Wisconsin 2023-2024 Regular Session

Wisconsin Senate Bill SB257 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 SENATE BILL 257
5	5	May 2, 2023 - Introduced by Senators JACQUE, CABRAL-GUEVARA and TOMCZYK,
6	6	cosponsored by Representatives WICHGERS, MAXEY, BRANDTJEN, MURPHY,
7	7	RETTINGER, MOSES and BEHNKE. Referred to Committee on Health.
8	8	AN ACT to amend 146.95 (2) (b) (intro.); and to create 146.955 of the statutes;
9	9	relating to: patients' and residents' rights to visitors in a health care facility,
10	10	restricting visitation, and liability for the actions of visitors.
11	11	Analysis by the Legislative Reference Bureau
12	12	Under current law, an inpatient health care facility must allow an adult patient
13	13	to receive visitors during the facility's regular visiting hours, unless the patient
14	14	expresses in writing that he or she no longer wishes to receive a particular visitor,
15	15	or the facility determines that the patient cannot receive visitors or that the presence
16	16	of the visitor would endanger the health or safety of the patient or interfere with the
17	17	primary operations of the inpatient health care facility. This bill expands health care
18	18	facilities' obligations to allow patients and residents to receive visitors, subject to
19	19	COVID-19 infection protocols.
20	20	Under the bill, a health care facility must permit a patient with a disability to
21	21	designate up to three support persons, defined as a family member, guardian,
22	22	personal care assistant, or other paid or unpaid attendant designated by a patient
23	23	to advocate or provide support for the patient. The health care facility must allow
24	24	at least one support person to be physically present with the patient during the
25	25	patient's stay, if necessary to facilitate the care of the patient. The bill prohibits a
26	26	health care provider from requiring a patient to execute a declaration to physicians,
27	27	consent to a do-not-resuscitate order, or execute a physician order for
28	28	life-sustaining treatment as a condition of having a support person present.
29	29	The bill requires certain long-term care facilities to grant residents
30	30	compassionate care visitation, defined as in-person visitation between a resident
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36	36	and any individual the resident requests as needed to alleviate the resident's
37	37	physical or mental distress. Under the bill, if the COVID-19 infection rate is 20
38	38	percent or higher in the county in which a long-term care facility is located, the
39	39	long-term care facility must continue to offer compassionate care visitation in a way
40	40	that minimizes infection risk. If a long-term care facility has had no new onset of
41	41	COVID-19 in the past 14 days and it is located in a county with a COVID-19
42	42	infection rate under 10 percent, the facility must permit indoor visitation in addition
43	43	to compassionate care visitation.
44	44	The bill requires a hospital or primary care facility to allow a child patient to
45	45	have daily, in-person visitation at reasonable times with a parent, individual
46	46	standing in the place of a parent, or legal guardian. In addition, the bill requires a
47	47	hospital or primary care facility to allow an adult patient to have daily, in-person
48	48	visitation at reasonable times with a spouse, support person, or legal guardian.
49	49	Under the bill, a hospital or primary care facility may restrict this visitation 1) at the
50	50	request of the patient, law enforcement, or a court order; 2) if restricted access is
51	51	necessary to prevent disruption to the care of the patient; 3) if the individual has
52	52	signs and symptoms of a communicable infection, except that access must still be
53	53	permitted through means that ensure patient safety; or 4) if the individual is
54	54	determined to be dangerous or contrary to the welfare of the patient.
55	55	The bill requires a hospice to allow a patient to have in-person visitation at
56	56	reasonable times with individuals designated by the patient or a guardian, spouse,
57	57	or support person. In addition, the bill requires any health care facility to allow a
58	58	clergy member or lay person to have in-person visitation with a patient to pray or
59	59	offer spiritual support.
60	60	The bill permits a health care facility to establish a visitation policy which
61	61	limits or restricts visitation when 1) the presence of visitors would be medically or
62	62	therapeutically contraindicated; 2) the presence of visitors would interfere with the
63	63	care of or rights of any patient or resident; 3) visitors are engaging in disruptive,
64	64	threatening, or violent behavior toward any staff member, patient, or other visitor;
65	65	or 4) visitors are noncompliant with the health care facility's policy.
66	66	The bill directs the Department of Health Services to develop informational
67	67	material regarding health care facility visitation, to present the informational
68	68	material to the appropriate legislative committees, and to update the informational
69	69	material as needed to allow for the maximum visitation possible in health care
70	70	facilities. Health care facilities must make the informational material available to
71	71	patients and residents.
72	72	The bill provides that patients may file complaints with appropriate state
73	73	agencies and licensing boards for a health care facility's violation of the provisions
74	74	of this bill, and state agencies and licensing boards must investigate and penalize
75	75	health care facilities for failure to comply with this bill. However, the bill prohibits - 3 -2023 - 2024 Legislature
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79	79	a state agency from taking action against a health care facility for granting visitors
80	80	access to the facility or for the actions and omissions of those visitors.
81	81	The people of the state of Wisconsin, represented in senate and assembly, do
82	82	enact as follows:
83	83	SECTION 1. 146.95 (2) (b) (intro.) of the statutes is amended to read:
84	84	146.95 (2) (b) (intro.) Subject to s. 51.61 for a treatment facility, and except as
85	85	provided in s. 146.955, an inpatient health care facility may deny visitation with a
86	86	patient to any person if any of the following applies:
87	87	SECTION 2. 146.955 of the statutes is created to read:
88	88	146.955 Patient visitation rights. (1) DEFINITIONS. In this section:
89	89	(a) “Compassionate care visitation” means a visit with a resident that is
90	90	necessary to meet the physical or mental needs of the resident.
91	91	(b) “Health care facility" means a hospice, hospital, long-term care facility,
92	92	primary care facility, or any other system, care clinic, care provider, or entity whose
93	93	staff provides health care service to individuals in this state.
94	94	(c) “Hospice” has the meaning given in s. 50.90 (1) (c).
95	95	(d) “Hospital” has the meaning given in s. 50.33 (2).
96	96	(e) “Long-term care facility” includes any of the following:
97	97	1. A nursing home, as defined in s. 50.01 (3).
98	98	2. A community-based residential facility, as defined in s. 50.01 (1g).
99	99	3. A facility, as defined in s. 647.01 (4).
100	100	4. A swing bed in an acute care facility or extended care facility, as specified
101	101	under 42 USC 1395tt.
102	102	5. An adult family home, as defined in s. 50.01 (1).
103	103	6. A residential care apartment complex, as defined in s. 50.01 (6d).
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127	127	7. A brain injury rehabilitation facility, as defined in s. 46.278 (1m) (a).
128	128	(f) “Patient with a disability” means a patient who needs assistance to
129	129	effectively communicate with health care providers, make health care decisions, or
130	130	engage in activities of daily living due to a physical, intellectual, behavioral, or
131	131	cognitive disability, including deafness, being hard of hearing, communication
132	132	barriers, blindness, autism spectrum disorder, or dementia.
133	133	(g) “Personal contact” means an encounter in which 2 or more people are in
134	134	physical proximity to each other and may involve physical touching or oral
135	135	communication.
136	136	(h) “Primary care facility” means any building, structure, institution, or place
137	137	devoted primarily to the provision of outpatient, general health care services that is
138	138	a main source for regular health care services for patients.
139	139	(i) “Resident" means an individual cared for or treated in a long-term care
140	140	facility.
141	141	(j) “Support person” means a family member , guardian, personal care
142	142	assistant, or other paid or unpaid attendant designated by a patient to advocate or
143	143	provide support for the patient.
144	144	(2) LONG-TERM CARE FACILITY VISITATION; COMPASSIONATE CARE VISITATION. (a) 1.
145	145	A long-term care facility shall grant compassionate care visitation to residents.
146	146	2. A long-term care facility shall have in place a protocol for compassionate care
147	147	visitation which allows personal contact between residents and visitors that adheres
148	148	to infection prevention guidelines disseminated by the federal centers for disease
149	149	control and prevention or the federal centers for medicare and medicaid services.
150	150	(b) A resident may request any of the following individuals to visit for a
151	151	compassionate care visitation:
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181	181	1. A friend.
182	182	2. A family member.
183	183	3. A clergy member.
184	184	4. A lay person offering religious or spiritual support.
185	185	5. An individual providing a service to the resident.
186	186	(c) Any of the following is considered compassionate care visitation:
187	187	1. Support in end-of-life situations.
188	188	2. Adjustment support following a move to a new facility or environment.
189	189	3. Emotional support after the loss of a friend or family member.
190	190	4. Physical support after eating or drinking issues, including weight loss or
191	191	dehydration.
192	192	5. Social support for frequent crying, distress, or depression.
193	193	(d) A long-term care facility shall work with residents, families, caregivers,
194	194	resident representatives, and health care providers, and may include the
195	195	ombudsman program under s. 16.009 (4), to identify the need for compassionate care
196	196	visitation, using a person-centered approach that takes a resident's request into
197	197	account.
198	198	(e) A long-term care facility shall ensure that decisions regarding end-of-life
199	199	care are made by a resident with capacity or by the guardian or agent under an
200	200	activated power of attorney of a resident found to be incapacitated under s. 155.05
201	201	(2).
202	202	(f) Within the scope of visitation provided by this subsection, a long-term care
203	203	facility shall allow a resident making decisions regarding end-of-life care to be
204	204	accompanied by a family member, guardian, or support person designated by the
205	205	resident.
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233	233	(g) 1. If the COVID-19 infection rate in the county in which the long-term care
234	234	facility is located is 20 percent or higher, a long-term care facility shall identify at
235	235	least one way to allow compassionate care visitation, including personal contact, that
236	236	minimizes the risk of infection to the resident and other residents.
237	237	2. In a long-term care facility with no new onset of COVID-19 in the past 14
238	238	days and in counties with COVID-19 positivity rates that are less than 10 percent,
239	239	a long-term care facility shall accommodate and support indoor visitation for
240	240	reasons beyond compassionate care visitation.
241	241	(h) A long-term care facility may do any of the following:
242	242	1. For a resident who shares a room with another resident, prohibit visitation
243	243	in the resident's room, unless the health status of the resident prevents him or her
244	244	from leaving the room.
245	245	2. Limit the number of visitors per resident at a given time based on the size
246	246	of the building and the physical space of the building.
247	247	3. Limit movement in the long-term care facility.
248	248	4. Require visitors to go directly to the resident's room or to a designated
249	249	visitation area.
250	250	(i) A long-term care facility shall grant entry to a health care provider who is
251	251	not an employee of the long-term care facility but who provides direct care to a
252	252	resident, provided that the health care provider follows proper infection control
253	253	protocols.
254	254	(3) VISITATION AND SUPPORT FOR A PATIENT WITH A DISABILITY. (a) Upon the request
255	255	of a patient with a disability, a health care facility shall allow a patient with a
256	256	disability to designate at least 3 support persons and shall allow at least one support
257	257	person to be physically present with the patient with a disability during the patient's
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287	287	stay in the health care facility if necessary to facilitate the care of a patient with a
288	288	disability, including if any of the following apply:
289	289	1. The patient with a disability has a cognitive or mental health disability and
290	290	requires the assistance of a support person to ensure effective communication with
291	291	health care providers.
292	292	2. The patient with a disability is deaf, hard of hearing, or has other
293	293	communication barriers and requires the assistance of a support person to ensure
294	294	effective communication with health care providers.
295	295	3. The patient with a disability is making a decision to consent to treatment or
296	296	to refuse treatment.
297	297	4. The patient with a disability needs assistance with activities of daily living
298	298	and the health care providers are unable to assist or are less effective than the
299	299	support person at providing the assistance.
300	300	5. The patient with a disability has behavioral health needs that the support
301	301	person can address more effectively than the health care providers.
302	302	(b) A health care facility may not require, as a condition of having a support
303	303	person present under this subsection, a patient with a disability to execute a
304	304	declaration to physicians under s. 154.03, consent to a do-not-resuscitate order
305	305	under subch. III of ch. 154, or execute a physician order for life-sustaining
306	306	treatment.
307	307	(4) HOSPITAL OR PRIMARY CARE FACILITY VISITATION. (a) Notwithstanding s. 146.95
308	308	(2) (b), a child has the right to have daily personal contact at reasonable times with
309	309	a parent, an individual standing in the place of a parent, or a legal guardian while
310	310	the child receives care in a hospital or primary care facility, subject to par. (d). A
311	311	hospital or primary care facility shall allow a parent, an individual standing in the
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339	339	place of a parent, or a legal guardian visiting a child under this paragraph to leave
340	340	and reenter the hospital or primary care facility while the child is receiving care.
341	341	(b) Notwithstanding s. 146.95 (2) (b), an adult has the right to have daily
342	342	personal contact at reasonable times with a spouse, support person, or legal guardian
343	343	while the adult receives care in a hospital or primary care facility, subject to par. (d).
344	344	A hospital or primary care facility shall allow a spouse, support person, or legal
345	345	guardian visiting an adult under this paragraph to leave and reenter the hospital or
346	346	primary care facility while the adult is receiving care.
347	347	(c) A hospital or primary care facility may not require a patient to waive the
348	348	rights specified in par. (a) or (b).
349	349	(d) A hospital or primary care facility may restrict access of any individual to
350	350	a patient if any of the following apply:
351	351	1. The patient has requested the individual's access to the patient be restricted.
352	352	2. A law enforcement agency has requested the individual's access to the
353	353	patient be restricted.
354	354	3. A court order requires the individual's access to the patient be restricted.
355	355	4. Restricted access is necessary to prevent disruption to the care of the patient.
356	356	5. The individual has signs and symptoms of a communicable infection, except
357	357	that hospital or primary care facility shall permit an individual under this
358	358	subdivision to have access to a patient through means that ensure the protection of
359	359	the patient, including allowing access to the patient through telecommunication
360	360	means or allowing personal contact if the individual follows infection prevention and
361	361	control practices.
362	362	6. The individual is determined to be a danger to the patient or to be contrary
363	363	to the welfare of the patient.
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393	393	7. Restricted access is permissible under sub. (7).
394	394	(5) HOSPICE VISITATION. A patient who is receiving hospice care or the guardian,
395	395	spouse, or support person of a patient who is receiving hospice care may designate
396	396	additional family members and friends who may have personal contact with the
397	397	patient at reasonable times.
398	398	(6) CLERGY MEMBER OR LAY PERSON OFFERING RELIGIOUS OR SPIRITUAL SUPPORT
399	399	VISITATION. A health care facility must permit a clergy member or lay person offering
400	400	religious or spiritual support to have personal contact with a patient to pray with or
401	401	offer spiritual support for the patient while the patient receives care from the health
402	402	care facility.
403	403	(7) VISITATION LIMITS OR RESTRICTIONS. A health care facility may establish
404	404	visitation policies that limit or restrict visitation when any of the following is true:
405	405	(a) The presence of visitors would be medically or therapeutically
406	406	contraindicated.
407	407	(b) The presence of visitors would interfere with the care of or rights of any
408	408	patient or resident.
409	409	(c) Visitors are engaging in disruptive, threatening, or violent behavior toward
410	410	a staff member, patient, or other visitor.
411	411	(d) Visitors are noncompliant with a policy of the health care facility.
412	412	(8) INFORMATIONAL MATERIALS. (a) Within 30 days after the effective date of this
413	413	paragraph .... [LRB inserts date], the department shall develop informational
414	414	materials on patient visitation under this section.
415	415	(b) The department shall submit a report regarding patient visitation under
416	416	this section to the appropriate standing committees of the legislature under s. 13.172
417	417	(3).
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445	445	(c) A health care facility shall make the informational materials under par. (a)
446	446	accessible to patients and residents upon admission or registration and shall post the
447	447	informational materials on its website.
448	448	(d) Every 60 days or upon the release of applicable federal guidelines, the
449	449	department, with input from the long-term care industry and the hospital industry,
450	450	shall reevaluate and update the informational materials under par. (a) as needed to
451	451	allow for the maximum possible visitation in a health care facility under applicable
452	452	federal guidelines.
453	453	(e) The informational materials under par. (a) shall take into consideration and
454	454	include the highest amount of privacy and dignity for interaction between patients
455	455	and visitors.
456	456	(9) COMPLAINTS AND INVESTIGATION. (a) An individual may file with the
457	457	appropriate state agency or licensing board, including the department, a complaint
458	458	against a health care provider or a health care facility for failing to comply with this
459	459	section. That state agency or licensing board shall investigate the complaint and
460	460	may penalize a health care provider or health care facility for failure to comply with
461	461	this section.
462	462	(10) LIMITED LIABILITY OF HEALTH CARE FACILITIES. A state agency may not take
463	463	any action against a health care facility for any of the following:
464	464	(a) Giving a visitor or other individual access to a health care facility.
465	465	(b) Failing to protect or otherwise ensure the safety or comfort of a visitor or
466	466	other individual given access to a health care facility.
467	467	(c) Failing to follow the federal centers for disease control and prevention or the
468	468	federal centers for medicare and medicaid services guidelines or other national
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497	497	guidelines that require or recommend restricting visitor access to a health care
498	498	facility.
499	499	(d) The acts or omissions of any visitor or other individual who is given access
500	500	to a health care facility.
501	501	(11) CONSTRUCTION. (a) This section does not apply to any of the following:
502	502	1. A minor who is in the custody of a county department, as defined under s.
503	503	48.02 (2g), a licensed child welfare agency, or the department of children and
504	504	families.
505	505	2. A minor who is a suspected victim in a pending abuse investigation under
506	506	s. 48.981 (3).
507	507	3. An individual who is in the custody of the department of corrections.
508	508	4. An individual who is attending a preventive health care office visit during
509	509	which evidence-based guidelines for preventive care recommend a confidential visit
510	510	component for youth, as mutually agreed to by the patient and his or her physician.
511	511	(b) The rights specified in this section may not be terminated, suspended, or
512	512	waived by any of the following:
513	513	1. A health care facility.
514	514	2. The department.
515	515	3. A state or local board of health.
516	516	4. The governor upon declaring of a state of emergency under s. 323.10 or
517	517	ordering the department to take action.
518	518	(END)
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