Wisconsin 2023-2024 Regular Session

Wisconsin Assembly Bill AB257 Compare Versions

Only one version of the bill is available at this time.

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3	3	2023 - 2024 LEGISLATURE
4	4	2023 ASSEMBLY BILL 257
5	5	May 8, 2023 - Introduced by Representatives WICHGERS, MAXEY, BRANDTJEN,
6	6	MURPHY, RETTINGER, MOSES, BEHNKE and ALLEN, cosponsored by Senators
7	7	JACQUE, CABRAL-GUEVARA and TOMCZYK. Referred to Committee on Health,
8	8	Aging and Long-Term Care.
9	9	*AUTHORS SUBJECT TO CHANGE*
10	10	AN ACT to amend 146.95 (2) (b) (intro.); and to create 146.955 of the statutes;
11	11	relating to: patients' and residents' rights to visitors in a health care facility,
12	12	restricting visitation, and liability for the actions of visitors.
13	13	Analysis by the Legislative Reference Bureau
14	14	Under current law, an inpatient health care facility must allow an adult patient
15	15	to receive visitors during the facility's regular visiting hours, unless the patient
16	16	expresses in writing that he or she no longer wishes to receive a particular visitor,
17	17	or the facility determines that the patient cannot receive visitors or that the presence
18	18	of the visitor would endanger the health or safety of the patient or interfere with the
19	19	primary operations of the inpatient health care facility. This bill expands health care
20	20	facilities' obligations to allow patients and residents to receive visitors, subject to
21	21	COVID-19 infection protocols.
22	22	Under the bill, a health care facility must permit a patient with a disability to
23	23	designate up to three support persons, defined as a family member, guardian,
24	24	personal care assistant, or other paid or unpaid attendant designated by a patient
25	25	to advocate or provide support for the patient. The health care facility must allow
26	26	at least one support person to be physically present with the patient during the
27	27	patient's stay, if necessary to facilitate the care of the patient. The bill prohibits a
28	28	health care provider from requiring a patient to execute a declaration to physicians,
29	29	consent to a do-not-resuscitate order, or execute a physician order for
30	30	life-sustaining treatment as a condition of having a support person present.
31	31	The bill requires certain long-term care facilities to grant residents
32	32	compassionate care visitation, defined as in-person visitation between a resident
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38	38	and any individual the resident requests as needed to alleviate the resident's
39	39	physical or mental distress. Under the bill, if the COVID-19 infection rate is 20
40	40	percent or higher in the county in which a long-term care facility is located, the
41	41	long-term care facility must continue to offer compassionate care visitation in a way
42	42	that minimizes infection risk. If a long-term care facility has had no new onset of
43	43	COVID-19 in the past 14 days and it is located in a county with a COVID-19
44	44	infection rate under 10 percent, the facility must permit indoor visitation in addition
45	45	to compassionate care visitation.
46	46	The bill requires a hospital or primary care facility to allow a child patient to
47	47	have daily, in-person visitation at reasonable times with a parent, individual
48	48	standing in the place of a parent, or legal guardian. In addition, the bill requires a
49	49	hospital or primary care facility to allow an adult patient to have daily, in-person
50	50	visitation at reasonable times with a spouse, support person, or legal guardian.
51	51	Under the bill, a hospital or primary care facility may restrict this visitation 1) at the
52	52	request of the patient, law enforcement, or a court order; 2) if restricted access is
53	53	necessary to prevent disruption to the care of the patient; 3) if the individual has
54	54	signs and symptoms of a communicable infection, except that access must still be
55	55	permitted through means that ensure patient safety; or 4) if the individual is
56	56	determined to be dangerous or contrary to the welfare of the patient.
57	57	The bill requires a hospice to allow a patient to have in-person visitation at
58	58	reasonable times with individuals designated by the patient or a guardian, spouse,
59	59	or support person. In addition, the bill requires any health care facility to allow a
60	60	clergy member or lay person to have in-person visitation with a patient to pray or
61	61	offer spiritual support.
62	62	The bill permits a health care facility to establish a visitation policy which
63	63	limits or restricts visitation when 1) the presence of visitors would be medically or
64	64	therapeutically contraindicated; 2) the presence of visitors would interfere with the
65	65	care of or rights of any patient or resident; 3) visitors are engaging in disruptive,
66	66	threatening, or violent behavior toward any staff member, patient, or other visitor;
67	67	or 4) visitors are noncompliant with the health care facility's policy.
68	68	The bill directs the Department of Health Services to develop informational
69	69	material regarding health care facility visitation, to present the informational
70	70	material to the appropriate legislative committees, and to update the informational
71	71	material as needed to allow for the maximum visitation possible in health care
72	72	facilities. Health care facilities must make the informational material available to
73	73	patients and residents.
74	74	The bill provides that patients may file complaints with appropriate state
75	75	agencies and licensing boards for a health care facility's violation of the provisions
76	76	of this bill, and state agencies and licensing boards must investigate and penalize
77	77	health care facilities for failure to comply with this bill. However, the bill prohibits - 3 -2023 - 2024 Legislature
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81	81	a state agency from taking action against a health care facility for granting visitors
82	82	access to the facility or for the actions and omissions of those visitors.
83	83	The people of the state of Wisconsin, represented in senate and assembly, do
84	84	enact as follows:
85	85	SECTION 1. 146.95 (2) (b) (intro.) of the statutes is amended to read:
86	86	146.95 (2) (b) (intro.) Subject to s. 51.61 for a treatment facility, and except as
87	87	provided in s. 146.955, an inpatient health care facility may deny visitation with a
88	88	patient to any person if any of the following applies:
89	89	SECTION 2. 146.955 of the statutes is created to read:
90	90	146.955 Patient visitation rights. (1) DEFINITIONS. In this section:
91	91	(a) “Compassionate care visitation” means a visit with a resident that is
92	92	necessary to meet the physical or mental needs of the resident.
93	93	(b) “Health care facility" means a hospice, hospital, long-term care facility,
94	94	primary care facility, or any other system, care clinic, care provider, or entity whose
95	95	staff provides health care service to individuals in this state.
96	96	(c) “Hospice” has the meaning given in s. 50.90 (1) (c).
97	97	(d) “Hospital” has the meaning given in s. 50.33 (2).
98	98	(e) “Long-term care facility” includes any of the following:
99	99	1. A nursing home, as defined in s. 50.01 (3).
100	100	2. A community-based residential facility, as defined in s. 50.01 (1g).
101	101	3. A facility, as defined in s. 647.01 (4).
102	102	4. A swing bed in an acute care facility or extended care facility, as specified
103	103	under 42 USC 1395tt.
104	104	5. An adult family home, as defined in s. 50.01 (1).
105	105	6. A residential care apartment complex, as defined in s. 50.01 (6d).
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129	129	7. A brain injury rehabilitation facility, as defined in s. 46.278 (1m) (a).
130	130	(f) “Patient with a disability” means a patient who needs assistance to
131	131	effectively communicate with health care providers, make health care decisions, or
132	132	engage in activities of daily living due to a physical, intellectual, behavioral, or
133	133	cognitive disability, including deafness, being hard of hearing, communication
134	134	barriers, blindness, autism spectrum disorder, or dementia.
135	135	(g) “Personal contact” means an encounter in which 2 or more people are in
136	136	physical proximity to each other and may involve physical touching or oral
137	137	communication.
138	138	(h) “Primary care facility” means any building, structure, institution, or place
139	139	devoted primarily to the provision of outpatient, general health care services that is
140	140	a main source for regular health care services for patients.
141	141	(i) “Resident" means an individual cared for or treated in a long-term care
142	142	facility.
143	143	(j) “Support person” means a family member , guardian, personal care
144	144	assistant, or other paid or unpaid attendant designated by a patient to advocate or
145	145	provide support for the patient.
146	146	(2) LONG-TERM CARE FACILITY VISITATION; COMPASSIONATE CARE VISITATION. (a) 1.
147	147	A long-term care facility shall grant compassionate care visitation to residents.
148	148	2. A long-term care facility shall have in place a protocol for compassionate care
149	149	visitation which allows personal contact between residents and visitors that adheres
150	150	to infection prevention guidelines disseminated by the federal centers for disease
151	151	control and prevention or the federal centers for medicare and medicaid services.
152	152	(b) A resident may request any of the following individuals to visit for a
153	153	compassionate care visitation:
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183	183	1. A friend.
184	184	2. A family member.
185	185	3. A clergy member.
186	186	4. A lay person offering religious or spiritual support.
187	187	5. An individual providing a service to the resident.
188	188	(c) Any of the following is considered compassionate care visitation:
189	189	1. Support in end-of-life situations.
190	190	2. Adjustment support following a move to a new facility or environment.
191	191	3. Emotional support after the loss of a friend or family member.
192	192	4. Physical support after eating or drinking issues, including weight loss or
193	193	dehydration.
194	194	5. Social support for frequent crying, distress, or depression.
195	195	(d) A long-term care facility shall work with residents, families, caregivers,
196	196	resident representatives, and health care providers, and may include the
197	197	ombudsman program under s. 16.009 (4), to identify the need for compassionate care
198	198	visitation, using a person-centered approach that takes a resident's request into
199	199	account.
200	200	(e) A long-term care facility shall ensure that decisions regarding end-of-life
201	201	care are made by a resident with capacity or by the guardian or agent under an
202	202	activated power of attorney of a resident found to be incapacitated under s. 155.05
203	203	(2).
204	204	(f) Within the scope of visitation provided by this subsection, a long-term care
205	205	facility shall allow a resident making decisions regarding end-of-life care to be
206	206	accompanied by a family member, guardian, or support person designated by the
207	207	resident.
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235	235	(g) 1. If the COVID-19 infection rate in the county in which the long-term care
236	236	facility is located is 20 percent or higher, a long-term care facility shall identify at
237	237	least one way to allow compassionate care visitation, including personal contact, that
238	238	minimizes the risk of infection to the resident and other residents.
239	239	2. In a long-term care facility with no new onset of COVID-19 in the past 14
240	240	days and in counties with COVID-19 positivity rates that are less than 10 percent,
241	241	a long-term care facility shall accommodate and support indoor visitation for
242	242	reasons beyond compassionate care visitation.
243	243	(h) A long-term care facility may do any of the following:
244	244	1. For a resident who shares a room with another resident, prohibit visitation
245	245	in the resident's room, unless the health status of the resident prevents him or her
246	246	from leaving the room.
247	247	2. Limit the number of visitors per resident at a given time based on the size
248	248	of the building and the physical space of the building.
249	249	3. Limit movement in the long-term care facility.
250	250	4. Require visitors to go directly to the resident's room or to a designated
251	251	visitation area.
252	252	(i) A long-term care facility shall grant entry to a health care provider who is
253	253	not an employee of the long-term care facility but who provides direct care to a
254	254	resident, provided that the health care provider follows proper infection control
255	255	protocols.
256	256	(3) VISITATION AND SUPPORT FOR A PATIENT WITH A DISABILITY. (a) Upon the request
257	257	of a patient with a disability, a health care facility shall allow a patient with a
258	258	disability to designate at least 3 support persons and shall allow at least one support
259	259	person to be physically present with the patient with a disability during the patient's
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289	289	stay in the health care facility if necessary to facilitate the care of a patient with a
290	290	disability, including if any of the following apply:
291	291	1. The patient with a disability has a cognitive or mental health disability and
292	292	requires the assistance of a support person to ensure effective communication with
293	293	health care providers.
294	294	2. The patient with a disability is deaf, hard of hearing, or has other
295	295	communication barriers and requires the assistance of a support person to ensure
296	296	effective communication with health care providers.
297	297	3. The patient with a disability is making a decision to consent to treatment or
298	298	to refuse treatment.
299	299	4. The patient with a disability needs assistance with activities of daily living
300	300	and the health care providers are unable to assist or are less effective than the
301	301	support person at providing the assistance.
302	302	5. The patient with a disability has behavioral health needs that the support
303	303	person can address more effectively than the health care providers.
304	304	(b) A health care facility may not require, as a condition of having a support
305	305	person present under this subsection, a patient with a disability to execute a
306	306	declaration to physicians under s. 154.03, consent to a do-not-resuscitate order
307	307	under subch. III of ch. 154, or execute a physician order for life-sustaining
308	308	treatment.
309	309	(4) HOSPITAL OR PRIMARY CARE FACILITY VISITATION. (a) Notwithstanding s. 146.95
310	310	(2) (b), a child has the right to have daily personal contact at reasonable times with
311	311	a parent, an individual standing in the place of a parent, or a legal guardian while
312	312	the child receives care in a hospital or primary care facility, subject to par. (d). A
313	313	hospital or primary care facility shall allow a parent, an individual standing in the
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341	341	place of a parent, or a legal guardian visiting a child under this paragraph to leave
342	342	and reenter the hospital or primary care facility while the child is receiving care.
343	343	(b) Notwithstanding s. 146.95 (2) (b), an adult has the right to have daily
344	344	personal contact at reasonable times with a spouse, support person, or legal guardian
345	345	while the adult receives care in a hospital or primary care facility, subject to par. (d).
346	346	A hospital or primary care facility shall allow a spouse, support person, or legal
347	347	guardian visiting an adult under this paragraph to leave and reenter the hospital or
348	348	primary care facility while the adult is receiving care.
349	349	(c) A hospital or primary care facility may not require a patient to waive the
350	350	rights specified in par. (a) or (b).
351	351	(d) A hospital or primary care facility may restrict access of any individual to
352	352	a patient if any of the following apply:
353	353	1. The patient has requested the individual's access to the patient be restricted.
354	354	2. A law enforcement agency has requested the individual's access to the
355	355	patient be restricted.
356	356	3. A court order requires the individual's access to the patient be restricted.
357	357	4. Restricted access is necessary to prevent disruption to the care of the patient.
358	358	5. The individual has signs and symptoms of a communicable infection, except
359	359	that hospital or primary care facility shall permit an individual under this
360	360	subdivision to have access to a patient through means that ensure the protection of
361	361	the patient, including allowing access to the patient through telecommunication
362	362	means or allowing personal contact if the individual follows infection prevention and
363	363	control practices.
364	364	6. The individual is determined to be a danger to the patient or to be contrary
365	365	to the welfare of the patient.
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395	395	7. Restricted access is permissible under sub. (7).
396	396	(5) HOSPICE VISITATION. A patient who is receiving hospice care or the guardian,
397	397	spouse, or support person of a patient who is receiving hospice care may designate
398	398	additional family members and friends who may have personal contact with the
399	399	patient at reasonable times.
400	400	(6) CLERGY MEMBER OR LAY PERSON OFFERING RELIGIOUS OR SPIRITUAL SUPPORT
401	401	VISITATION. A health care facility must permit a clergy member or lay person offering
402	402	religious or spiritual support to have personal contact with a patient to pray with or
403	403	offer spiritual support for the patient while the patient receives care from the health
404	404	care facility.
405	405	(7) VISITATION LIMITS OR RESTRICTIONS. A health care facility may establish
406	406	visitation policies that limit or restrict visitation when any of the following is true:
407	407	(a) The presence of visitors would be medically or therapeutically
408	408	contraindicated.
409	409	(b) The presence of visitors would interfere with the care of or rights of any
410	410	patient or resident.
411	411	(c) Visitors are engaging in disruptive, threatening, or violent behavior toward
412	412	a staff member, patient, or other visitor.
413	413	(d) Visitors are noncompliant with a policy of the health care facility.
414	414	(8) INFORMATIONAL MATERIALS. (a) Within 30 days after the effective date of this
415	415	paragraph .... [LRB inserts date], the department shall develop informational
416	416	materials on patient visitation under this section.
417	417	(b) The department shall submit a report regarding patient visitation under
418	418	this section to the appropriate standing committees of the legislature under s. 13.172
419	419	(3).
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447	447	(c) A health care facility shall make the informational materials under par. (a)
448	448	accessible to patients and residents upon admission or registration and shall post the
449	449	informational materials on its website.
450	450	(d) Every 60 days or upon the release of applicable federal guidelines, the
451	451	department, with input from the long-term care industry and the hospital industry,
452	452	shall reevaluate and update the informational materials under par. (a) as needed to
453	453	allow for the maximum possible visitation in a health care facility under applicable
454	454	federal guidelines.
455	455	(e) The informational materials under par. (a) shall take into consideration and
456	456	include the highest amount of privacy and dignity for interaction between patients
457	457	and visitors.
458	458	(9) COMPLAINTS AND INVESTIGATION. (a) An individual may file with the
459	459	appropriate state agency or licensing board, including the department, a complaint
460	460	against a health care provider or a health care facility for failing to comply with this
461	461	section. That state agency or licensing board shall investigate the complaint and
462	462	may penalize a health care provider or health care facility for failure to comply with
463	463	this section.
464	464	(10) LIMITED LIABILITY OF HEALTH CARE FACILITIES. A state agency may not take
465	465	any action against a health care facility for any of the following:
466	466	(a) Giving a visitor or other individual access to a health care facility.
467	467	(b) Failing to protect or otherwise ensure the safety or comfort of a visitor or
468	468	other individual given access to a health care facility.
469	469	(c) Failing to follow the federal centers for disease control and prevention or the
470	470	federal centers for medicare and medicaid services guidelines or other national
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499	499	guidelines that require or recommend restricting visitor access to a health care
500	500	facility.
501	501	(d) The acts or omissions of any visitor or other individual who is given access
502	502	to a health care facility.
503	503	(11) CONSTRUCTION. (a) This section does not apply to any of the following:
504	504	1. A minor who is in the custody of a county department, as defined under s.
505	505	48.02 (2g), a licensed child welfare agency, or the department of children and
506	506	families.
507	507	2. A minor who is a suspected victim in a pending abuse investigation under
508	508	s. 48.981 (3).
509	509	3. An individual who is in the custody of the department of corrections.
510	510	4. An individual who is attending a preventive health care office visit during
511	511	which evidence-based guidelines for preventive care recommend a confidential visit
512	512	component for youth, as mutually agreed to by the patient and his or her physician.
513	513	(b) The rights specified in this section may not be terminated, suspended, or
514	514	waived by any of the following:
515	515	1. A health care facility.
516	516	2. The department.
517	517	3. A state or local board of health.
518	518	4. The governor upon declaring of a state of emergency under s. 323.10 or
519	519	ordering the department to take action.
520	520	(END)
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