Section DOC 316.04 - Copayment(1) Except for the exclusions listed under s. DOC 316.05, an inmate or a juvenile shall be charged a copayment for medical, dental or nursing services received at the request of the inmate or juvenile, including any face-to-face contact wherein the inmate or juvenile refuses to consent to a service offered in response to the inmate's or juvenile's request.(2)(a) During the assessment and evaluation process, the inmate and juvenile shall sign a notice form acknowledging that the inmate and juvenile shall be charged a copayment for non-emergency medical, dental or nursing services received at the request of the inmate or juvenile.(b) The notice form shall include a statement identifying the medical, dental or nursing services for which the inmate or juvenile will and will not be charged a copayment.(c) If the inmate or juvenile refuses to sign the notice form, the health care provider shall make a notation that the inmate or juvenile refused to sign the notice form and the health care provider shall sign the notation.(3) Staff shall charge a $7.50 copayment for each face-to-face contact for medical, dental or nursing services regardless of the number of services provided during the face-to-face contact. At the time of the face-to-face contact for medical, dental or nursing services, the inmate or juvenile shall sign a disbursement form acknowledging the receipt of health services. If the inmate or juvenile refuses to sign the disbursement form, the health care provider shall make a notation that the inmate or juvenile refused to sign the disbursement form and the health care provider shall sign the notation.Wis. Admin. Code Department of Corrections § DOC 316.04
Cr. Register, October, 1995, No. 478, eff. 11-1-95; emerg. am. (3), eff. 9-3-02; CR 02-123: am. Register April 2003, No. 568, eff. 5-1-03.