Date of enactment: March 22, 2024
2023 Senate Bill 174 Date of publication*: March 23, 2024
2023 WISCONSIN ACT 172
AN ACT to amend 69.18 (2) (b), 69.18 (2) (d) and 448.02 (3) (a); and to create 69.18 (2) (g) of the statutes; relating
to: requiring use of the electronic system of vital records for medical certifications of death.
The people of the state of Wisconsin, represented in
senate and assembly, do enact as follows:
JOINT LEGISLATIVE COUNCIL PREFATORY NOTE: This bill
was prepared for the Joint Legislative Council Study Commit-
tee on Uniform Death Reporting Standards.
Current law requires the Department of Health Services
(DHS) to establish an Office of Vital Records and appoint a
state registrar who, among other duties, directs the system of
vital records. DHS currently uses an electronic system of vital
records.
Current law requires that a death record be filed by certain
parties identified in statute, a function most commonly ful-
filled by a funeral director. The filing party must obtain cer-
tain factual information for the death record and then, within
24 hours of being notified of a death, present the record to the
appropriate individual for completion of the medical certifica-
tion, which is a portion of the death record providing cause−
of−death and other information. Depending on the circum-
stances of the death, the medical certification may be
completed and signed by a medical examiner, coroner, physi-
cian, or other specified medical professionals with access to
a decedent’s medical history. Current law requires that the
individual completing and signing the medical certification
return the death record to the filing party either by mailing the
death record within 5 days after the pronouncement of death
or presenting the death record within 6 days after the pro-
nouncement of death. The filing party then submits the death
record to the local vital records office for registration with
DHS’s Office of Vital Records.
Under current practice, the electronic system of vital
records is widely used by funeral directors, medical examin-
ers, and coroners, and less commonly used by other individu-
als authorized to complete a medical certification, such as
physicians. Those individuals who complete a medical certi-
fication without use of the electronic system of vital records
instead use a “fax attestation form.” Under this method, the
medical certification is sent by facsimile to the filing party for
manual entry into the electronic system of vital records.
The bill requires any person who completes and signs a
medical certification to use the electronic system of vital
records to complete and sign the medical certification as
required under current law. The bill also eliminates the option
for individuals completing and signing the medical certifica-
tion to mail the death record to the filing party. Finally, the bill
delays the effective date of these provisions for 24 months.
SECTION 1. 69.18 (2) (b) of the statutes is amended
to read:
69.18 (2) (b) If a person under the care of a physician
dies from the illness or condition for which the care is
given and a coroner or medical examiner does not certify
the cause of death under par. (d) 1., the physician shall
complete and sign a medical certification for the death
under par. (f) and mail the medical certification within 5
days after the pronouncement of death or use the state
registrar’s electronic system of vital records to present
the medical certification to the person responsible for fil-
ing the death record under sub. (1) within 6 days after the
pronouncement of death.
SECTION 2. 69.18 (2) (d) of the statutes is amended
to read:
69.18 (2) (d) 1. Except as provided under par. (e), if
a death is the subject of a coroner’s or medical examiner’s
determination under s. 979.01 or 979.03, the coroner or
medical examiner or a physician supervised by a coroner
* Section 991.11, WISCONSIN STATUTES: Effective date of acts. “Every act and every portion of an act enacted by the legislature over the governor’s
partial veto which does not expressly prescribe the time when it takes effect shall take effect on the day after its date of publication.” − 2 −2023 Wisconsin Act 172 2023 Senate Bill 174
or medical examiner in the county where the event which
caused the death occurred shall complete and sign the
medical certification for the death and mail the death
record within 5 days after the pronouncement of death or
use the state registrar’s electronic system of vital records
to present the record to the person responsible for filing
the death record under sub. (1) within 6 days after the pro-
nouncement of death.
2. Except as provided under par. (e), if the decedent
was not under the care of a physician for the illness or
condition from which the person died, the coroner or
medical examiner, or a physician supervised by a coroner
or medical examiner, in the county of the place of death
shall complete and sign the medical certification for the
death and mail the death record within 5 days after the
pronouncement of death or use the state registrar’s elec-
tronic system of vital records to present the record to the
person responsible for filing the death record under sub.
(1) within 6 days after the pronouncement of death.
3. For a medical certification under this paragraph,
except a medical certification of the cause of death of an
indigent, a coroner or medical examiner may charge a fee
established by the county board, not to exceed an amount
reasonably related to the actual and necessary cost of pro-
viding the medical certification. The coroner or medical
examiner, or the physician employed by the coroner or
medical examiner, shall mail or use the state registrar’s
electronic system of vital records to present a medical
certification as required under subd. 1., whether or not the
fee has been paid.
SECTION 3. 69.18 (2) (g) of the statutes is created to
read:
69.18 (2) (g) Any person who completes and signs
medical certifications under this subsection shall use the
state registrar’s electronic system of vital records to
present the medical certification as required under this
subsection.
SECTION 4. 448.02 (3) (a) of the statutes is amended
to read:
448.02 (3) (a) The board shall investigate allegations
of unprofessional conduct and negligence in treatment by
persons holding a license or certificate granted by the
board. An allegation that a physician has violated s.
253.10 (3), 448.30 or 450.13 (2) or has failed to mail or
present a medical certification required under s. 69.18 (2)
within 21 days after the pronouncement of death of the
person who is the subject of the required certificate or that
a physician has failed at least 6 times within a 6−month
period to mail or present a medical certificate required
under s. 69.18 (2) within 6 days after the pronouncement
of death of the person who is the subject of the required
certificate is an allegation of unprofessional conduct.
Information contained in reports filed with the board
under s. 49.45 (2) (a) 12r., 50.36 (3) (b), 609.17 or
632.715, or under 42 CFR 1001.2005, shall be investi-
gated by the board. Information contained in a report
filed with the board under s. 655.045 (1), as created by
1985 Wisconsin Act 29, which is not a finding of negli-
gence or in a report filed with the board under s. 50.36 (3)
(c) may, within the discretion of the board, be used as the
basis of an investigation of a person named in the report.
The board may require a person holding a license or cer-
tificate to undergo and may consider the results of one or
more physical, mental or professional competency exam-
inations if the board believes that the results of any such
examinations may be useful to the board in conducting its
investigation.
SECTION 4m.0Nonstatutory provisions.
(1) The department of health services shall within a
reasonable time implement nationally recognized health
information exchange standards to ensure interoperabil-
ity of its electronic system of vital records and other elec-
tronic health record software in support of workflows
related to medical certifications for death records.
SECTION 5m.0Effective dates. This act takes effect
on the first day of the 24th month beginning after publica-
tion, except as follows:
(1) SECTION 4m of this act takes effect on the day after
publication.