Wis. Admin. Code Department of Health Services DHS 145.10 - Restriction and management of patients and contacts
(1) All persons with
infectious tuberculosis or suspected tuberculosis, and their contacts, shall
exercise all reasonable precautions to prevent the infection of others, using
the applicable methods of control set out in the official report of the
American Public Health Association, unless specified otherwise by the state
epidemiologist.
Note: 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.
(2) All persons
with infectious tuberculosis or suspected tuberculosis shall be excluded from
work, school and other premises that cannot be maintained in a manner adequate
to protect others from being exposed to tuberculosis, as determined by the
local health officer.
(3) Official
statements of the American Thoracic Society shall be considered in the
treatment of tuberculosis, unless specified otherwise by the state
epidemiologist. Specific medical treatment shall be prescribed by a physician
or other licensed prescriber.
Note: The official statements of the American Thoracic Society may be found in the Centers for Disease Control and Prevention's recommendations and report "Targeted Tuberculin Testing and Treatment of Latent Tuberculosis Infection." The report 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. 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.
(4)
(a) Any physician or licensed prescriber who
treats a person with tuberculosis disease shall report all of the following to
the local health officer:
1. The date of the
person's sputum conversion.
2. The
date of the person's completion of the tuberculosis treatment
regimen.
(b) The
physician or his or her designee shall immediately report to the local health
officer when a person with tuberculosis disease does any of the following:
1. Terminates treatment against medical
advice.
2. Fails to comply with the
medical treatment plan.
3. Fails to
comply with measures to prevent transmission.
4. Leaves the hospital against the advice of
a physician.
(5) Upon receiving a report under sub. (4)
(b), the local health officer shall immediately investigate and transmit the
report to the department.
(6) The
local health officer or the department may do any of the following:
(a) Order a medical evaluation of a
person.
(b) Require a person to
receive directly observed therapy.
(c) Require a person to be isolated under ss.
252.06 and
252.07(5),
Stats.
(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:
1. The department or local health officer
notifies a court in writing of the confinement.
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.
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.
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.
(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.
(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.
(7)
(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:
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.
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.
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.
4. The person poses an imminent and
substantial threat to himself or herself or to the public health.
(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:
1. The date, time and place of
the hearing.
2. The grounds, and
underlying facts, upon which confinement of the person is being
sought.
3. An explanation of the
person's rights under sub. (8).
4.
The proposed actions to be taken and the reasons for each action.
(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.
(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.
(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.
(11)
(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.
(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.
(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.
(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.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.