatment facility where the subject individual is receiving treatment confidential information may be disclosed to individuals employed, individuals serving in bona fide training programs or individuals participating in supervised volunteer programs, at the facility when and to the extent that performance of their duties requires that they have access to such information.
51.30(4)(b)7.
7. Within the department to the extent necessary to coordinate treatment for mental illness, developmental disabilities, alcoholism or drug abuse of individuals who have been committed to or who are under the supervision of the department. The department shall promulgate rules to assure the confidentiality of such information.
51.30(4)(b)8.
8. To a licensed physician who has determined that the life or health of the individual is in danger and that treatment without the information contained in the treatment records could be injurious to the patient's health. Such disclosure shall be limited to that part of the records necessary to meet the medical emergency.
51.30(4)(b)9.
9. To a facility which is to receive an individual who is involuntarily committed under this chapter,
ch. 48,
971 or
975 upon transfer of the individual from one treatment facility to another. Release of records under this subdivision shall be limited to such treatment records as are required by law, a record or summary of all somatic treatments, and a discharge summary. The discharge summary may include a statement of the patient's problem, the treatment goals, the type of treatment which has been provided, and recommendation for future treatment, but it may not include the patient's complete treatment record. The department shall promulgate rules to implement this subdivision.
51.30(4)(b)10.
10. To a correctional facility or to a probation, extended supervision and parole agent who is responsible for the supervision of an individual who is receiving inpatient or outpatient evaluation or treatment under this chapter in a program that is operated by, or is under contract with, the department or a county department under
s. 51.42 or
51.437, or in a treatment facility, as a condition of the probation, extended supervision and parole supervision plan, or whenever such an individual is transferred from a state or local correctional facility to such a treatment program and is then transferred back to the correctional facility. Every probationer, parolee or person on extended supervision who receives evaluation or treatment under this chapter shall be notified of the provisions of this subdivision by the individual's probation, extended supervision and parole agent. Release of records under this subdivision is limited to:
51.30(4)(b)10.a.
a. The report of an evaluation which is provided pursuant to the written probation, extended supervision and parole supervision plan.
51.30(4)(b)10.b.
b. The discharge summary, including a record or summary of all somatic treatments, at the termination of any treatment which is provided as part of the probation, extended supervision and parole supervision plan.
51.30(4)(b)10.c.
c. When an individual is transferred from a treatment facility back to a correctional facility, the information provided under
subd. 10. d.
51.30(4)(b)10.d.
d. Any information necessary to establish, or to implement changes in, the individual's treatment plan or the level and kind of supervision on probation, extended supervision or parole, as determined by the director of the facility or the treatment director. In cases involving a person transferred back to a correctional facility, disclosure shall be made to clinical staff only. In cases involving a person on probation, extended supervision or parole, disclosure shall be made to a probation, extended supervision and parole agent only. The department shall promulgate rules governing the release of records under this subdivision.
51.30(4)(b)10m.
10m. To the department of justice or a district attorney under
s. 980.015 (3) (b), if the treatment records are maintained by an agency with jurisdiction, as defined in
s. 980.015 (1), that has control or custody over a person who may meet the criteria for commitment as a sexually violent person under
ch. 980.
51.30(4)(b)11.
11. To the subject individual's counsel or guardian ad litem and the corporation counsel, without modification, at any time in order to prepare for involuntary commitment or recommitment proceedings, reexaminations, appeals, or other actions relating to detention, admission, commitment, or patients' rights under this chapter or
ch. 48,
971, or
975.
51.30(4)(b)11m.
11m. To the guardian ad litem of the unborn child, as defined in
s. 48.02 (19), of a subject individual, without modification, at any time to prepare for proceedings under
s. 48.133.
51.30(4)(b)12.
12. To a correctional officer of the department of corrections who has custody of or is responsible for the supervision of an individual who is transferred or discharged from a treatment facility. Records released under this subdivision are limited to notice of the subject individual's change in status.
51.30(4)(b)12m.
12m. To any person if the patient was admitted under
s. 971.14,
971.17 or
980.06 or
ch. 975 or transferred under
s. 51.35 (3) or
51.37 and is on unauthorized absence from a treatment facility. Information released under this subdivision is limited to information that would assist in the apprehension of the patient.
51.30(4)(b)13.
13. To the parents, children or spouse of an individual who is or was a patient at an inpatient facility, to a law enforcement officer who is seeking to determine whether an individual is on unauthorized absence from the facility, and to mental health professionals who are providing treatment to the individual at the time that the information is released to others. Information released under this subdivision is limited to notice as to whether or not an individual is a patient at the inpatient facility.
51.30(4)(b)15.
15. To personnel employed by a county department under
s. 46.215,
46.22,
51.42 or
51.437 in any county where the county department has established and submitted to the department a written agreement to coordinate services to individuals receiving services under this chapter. This information shall be released upon request of such county department personnel, and may be utilized only for the purposes of coordinating human services delivery and case management. This information shall remain confidential, and shall continue to be governed by this section. Information may be released under this subdivision only if the subject individual has received services through a county department under
s. 51.42 or
51.437 within 6 months preceding the request for information, and the information is limited to:
51.30(4)(b)15.a.
a. The subject individual's name, address, age, birthdate, sex, client-identifying number and primary disability.
51.30(4)(b)15.b.
b. The type of service rendered or requested to be provided to the subject individual, and the dates of such service or request.
51.30(4)(b)16.
16. If authorized by the secretary or his or her designee, to a law enforcement agency upon request if the individual was admitted under
ch. 971 or
975 or transferred under
s. 51.35 (3) or
51.37. Information released under this subdivision is limited to the individual's name and other identifying information, including photographs and fingerprints, the branch of the court that committed the individual, the crime that the individual is charged with, found not guilty of by reason of mental disease or defect or convicted of, whether or not the individual is or has been authorized to leave the grounds of the institution and information as to the individual's whereabouts during any time period. In this subdivision "law enforcement agency" has the meaning provided in
s. 165.83 (1) (b).
51.30(4)(b)17.
17. To the county agency designated under
s. 46.90 (2) or other investigating agency under
s. 46.90 for the purposes of
s. 46.90 (4) (a) and
(5), to the county department, as defined in
s. 48.02 (2g), or the sheriff or police department for the purposes of
s. 48.981 (2) and
(3) or to the county protective services agency designated under
s. 55.02 for purposes of
s. 55.043. The treatment record holder may release treatment record information by initiating contact with the county protective services agency or county department, as defined in
s. 48.02 (2g), without first receiving a request for release of the treatment record from the county protective services agency or county department.
51.30(4)(b)18.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.
51.30(4)(b)18.b.
b. Except as provided in
subd. 18. 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 persons with developmental disabilities, as defined under
s. 51.62 (1) (am), or mental illness, as defined under
s. 51.62 (1) (bm).
51.30(4)(b)18.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 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. 18. 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.
51.30(4)(b)18.d.
d. Except as provided in
subd. 18. e., any staff member who wishes to obtain additional information about a patient described in
subd. 18. 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.
51.30(4)(b)18.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. 18. 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.
51.30(4)(b)19.
19. To state and local law enforcement agencies for the purpose of reporting an apparent crime committed on the premises of an inpatient treatment facility or nursing home, if the facility or home has treatment records subject to this section, or observed by staff or agents of any such facility or nursing home. Information released under this subdivision is limited to identifying information that may be released under
subd. 16. and information related to the apparent crime.
51.30(4)(b)20.
20. Except with respect to the treatment records of a subject individual who is receiving or has received services for alcoholism or drug dependence, to the spouse, parent, adult child or sibling of a subject individual, if the spouse, parent, adult child or sibling is directly involved in providing care to or monitoring the treatment of the subject individual and if the involvement is verified by the subject individual's physician, psychologist or by a person other than the spouse, parent, adult child or sibling who is responsible for providing treatment to the subject individual, in order to assist in the provision of care or monitoring of treatment. Except in an emergency as determined by the person verifying the involvement of the spouse, parent, adult child or sibling, the request for treatment records under this subdivision shall be in writing, by the requester. Unless the subject individual has been adjudged incompetent under
ch. 880, the person verifying the involvement of the spouse, parent, adult child or sibling shall notify the subject individual about the release of his or her treatment records under this subdivision. Treatment records released under this subdivision are limited to the following:
51.30(4)(b)20.a.
a. A summary of the subject individual's diagnosis and prognosis.
51.30(4)(b)20.b.
b. A listing of the medication which the subject individual has received and is receiving.
51.30(4)(b)23.
23. To the department under
s. 51.03 (2) or to a sheriff, police department or district attorney for purposes of investigation of a death reported under
s. 51.64 (2) (a).
51.30(4)(b)24.
24. To the department of corrections for the purpose of obtaining information concerning a person required to register under
s. 301.45. The department of corrections may disclose information that it receives under this subdivision as provided under
s. 301.46.
51.30(4)(b)25.
25. If the treatment records do not contain information and the circumstances of the release do not provide information that would permit the identification of the individual.
51.30(4)(b)26.
26. To the department of corrections or to a sheriff, to determine if a person incarcerated is complying with the assessment or the driver safety plan ordered under
s. 343.30 (1q) (c).
51.30(4)(c)
(c)
Limitation on release of alcohol and drug treatment records. Notwithstanding
par. (b), whenever federal law or applicable federal regulations restrict, or as a condition to receipt of federal aids require that this state restrict the release of information contained in the treatment records of any patient who receives treatment for alcoholism or drug dependency in a program or facility to a greater extent than permitted under this section, the department may by rule restrict the release of such information as may be necessary to comply with federal law and regulations. Rules promulgated under this paragraph shall supersede this section with respect to alcoholism and drug dependency treatment records in those situations in which they apply.
51.30(4)(d)1.1. Access to treatment records by a subject individual during his or her treatment may be restricted by the director of the treatment facility. However, access may not be denied at any time to records of all medications and somatic treatments received by the individual.
51.30(4)(d)2.
2. The subject individual shall have a right, following discharge under
s. 51.35 (4), to a complete record of all medications and somatic treatments prescribed during admission or commitment and to a copy of the discharge summary which was prepared at the time of his or her discharge. A reasonable and uniform charge for reproduction may be assessed.
51.30(4)(d)3.
3. In addition to the information provided under
subd. 2., the subject individual shall, following discharge, if the individual so requests, have access to and have the right to receive from the facility a photostatic copy of any or all of his or her treatment records. A reasonable and uniform charge for reproduction may be assessed. The director of the treatment facility or such person's designee and the treating physician have a right to be present during inspection of any treatment records. Notice of inspection of treatment records shall be provided to the director of the treatment facility and the treating physician at least one full day, excluding Saturdays, Sundays and legal holidays, before inspection of the records is made. Treatment records may be modified prior to inspection to protect the confidentiality of other patients or the names of any other persons referred to in the record who gave information subject to the condition that his or her identity remain confidential. Entire documents may not be withheld in order to protect such confidentiality.
51.30(4)(d)4.
4. At the time of discharge all individuals shall be informed by the director of the treatment facility or such person's designee of their rights as provided in this subsection.
51.30(4)(dm)
(dm)
Destruction, damage, falsification or concealment of treatment records. No person may do any of the following:
51.30(4)(dm)2.
2. Conceal or withhold a treatment record with intent to prevent its release to the subject individual under
par. (d), to his or her guardian appointed under
ch. 880 or to persons with the informed written consent of the subject individual or with intent to prevent or obstruct an investigation or prosecution.
51.30(4)(dm)3.
3. Intentionally destroy or damage records in order to prevent or obstruct an investigation or prosecution.
51.30(4)(e)
(e)
Notation of release of information. Each time written information is released from a treatment record, a notation shall be made in the record by the custodian thereof that includes the following: the name of the person to whom the information was released; the identification of the information released; the purpose of the release; and the date of the release. The subject individual shall have access to such release data as provided in
par. (d).
51.30(4)(f)
(f)
Correction of information. A subject individual, or the parent, guardian or person in the place of a parent of a minor, or the guardian of an incompetent may, after having gained access to treatment records, challenge the accuracy, completeness, timeliness, or relevance of factual information in his or her treatment records and request in writing that the facility maintaining the record correct the challenged information. Such request shall be granted or denied within 30 days by the director of the treatment facility, the director of the county department under
s. 51.42 or
51.437, or the secretary depending upon which person has custody of the record. Reasons for denial of the requested changes shall be given by the responsible officer and the individual shall be informed of any applicable grievance procedure or court review procedure. If the request is denied, the individual, parent, guardian or person in the place of a parent shall be allowed to insert into the record a statement correcting or amending the information at issue. The statement shall become a part of the record and shall be released whenever the information at issue is released.
51.30(4)(g)
(g)
Applicability. Paragraphs (a),
(b),
(c),
(dm) and
(e) apply to all treatment records, including those on which written, drawn, printed, spoken, visual, electromagnetic or digital information is recorded or preserved, regardless of physical form or characteristics.
51.30(5)(a)(a)
Consent for release of information. The parent, guardian, or person in the place of a parent of a minor or the guardian of an adult adjudged incompetent under
ch. 880 may consent to the release of confidential information in court or treatment records. A minor who is aged 14 or more may consent to the release of confidential information in court or treatment records without the consent of the minor's parent, guardian or person in the place of a parent. Consent under this paragraph must conform to the requirements of
sub. (2).
51.30(5)(b)1.1. The guardian of an individual who is adjudged incompetent under
ch. 880 shall have access to the individual's court and treatment records at all times. The parent, guardian or person in the place of a parent of a developmentally disabled minor shall have access to the minor's court and treatment records at all times except in the case of a minor aged 14 or older who files a written objection to such access with the custodian of the records. The parent, guardian or person in the place of a parent of other minors shall have the same rights of access as provided to subject individuals under this section.
51.30(5)(b)2.
2. A minor upon reaching the age of 14 shall have access to his or her own court and treatment records, as provided in this section. A minor under the age of 14 shall have access to court records but only in the presence of parent, guardian, counsel, guardian ad litem or judge and shall have access to treatment records as provided in this section but only in the presence of parent, guardian, counsel, guardian ad litem or staff member of the treatment facility.
51.30(5)(bm)
(bm)
Parents denied physical placement. A parent who has been denied periods of physical placement with a child under
s. 767.24 (4) (b) or
767.325 (4) may not have the rights of a parent or guardian under
pars. (a) and
(b) with respect to access to that child's court or treatment records.
51.30(5)(c)
(c)
Juvenile court records. The court records of juveniles admitted or committed under this chapter shall be kept separately from all other juvenile court records.
51.30(5)(d)
(d)
Other juvenile records. Section 48.78 does not apply to records covered by this section.
51.30(5)(e)
(e)
Temporary guardian for adult incompetent. If an adult is believed to be incompetent to consent to the release of records under this section, but no guardian has been appointed for such individual, consent for the release of records may be given by a temporary guardian who is appointed for the purpose of deciding upon the release of records.
51.30(5)(f)
(f)
Applicability. Paragraph (a) and
(bm) to
(e) apply to all treatment records, including those on which written, drawn, printed, spoken, visual, electromagnetic or digital information is recorded or preserved, regardless of physical form or characteristics.
51.30(6)
(6) Privileges. Sections 905.03 and
905.04 supersede this section with respect to communications between physicians and patients and between attorneys and clients.
51.30(7)
(7) Criminal commitments. Except as otherwise specifically provided, this section applies to the treatment records of persons who are committed under
chs. 971 and
975.
51.30(8)
(8) Grievances. Failure to comply with any provisions of this section may be processed as a grievance under
s. 51.61 (5). However, use of the grievance procedure is not required before bringing any civil action or filing a criminal complaint under this section.
51.30(9)
(9) Actions for violations; damages; injunction. 51.30(9)(a)(a) Any person, including the state or any political subdivision of the state, violating this section shall be liable to any person damaged as a result of the violation for such damages as may be proved, together with exemplary damages of not more than $1,000 for each violation and such costs and reasonable actual attorney fees as may be incurred by the person damaged. A custodian of records incurs no liability under this paragraph for the release of records in accordance with this section while acting in good faith.
51.30(9)(b)
(b) In any action brought under
par. (a) in which the court determines that the violator acted in a manner that was knowing and willful, the violator shall be liable for such damages as may be proved together with exemplary damages of not more than $25,000 for each violation, together with costs and reasonable actual attorney fees as may be incurred. It is not a prerequisite to an action under this subsection that the plaintiff suffer or be threatened with actual damages.
