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Care Coordination/Care Management in Wisconsin

 

        The state of Wisconsin advocates coordination in health care and patient management of care.  Wisconsin allows physicians to enter into agreements for the sharing, allocation, and referral of patients, personnel and medical facilities.[1]  The law also encourages advanced practice nurses to coordinate patient care by authorizing the sharing of patient medical records with other health care providers.[2]

        The law encourages patients to participate in their own care and treatment.[3]  The state requires patients to give informed consent to medications, treatment, and research, and gives patients the right to refuse any medications or treatments.[4] The parents, guardian, or representative of a patient may give informed consent on their behalf if the patient is a minor or incapacitated.[5]

        Furthermore, the Wisconsin Department of Health Services is authorized to develop a consumer guide to enable health care consumers to choose a provider and health plan, educate consumers on getting health insurance, and direct consumers to sources of disease specific information.[6]  The consumer guide must be widely publicized and disseminated to health care consumers throughout the state.[7]  In addition, the law authorizes the collection and reporting of quality assurance and provider information to be put in a central repository.[8]

 

 

Care Coordination/Care Management in Wisconsin

Subtopic Statute/Regulation Description
Informed consent requirements (If the information is going beyond the patient and provider Admission to and care in a hospice for certain incapacitated persons – Wis. Stat. Ann. § 50.94 Admission to and care in a hospice for certain incapacitated persons An authorized individual may place an incapacitated person into hospice care if...
Confidentiality of patient health care records – Wis. Stat. Ann. § 146.82 All identifiable health information is confidential and the release of such information requires consent of the patient, except under very limited...
Informed consent for psychotropic medications – Wis. Stat. Ann. § 50.08 Informed consent for psychotropic medications Nursing homes must obtain the written informed consent of nursing home residents or individuals...
Informed consent – Wis. Admin. Code DHS §94-03 All informed consent documents must declare that the patient has been given complete and accurate information, and time to study or get more...
Medications and other treatment – Wis. Admin. Code DHS §94-09 All patients must be informed of their treatment plans and are encouraged to participate in their own care.  A patient has the right to refuse...
Notification of rights – Wis. Admin. Code DHS §94-04 Upon admission, a patient must be notified either orally or in writing of his or her rights.  Oral notification may be satisfied by showing the...
Patient rights in Hospices – Wis. Admin. Code DHS §131-19 A hospice must provide each patient or patient representative with a written statement of rights before services are provided.  The statement...
Patient rights – Wis. Admin. Code DHS §133-08 A home health agency must provide each patient with a written notice of the patient’s rights before services are provided.  Each patient...
Patients rights – Wis. Stat. Ann. § 51.61 Patients Rights When patients are admitted or committed, they must be informed orally and in writing of his/her rights.  These rights include...
Review of outpatient mental health treatment of minors aged 14 or older – Wis. Stat. Ann. § 51.14 Review of outpatient mental health treatment of minors aged 14 or older This law requires that each court assigned to exercise the requisite...
Rights of residents in certain facilities – Wis. Stat. Ann. § 50.09 Rights of residents in certain facilities Nursing home and community-based residential facility residents have the following rights: The right to...
Rights of residents in Nursing Homes – Wis. Admin. Code DHS §132-31 Each resident in a nursing home facility has the right to be informed of all services and their charges upon admission.  The patient or patient...
Use of genetic tests – Wis. Stat. Ann. § 942.07 Employers, labor organizations, employment agencies, and licensing agencies must obtain informed consent from their employee, member, licensee, or...
Voluntary and informed consent for abortions – Wis. Stat. Ann. § 253.10 Women must give both voluntary and informed consent before receiving an abortion. A woman gives voluntary consent if she agrees to the abortion...
Information sharing across providers (including communication with other providers, across state lines, patient transfer) Case management and collaboration with other health care professionals – Wis. Admin. Code N §8-10 This regulation pertains to advanced practice nurses.  They are required to communicate with patients using modern communication techniques....
Collection and dissemination of health care and related information – Wis. Stat. Ann. § 153.05 Collection and Dissemination of health care and related information The purpose of this section is to give providers, consumers, insurers, and...
Confidentiality of patient health care records – Wis. Stat. Ann. § 146.82 All identifiable health information is confidential and the release of such information requires consent of the patient, except under very limited...
New coordinated systems of care (ACOs, Patient Centered Medical Homes/Health homes) (Cross reference with Quality Measurement) Certificate of public advantage – Wis. Stat. Ann. § 158.85 The state of Wisconsin allows physicians to enter into agreements for sharing, allocation and referral of patients, personnel, or medical facilities...
Patient authorization requirements (to provide health information to another individual) Do-not-resuscitate order – Wis. Stat. Ann. § 154.19 Attending physicians may issue a do-not-resuscitate order (“DNR”) if: The patient has a terminal condition, a condition that limit...
Revocation of do-not-resuscitate order – Wis. Stat. Ann. § 154.21 A patient may revoke their do-not-resuscitate order (“DNR”) by asking an emergency medical professional to remove their DNR bracelet,...
Testing infants for controlled substances or controlled substance analogs – Wis. Stat. Ann. § 146.0255 Health care providers employed by hospitals, social workers, and intake workers that suspect that an infant or expectant mother has a controlled...
Wis. Stat. Ann. § 155.40 – Revocation of power of attorney for health care Revocation of power of attorney for health care This law allows a person to revoke his/her "power of attorney for health care" in a few different...
Licensure laws requiring or recommending care coordination or care management activities (Cross reference with private insurance/Medicaid/Medicare data requirements) Medical assistance; administration – Wis. Stat. Ann. § 49.45 Medical Assistance; Administration This law sets forth the detailed instructions to the Department of Health Services on running the state's Medical...
Disease management Restrictions on use of an HIV test – Wis. Stat. Ann. § 252.15 Informed Consent Health care providers, blood banks, and plasma centers (“providers”) must take the following actions prior to...