51.61(5)(e)(e) A licensed mental health professional who is not affiliated with a county department or treatment facility shall notify in writing each patient to whom the professional provides services of the procedure to follow to resolve a grievance. The notice shall provide an option that the professional makes available to the patient, as required under s. 457.04 (8). Paragraphs (a) and (b) do not apply to this paragraph. 51.61(6)(6) Subject to the rights of patients provided under this chapter, the department, county departments under s. 51.42 or 51.437, and any agency providing services under an agreement with the department or those county departments have the right to use customary and usual treatment techniques and procedures in a reasonable and appropriate manner in the treatment of patients who are receiving services under the mental health system, for the purpose of ameliorating the conditions for which the patients were admitted to the system. The written, informed consent of any patient shall first be obtained, unless the person has been found not competent to refuse medication and treatment under sub. (1) (g) or the person is a minor 14 years of age or older who is receiving services for alcoholism or drug abuse or a minor under 14 years of age who is receiving services for mental illness, developmental disability, alcoholism, or drug abuse. In the case of such a minor, the written, informed consent of the parent or guardian is required, except as provided under an order issued under s. 51.13 (1) (c) or 51.14 (3) (h) or (4) (g), or as provided in s. 51.138 or 51.47. Except as provided in s. 51.138, if the minor is 14 years of age or older and is receiving services for mental illness or developmental disability, the written, informed consent of the minor and the minor’s parent or guardian is required, except that a refusal of either such a minor 14 years of age or older or the minor’s parent or guardian to provide written, informed consent for admission or transfer to an approved inpatient treatment facility is reviewable under s. 51.13 (1) (c), (3), or (4), or 51.35 (3) (b), and a refusal of either a minor 14 years of age or older or the minor’s parent or guardian to provide written, informed consent for outpatient mental health treatment is reviewable under s. 51.14. 51.61(7)(a)(a) Any patient whose rights are protected under this section who suffers damage as the result of the unlawful denial or violation of any of these rights may bring an action against the person, including the state or any political subdivision thereof, which unlawfully denies or violates the right in question. The individual may recover any damages as may be proved, together with exemplary damages of not less than $100 for each violation and such costs and reasonable actual attorney fees as may be incurred. 51.61(7)(b)(b) Any patient whose rights are protected under this section may bring an action against any person, including the state or any political subdivision thereof, which willfully, knowingly and unlawfully denies or violates any of his or her rights protected under this section. The patient may recover such damages as may be proved together with exemplary damages of not less than $500 nor more than $1,000 for each violation, together with costs and reasonable actual attorney fees. It is not a prerequisite to an action under this paragraph that the plaintiff suffer or be threatened with actual damages. 51.61(7)(c)(c) Any patient whose rights are protected under this section may bring an action to enjoin the unlawful violation or denial of rights under this section and may in the same action seek damages as provided in this section. The individual may also recover costs and reasonable actual attorney fees if he or she prevails. 51.61(7)(d)(d) Use of the grievance procedure established under sub. (5) is not a prerequisite to bringing an action under this subsection. 51.61(7m)(7m) Whoever intentionally deprives a patient of the ability to seek redress for the alleged violation of his or her rights under this section by unreasonably precluding the patient from doing any of the following may be fined not more than $1,000 or imprisoned for not more than 6 months or both: 51.61(7m)(b)(b) Communicating, subject to sub. (1) (p), with a court, government official or staff member of the protection and advocacy agency that is designated under s. 51.62 or with legal counsel. 51.61(8)(8) Any informed consent which is required under sub. (1) (a) to (i) may be exercised by the patient’s legal guardian if the patient has been adjudicated incompetent and the guardian is so empowered, or by the parent of the patient if the patient is a minor. 51.61(9)(9) Except for grievance resolution procedure options specified under s. 457.04 (8) (a), (b), and (c), the department shall promulgate rules to implement this section. 51.61(10)(10) No person who, in good faith, files a report with the appropriate examining board concerning the violation of rights under this section by persons licensed, certified, registered or permitted under ch. 441, 446, 450, 455 or 456, or who participates in an investigation of an allegation by the appropriate examining board, is liable for civil damages for the filing or participation. 51.61 HistoryHistory: 1975 c. 430; 1977 c. 428 ss. 96 to 109, 115; 1981 c. 20; 1981 c. 314 s. 144; 1983 a. 189 s. 329 (5); 1983 a. 293, 357, 538; 1985 a. 176; 1987 a. 366, 367, 403; 1989 a. 31; 1993 a. 184, 445, 479; 1995 a. 27 s. 9126 (19); 1995 a. 92, 268, 292; 1997 a. 292; 2001 a. 16 ss. 1993j to 1993w, 4034zk, 4034zl; 2001 a. 104; 2005 a. 387, 434, 444; 2007 a. 20 s. 9121 (6) (a); 2007 a. 97; 2009 a. 28; 2011 a. 32; 2013 a. 161, 203; 2017 a. 184, 204; 2021 a. 240 s. 30. 51.61 Cross-referenceCross-reference: See also ch. DHS 94, Wis. adm. code. 51.61 AnnotationA patient in a state facility can recover fees under sub. (7) (c) from the county. J.S. v. State, 144 Wis. 2d 670, 425 N.W.2d 15 (Ct. App. 1988). 51.61 AnnotationThe court may order an agency to do planning and the implementation work necessary to fulfill the obligation to order placement conforming to sub. (1) (e) and s. 55.06 (9) (a). Fond du Lac County v. J.G.S., 159 Wis. 2d 685, 465 N.W.2d 227 (Ct. App. 1990). 51.61 AnnotationA nurse’s decision to take a mental health patient on a recreational walk is not treatment under sub. (1) (f), and no cause of action was created under this section for injuries incurred when the patient fell. Erbstoeszer v. American Casualty Co., 169 Wis. 2d 637, 486 N.W.2d 549 (Ct. App. 1992). 51.61 AnnotationSub. (1) (g) 4. is not merely illustrative; it establishes the only standard by which a court may determine whether a patient is competent to refuse psychotropic medication. Discussing factors to be considered in determining whether this competency standard is met. Virgil D. v. Rock County, 189 Wis. 2d 1, 524 N.W.2d 894 (1994). 51.61 AnnotationSub. (1) (k) is unconstitutionally overbroad because it prevents all patients unable to give “express and informed” consent from receiving electroconvulsive treatment under any circumstances, even when the treatment may be life saving. Professional Guardianships, Inc. v. Ruth E.J., 196 Wis. 2d 794, 540 N.W.2d 213 (Ct. App. 1995), 95-2010. 51.61 AnnotationCourt commissioners have the authority to conduct hearings under sub. (1) (g). Carol J.R. v. County of Milwaukee, 196 Wis. 2d 882, 540 N.W.2d 233 (Ct. App. 1995), 94-0688. 51.61 AnnotationIn an action for negligence and malpractice, when a provider’s treatment techniques or deficiencies were part and parcel of the plaintiff’s claim, it was appropriate to award costs and attorney fees under sub. (7) (a). Wright v. Mercy Hospital of Janesville, Wisconsin, Inc., 206 Wis. 2d 449, 557 N.W.2d 846 (Ct. App. 1996), 95-2289. 51.61 AnnotationSub. (7) contemplates two separate and distinct causes of action. Sub. (7) (a) applies when the denial of a patient’s rights have caused actual damages. Sub. (7) (b) does not require damages, but allows recovery if the patient’s rights were violated willfully, knowingly, and unlawfully. Schaidler v. Mercy Medical Center of Oshkosh, Inc., 209 Wis. 2d 457, 563 N.W.2d 554 (Ct. App. 1997), 96-0645. 51.61 AnnotationThis section and ch. 980 provide the statutory basis for a court to issue an involuntary medication order for individuals who suffer from a chronic mental illness and are committed under ch. 980. State v. Anthony D.B., 2000 WI 94, 237 Wis. 2d 1, 614 N.W.2d 435, 98-0576. 51.61 AnnotationInvoluntarily committed persons are entitled to more considerate treatment and conditions of confinement than criminals, but their rights are not absolute. A restriction of rights must be reasonably related to legitimate therapeutic and institutional interests. West v. Macht, 2000 WI App 134, 237 Wis. 2d 265, 614 N.W.2d 34, 99-1710. 51.61 AnnotationSub. (1) (i) grants broad discretionary power to the Department of Health and Family Services sufficient to permit its treatment facilities to transport ch. 980 patients in restraints for security reasons. Nothing requires treatment facilities to exercise discretion for each individual patient rather than on the basis of its experience with ch. 980 patients as a group and the individualized prior finding of sexual dangerousness that each ch. 980 patient has had made. Thielman v. Leean, 2003 WI App 33, 260 Wis. 2d 253, 659 N.W.2d 73, 02-0888. 51.61 AnnotationA “patient” under sub. (1) includes a person receiving services for developmental disabilities. Under s. 51.437, sheltered employment is one of those services. Sheltered employment did not constitute rehabilitation, and thus the patient’s place of sheltered employment was not a treatment facility and the sheltered employee could not bring a sub. (1) (x) claim. That assaults occurred in a restroom did not mean his right to privacy in the restroom under sub. (1) (s) was violated. Sheltered employment may include educational programs, and the patient’s complaint stated a claim that the assaults deprived him of his right to prompt and adequate educational services under sub. (1) (f). St. Paul Fire & Marine Insurance Co. v. Keltgen, 2003 WI App 53, 260 Wis. 2d 523, 659 N.W.2d 906, 02-1249. 51.61 AnnotationThe exclusive remedy provision of the worker’s compensation act, s. 102.03, does not bar a claim under this section when the injuries result from the same set of facts. An entity that acted as both sheltered employer and developmentally disabled service provider did not possess a dual persona, allowing both worker’s compensation recovery and tort recovery for the same act. St. Paul Fire & Marine Insurance Co. v. Keltgen, 2003 WI App 53, 260 Wis. 2d 523, 659 N.W.2d 906, 02-1249. 51.61 AnnotationThe injured patients and families compensation fund under ch. 655 is not a person “who violates the right in question,” as this section requires. The fund does not provide any treatment and could never violate any of the rights proscribed in this section. As a result, there is no basis to conclude that it is subject to costs and reasonable actual attorney fees. Hess v. Fernandez, 2005 WI 19, 278 Wis. 2d 283, 692 N.W.2d 655, 03-0327. 51.61 AnnotationUnder sub. (1) (g) 4. b., the county petitioner may prove by clear and convincing evidence that the individual is substantially incapable of applying the understanding the individual has of the advantages and disadvantages of the medication, and the alternatives, to the individual’s mental illness in order to make an informed choice as to whether to accept or refuse the medication. Medical experts must apply the standards set out in the competency statute. An expert’s use of different language to explain the expert’s conclusions should be linked back to the standards in the statute. Outagamie County v. Melanie L., 2013 WI 67, 349 Wis. 2d 148, 833 N.W.2d 607, 12-0099. 51.61 AnnotationSub. (1) (g) 3. is facially unconstitutional for any inmate who is involuntarily committed under s. 51.20 (1) (ar), which does not require a determination of dangerousness, when the inmate is involuntarily medicated based merely on a determination of incompetence to refuse medication. Winnebago County v. C.S., 2020 WI 33, 391 Wis. 2d 35, 940 N.W.2d 875, 16-1982. 51.61 AnnotationSub. (1) (g) 4. requires that the advantages and disadvantages of and alternatives to accepting a particular medication or treatment must be explained to a patient who is subject to an involuntary medication order. In this case, the county met its burden to prove that the patient was not competent to refuse medication or treatment under sub. (1) (g) 4. when the patient, by the patient’s own express conduct, refused to engage with the examining psychiatrist to receive the full, required explanations. The patient could not later assert that the patient’s efforts to avoid the medication discussion should defeat the medication order. Outagamie County v. L.X.D.-O., 2023 WI App 17, 407 Wis. 2d 441, 991 N.W.2d 518, 20-1806. 51.61 AnnotationNonconsensual drug therapy did not violate due process. Stensvad v. Reivitz, 601 F. Supp. 128 (1985). 51.61 AnnotationSub. (1) (e) and (i) does not restrict the discretion of institution administrators to restrain patients during transport. Thielman v. Leean, 140 F. Supp. 2d 982 (2001). 51.6251.62 Protection and advocacy system. 51.62(1)(1) Definitions. In this section: 51.62(1)(am)(am) “Developmental disability” means a severe, chronic disability of a person that is characterized by all of the following: 51.62(1)(am)1.1. Is attributable to a mental or physical impairment or a combination of a mental and a physical impairment. 51.62(1)(am)2.2. Is manifested before the person has attained the age of 22. 51.62(1)(am)4.4. Results in substantial functional limitation in at least 3 of the following areas of major life activity: 51.62(1)(am)5.5. Requires a combination and sequence of special interdisciplinary or generic care, treatment or other services that are of lifelong or extended duration and are individually planned and coordinated. 51.62(1)(b)(b) “Inpatient health care facility” has the meaning provided under s. 50.135 (1), except that it does include community-based residential facilities as defined under s. 50.01 (1g). 51.62(1)(bm)(bm) “Mental illness” means mental disease to such extent that a person so afflicted requires care and treatment for his or her welfare, or the welfare of others, or of the community and is an inpatient or resident in a facility rendering care or treatment or has been discharged from the facility for not more than 90 days. 51.62(1)(c)(c) “Protection and advocacy agency” means an entity designated by the governor to implement a system to protect and advocate the rights of persons with developmental disabilities, as authorized under 42 USC 6012 or mental illness, as authorized under 42 USC 10801 to 10851. 51.62(2)(a)(a) The governor shall designate as the protection and advocacy agency a private, nonprofit corporation that is independent of all of the following: 51.62(2)(a)2.2. The board for people with developmental disabilities and the council on mental health. 51.62(2)(a)3.3. An agency that provides treatment, services or habilitation to persons with developmental disabilities or mental illness. 51.62(2)(b)(b) After the governor has designated a protection and advocacy agency under par. (a), the protection and advocacy agency so designated shall continue in that capacity unless and until the governor redesignates the protection and advocacy agency to another private, nonprofit corporation that meets the requirements of par. (a). The governor may redesignate this private, nonprofit corporation the protection and advocacy agency only if all of the following conditions are met: 51.62(2)(b)2.2. Prior notice and an opportunity to comment on a proposed redesignation has been given to all of the following: 51.62(2)(b)2.a.a. The board for people with developmental disabilities and the council on mental health. 51.62(2)(b)2.b.b. Major organizations, in the state, of persons with developmental disabilities or mental illness and families and representatives of these persons. 51.62(2)(c)(c) If the governor has designated a protection and advocacy agency before July 20, 1985, that entity shall continue in that capacity unless and until the governor redesignates the protection and advocacy agency to another private, nonprofit corporation that meets the requirements of par. (a). 51.62(3)(a)1.1. Pursue legal, administrative and other appropriate remedies to ensure the protection of the rights of persons with developmental disabilities or mental illness and to provide information on and referral to programs and services addressing the needs of persons with developmental disabilities or mental illness. 51.62(3)(a)2m.2m. Have immediate access to any individual with mental illness or developmental disability, regardless of age, who has requested services or on whose behalf services have been requested from the protection and advocacy agency or concerning whom the protection and advocacy agency has reasonable cause to believe that abuse, neglect, financial exploitation, or a violation of rights of the individual has occurred. 51.62(3)(a)3.3. Contract with a private, nonprofit corporation to confer to that corporation the powers and duties specified for the protection and advocacy agency under this subsection, except that the corporation may have access to records as specified under ss. 51.30 (4) (b) 18. and 146.82 (2) (a) 9. only if all of the following conditions are met: 51.62(3)(a)3.a.a. The contract of the corporation with the protection and advocacy agency so provides. 51.62(3)(b)(b) The protection and advocacy agency shall pay reasonable costs related to the reproducing or copying of patient health care or treatment records. 51.62(3m)(3m) Funding. From the appropriation under s. 20.435 (7) (md), the department shall distribute $75,000 in each fiscal year to the protection and advocacy agency for performance of community mental health protection and advocacy services. 51.62(4)(4) Departmental duties. The department shall provide the protection and advocacy agency with copies of annual surveys and plans of correction for intermediate care facilities for persons with an intellectual disability on or before the first day of the 2nd month commencing after completion of the survey or plan. 51.62 AnnotationThe Wisconsin statutory scheme does not give an agency express authority to investigate incidents of abuse and neglect or to obtain patient records, but under federal law any state system established to protect the rights of persons with developmental disabilities has that authority. Wisconsin Coalition for Advocacy, Inc. v. Czaplewski, 131 F. Supp. 2d 1039 (2001). 51.6351.63 Private pay for patients. Any person may pay, in whole or in part, for the maintenance and clothing of any mentally ill, developmentally disabled, alcoholic or drug dependent person at any institution for the treatment of persons so afflicted, and his or her account shall be credited with the sums paid. The person may also be likewise provided with such special care in addition to those services usually provided by the institution as is agreed upon with the director, upon payment of the charges therefor. 51.63 HistoryHistory: 1975 c. 430. 51.6451.64 Reports of death required; penalty; assessment. 51.64(1)(a)(a) “Physical restraint” includes all of the following: 51.64(1)(a)2.2. A device or garment that interferes with an individual’s freedom of movement and that the individual is unable to remove easily. 51.64(1)(a)3.3. Restraint by a treatment facility staff member of a person admitted or committed to the treatment facility, by use of physical force.
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Chs. 46-58, Charitable, Curative, Reformatory and Penal Institutions and Agencies
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