Ch. DHS 145 NoteNote: Chapter HSS 145 was renumbered chapter HFS 145 under s. 13.93 (2m) (b) 1., Stats., and corrections made under s. 13.93 (2m) (b) 6. and 7., Stats., Register, June, 1997, No. 498. Chapter HFS 145 was renumbered chapter DHS 145 under s. 13.92 (4) (b) 1., Stats., and corrections made under s. 13.92 (4) (b) 7., Stats., Register January 2009 No. 637. DHS 145.01 HistoryHistory: Cr. Register, April, 1984, No. 340, eff. 5-1-84; corrections made under s. 13.93 (2m) (b) 7., Stats., Register, August, 1995, No. 476; am. Register, March, 2000, No. 531, eff. 4-1-00; correction made under s. 13.93 (2m) (b) 7., Stats., Register, March, 2002 No. 555; CR 01-105: am. Register March 2002 No. 555, eff. 4-1-02. DHS 145.02DHS 145.02 Purpose and scope. This chapter establishes a surveillance system for the purpose of controlling the incidence and spread of communicable diseases. This surveillance system consists of timely and effective communicable disease reporting, means of intervention to prevent transmission of communicable diseases, and investigation, prevention and control of outbreaks by local health officers and the department, and in addition provides information otherwise pertinent to understanding the burden of communicable disease on the general population. DHS 145.02 HistoryHistory: Cr. Register, April, 1984, No. 340, eff. 5-1-84; am. Register, March, 2000, No. 531, eff. 4-1-00. DHS 145.03DHS 145.03 Definitions. In this chapter: DHS 145.03(1)(1) “Advanced practice nurse prescriber” means an advanced practice nurse, as defined in s. N 8.02 (1), who under s. 441.16 (2), Stats., has been granted a certificate to issue prescription orders. DHS 145.03(2)(2) “Case” means a person determined to have a particular communicable disease on the basis of clinical or laboratory criteria or both. DHS 145.03(3)(3) “Chief medical officer” means the person appointed by the state health officer under s. 250.02 (2), Stats., to provide public health consultation and leadership in the program area of acute and communicable disease and who serves also as state epidemiologist for that program area. DHS 145.03(4)(4) “Communicable disease” means a disease or condition listed in Appendix A of this chapter. DHS 145.03(5)(5) “Control” means to take actions designed to prevent the spread of communicable diseases. DHS 145.03(6)(6) “Conveyance” means any publicly or privately owned vehicle used for providing transportation services. DHS 145.03(7)(7) “Date of onset” means the day on which the case or suspected case experienced the first sign or symptom of the communicable disease. DHS 145.03(8)(8) “Day care center” has the meaning prescribed in s. 48.65, Stats., and includes nursery schools that fit that definition. DHS 145.03(9)(9) “Department” means the department of health services. DHS 145.03(10)(10) “Food handler” means a person who handles food utensils or who prepares, processes or serves food or beverages for people other than members of his or her immediate household. DHS 145.03(11)(11) “Health care facility” has the meaning prescribed in s. 155.01 (6), Stats., and includes providers of ambulatory health care. DHS 145.03(13)(13) “Individual case report form” means the form provided by the department for the purpose of reporting communicable diseases. DHS 145.03(14)(14) “Investigation” means a systematic inquiry designed to identify factors which contribute to the occurrence and spread of communicable diseases. DHS 145.03(16)(16) “Local health department” means an agency of local government that takes any of the forms specified in s. 250.01 (4), Stats. DHS 145.03(17)(17) “Local health officer” has the meaning prescribed in s. 250.01 (5), Stats., and applies to the person who is designated as the local health officer for the place of residence of a case or suspected case of communicable disease. DHS 145.03(18)(18) “Organized program of infection control” means written and implemented policies and procedures for the purpose of surveillance, investigation, control and prevention of infections in a health care facility. DHS 145.03(19)(19) “Other disease or condition having the potential to affect the health of other persons” means a disease that can be transmitted from one person to another but that is not listed in Appendix A of this chapter and therefore is not reportable under this chapter, although it is listed in the official report of the American Public Health Association, unless specified otherwise by the state epidemiologist. DHS 145.03 NoteNote: The official report of the American Public Health Association entitled Control of Communicable Diseases Manual, 20th edition (2015), edited by David L. Heymann, is on file in the Department’s Division of Public Health and the Legislative Reference Bureau, and is available for purchase from the American Public Health Association, Publications Sales, PO Box 933019, Atlanta, GA 31193-3019.
DHS 145.03(20)(20) “Outbreak” means an unusual aggregation of health events that are grouped together in a short time period and limited geographic area. DHS 145.03(21)(21) “Personal care” means the service provided by one person to another person who is not a member of his or her immediate household for the purpose of feeding, bathing, dressing, assisting with personal hygiene, changing diapers, changing bedding and other services involving direct physical contact. DHS 145.03(22)(22) “Physician” means an individual possessing the degree of doctor of medicine or doctor of osteopathy or an equivalent degree as determined by the medical examining board, and holding a license granted by the board under s. 448.01 (5), Stats. DHS 145.03(23)(23) “Public building” means any privately or publicly owned building which is open to the public. DHS 145.03(24)(24) “Public health intervention” means an action designed to promote and protect the health of the public. DHS 145.03(25)(25) “State epidemiologist” means the person appointed by the state health officer under s. 250.02 (1), Stats., to be the person in charge of communicable disease control for the state who serves also as chief medical officer for the acute and communicable disease program area. DHS 145.03(26)(26) “Surveillance” means the systematic collection of data pertaining to the occurrence of specific diseases, the analysis and interpretation of these data and the dissemination of consolidated and processed information to those who need to know. DHS 145.03(27)(27) “Suspected case” means a person thought to have a particular communicable disease on the basis of clinical or laboratory criteria or both. DHS 145.03 HistoryHistory: Cr. Register, April, 1984, No. 340, eff. 5-1-84; am. (2) and (11), Register, February, 1989, No. 398, eff. 3-1-89; correction in (8) and (9) made under s. 13.93 (2m) (b) 7., Stats., Register, August, 1995, No. 476; r. and recr. Register, March, 2000, No. 531, eff. 4-1-00; CR 07-090: am. (19) and (20) Register February 2008 No. 626, eff. 3-1-08; correction in (9) made under s. 13.92 (4) (b) 6., Stats., Register January 2009 No. 637; CR 17-014: am. (19), Register June 2018 No. 750 eff. 7-1-18; correction in (19) made under s. 35.17, Stats., Register June 2018 No. 750. DHS 145.04DHS 145.04 Reports of communicable diseases. DHS 145.04(1)(a)(a) Any person licensed under ch. 441 or 448, Stats., knowing of or in attendance on a case or suspected case shall notify the local health officer or, if required under Appendix A of this chapter, the state epidemiologist, in the manner prescribed in this section. DHS 145.04(1)(b)(b) Each laboratory shall report the identification or suspected identification of a disease-causing organism or laboratory findings indicating the presence of a communicable disease to the local health officer or, if required under Appendix A of this chapter, to the state epidemiologist. DHS 145.04(1)(bg)(bg) Each laboratory shall forward a specimen to the state laboratory of hygiene, or another laboratory designated by the state epidemiologist, for confirmatory or investigation purposes if requested by the state epidemiologist. DHS 145.04(1)(br)(br) Each laboratory shall report a negative test result to the local health officer to justify release from isolation or quarantine if requested by the state epidemiologist or the local health officer. DHS 145.04(1)(c)(c) Each health care facility shall ensure that reports are made to the local health officer or, if required under Appendix A of this chapter, to the state epidemiologist, in the manner specified in sub. (3). When a case is identified or suspected in a health care facility having an organized program of infection control, the person in charge of the infection control program shall ensure that the case or suspected case is reported to the local health officer or, if required under Appendix A of this chapter, to the state epidemiologist, minimizing unnecessary duplication. DHS 145.04(1)(cm)(cm) Each health care facility shall report a negative test result to the local health officer to justify release from isolation or quarantine if requested by the state epidemiologist or the local health officer. DHS 145.04(1)(d)(d) Any teacher, principal or nurse serving a school or day care center knowing of a case or suspected case in the school or center shall notify the local health officer or, if required under Appendix A of this chapter, the state epidemiologist, in the manner prescribed in this section. DHS 145.04(1)(e)(e) Any person who knows or suspects that a person has a communicable disease shall report the facts to the local health officer or, if required under Appendix A of this chapter, to the state epidemiologist. DHS 145.04(1)(g)(g) Nothing in this subsection lessens the requirement for confidentiality of HIV test results under s. 252.15, Stats. DHS 145.04(2)(a)(a) Each report under sub. (1) (a) to (d) of a case or suspected case of a communicable disease to the local health officer or the state epidemiologist shall include the name and address of the person reporting and of the attending physician, if any, the diagnosed or suspected disease, the name of the ill or affected individual, that individual’s address and telephone number, age or date of birth, race and ethnicity, sex, county of residence, date of onset of the disease, name of parent or guardian if a minor, and other facts the department or local health officer requires for the purposes of surveillance, control and prevention of communicable disease. DHS 145.04(2)(b)(b) Reports may be written, verbal, or by electronic transmission. Written reports shall be on the individual case report form provided by the department and distributed by the local health officer or on a form containing the information required under par. (a). Reports shall be submitted to the local health officer or, if required under Appendix A of this chapter, to the state epidemiologist. DHS 145.04(2)(c)(c) Reports by laboratories of the identification or suspected identification of a disease-causing organism or laboratory findings indicating the presence of a communicable disease shall be made to the local health officer or, if required under Appendix A of this chapter, to the state epidemiologist. These reports shall include the name of the individual affected or ill, the individual’s address, telephone number, county of residence, age or date of birth, the name of the attending physician and the identity or suspected identity of the organism or the laboratory findings. DHS 145.04(2)(d)(d) All information provided under this subsection shall remain confidential except as may be needed for the purposes of investigation, control and prevention of communicable diseases. DHS 145.04(3)(a)(a) A person, laboratory or health care facility required to report under sub. (1) shall report communicable diseases of urgent public health importance as listed in category I of Appendix A of this chapter to the local health officer immediately upon identification of a case or suspected case. If the local health officer is unavailable, the report shall be made immediately to the state epidemiologist. DHS 145.04(3)(b)(b) A person, laboratory or health care facility required to report under sub. (1) shall report communicable diseases of less urgent public health importance as listed in categories II and III of Appendix A of this chapter to the local health officer or, if required under Appendix A, to the state epidemiologist, by individual case report form or by telephone within 72 hours of the identification of a case or suspected case. DHS 145.04(4)(4) Handling of reports by the local health officer. DHS 145.04(4)(a)(a) The local health officer shall notify the state epidemiologist immediately of any cases or suspected cases reported under sub. (3) (a). DHS 145.04(4)(b)(b) At the close of each week, the local health officer shall notify the state epidemiologist in writing on a form provided by the department of all cases of reported diseases listed in Appendix A. DHS 145.04(4)(c)(c) Local health departments serving jurisdictions within the same county may, in conjunction with the department, establish a combined reporting system to expedite the reporting process. DHS 145.04 HistoryHistory: Cr. Register, April, 1984, No. 340, eff. 5-1-84; am. (1), (2) (a) to (c), (3) (a) and (b), cr. (1m), Register, February, 1989, No. 398, eff. 3-1-89; correction in (1m) made under s. 13.93 (2m) (b) 7., Stats., Register, August, 1995, No. 476; renum. and am. (1m) to be (1) (g), am. (3) (a), (4) (a) and cr. (4) (c), Register, March, 2000, No. 531, eff. 4-1-00; CR 07-090: cr. (1) (bg), (br) and (cm), am. (2) (b), r. (3) (c) Register February 2008 No. 626, eff. 3-1-08. DHS 145.05DHS 145.05 Investigation and control of communicable diseases. DHS 145.05(1)(1) The local health officer shall use all reasonable means to confirm in a timely manner any case or suspected case of a communicable disease and shall ascertain so far as possible all sources of infection and exposures to the infection. Follow-up and investigative information shall be completed by the local health officer and reported to the state epidemiologist on forms provided by the department. DHS 145.05(2)(2) Local health officers shall follow the methods of control set out in official reports of the American Public Health Association and the American Academy of Pediatrics, unless specified otherwise by the state epidemiologist. Specific medical treatment shall be prescribed by a physician or an advanced practice nurse prescriber. DHS 145.05(3)(3) Any person licensed under ch. 441 or 448, Stats., attending a person with a communicable disease shall instruct the person in the applicable methods of control contained in official reports of the American Public Health Association and the American Academy of Pediatrics, unless specified otherwise by the state epidemiologist, and shall cooperate with the local health officer and the department in their investigation and control procedures. DHS 145.05(4)(4) The department in cooperation with the local health officer shall institute special disease surveillances, follow-up reports and control measures consistent with contemporary epidemiologic practice in order to study and control any apparent outbreak or unusual occurrence of communicable diseases. DHS 145.05 NoteNote: The official report of the American Public Health Association entitled Control of Communicable Diseases Manual, 20th edition (2015), edited by David L. Heymann, is available for purchase from the American Public Health Association, Publications Sales, PO Box 933019, Atlanta, GA 31193-3019. The official report of the American Academy of Pediatrics entitled Red Book: 2015 Report of the Committee on Infectious Diseases, 30th edition (2015), edited by David W. Kimberlin is available for purchase from the American Academy of Pediatrics, 141 Northwest Point Blvd, Elk Grove Village, IL 60007-1019. These reports are on file in the Department’s Division of Public Health and the Legislative Reference Bureau.
DHS 145.05 HistoryHistory: Cr. Register, April, 1984, No. 340, eff. 5-1-84; am. (2) and (3), Register, February, 1989, No. 398, eff. 3-1-89; am. (2) and (3), Register, March, 2000, No. 531, eff. 4-1-00; CR 03-033: am. (2) and (3) Register December 2003 No. 576, eff. 1-1-04; CR 07-090: am. (2) and (3) Register February 2008 No. 626, eff. 3-1-08; CR 17-014: am. (2), (3), Register June 2018 No. 750 eff. 7-1-18. DHS 145.06DHS 145.06 General statement of powers for control of communicable disease. DHS 145.06(1)(1) Applicability. The general powers under this section apply to all communicable diseases listed in Appendix A of this chapter and any other infectious disease which the chief medical officer deems poses a threat to the citizens of the state. DHS 145.06(2)(2) Persons whose substantiated condition poses a threat to others. A person may be considered to have a contagious medical condition which poses a threat to others if that person has been medically diagnosed as having any communicable disease and exhibits any of the following: DHS 145.06(2)(a)(a) A behavior which has been demonstrated epidemiologically to transmit the disease to others or which evidences a careless disregard for the transmission of the disease to others. DHS 145.06(2)(b)(b) Past behavior that evidences a substantial likelihood that the person will transmit the disease to others or statements of the person that are credible indicators of the person’s intent to transmit the disease to others. DHS 145.06(2)(c)(c) Refusal to complete a medically directed regimen of examination and treatment necessary to render the disease noncontagious. DHS 145.06(2)(d)(d) A demonstrated inability to complete a medically directed regimen of examination and treatment necessary to render the disease noncontagious, as evidenced by any of the following: DHS 145.06(2)(d)1.1. A diminished capacity by reason of use of mood-altering chemicals, including alcohol. DHS 145.06(2)(d)2.2. A diagnosis as having significantly below average intellectual functioning. DHS 145.06(2)(d)3.3. An organic disorder of the brain or a psychiatric disorder of thought, mood, perception, orientation or memory. DHS 145.06(2)(d)4.4. Being a minor, or having a guardian appointed under ch. 54, Stats., following documentation by a court that the person is incompetent. DHS 145.06(2)(e)(e) Misrepresentation by the person of substantial facts regarding the person’s medical history or behavior, which can be demonstrated epidemiologically to increase the threat of transmission of disease. DHS 145.06(2)(f)(f) Any other willful act or pattern of acts or omission or course of conduct by the person which can be demonstrated epidemiologically to increase the threat of transmission of disease to others. DHS 145.06(3)(3) Persons whose suspected condition poses a threat to others. A person may be suspected of harboring a contagious medical condition which poses a threat to others if that person exhibits any of the factors noted in sub. (2) and, in addition, demonstrates any of the following without medical evidence which refutes it: DHS 145.06(3)(a)(a) Has been linked epidemiologically to exposure to a known case of communicable disease. DHS 145.06(3)(b)(b) Has clinical laboratory findings indicative of a communicable disease. DHS 145.06(3)(c)(c) Exhibits symptoms that are medically consistent with the presence of a communicable disease. DHS 145.06(4)(4) Authority to control communicable diseases. When it comes to the attention of an official empowered under s. 250.02 (1), 250.04 (1) or 252.02 (4) and (6), Stats., or under s. 252.03 (1) and (2), Stats., that a person is known to have or is suspected of having a contagious medical condition which poses a threat to others, the official may direct that person to comply with any of the following, singly or in combination, as appropriate: DHS 145.06(4)(a)(a) Participate in a designated program of education or counseling. DHS 145.06(4)(b)(b) Participate in a defined program of treatment for the known or suspected condition. DHS 145.06(4)(c)(c) Undergo examination and tests necessary to identify a disease, monitor its status or evaluate the effects of treatment on it.
