DHS 145.10(6)(d)(d) Order the confinement of a person if the local health officer or the department decides that confinement is necessary and all of the following conditions are met: DHS 145.10(6)(d)1.1. The department or local health officer notifies a court in writing of the confinement. DHS 145.10(6)(d)2.2. The department or local health officer provides to the court a written statement from a physician that the person has infectious tuberculosis or suspected tuberculosis. DHS 145.10(6)(d)3.3. The department or local health officer provides to the court evidence that the person has refused to follow a prescribed treatment regimen or, in the case of a person with suspected tuberculosis, has refused to undergo a medical examination under par. (a) to confirm whether the person has infectious tuberculosis. DHS 145.10(6)(d)4.4. In the case of a person with a confirmed diagnosis of infectious tuberculosis, the department or local health officer determines that the person poses an imminent and substantial threat to himself or herself or to the public health. The department or the local health officer shall provide to the court a written statement of that determination. DHS 145.10(6)(e)(e) If the department or local health officer orders the confinement of a person under par. (d), a law enforcement officer, or other person authorized by the local public health officer, shall transport the person, if necessary, to a location that the department or local health officer determines will meet the person’s need for medical evaluation, isolation and treatment. DHS 145.10(6)(f)(f) No person may be confined under par. (d) for more than 72 hours, excluding Saturdays, Sundays and legal holidays, without a court hearing under sub. (7) to determine whether the confinement should continue. DHS 145.10(7)(a)(a) If the department or a local health officer wishes to confine a person for more than 72 hours, the department or a local health officer may petition any court for a hearing to determine whether a person with infectious or suspected tuberculosis should be confined for longer than 72 hours. The department or local health officer shall include in the petition documentation that demonstrates all the following: DHS 145.10(7)(a)1.1. The person named in the petition has infectious tuberculosis; the person has noninfectious tuberculosis but is at high risk of developing infectious tuberculosis; or that the person has suspected tuberculosis. DHS 145.10(7)(a)2.2. The person has failed to comply with the prescribed treatment regimen or with any rules promulgated by the department under s. 252.07 (11), Stats.; or that the disease is resistant to the medication prescribed to the person. DHS 145.10(7)(a)3.3. All other reasonable means of achieving voluntary compliance with treatment have been exhausted and no less restrictive alternative exists; or that no other medication to treat the resistant disease is available. DHS 145.10(7)(a)4.4. The person poses an imminent and substantial threat to himself or herself or to the public health. DHS 145.10(7)(b)(b) If the department or a local health officer petitions the court for a hearing under par. (a), the department or local health officer shall provide the person who is the subject of the petition written notice of a hearing at least 48 hours before a scheduled hearing is to be held. Notice of the hearing shall include all the following information: DHS 145.10(7)(b)2.2. The grounds, and underlying facts, upon which confinement of the person is being sought. DHS 145.10(8)(8) A person who is the subject of a petition for a hearing under sub. (6) (a) has the right to appear at the hearing, the right to present evidence and cross-examine witnesses and the right to be represented by counsel. At the time of the filing of the petition, the court shall assure that the person who is the subject of the petition is represented by counsel. If the person claims or appears to be indigent, the court shall refer the person to the authority for indigency determinations under s. 977.07 (1), Stats. If the person is a child, the court shall refer that child to the state public defender who shall appoint counsel for the child without a determination of indigency, as provided in s. 48.23 (4), Stats. Unless good cause is shown, a hearing under this paragraph may be conducted by telephone or live audiovisual means, if available. DHS 145.10(9)(9) An order issued by the court under sub. (6) (a) may be appealed as a matter of right. An appeal shall be heard within 30 days after the appeal is filed. An appeal does not stay the order. DHS 145.10(10)(10) If the court orders confinement of a person under sub. (6) (a), the person shall remain confined until the department or local health officer, with the concurrence of a treating physician, determines that treatment is complete or that the person is no longer a substantial threat to himself or herself or to the public health. If the person is to be confined for more than 6 months, the court shall review the confinement every 6 months, beginning with the conclusion of the initial 6-month confinement period. DHS 145.10(11)(a)(a) If the administrative officer of the facility where a person is isolated or confined has good cause to believe that the person may leave the facility, the officer shall use any legal means to restrain the person from leaving. DHS 145.10(11)(b)(b) The local health officer or a person designated by the local health officer shall monitor all persons under isolation or confinement as needed to ascertain that the isolation or confinement is being maintained. DHS 145.10(11)(c)(c) The local health officer or a person designated by the local health officer shall monitor all persons with tuberculosis disease until treatment is successfully completed. DHS 145.10(12)(12) The local health officer or the department may order an examination of a contact to detect tuberculosis. Contacts shall be reexamined at times and in a manner as the local health officer may require. DHS 145.10 HistoryHistory: Cr. Register, April, 1984, No. 340, eff. 5-1-84; r. and recr. Register, March, 2000, No. 531, eff. 4-1-00; CR 01-105: r. and recr. Register March 2002 No. 555, eff. 4-1-02; CR 07-090: am. (1) Register February 2008 No. 626, eff. 3-1-08; CR 17-014: am. (1), Register June 2018 No. 750 eff. 7-1-18. DHS 145.11DHS 145.11 Discharge from isolation or confinement. The local health officer or the department shall authorize the release of a person from isolation or confinement if all the following conditions are met: DHS 145.11(1)(1) An adequate course of chemotherapy has been administered for a minimum of 2 weeks and there is clinical evidence of improvement, such as a decrease in symptom severity, radiographic findings indicating improvement, or other medical determination of improvement. DHS 145.11(2)(2) Sputum or bronchial secretions are free of acid–fast bacilli. DHS 145.11(3)(3) Specific arrangements have been made for post–isolation or post–confinement care. DHS 145.11(4)(4) The person is considered by the local health officer or the department not to be a threat to the health of the general public and is likely to comply with the remainder of the treatment regimen. DHS 145.11 HistoryHistory: Cr. Register, April, 1984, No. 340, eff. 5-1-84; r. and recr. Register, March, 2000, No. 531, eff. 4-1-00; CR 01-105: r. and recr. Register March 2002 No. 555, eff. 4-1-02. DHS 145.12DHS 145.12 Certification of public health dispensaries. DHS 145.12(1)(1) A local health department or 2 or more local health departments jointly may be certified by the department as a public health dispensary under s. 252.10, Stats., if the public health dispensary provides or ensures provision of all of the following: DHS 145.12(1)(b)(b) Medication for treatment of tuberculosis disease and infection. DHS 145.12(2)(2) A local health department that meets the requirements under sub. (1) and wishes to be certified as a public health dispensary shall submit a request for certification to the department. The request for certification shall include a list of the tuberculosis-related services provided or arranged for and a plan for tuberculosis prevention and control at the local level, including tuberculin skin testing of high-risk groups as defined by the Centers for Disease Control and Prevention. DHS 145.12 NoteNote: “High-risk groups” are defined in the Centers for Disease Control and Prevention report, entitled “Updated Guidelines for Using Interferon Gamma Release Assays to Detect Mycobacterium tuberculosis Infection – United States, 2010.” The report may be found in the Morbidity and Mortality Weekly Report, June 25, 2010, vol. 59, No. RR-5, and is on file in the Legislative Reference Bureau, and is available from the Department’s Division of Public Health, P.O. Box 2659, Madison, WI 53701–2659.
DHS 145.12(3)(3) Upon authority of s. 252.10, Stats., the department shall review the request for certification as a public health dispensary and the related local health department operations within 6 months of receiving the application. The department shall either issue a written certificate signed by the state health officer or deny the application and provide a written explanation of the recommendations for improvement needed before the department reconsiders the request for certification. DHS 145.12(4)(a)(a) The department shall review the operations of the public health dispensary at least every 5 years. DHS 145.12(4)(b)(b) The department may withhold, suspend or revoke its certification if the local health department fails to comply with any of the following: DHS 145.12(4)(b)1.1. Applicable federal or state statutes, or federal regulations or administrative rules pertaining to medical assistance, occupational safety, public health, professional practice, medical records and confidentiality. DHS 145.12(4)(b)2.2. The official statement of the national tuberculosis controllers association. DHS 145.12 NoteNote: The official statement of the National Tuberculosis Controllers Association entitled Tuberculosis Nursing: a Comprehensive Guide to Patient Care, 2nd edition (2011) is on file in the Legislative Reference Bureau, and is available from the National Tuberculosis Controllers Association, 2452 Spring Rd, SE, Smyrna, GA 30080-3838.
DHS 145.12 NoteNote: The official statements of the American Thoracic Society entitled “Targeted Tuberculin Testing and Treatment of Latent Tuberculosis Infection” may be found in the Morbidity and Mortality Weekly Report, June 9, 2000, Vol. 49, No. RR-6. The official statements of the American Thoracic Society entitled “Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis” may be found in Clinical Infectious Diseases, vol. 63, 2016, pp. e147-e195. The official statements of the American Thoracic Society entitled “Diagnostic Standards and Classification of Tuberculosis in Adults and Children” may be found in American Journal of Respiratory and Critical Care Medicine, vol. 161, 2000, pp.1376-1395. These reports are on file in the Legislative Reference Bureau, and are available from the Department’s Division of Public Health, P.O. Box 2659, Madison, WI 53701-2659..
DHS 145.12(4)(c)(c) The department shall provide the local health department with at least 30 days notice of the department’s decision to withhold, suspend or revoke its certification. DHS 145.12(5)(a)(a) A department action under sub. (3) or (4) is subject to administrative review under ch. 227, Stats. To request a hearing under ch. 227, Stats., the public health dispensary shall file, within 10 working days after the date of the department’s action, a written request for a hearing under s. 227.42, Stats. A request is considered filed on the date the division of hearings and appeals receives the request. A request by facsimile is complete upon transmission. If the request is filed by facsimile transmission between 5 P.M. and midnight, it shall be considered received on the following day. DHS 145.12 NoteNote: A hearing request should be addressed to the Department of Administration’s Division of Hearings and Appeals, P.O. Box 7875, Madison, WI 53707. Hearing requests may be delivered in person to that office at 5005 University Avenue, Room 201, Madison, WI. Hearing requests may be faxed to 608-264-9885.
DHS 145.12(5)(b)(b) The division of hearings and appeals shall hold an administrative hearing under s. 227.44, Stats., within 30 calendar days after receipt of the request for the administrative hearing, unless the public health dispensary consents to an extension of that time period. The division of hearings and appeals shall issue a proposed decision to the department no later than 30 calendar days after holding the hearing, unless the department and the public health dispensary agree to a later date. DHS 145.12(6)(6) Public health dispensaries or the department may contract with other agencies, institutions, hospitals, and persons for the necessary space, equipment, facilities and personnel to operate a public health dispensary or for provision of medical consultation. DHS 145.12(7)(7) If a public health dispensary charges fees for its services, the dispensary shall do all the following: DHS 145.12(7)(a)(a) Establish a fee schedule that is based upon the reasonable costs the public health dispensary incurs. DHS 145.12(7)(b)(b) Forward a copy of the fee schedule and any subsequent changes to the department. DHS 145.12(8)(a)(a) Public health dispensaries and branches thereof shall maintain records containing all the following: DHS 145.12(8)(a)4.4. The amount the dispensary billed and received for providing service to each person. DHS 145.12(8)(b)(b) The department may audit the records of public health dispensary and branches specified under par. (a). DHS 145.12 HistoryHistory: Cr. Register, March, 2000, No. 531, eff. 4-1-00; CR 01-105: r. and recr. Register March 2002 No. 555, eff. 4-1-02. DHS 145.13(1)(1) Reimbursable services. Public health dispensary services reimbursable by the department shall include at least the following: DHS 145.13(1)(a)(a) Tuberculin skin testing of high-risk persons as defined by the Centers for Disease Control and Prevention. The administration and reading of a tuberculin skin test shall be considered one visit. Tuberculin skin tests administered to persons who are not defined as high–risk by the Centers for Disease Control and Prevention, such as school employees, are not reimbursable. DHS 145.13 NoteNote: “High-risk persons” are defined in the Centers for Disease Control and Prevention report entitled “Updated Guidelines for Using Interferon Gamma Release Assays to Detect Mycobacterium tuberculosis Infection – United States, 2010.” The report may be found in the Morbidity and Mortality Weekly Report, June 25, 2010, vol. 59, No. RR-5, and is on file in the Legislative Reference Bureau, and is available from the Department’s Division of Public Health, P.O. Box 2659, Madison, WI 53701–2659.
DHS 145.13(1)(b)(b) One chest radiograph for a person with a newly identified significant skin test result, including interpretation and consultation services. DHS 145.13(1)(c)(c) One follow-up chest radiograph, including interpretation and consultation services, to document response to therapy. DHS 145.13(1)(d)(d) An initial medical evaluation and one interim medical evaluation, as needed. DHS 145.13(1)(e)(e) Blood specimen collection for one baseline and up to 3 follow-up liver function tests. DHS 145.13(1)(f)(f) Visits to collect initial diagnostic sputum specimens, either freely coughed or induced, and follow-up specimens to monitor successful treatment, up to a total of 3 initial and 6 follow-up specimens. DHS 145.13(1)(g)(g) Sputum induction for collection of up to 3 specimens for initial diagnosis and 3 for documentation of sputum conversion. DHS 145.13(1)(h)(h) Case management visits and visits to provide directly observed therapy to persons with tuberculosis disease up to a maximum of 66 visits. DHS 145.13(2)(a)(a) The department shall reimburse public health dispensaries on a quarterly basis for services provided under sub. (1) to clients who are not recipients of medical assistance until the biennial appropriation under s. 20.435 (1) (e), Stats., is totally expended. Reimbursement shall be at least at the medical assistance program rate in effect at the time of the delivery of the service.
