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. DHS 145.13 HistoryHistory: Cr. Register, March, 2000, No. 531, eff. 4-1-00; CR 01-105: Cr. Register March 2002 No. 555, eff. 4-1-02; correction in (2) (b) made under s. 13.92 (4) (b) 7., Stats., Register January 2009 No. 637; correction in (2) (a) made under s. 13.92 (4) (b) 7., Stats., Register July 2011 No. 667. DHS 145.14DHS 145.14 Definitions. In this subchapter: DHS 145.14(1)(1) “Commitment” means the process by which a court of record orders the confinement of a person to a place providing treatment. DHS 145.14(2)(2) “Contact” means a person who had physical contact with a case that involved the genitalia of one of them during a period of time which covers both the maximum incubation period for the disease and the time during which the case showed symptoms of the disease, or could have either infected the case or been infected by the case. DHS 145.14(4)(4) “Sexually transmitted diseases” means syphilis, gonorrhea, chancroid, genital herpes infection, chlamydia trachomatis, and sexually transmitted pelvic inflammatory disease. DHS 145.14(5)(5) “Source” means the person epidemiologic evidence indicates is the origin of an infection. DHS 145.14 HistoryHistory: Cr. Register, April, 1984, No. 340, eff. 5-1-84; renum. and am. from HFS 145.12, Register, March, 2000, No. 531, eff. 4-1-00. DHS 145.15DHS 145.15 Case reporting. Any administrator of a health care facility, state correctional institution or local facility subject to ch. DOC 350, who has knowledge of a case of a sexually transmitted disease shall report the case by name and address to the local health officer. If the services of an attending physician are available in an institution or health care facility, the physician or a designee shall report as described in s. DHS 145.04 (1) (a). The administrator shall ensure that this reporting requirement is fulfilled. DHS 145.15 HistoryHistory: Cr. Register, April, 1984, No. 340, eff. 5-1-84; correction made under s. 13.93 (2m) (b) 7., Stats., Register, October, 1991, No. 430; renum. and am. from HFS 145.13, Register, March, 2000, No. 531, eff. 4-1-00. DHS 145.16DHS 145.16 Reporting of cases delinquent in treatment. Whenever any person with a sexually transmitted disease fails to return within the time directed to the physician or advanced practice nurse prescriber who has treated that person, the physician or advanced practice nurse prescriber or a designee shall report the person, by name and address, to the local health officer and the department as delinquent in treatment. DHS 145.16 HistoryHistory: Cr. Register, April, 1984, No. 340, eff. 5-1-84; renum. and am. from HFS 145.14, Register, March, 2000, No. 531, eff. 4-1-00. DHS 145.17DHS 145.17 Determination of sources and contacts. Physicians accepting cases for treatment shall determine the probable source of infection and any other contacts, and shall attempt to diagnose and treat those persons, or shall request that the local health officer or the department do so. DHS 145.17 HistoryHistory: Cr. Register, April, 1984, No. 340, eff. 5-1-84; renum. from HFS 145.15, Register, March, 2000, No. 531, eff. 4-1-00. DHS 145.18DHS 145.18 Criteria for determination of suspects. Any person falling into one or more of the following categories is designated as a suspect: DHS 145.18(1)(1) Persons identified as sexual contacts of a sexually transmitted disease case; DHS 145.18(2)(2) Persons having positive laboratory or clinical findings of sexually transmitted disease; and DHS 145.18(3)(3) Persons in whom epidemiologic evidence indicates a sexually transmitted disease may exist. DHS 145.18 HistoryHistory: Cr. Register, April, 1984, No. 340, eff. 5-1-84; renum. from HFS 145.16, Register, March, 2000, No. 531, eff. 4-1-00. DHS 145.19DHS 145.19 Examination of suspects. Local health officers shall require the examination of suspects. The examination shall include a physical examination and appropriate laboratory and clinical tests. DHS 145.19 HistoryHistory: Cr. Register, April, 1984, No. 340, eff. 5-1-84; renum. from HFS 145.17, Register, March, 2000, No. 531, eff. 4-1-00. DHS 145.20DHS 145.20 Commitment of suspects. If, following the order of a local health officer or the department, a suspect refuses or neglects examination or treatment, a local health officer or the department shall file a petition with a court to have the person committed to a health care facility for examination, treatment or observation. DHS 145.20 HistoryHistory: Cr. Register, April, 1984, No. 340, eff. 5-1-84; renum. from HFS 145.18, Register, March, 2000, No. 531, eff. 4-1-00. DHS 145.21DHS 145.21 Treatment of minors. A physician or advanced practice nurse prescriber may treat a minor with a sexually transmitted disease or examine and diagnose a minor for the presence of the disease without obtaining the consent of the minor’s parents or guardian. The physician or advanced practice nurse prescriber shall incur no civil liability solely by reason of the lack of consent of the minor’s parents or guardian, as stated in s. 252.11 (1m), Stats. DHS 145.21 HistoryHistory: Cr. Register, April, 1984, No. 340, eff. 5-1-84; renum. and am. from HFS 145.19, Register, March, 2000, No. 531, eff. 4-1-00. DHS 145.22DHS 145.22 Treatment guidelines. The official statements of the Centers for Disease Control and Prevention shall be considered in the treatment of sexually transmitted diseases unless otherwise specified by the state epidemiologist. Specific medical treatment shall be prescribed by a physician or advanced practice nurse prescriber. DHS 145.22 NoteNote: The official statements of the Centers for Disease Control and Prevention entitled “Sexually Transmitted Diseases Treatment Guidelines, 2015,” is on file in the Department’s Division of Public Health and the Legislative Reference Bureau, and may be found in the Morbidity and Mortality Weekly Report, June 5, 2015, vol. 64, RR-3.
DHS 145.22 HistoryHistory: Cr. Register, April, 1984, No. 340, eff. 5-1-84; renum. and am. from HFS 145.20, Register, March, 2000, No. 531, eff. 4-1-00; CR 07-090: am. Register February 2008 No. 626, eff. 3-1-08; CR 17-014: am., Register June 2018 No. 750 eff. 7-1-18.
