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March 19, 2019 - Introduced by Representatives Horlacher, Macco, Brooks,
Edming, Hutton, Meyers, Murphy, Mursau, Novak, Rodriguez, Skowronski,
Snyder, Spiros, Spreitzer, Steffen, Subeck, C. Taylor, Tusler, VanderMeer
and Wichgers, cosponsored by Senators Feyen, Bewley, Carpenter, Cowles,
Marklein, Nass, Olsen, Wanggaard and Wirch. Referred to Committee on
Health.
AB83,1,6 1An Act to amend subchapter I (title) of chapter 154 [precedes 154.01], 154.03
2(2) (intro.), 154.13 (title), 154.13 (1), 154.13 (2) (intro.), 154.13 (3), 155.30 (3)
3(intro.), 155.65 (title), 155.65 (1), 155.65 (2) (intro.) and 155.65 (3); and to
4create
154.015, 154.13 (1m) and 155.65 (1m) of the statutes; relating to:
5authorizing creation and implementation of an advance directive registry and
6granting rule-making authority.
Analysis by the Legislative Reference Bureau
This bill authorizes the Department of Health Services to develop and
implement a registry for power of attorney for health care instruments, declarations
to physicians, do-not-resuscitate orders, authorizations for final disposition, and
any other advance directives included by DHS. If DHS develops a registry, DHS may
promulgate rules to implement the registry.
Also, if a registry is established, DHS may determine whether to incorporate
advance directives previously filed with the county registers in probate. If DHS
decides to incorporate these advance directives, DHS must request the documents
from the registers in probate and the registers in probate must transfer a copy of the
documents to DHS. If DHS requests copies of any previously filed advance
directives, the registers in probate may not accept for filing new advance directives.

For further information see the state and local 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:
AB83,1 1Section 1 . Subchapter I (title) of chapter 154 [precedes 154.01] of the statutes
2is amended to read:
AB83,2,33 CHAPTER 154
AB83,2,44 SUBCHAPTER I
AB83,2,65 DEFINITIONS and
6 general provisions
AB83,2 7Section 2 . 154.015 of the statutes is created to read:
AB83,2,8 8154.015 Advance directive registry. (1) In this section:
AB83,2,99 (a) “Advance directive” has the meaning given in 42 CFR 489.100.
AB83,2,1110 (b) “Authorization for final disposition” has the meaning given in s. 154.30 (1)
11(a).
AB83,2,1212 (c) “Declaration” has the meaning given in s. 154.02 (1).
AB83,2,1313 (d) “Do-not-resuscitate order” has the meaning given in s. 154.17 (2).
AB83,2,1514 (e) “Power of attorney for health care instrument” means an instrument
15designating a power of attorney for health care executed under ch. 155.
AB83,3,6 16(2) The department may develop and implement a registry for power of
17attorney for health care instruments, declarations to physicians, do-not-resuscitate
18orders, authorizations for final disposition, and any other advance directives
19included by the department. If the department establishes a registry under this
20section, the department may incorporate advance directives previously filed with a
21county register in probate into the registry. If the department determines

1incorporation of advance directives is appropriate, the department shall request and
2the county registers in probate shall complete the transfer of a copy of any advance
3directives filed under s. 154.13 (1) or 155.65 (1) for inclusion by the department in
4the registry. The department shall notify the subject of the advance directive within
514 days of the transfer of a copy of the advance directive and provide information
6regarding the registry and access to advance directives included in the registry.
AB83,3,11 7(3) (a) Registration of a document or failure to register a document with a
8registry maintained by the department under this section does not affect the validity
9of the document. Failure to notify the department of the revocation of a document
10included on a registry under this section does not affect the validity of a revocation
11that otherwise meets the statutory requirements for revocation.
AB83,3,1412 (b) The department is not required to review a document submitted for
13inclusion on a registry under this section to determine whether the document
14complies with statutory requirements applicable to that document.
AB83,3,18 15(4) If an individual or a person authorized by that individual has submitted a
16copy of an advance directive to any registry established by the department under this
17section, the following persons may have access to that advance directive without first
18obtaining consent from the individual:
AB83,3,2019 (a) The person authorized by the individual who is the subject of the advance
20directive.
AB83,3,2121 (b) A health care provider who is providing care to the individual.
AB83,3,2522 (c) The court and all parties involved in proceedings in this state for
23adjudication of incompetency and appointment of a guardian for the individual, for
24emergency detention under s. 51.15, for involuntary commitment under s. 51.20, or
25for protective placement or protective services under ch. 55.
AB83,4,1
1(d) Any person under the order of a court for good cause shown.
AB83,4,3 2(5) The department may promulgate rules to implement any registry
3established under this section.
AB83,4,6 4(6) All data and information submitted to or contained in a registry under this
5section shall remain confidential and is not subject to public inspection or copying
6under s. 19.35 (1).
AB83,4,11 7(7) The department and its employees and agents are immune from liability
8for any act or omission, in good faith, relating to the creation, installation,
9implementation, operation, maintenance, or use of any registry established by the
10department under this section. This subsection does not limit immunity otherwise
11available under s. 893.80 (4).
AB83,3 12Section 3 . 154.03 (2) (intro.) of the statutes is amended to read:
AB83,5,513 154.03 (2) (intro.) The department shall prepare and provide copies of the
14declaration and accompanying information for distribution in quantities to health
15care professionals, hospitals, nursing homes, county clerks, and local bar
16associations and individually to private persons. The department shall include, in
17information accompanying the declaration, at least the statutory definitions of terms
18used in the declaration, statutory restrictions on who may be witnesses to a valid
19declaration, a statement explaining that valid witnesses acting in good faith are
20statutorily immune from civil or criminal liability, an instruction to potential
21declarants to read and understand the information before completing the
22declaration, and a statement explaining that an instrument may, but need not be,
23filed with the register in probate of the declarant's county of residence or submitted
24to any registry established by the department under s. 154.015
. The department
25may charge a reasonable fee for the cost of preparation and distribution. The

1declaration distributed by the department of health services shall be easy to read,
2the type size may be no smaller than 10 point, and the declaration shall be in the
3following form, setting forth on the first page the wording before the ATTENTION
4statement and setting forth on the 2nd page the ATTENTION statement and
5remaining wording:
AB83,4 6Section 4 . 154.13 (title) of the statutes is amended to read:
AB83,5,7 7154.13 (title) Filing or registering declaration.
AB83,5 8Section 5 . 154.13 (1) of the statutes is amended to read:
AB83,5,179 154.13 (1) A declarant or an individual authorized by the declarant may, for
10a fee, file the declarant's declaration, for safekeeping, with the register in probate of
11the county in which the declarant resides. If the department establishes an advance
12directive registry under s. 154.015 and determines under s. 154.015 (2) that
13incorporation of advance directives previously filed with the register in probate is
14appropriate, upon request from the department, the register in probate shall
15transfer a copy of any declarations filed under this subsection to the department and
16may not accept for filing any declarations after the request from the department is
17received.
AB83,6 18Section 6 . 154.13 (1m) of the statutes is created to read:
AB83,5,2119 154.13 (1m) A declarant or an individual authorized by the declarant may
20submit a copy of the declarant's declaration to any registry established by the
21department under s. 154.015.
AB83,7 22Section 7 . 154.13 (2) (intro.) of the statutes is amended to read:
AB83,6,223 154.13 (2) (intro.) If a declarant or authorized individual has filed the
24declarant's declaration as specified in sub. (1) or submitted a copy of the declaration

1under sub. (1m)
, the following persons may have access to the declaration without
2first obtaining consent from the declarant:
AB83,8 3Section 8 . 154.13 (3) of the statutes is amended to read:
AB83,6,64 154.13 (3) Failure to file a declaration under sub. (1) or submit a declaration
5under sub. (1m)
creates no presumption about the intent of an individual with regard
6to his or her health care decisions.
AB83,9 7Section 9 . 155.30 (3) (intro.) of the statutes is amended to read:
AB83,6,228 155.30 (3) (intro.) The department shall prepare and provide copies of a power
9of attorney for health care instrument and accompanying information for
10distribution in quantities to health care professionals, hospitals, nursing homes,
11multipurpose senior centers, county clerks, and local bar associations and
12individually to private persons. The department shall include, in information
13accompanying the copy of the instrument, at least the statutory definitions of terms
14used in the instrument, statutory restrictions on who may be witnesses to a valid
15instrument, a statement explaining that valid witnesses acting in good faith are
16statutorily immune from civil or criminal liability, and a statement explaining that
17an instrument may, but need not, be filed with the register in probate of the
18principal's county of residence or submitted to any registry established by the
19department under s. 154.015
. The department may charge a reasonable fee for the
20cost of preparation and distribution. The power of attorney for health care
21instrument distributed by the department shall include the notice specified in sub.
22(1) and shall be in the following form:
AB83,10 23Section 10 . 155.65 (title) of the statutes is amended to read:
AB83,6,24 24155.65 (title) Filing or registering power of attorney instrument.
AB83,11 25Section 11 . 155.65 (1) of the statutes is amended to read:
AB83,7,9
1155.65 (1) A principal or a principal's health care agent may, for a fee, file the
2principal's power of attorney for health care instrument, for safekeeping, with the
3register in probate of the county in which the principal resides. If the department
4establishes an advance directive registry under s. 154.015 and determines under s.
5154.015 (2) that incorporation of advance directives previously filed with the register
6in probate is appropriate, upon request from the department, the register in probate
7shall transfer a copy of any power of attorney for health care instrument filed under
8this subsection to the department and may not accept for filing any power of attorney
9health care instrument after the request from the department is received.
AB83,12 10Section 12 . 155.65 (1m) of the statutes is created to read:
AB83,7,1311 155.65 (1m) A principal or a principal's health care agent may submit a copy
12of the principal's power of attorney for health care instrument to any registry
13established by the department under s. 154.015.
AB83,13 14Section 13 . 155.65 (2) (intro.) of the statutes is amended to read:
AB83,7,1915 155.65 (2) (intro.) If a principal or health care agent has filed the principal's
16power of attorney for health care instrument as specified in sub. (1) or submitted a
17copy of the power of attorney for health care instrument in sub. (1m)
, the following
18persons may have access to the instrument without first obtaining consent from the
19principal:
AB83,14 20Section 14 . 155.65 (3) of the statutes is amended to read:
AB83,7,2421 155.65 (3) Failure to file a power of attorney for health care instrument under
22sub. (1) or to submit a power of attorney for health care instrument under sub. (1m)
23creates no presumption about the intent of an individual with regard to his or her
24health care decisions.
AB83,7,2525 (End)
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