2023 - 2024 LEGISLATURE
LRB-2581/1
SWB:wlj
2023 ASSEMBLY BILL 185
April 20, 2023 - Introduced by JOINT LEGISLATIVE COUNCIL. Referred to Committee
on Health, Aging and Long-Term Care.
1 AN ACT to amend 69.18 (2) (b), 69.18 (2) (d) and 448.02 (3) (a); and to create 69.18
2 (2) (g) of the statutes; relating to: requiring use of the electronic system of vital
3 records for medical certifications of death.
Analysis by the Legislative Reference Bureau
This bill is explained in the NOTES provided by the Joint Legislative Council in
the bill.
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 Committee 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 fulfilled by a funeral director. The filing party must
obtain certain 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 certification, which is a portion of the death record providing cause-of-death and
other information. Depending on the circumstances of the death, the medical
certification may be completed and signed by a medical examiner, coroner, physician, 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
 2023 - 2024 Legislature -2- LRB-2581/1
SWB:wlj
ASSEMBLY BILL 185
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
pronouncement 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 examiners, and coroners, and less commonly used by other
individuals authorized to complete a medical certification, such as physicians. Those
individuals who complete a medical certification 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 certification to mail the death record to the filing party. Finally,
the bill delays the effective date of these provisions for 24 months.
1 SECTION 1. 69.18 (2) (b) of the statutes is amended to read:
2 69.18 (2) (b) If a person under the care of a physician dies from the illness or
3 condition for which the care is given and a coroner or medical examiner does not
4 certify the cause of death under par. (d) 1., the physician shall complete and sign a
5 medical certification for the death under par. (f) and mail the medical certification
6 within 5 days after the pronouncement of death or use the state registrar's electronic
7 system of vital records to present the medical certification to the person responsible
8 for filing the death record under sub. (1) within 6 days after the pronouncement of
9 death.
10 SECTION 2. 69.18 (2) (d) of the statutes is amended to read:
11 69.18 (2) (d) 1. Except as provided under par. (e), if a death is the subject of a
12 coroner's or medical examiner's determination under s. 979.01 or 979.03, the coroner
13 or medical examiner or a physician supervised by a coroner or medical examiner in
14 the county where the event which caused the death occurred shall complete and sign
15 the medical certification for the death and mail the death record within 5 days after
16 the pronouncement of death or use the state registrar's electronic system of vital
 LRB-2581/1
2023 - 2024 Legislature -3- SWB:wlj
ASSEMBLY BILL 185 SECTION 2
1 records to present the record to the person responsible for filing the death record
2 under sub. (1) within 6 days after the pronouncement of death.
3 2. Except as provided under par. (e), if the decedent was not under the care of
4 a physician for the illness or condition from which the person died, the coroner or
5 medical examiner, or a physician supervised by a coroner or medical examiner, in the
6 county of the place of death shall complete and sign the medical certification for the
7 death and mail the death record within 5 days after the pronouncement of death or
8 use the state registrar's electronic system of vital records to present the record to the
9 person responsible for filing the death record under sub. (1) within 6 days after the
10 pronouncement of death.
11 3. For a medical certification under this paragraph, except a medical
12 certification of the cause of death of an indigent, a coroner or medical examiner may
13 charge a fee established by the county board, not to exceed an amount reasonably
14 related to the actual and necessary cost of providing the medical certification. The
15 coroner or medical examiner, or the physician employed by the coroner or medical
16 examiner, shall mail or use the state registrar's electronic system of vital records to
17 present a medical certification as required under subd. 1., whether or not the fee has
18 been paid.
19 SECTION 3. 69.18 (2) (g) of the statutes is created to read:
20 69.18 (2) (g) Any person who completes and signs medical certifications under
21 this subsection shall use the state registrar's electronic system of vital records to
22 present the medical certification as required under this subsection.
23 SECTION 4. 448.02 (3) (a) of the statutes is amended to read:
24 448.02 (3) (a) The board shall investigate allegations of unprofessional conduct
25 and negligence in treatment by persons holding a license or certificate granted by the
 2023 - 2024 Legislature -4- LRB-2581/1
SWB:wlj
ASSEMBLY BILL 185 SECTION 4
1 board. An allegation that a physician has violated s. 253.10 (3), 448.30 or 450.13 (2)
2 or has failed to mail or present a medical certification required under s. 69.18 (2)
3 within 21 days after the pronouncement of death of the person who is the subject of
4 the required certificate or that a physician has failed at least 6 times within a
5 6-month period to mail or present a medical certificate required under s. 69.18 (2)
6 within 6 days after the pronouncement of death of the person who is the subject of
7 the required certificate is an allegation of unprofessional conduct. Information
8 contained in reports filed with the board under s. 49.45 (2) (a) 12r., 50.36 (3) (b),
9 609.17 or 632.715, or under 42 CFR 1001.2005, shall be investigated by the board.
10 Information contained in a report filed with the board under s. 655.045 (1), as created
11 by 1985 Wisconsin Act 29, which is not a finding of negligence or in a report filed with
12 the board under s. 50.36 (3) (c) may, within the discretion of the board, be used as the
13 basis of an investigation of a person named in the report. The board may require a
14 person holding a license or certificate to undergo and may consider the results of one
15 or more physical, mental or professional competency examinations if the board
16 believes that the results of any such examinations may be useful to the board in
17 conducting its investigation.
18 SECTION 5.0Effective date.
19 (1) This act takes effect on the first day of the 24th month beginning after
20 publication.
21 (END)


Statutes affected:
Bill Text: 69.18(2)(b), 69.18, 69.18(2)(d), 448.02(3)(a), 448.02