Reporting Procedures for Statutorily Reportable Deaths – DHS Responsibilities

Department Responsibilities

Some of the most vulnerable citizens of the state of Wisconsin are served by a variety of institutions, residential facilities, and treatment facilities (mental health or substance abuse programs/services) that are overseen by the Department of Health Services (DHS).

Wis. Stats. §§ 50.035(5), 50.04(2t), 51.03(2), and 51.64(2)(a) establish the reporting requirements when there is reasonable cause to believe that the death of a client may have been related to:

  • the use of a physical restraint or seclusion
  • a prescribed psychotropic medication
  • a suspected suicide

DHS has a responsibility to investigate reportable deaths in a Department licensed or certified program or facility no later than 14 days after the date the death is reported. DHS, Division of Quality Assurance (DQA) conducts the investigation and does the following:

  • Determines if minimum standards were followed in the use of seclusion and/or restraints, psychotropic medications, and the prevention of a suicide
  • Takes appropriate action based on the findings of the death investigation which may include, but is not limited to:
    • the provision of technical assistance to the care/treatment providers,
    • development of needed training,
    • publication of special alerts and bulletins, and
    • certification or licensing action.

DHS has the authority and responsibility to conduct a thorough investigation using whatever customary means and techniques are warranted including, but not limited to, all of the following:

  • individual interviews with staff, clients, and other persons
  • a review of treatment, medication, and somatic treatment records
  • a review of policies and procedures of the program/facility
  • inspection of any buildings and their contents

DQA investigators/surveyors have access under Wis. Stat. § 51.30(4)(b) to all treatment and medication records without the informed written consent of the client (or guardian), and may request:

  • a copy of any documentation from the client’s treatment and medication records
  • the program’/facility policies and procedures

For information about reportable death investigations, contact:

Kelly Terrab
Division of Quality Assurance
P. O. Box 2969
Madison, WI 53701-2969
Phone: 608-267-2838

Last Revised: November 28, 2016