SB184: Bill Text

SB184,10 Section 10 . 50.01 (4p) of the statutes is repealed.

SB184,11 Section 11 . 50.08 (2) of the statutes is amended to read:

SB184,5,18 50.08 (2) A physician, an advanced practice nurse prescriber certified under s. 441.16 (2), or a physician assistant licensed under ch. 448, who prescribes a psychotropic medication to a nursing home resident who has degenerative brain disorder shall notify the nursing home if the prescribed medication has a boxed warning under 21 CFR 201.57.

SB184,12 Section 12 . 50.39 (3) of the statutes is amended to read:

SB184,6,3 50.39 (3) Facilities governed by ss. 45.50, 48.62, 49.70, 49.72, 50.02, 51.09, and 252.10, juvenile correctional facilities as defined in s. 938.02 (10p), correctional institutions governed by the department of corrections under s. 301.02, and the offices and clinics of persons licensed to treat the sick under chs. 446, 447, and 448 are exempt from ss. 50.32 to 50.39. Sections 50.32 to 50.39 do not abridge the rights of the medical examining board, physician assistant affiliated credentialing board, physical therapy examining board, podiatry affiliated credentialing board, dentistry examining board, pharmacy examining board, chiropractic examining board, and board of nursing in carrying out their statutory duties and responsibilities.

SB184,13 Section 13 . 55.14 (8) (b) of the statutes is amended to read:

SB184,6,15 55.14 (8) (b) Order the individual to comply with the treatment plan under par. (a). The order shall provide that if the individual fails to comply with provisions of the treatment plan that require the individual to take psychotropic medications, the medications may be administered involuntarily with consent of the guardian. The order shall specify the methods of involuntary administration of psychotropic medication to which the guardian may consent. An order authorizing the forcible restraint of an individual shall specify that a person licensed under s. 441.06, 441.10, or 448.05 (2) or (5), or 448.974 shall be present at all times that psychotropic medication is administered in this manner and shall require the person or facility using forcible restraint to maintain records stating the date of each administration, the medication administered, and the method of forcible restraint utilized.

SB184,14 Section 14 . 69.01 (6g) of the statutes is amended to read:

SB184,6,19 69.01 (6g) “Date of death" means the date that a person is pronounced dead by a physician, coroner, deputy coroner, medical examiner, deputy medical examiner, physician assistant, or hospice nurse.

SB184,15 Section 15 . 69.18 (1) (ck) of the statutes is created to read:

SB184,6,24 69.18 (1) (ck) For purposes of preparation of the certificate of death and in accordance with accepted medical standards, a physician assistant who is directly involved with the care of a patient who dies may pronounce the date, time, and place of the patient's death.

SB184,16 Section 16 . 70.47 (8) (intro.) of the statutes is amended to read:

SB184,7,13 70.47 (8) Hearing. (intro.) The board shall hear upon oath all persons who appear before it in relation to the assessment. Instead of appearing in person at the hearing, the board may allow the property owner, or the property owner's representative, at the request of either person, to appear before the board, under oath, by telephone or to submit written statements, under oath, to the board. The board shall hear upon oath, by telephone, all ill or disabled persons who present to the board a letter from a physician, osteopath, physician assistant, as defined in s. 448.01 (6), or advanced practice nurse prescriber certified under s. 441.16 (2) that confirms their illness or disability. At the request of the property owner or the property owner's representative, the board may postpone and reschedule a hearing under this subsection, but may not postpone and reschedule a hearing more than once during the same session for the same property. The board at such hearing shall proceed as follows:

SB184,17 Section 17 . 97.67 (5m) (a) 3. of the statutes is amended to read:

SB184,7,15 97.67 (5m) (a) 3. A physician assistant licensed under subch. II VIII of ch. 448.

SB184,18 Section 18 . 118.2925 (1) (f) of the statutes is amended to read:

SB184,7,18 118.2925 (1) (f) “Physician assistant" means a person licensed under s. 448.04 (1) (f) 448.974.

SB184,19 Section 19 . 146.81 (1) (d) of the statutes is amended to read:

SB184,7,21 146.81 (1) (d) A physician, physician assistant, perfusionist, or respiratory care practitioner licensed or certified under subch. II of ch. 448.

SB184,20 Section 20 . 146.81 (1) (eu) of the statutes is created to read:

SB184,7,23 146.81 (1) (eu) A physician assistant licensed under subch. VIII of ch. 448.

SB184,21 Section 21 . 146.82 (3) (a) of the statutes is amended to read:

SB184,8,7 146.82 (3) (a) Notwithstanding sub. (1), a physician, a physician assistant, as defined in s. 448.01 (6), or an advanced practice nurse prescriber certified under s. 441.16 (2) who treats a patient whose physical or mental condition in the physician's, physician assistant's, or advanced practice nurse prescriber's judgment affects the patient's ability to exercise reasonable and ordinary control over a motor vehicle may report the patient's name and other information relevant to the condition to the department of transportation without the informed consent of the patient.

SB184,22 Section 22 . 146.89 (1) (r) 1. of the statutes is amended to read:

SB184,8,13 146.89 (1) (r) 1. Licensed as a physician under ch. 448, a dentist or dental hygienist under ch. 447, a registered nurse, practical nurse, or nurse-midwife under ch. 441, an optometrist under ch. 449, a physician assistant under subch. VIII of ch. 448, a pharmacist under ch. 450, a chiropractor under ch. 446, a podiatrist under subch. IV of ch. 448, or a physical therapist under subch. III of ch. 448.

SB184,23 Section 23 . 146.997 (1) (d) 5. of the statutes is amended to read:

SB184,8,17 146.997 (1) (d) 5. An occupational therapist, occupational therapy assistant, physician assistant or respiratory care practitioner licensed or certified under ch. 448.

SB184,24 Section 24 . 154.01 (3) (intro.) of the statutes is amended to read:

SB184,8,20 154.01 (3) (intro.) “Health care professional" means who is, or who holds a compact privilege under subch. IX of ch. 448 any of the following:

SB184,25 Section 25 . 154.03 (2) of the statutes is amended to read:

SB184,9,14 154.03 (2) The department shall prepare and provide copies of the declaration and accompanying information for distribution in quantities to persons licensed, certified, or registered under ch. 441, 448, or 455, persons who hold a compact privilege under subch. IX X of ch. 448, hospitals, nursing homes, county clerks and local bar associations and individually to private persons. The department shall include, in information accompanying the declaration, at least the statutory definitions of terms used in the declaration, statutory restrictions on who may be witnesses to a valid declaration, a statement explaining that valid witnesses acting in good faith are statutorily immune from civil or criminal liability, an instruction to potential declarants to read and understand the information before completing the declaration and a statement explaining that an instrument may, but need not be, filed with the register in probate of the declarant's county of residence. The department may charge a reasonable fee for the cost of preparation and distribution. The declaration distributed by the department of health services shall be easy to read, the type size may be no smaller than 10 point, and the declaration shall be in the following form, setting forth on the first page the wording before the ATTENTION statement and setting forth on the 2nd page the ATTENTION statement and remaining wording:

SB184,9,15 Declaration to health care professionals

SB184,9,16 (WISCONSIN LIVING WILL)

SB184,9,23 I,...., being of sound mind, voluntarily state my desire that my dying not be prolonged under the circumstances specified in this document. Under those circumstances, I direct that I be permitted to die naturally. If I am unable to give directions regarding the use of life-sustaining procedures or feeding tubes, I intend that my family and physician, physician assistant, or advanced practice registered nurse honor this document as the final expression of my legal right to refuse medical or surgical treatment.

SB184,9,25 1. If I have a TERMINAL CONDITION, as determined by a physician, physician assistant, or advanced practice registered nurse who has personally examined me, and if a physician who has also personally examined me agrees with that determination, I do not want my dying to be artificially prolonged and I do not want life-sustaining procedures to be used. In addition, the following are my directions regarding the use of feeding tubes:

SB184,10,5 .... YES, I want feeding tubes used if I have a terminal condition.

SB184,10,6 .... NO, I do not want feeding tubes used if I have a terminal condition.

SB184,10,7 If you have not checked either box, feeding tubes will be used.

SB184,10,12 2. If I am in a PERSISTENT VEGETATIVE STATE, as determined by a physician, physician assistant, or advanced practice registered nurse who has personally examined me, and if a physician who has also personally examined me agrees with that determination, the following are my directions regarding the use of life-sustaining procedures:

SB184,10,14 .... YES, I want life-sustaining procedures used if I am in a persistent vegetative state.

SB184,10,16 .... NO, I do not want life-sustaining procedures used if I am in a persistent vegetative state.

SB184,10,17 If you have not checked either box, life-sustaining procedures will be used.

SB184,10,22 3. If I am in a PERSISTENT VEGETATIVE STATE, as determined by a physician, physician assistant, or advanced practice registered nurse who has personally examined me, and if a physician who has also personally examined me agrees with that determination, the following are my directions regarding the use of feeding tubes:

SB184,10,23 .... YES, I want feeding tubes used if I am in a persistent vegetative state.

SB184,10,24 .... NO, I do not want feeding tubes used if I am in a persistent vegetative state.

SB184,10,25 If you have not checked either box, feeding tubes will be used.

SB184,11,3 If you are interested in more information about the significant terms used in this document, see section 154.01 of the Wisconsin Statutes or the information accompanying this document.

SB184,11,5 ATTENTION: You and the 2 witnesses must sign the document at the same time.

SB184,11,6 Signed ....   Date ....

SB184,11,7 Address ....   Date of birth ....

SB184,11,11 I believe that the person signing this document is of sound mind. I am an adult and am not related to the person signing this document by blood, marriage or adoption. I am not entitled to and do not have a claim on any portion of the person's estate and am not otherwise restricted by law from being a witness.

SB184,11,12 Witness signature ....   Date signed ....

SB184,11,13 Print name ....

SB184,11,14 Witness signature ....   Date signed ....

SB184,11,15 Print name ....

SB184,11,16 DIRECTIVES TO ATTENDING PHYSICIAN,

SB184,11,17 PHYSICIAN ASSISTANT, OR ADVANCED

SB184,11,18 PRACTICE REGISTERED NURSE

SB184,11,23 1. This document authorizes the withholding or withdrawal of life-sustaining procedures or of feeding tubes when a physician and another physician, physician assistant, or advanced practice registered nurse, one of whom is the attending health care professional, have personally examined and certified in writing that the patient has a terminal condition or is in a persistent vegetative state.

SB184,12,4 2. The choices in this document were made by a competent adult. Under the law, the patient's stated desires must be followed unless you believe that withholding or withdrawing life-sustaining procedures or feeding tubes would cause the patient pain or reduced comfort and that the pain or discomfort cannot be alleviated through pain relief measures. If the patient's stated desires are that life-sustaining procedures or feeding tubes be used, this directive must be followed.

SB184,12,8 3. If you feel that you cannot comply with this document, you must make a good faith attempt to transfer the patient to another physician, physician assistant, or advanced practice registered nurse who will comply. Refusal or failure to make a good faith attempt to do so constitutes unprofessional conduct.

SB184,12,10 4. If you know that the patient is pregnant, this document has no effect during her pregnancy.

SB184,12,11 * * * * *

SB184,12,14 The person making this living will may use the following space to record the names of those individuals and health care providers to whom he or she has given copies of this document:

SB184,12,15 .................................................................

SB184,12,16 .................................................................

SB184,12,17 .................................................................

SB184,26 Section 26 . 154.07 (1) (a) (intro.) of the statutes is amended to read:

SB184,12,23 154.07 (1) (a) (intro.) No health care professional, inpatient health care facility or person licensed, certified, or registered under ch. 441, 448, or 455, or a person who holds a compact privilege under subch. IX X of ch. 448 acting under the direction of a health care professional may be held criminally or civilly liable, or charged with unprofessional conduct, for any of the following:

SB184,27 Section 27 . 165.77 (1) (a) of the statutes is amended to read:

SB184,13,3 165.77 (1) (a) “Health care professional" means a person licensed, certified, or registered under ch. 441, 448, or 455 or a person who holds a compact privilege under subch. IX X of ch. 448.

SB184,28 Section 28 . 252.01 (5) of the statutes is repealed.

SB184,29 Section 29 . 255.07 (1) (d) of the statutes is amended to read:

SB184,13,8 255.07 (1) (d) “Health care practitioner" means a physician, a physician assistant licensed under s. 448.04 (1) (f), or an advanced practice nurse who is certified to issue prescription orders under s. 441.16.

SB184,30 Section 30 . 343.16 (5) (a) of the statutes is amended to read:

SB184,14,7 343.16 (5) (a) The secretary may require any applicant for a license or any licensed operator to submit to a special examination by such persons or agencies as the secretary may direct to determine incompetency, physical or mental disability, disease, or any other condition that might prevent such applicant or licensed person from exercising reasonable and ordinary control over a motor vehicle. If the department requires the applicant to submit to an examination, the applicant shall pay for the examination. If the department receives an application for a renewal or duplicate license after voluntary surrender under s. 343.265 or receives a report from a physician, physician assistant, as defined in s. 448.01 (6), advanced practice nurse prescriber certified under s. 441.16 (2), or optometrist under s. 146.82 (3), or if the department has a report of 2 or more arrests within a one-year period for any combination of violations of s. 346.63 (1) or (5) or a local ordinance in conformity with s. 346.63 (1) or (5) or a law of a federally recognized American Indian tribe or band in this state in conformity with s. 346.63 (1) or (5), or s. 346.63 (1m), 1985 stats., or s. 346.63 (2) or (6) or 940.25, or s. 940.09 where the offense involved the use of a vehicle, the department shall determine, by interview or otherwise, whether the operator should submit to an examination under this section. The examination may consist of an assessment. If the examination indicates that education or treatment for a disability, disease or condition concerning the use of alcohol, a controlled substance or a controlled substance analog is appropriate, the department may order a driver safety plan in accordance with s. 343.30 (1q). If there is noncompliance with assessment or the driver safety plan, the department shall revoke the person's operating privilege in the manner specified in s. 343.30 (1q) (d).

SB184,31 Section 31 . 440.035 (2m) (b) of the statutes is amended to read:

SB184,14,14 440.035 (2m) (b) The medical examining board, the physician assistant affiliated credentialing board, the podiatry affiliated credentialing board, the board of nursing, the dentistry examining board, or the optometry examining board may issue guidelines regarding best practices in prescribing controlled substances for persons credentialed by that board who are authorized to prescribe controlled substances.

SB184,32 Section 32 . 440.035 (2m) (c) 1. (intro.) of the statutes is amended to read:

SB184,14,20 440.035 (2m) (c) 1. (intro.) The medical examining board, the physician assistant affiliated credentialing board, the podiatry affiliated credentialing board, the board of nursing, the dentistry examining board, and the optometry examining board shall, by November 1, 2018, and annually thereafter of each year, submit a report to the persons specified in subd. 2. that does all of the following:

SB184,33 Section 33 . 448.01 (6) of the statutes is repealed.

SB184,34 Section 34 . 448.015 (4) (am) 2. of the statutes is amended to read:

SB184,14,24 448.015 (4) (am) 2. Any act by a physician or physician assistant in violation of ch. 450 or 961.

SB184,35 Section 35 . 448.02 (1) of the statutes is amended to read:

SB184,15,4 448.02 (1) License. The board may grant licenses, including various classes of temporary licenses, to practice medicine and surgery, to practice as an administrative physician, to practice perfusion, and to practice as an anesthesiologist assistant, and to practice as a physician assistant.

SB184,36 Section 36 . 448.03 (1) (b) of the statutes is repealed.

SB184,37 Section 37 . 448.03 (2) (a) of the statutes is amended to read:

SB184,15,13 448.03 (2) (a) Any person lawfully practicing within the scope of a license, permit, registration, certificate or certification granted to practice midwifery under subch. XIII of ch. 440, to practice professional or practical nursing or nurse-midwifery under ch. 441, to practice chiropractic under ch. 446, to practice dentistry or dental hygiene under ch. 447, to practice optometry under ch. 449, to practice as a physician assistant under subch. VIII, to practice acupuncture under ch. 451 or under any other statutory provision, or as otherwise provided by statute.

SB184,38 Section 38 . 448.03 (2) (e) of the statutes is amended to read: