146.645(2)(c)2.2. If the department receives matching federal Medical Assistance funds, the department shall distribute those funds for grants under par. (a) in addition to any funds distributed under subd. 1. 146.645(2)(d)(d) In awarding grants under par. (a), the department shall give preference to graduate medical training consortia that are the sponsoring institutions for graduate medical training programs in rural hospitals that have limited or no direct access to graduate medical training funding from the federal centers for medicare and medicaid services or have reached the maximum available amount of graduate medical training funding from the federal centers for medicare and medicaid services. 146.645(3)(3) Eligibility. A graduate medical training consortium may only receive a grant under this section if the graduate medical training consortium includes at least one partner rural hospital or health system. 146.645(4)(4) Grant application. Except as provided in sub. (2) (a) 2., a graduate medical training consortium may apply, in the manner determined by the department, to receive a grant under sub. (2) (a). A graduate medical training consortium shall identify all of the partner rural hospitals and health systems in the consortium in its grant application. 146.645(5)(5) Grant nonrenewal. A graduate medical training consortium that receives a grant under sub. (2) (a) shall notify the department, in the manner determined by the department, if the consortium no longer satisfies the criteria established by the department under sub. (2) (b) or the eligibility requirement under sub. (3), the consortium is not accredited as a sponsoring institution by the Accreditation Council for Graduate Medical Education, or any successor organization, or another accrediting body as determined by the department, or the consortium no longer wishes to receive the grant. 146.645(6)(6) Accreditation. A graduate medical training consortium shall, within 12 months of receiving a grant under sub. (2) (a), obtain and maintain accreditation as a sponsoring institution by the Accreditation Council for Graduate Medical Education, or any successor organization, or another accrediting body as determined by the department. 146.645(7)(7) Effect on graduate medical training expansion grants. The receipt of a grant under this section by a graduate medical training consortium does not affect the eligibility for a grant under s. 146.64 of any hospital that has an accredited graduate medical training program facilitated, organized, or implemented by the graduate medical training consortium. 146.645 HistoryHistory: 2023 a. 185. 146.65146.65 Rural health dental clinics. 146.65(1)(1) From the appropriation account under s. 20.435 (1) (dm), the department shall distribute moneys as follows: 146.65(1)(a)(a) In each fiscal year, not more than $232,000, to the rural health dental clinic located in Ladysmith that provides dental services to persons who are developmentally disabled or elderly or who have low income, in the counties of Rusk, Price, Taylor, Sawyer, and Chippewa. 146.65(1)(b)(b) In each fiscal year, not more than $355,600, to the rural health dental clinic located in Menomonie that provides dental services to persons who are developmentally disabled or elderly or who have low income, in the counties of Barron, Chippewa, Dunn, Pepin, Pierce, Polk, and St. Croix. 146.65(1)(c)(c) In each fiscal year, not more than $400,000, to a rural health clinic in Chippewa Falls to provide dental services to persons who are developmentally disabled or elderly or who have low income, in the area surrounding Chippewa Falls, including the counties of Chippewa, Dunn, Barron, Taylor, Clark, and Eau Claire. 146.65(2)(2) The department shall also seek federal funding to support the operations of the rural health dental clinics under sub. (1). 146.66146.66 Low-income dental clinics. 146.66(1)(1) From the appropriation account under s. 20.435 (1) (dk), in each fiscal year, the department shall award grants to no fewer than 9 nonprofit dental clinics that meet the eligibility requirements under sub. (2) and are located in this state. 146.66(2)(2) To be eligible for a grant under sub. (1), a nonprofit dental clinic must satisfy all of the following requirements: 146.66(2)(b)(b) The clinic’s primary purpose is to provide dental care to low-income patients, which may include any of the following individuals: 146.66(3)(3) The department shall seek federal funding to support the operations of dental clinics that receive grants under sub. (1) and shall request that the federal department of health and human services encourage collaborative arrangements between private dentists and health centers that receive federal funds under 42 USC 254b. 146.66 HistoryHistory: 2011 a. 32. 146.68146.68 Grant for colposcopies and other services. From the appropriation account under s. 20.435 (1) (dg), the department shall provide $75,000 in each fiscal year to an entity that satisfies the following criteria to provide colposcopic examinations and to provide services to medical assistance recipients or persons who are eligible for medical assistance: 146.68(1)(1) The entity is located in the western or northern public health region of the state, as determined by the department. 146.68(2)(2) The entity provides Papanicolaou tests, and at least 50 percent of the persons for whom the entity provides Papanicolaou tests are recipients of medical assistance or are eligible for medical assistance. 146.68 HistoryHistory: 2007 a. 20; 2009 a. 28. 146.69146.69 Grants for the Surgical Collaborative of Wisconsin. The department shall award a grant in an amount of $150,000 per fiscal year to the Surgical Collaborative of Wisconsin. Effective date noteNOTE: This section is repealed eff. 7-1-25 by 2023 Wis. Act 19. 146.69 HistoryHistory: 2023 a. 19. 146.71146.71 Determination of death. An individual who has sustained either irreversible cessation of circulatory and respiratory functions or irreversible cessation of all functions of the entire brain, including the brain stem, is dead. A determination of death shall be made in accordance with accepted medical standards. 146.71 HistoryHistory: 1981 c. 134. 146.71 AnnotationTo determine whether an infant was “born alive” under s. 939.22 (16) for purposes of the homicide laws, courts apply this section. State v. Cornelius, 152 Wis. 2d 272, 448 N.W.2d 434 (Ct. App. 1989). 146.81(1)(1) “Health care provider” means any of the following: 146.81 NoteNOTE: Par. (c) is shown as amended by 2023 Wis. Acts 87 and 88 and as merged by the legislative reference bureau under s. 13.92 (2) (i). 146.81(1)(d)(d) A physician, perfusionist, or respiratory care practitioner licensed or certified under subch. II of ch. 448. 146.81(1)(dc)(dc) A naturopathic doctor or limited-scope naturopathic doctor licensed under ch. 466. 146.81 NoteNOTE: Par. (dg) is shown as affected by 2021 Wis. Acts 23 and 251 and as merged by the legislative reference bureau under s. 13.92 (2) (i). The cross-reference to subch. XI of ch. 448 was changed from subch. X of ch. 448 by the legislative reference bureau under s. 13.92 (1) (bm) 2. to reflect the renumbering under s. 13.92 (1) (bm) 2. of subch. X of ch. 448. 146.81 NoteNOTE: The cross-reference to subch. XII of ch. 448 was changed from subch. XI of ch. 448 by the legislative reference bureau under s. 13.92 (1) (bm) 2. to reflect the renumbering under s. 13.92 (1) (bm) 2. of subch. XI of ch. 448.
146.81 NoteNOTE: The cross-reference to subch. IX of ch. 448 was changed from subch. VIII of ch. 448 by the legislative reference bureau under s. 13.92 (1) (bm) 2. to reflect the renumbering under s. 13.92 (1) (bm) 2. of subch. VIII of ch. 448.
146.81(1)(fm)(fm) A pharmacist or pharmacy technician licensed or registered under ch. 450. 146.81(1)(h)(h) A psychologist who is licensed under ch. 455, who is exercising the temporary authorization to practice, as defined in s. 455.50 (2) (o), in this state, or who is practicing under the authority to practice interjurisdictional telepsychology, as defined in s. 455.50 (2) (b). 146.81(1)(hg)(hg) A social worker, marriage and family therapist, or professional counselor certified or licensed under subch. I of ch. 457 or a professional counselor who is exercising the privilege to practice, as defined in s. 457.50 (2) (s), in this state. 146.81(1)(hm)(hm) A speech-language pathologist or audiologist who is licensed under subch. II of ch. 459 or who holds a compact privilege under subch. III of ch. 459, or a speech and language pathologist licensed by the department of public instruction. 146.81(1)(hp)(hp) A massage therapist or bodywork therapist licensed under ch. 460. 146.81(1)(j)(j) A corporation or limited liability company of any providers specified under pars. (a) to (hp) that provides health care services. 146.81(1)(k)(k) A cooperative health care association organized under s. 185.981 that directly provides services through salaried employees 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; and all records made by an ambulance service provider, as defined in s. 256.01 (3), an emergency medical services practitioner, as defined in s. 256.01 (5), or an emergency medical responder, as defined in s. 256.01 (4p), in administering emergency care procedures to and handling and transporting sick, disabled, or injured individuals. “Patient health care records” includes billing statements and invoices for treatment or services provided by a health care provider and includes health summary forms prepared under s. 302.388 (2). “Patient health care records” does not include those records subject to s. 51.30, reports collected under s. 69.186, records of tests administered under s. 252.15 (5g) or (5j), 343.305, 938.296 (4) or (5) or 968.38 (4) or (5), records related to sales of pseudoephedrine products, as defined in s. 961.01 (20c), that are maintained by pharmacies under s. 961.235, 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 adjudicated incompetent in this state, the personal representative, spouse, or domestic partner under ch. 770 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 or domestic partner 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 HistoryHistory: 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; 1997 a. 27, 67, 75, 156, 175; 1999 a. 9, 32, 151, 180, 188; 2001 a. 38, 70, 74, 80, 89; 2005 a. 262, 387; 2007 a. 108; 2009 a. 28, 165, 209, 355; 2015 a. 195 s. 83; 2015 a. 265; 2017 a. 12; 2019 a. 100; 2021 a. 23 ss. 19, 20, 71; 2021 a. 100, 123, 130, 131, 251; 2023 a. 55, 56, 81, 87, 88; s. 13.92 (1) (bm) 2.; s. 13.92 (2) (i). 146.81 AnnotationA letter written by a person not licensed as a health care provider under sub. (1) was not a record under sub. (4) prepared under the supervision of a health care provider under sub. (1) (j) when the person was employed by a corporation that employed health care professionals but the corporation’s shareholders were not health care providers. Hart v. Bennet, 2003 WI App 231, 267 Wis. 2d 919, 672 N.W.2d 306, 02-2933. 146.81 AnnotationWhen a health care provider denied access to records on the ground that the patient was possibly incompetent to consent to the release of the records, it was obligated under sub. (5) to petition for a temporary guardian for the patient. Szymczak v. Terrace at St. Francis, 2006 WI App 3, 289 Wis. 2d 110, 709 N.W.2d 103, 04-2067. 146.81 AnnotationThe plaintiff in this case failed to state a claim that the defendant health care provider violated s. 146.83 (4) (b). The plaintiff did not allege that the defendant withheld any record when it alleged that the defendant concealed the results of an internal investigation into why and under what authority its employees had accessed the plaintiff’s health care records. Any records the defendant might have kept regarding its internal investigation would not have related to the plaintiff’s health or any treatment or services received. Accordingly, such information, even if reduced to a record, would not have constituted a patient health care record, as that term is defined in sub. (4). Wall v. Pahl, 2016 WI App 71, 371 Wis. 2d 716, 886 N.W.2d 373, 15-1230. 146.81 AnnotationThe context of the definition of “person authorized by the patient” in sub. (5) indicates that “any person authorized in writing by the patient” is a stand-alone category, separate and apart from the remaining categories, containing no limitations beyond those expressly written. This language requires only a person with a written authorization from the patient. The statute does not require that the authorization be an authorization to make health care decisions on behalf of the patient. Moya v. Aurora Healthcare, Inc., 2017 WI 45, 375 Wis. 2d 38, 894 N.W.2d 405, 14-2236.
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