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LRB-1724/1
TJD:kjf
2015 - 2016 LEGISLATURE
January 22, 2016 - Introduced by Representatives Rohrkaste, Hesselbein,
Bernier, Novak, Katsma, Tittl, Macco, Skowronski, Knodl, Milroy, Petryk,
Swearingen, Kleefisch, Quinn, Kitchens, Kahl, A. Ott, Ripp, Zepnick,
Spiros, Subeck, Murphy, E. Brooks, Sargent, Kulp, Ballweg and Nygren,
cosponsored by Senators Olsen and Carpenter. Referred to Committee on
Mental Health Reform.
AB791,1,7 1An Act to renumber 50.08 (3) (h); to renumber and amend 50.08 (3m); to
2amend
50.08 (2), 50.08 (3) (a), 50.08 (3) (c), 50.08 (3) (cm), 50.08 (3) (d), 50.08
3(3) (e), 50.08 (3) (f), 50.08 (3) (fm) (intro.), 50.08 (3) (fm) 1., 50.08 (3) (fm) 2., 50.08
4(3) (g), 50.08 (4) (a) (intro.), 50.08 (4) (a) 2., 50.08 (4) (a) 3., 50.08 (4) (b) and 50.08
5(4) (c); and to create 50.08 (3) (bg), 50.08 (3) (bh), 50.08 (3) (h) 2. and 50.08 (3m)
6(b) of the statutes; relating to: informed consent for psychotropic medications
7in nursing homes and community-based residential facilities.
Analysis by the Legislative Reference Bureau
This bill requires a community-based residential facility to obtain a signed
acknowledgment form for administration of psychotropic medications in a similar
manner and for the same individuals as a nursing home is required to obtain
informed consent for administration of psychotropic medications under current law.
The bill also creates requirements for obtaining a signed acknowledgment form, for
residents who are prescribed medications while off the premises of a
community-based residential facility.
Current law prescribes the situations and procedures under which a guardian
may consent to the voluntary or involuntary administration of psychotropic
medications to his or her ward. Current law also requires that a nursing home obtain
written informed consent before administering a psychotropic medication that

contains a boxed warning to any resident who has degenerative brain disorder. A
psychotropic medication is an antipsychotic, an antidepressant, lithium carbonate,
or a tranquilizer. A boxed warning is a warning, described in federal regulations, the
text of which is contained in a black outlined box on the drug's label and in the full
prescribing information. Either the resident, or, if the resident is incapacitated, a
person acting on behalf of the resident, may provide written informed consent. A
nursing home is not required under current law to obtain written informed consent
if there is an emergency in which the resident, who is not under a court order for
administration of psychotropic medication, is at significant risk of physical or
emotional harm or puts others at significant risk of physical harm; if time and
distance preclude obtaining written informed consent; and if a physician has
determined that the resident or others will be harmed if treatment is not initiated.
In such an emergency situation, the nursing home must obtain oral consent and
must obtain written consent within ten days. If the nursing home is unable to contact
a person acting on behalf of an incapacitated resident to obtain oral consent but has
made a good faith effort to do so, the nursing home may administer the psychotropic
medication to the resident for up to 24 hours before it must obtain oral consent from
the resident or a person acting on behalf of the resident. The bill imposes those same
requirements on community-based residential facilities, except instead of written
informed consent the bill requires a signed acknowledgment form from a resident of
a community-based residential facility. The bill requires that the acknowledgment
form acknowledges receipt of an informational form indicating that the resident has
been prescribed a medication that has a boxed warning and information from the
federal Food and Drug Administration for the specific psychotropic medication the
resident has been prescribed. The acknowledgment form also notifies the resident,
or person acting on behalf of the resident, that if he or she seeks more information
that he or she should contact the prescriber of the medication. The
community-based residential facility is required to include contact information for
the prescriber on the acknowledgment form.
Under current law, a nursing home is not required to obtain written informed
consent before administering a psychotropic medication to a resident if the
prescription for the psychotropic medication is written or reauthorized while the
resident is off of the nursing home's premises. Under the bill, if the prescription for
the psychotropic medication is written or reauthorized while a resident of a
community-based residential facility is off of the premises of the community-based
residential facility and if the community-based residential facility has not
previously obtained a signed acknowledgment form for administration of that
psychotropic medication to that resident, the community-based residential facility
must obtain written informed consent or a signed acknowledgment form within 72
hours after first administering that psychotropic medication to that resident before
continuing to administer that psychotropic medication to that resident. The bill
maintains current law for nursing homes when a prescription for a psychotropic
medication for a nursing home resident is written or reauthorized while the resident
is off of the nursing home's premises.

For further information see the state 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:
AB791,1 1Section 1. 50.08 (2) of the statutes is amended to read:
AB791,3,72 50.08 (2) A physician, an advanced practice nurse prescriber certified under
3s. 441.16 (2), or a physician assistant licensed under ch. 448, who prescribes a
4psychotropic medication to a nursing home or community-based residential facility
5resident who has degenerative brain disorder shall notify the nursing home or
6community-based residential facility
if the prescribed medication has a boxed
7warning under 21 CFR 201.57.
AB791,2 8Section 2. 50.08 (3) (a) of the statutes is amended to read:
AB791,3,149 50.08 (3) (a) Except as provided in sub. (3m) or (4), before administering a
10psychotropic medication that has a boxed warning under 21 CFR 201.57 to a resident
11of a nursing home who has degenerative brain disorder, a nursing home shall obtain
12written informed consent from the resident or, if the resident is incapacitated, a
13person acting on behalf of the resident, on a form provided by the department under
14par. (b) or on a form that contains the same information as the form under par. (b).
AB791,3 15Section 3. 50.08 (3) (bg) of the statutes is created to read:
AB791,3,2116 50.08 (3) (bg) Except as provided in sub. (3m) or (4), before administering a
17psychotropic medication that has a boxed warning under 21 CFR 201.57 to a resident
18of a community-based residential facility who has a degenerative brain disorder, a
19community-based residential facility shall obtain a signed acknowledgment form
20described in par. (bh) from the resident or, if the resident is incapacitated, a person
21acting on behalf of the resident.
AB791,4
1Section 4. 50.08 (3) (bh) of the statutes is created to read:
AB791,4,42 50.08 (3) (bh) 1. The department shall make available on its Internet site or
3by mail acknowledgment forms for obtaining a signature acknowledging receipt of
4all of the following:
AB791,4,75 a. An informational form, created by the department, indicating that the
6resident has been prescribed a medication that has a boxed warning under 21 CFR
7201.57
.
AB791,4,128 b. Information created by the federal food and drug administration for the
9specific psychotropic medication the resident has been prescribed. The
10community-based residential facility shall obtain the information sheet from the
11federal food and drug administration or obtain information from the federal food and
12drug administration's Internet site.
AB791,4,1813 2. The acknowledgment form under this paragraph shall contain a notification
14that if the resident, or person acting on behalf of the resident, if applicable, seeks
15more information the resident or person acting on behalf of the resident should
16contact the individual who prescribed the medication. The community-based
17residential facility shall indicate on the acknowledgment form contact information
18for the prescriber of the medication.
AB791,5 19Section 5. 50.08 (3) (c) of the statutes is amended to read:
AB791,4,2120 50.08 (3) (c) Written informed consent or a signed acknowledgment form
21provided by a guardian is subject to s. 54.25 (2) (d) 2. ab. and ac.
AB791,6 22Section 6. 50.08 (3) (cm) of the statutes is amended to read:
AB791,5,223 50.08 (3) (cm) If a health care agent is acting on behalf of a resident, the health
24care agent shall give informed consent or sign an acknowledgment form in
25accordance with the desires of the resident as expressed in the power of attorney for

1health care instrument under ch. 155 or, if the resident's desires are unknown, in
2accordance with s. 155.20 (5).
AB791,7 3Section 7. 50.08 (3) (d) of the statutes is amended to read:
AB791,5,74 50.08 (3) (d) Upon request, the nursing home or community-based residential
5facility
shall give the resident, or a person acting on behalf of the resident, a copy of
6the completed informed consent form described under par. (a) or acknowledgment
7form described under par. (bg)
.
AB791,8 8Section 8. 50.08 (3) (e) of the statutes is amended to read:
AB791,5,139 50.08 (3) (e) Unless consent or acknowledgment is withdrawn sooner, written
10informed consent or a signed acknowledgment obtained under this subsection is
11valid for the period specified on the informed consent form or acknowledgment form
12but not for longer than 15 months from the date the resident, or a person acting on
13behalf of the resident, signed the form.
AB791,9 14Section 9. 50.08 (3) (f) of the statutes is amended to read:
AB791,5,1615 50.08 (3) (f) A resident, or a person acting on behalf of the resident, may
16withdraw consent or acknowledgment, in writing, at any time.
AB791,10 17Section 10. 50.08 (3) (fm) (intro.) of the statutes is amended to read:
AB791,5,2118 50.08 (3) (fm) (intro.) At the time a resident, or a person acting on behalf of the
19resident, signs the informed consent form or acknowledgment form, the nursing
20home or community-based residential facility shall orally inform the resident, or the
21person acting on behalf of the resident, of all of the following:
AB791,11 22Section 11. 50.08 (3) (fm) 1. of the statutes is amended to read:
AB791,5,2423 50.08 (3) (fm) 1. That the resident, or the person on behalf of the resident, may
24withdraw consent or acknowledgment, in writing, at any time.
AB791,12 25Section 12. 50.08 (3) (fm) 2. of the statutes is amended to read:
AB791,6,5
150.08 (3) (fm) 2. That, unless consent or acknowledgment is withdrawn sooner,
2the informed consent or acknowledgment is valid for the period specified on the
3informed consent form or acknowledgment form or for 15 months from the date on
4which the resident, or the person acting on behalf of the resident, signs the form,
5whichever is shorter.
AB791,13 6Section 13. 50.08 (3) (g) of the statutes is amended to read:
AB791,6,97 50.08 (3) (g) No person may retaliate against or threaten to retaliate against
8a resident or person acting on behalf of a resident for refusing to provide or
9withdrawing consent or acknowledgment.
AB791,14 10Section 14. 50.08 (3) (h) of the statutes is renumbered 50.08 (3) (h) 1.
AB791,15 11Section 15. 50.08 (3) (h) 2. of the statutes is created to read:
AB791,6,1412 50.08 (3) (h) 2. The community-based residential facility shall use the most
13current information available from the federal food and drug administration under
14par. (bh) 1. b.
AB791,16 15Section 16. 50.08 (3m) of the statutes is renumbered 50.08 (3m) (a) and
16amended to read:
AB791,6,2217 50.08 (3m) (a) A Except as provided in par. (b), a nursing home or
18community-based residential facility
is not required to obtain written informed
19consent or a signed acknowledgment form before administering a psychotropic
20medication to a resident under sub. (3) if the prescription for the psychotropic
21medication is written or reauthorized while the resident is off of the nursing home's
22premises of the nursing home or community-based residential facility.
AB791,17 23Section 17. 50.08 (3m) (b) of the statutes is created to read:
AB791,7,724 50.08 (3m) (b) If the prescription for the psychotropic medication is written or
25reauthorized while a resident of a community-based residential facility is off of the

1premises of the community-based residential facility and if the community-based
2residential facility has not previously obtained a signed acknowledgment form for
3administration of that psychotropic medication to that resident, the
4community-based residential facility shall obtain a signed acknowledgment form
5under sub. (3) within 72 hours after first administering that psychotropic medication
6to that resident before continuing to administer that psychotropic medication to that
7resident.
AB791,18 8Section 18. 50.08 (4) (a) (intro.) of the statutes is amended to read:
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