DHS 34.03(8)(c)(c) A program staff member has been convicted of a criminal offense related to the provision of or claiming reimbursement for services under the medicare program under 42 CFR 430 to 456, or under this state’s or any other state’s medical assistance program or any other third party payer. In this paragraph, “convicted” means that a judgment of conviction has been entered by a federal, state or local court, regardless of whether an appeal from that judgment is pending. DHS 34.03(8)(d)(d) A staff member has been convicted of a criminal offense related to the provision of care, treatment or services to a person who is mentally ill, developmentally disabled, alcoholic or drug dependent; or has been convicted of a crime against a child under ch. 948, Stats. DHS 34.03(8)(e)(e) The program has submitted, or caused to be submitted, statements for purposes of obtaining certification under this chapter which it knew or should have known to be false. DHS 34.03(8)(f)(f) The program failed to maintain compliance with or is in substantial non-compliance with one or more of the requirements set forth in this section. DHS 34.03(8)(g)(g) A program staff member signed billing or other documents as the provider of service when the service was not provided by the program staff member. DHS 34.03(8)(h)(h) There is no documentary evidence in a client’s services file that the client received services for which bills had been submitted to a third party payer. DHS 34.03(9)(a)(a) The department may make announced and unannounced inspections of the program to verify continuing compliance with this chapter or to investigate complaints received regarding the services provided by the program. DHS 34.03(9)(b)(b) Inspections shall minimize any disruption to the normal functioning of the program. DHS 34.03(9)(c)(c) If the department determines during an inspection that the program has one or more major deficiencies, or it finds that any of the conditions stated in sub. (8) or (11) exist, it may suspend or terminate the program’s certification. DHS 34.03(9)(d)(d) If the department determines during an inspection that the program has one or more minor deficiencies, it may issue a notice of deficiency to the program and offer the program provisional certification pursuant to sub. (10). DHS 34.03(9)(e)(e) If the department terminates or suspends the certification of a program, the department shall provide the program with a written notice of the reasons for the suspension or termination and inform the program of its right to a hearing on the suspension or termination as provided under sub. (12). DHS 34.03(10)(10) Provisional certification pending implementation of a plan of correction. DHS 34.03(10)(a)(a) If, during an inspection, the department determines that minor deficiencies exist, the department shall issue a notice of deficiency to the program and offer the program a provisional certificate pending correction of the identified deficiencies. DHS 34.03(10)(b)(b) If a program wishes to continue operation after the issuance of a notice of deficiency under an offer for provisional certification, it shall, within 30 days of the receipt of the notice of deficiency, submit a plan of correction to the department identifying the specific steps which will be taken to remedy the deficiencies and the timeline in which these steps will be taken. DHS 34.03(10)(c)(c) If the department approves the plan of correction, it shall issue the program a provisional certificate for up to 60 days of operation, pending the accomplishment of the goals of the plan of correction. DHS 34.03(10)(d)(d) Prior to the expiration of the provisional certification, the department shall conduct an on-site inspection of the program to determine whether the proposed corrections have occurred. DHS 34.03(10)(e)(e) Following the on-site inspection, if the department determines that the goals of the approved plan of correction have been accomplished, it shall restore the program to full certification and withdraw the notice of deficiency. DHS 34.03(10)(f)(f) If the goals of the plan of correction have not been accomplished, the department may suspend or terminate the program’s certification or allow the program one extension of no more than 30 additional days to complete the plan of correction. If after this extension the program has still not remedied the identified deficiencies, the department shall suspend or terminate the certification. DHS 34.03(10)(g)(g) If the department denies, suspends, or terminates the certification, the department shall provide the program with a written notice of the reasons for the action and inform the program of its right to a hearing under sub. (12). DHS 34.03(11)(a)(a) The department may immediately suspend the certification of a program or bar from practice in a certified program any program staff member, pending a hearing on the matter, if any of the following has occurred: DHS 34.03(11)(a)1.1. Any of the licenses, certificates or required local, state or federal approvals of the program or program staff member have been revoked, suspended or expired. DHS 34.03(11)(a)2.2. The health or safety of a client is in imminent danger because of knowing failure of the program or a program staff member to comply with requirements of this chapter or any other applicable local, state or federal statute or regulation. DHS 34.03(11)(b)(b) The department shall provide written notice to the program or program staff member of the nature of the immediate suspension, the acts or conditions on which the suspension is based, any additional remedies which the department will be seeking and information regarding the right of the program or the person under the suspension to a hearing pursuant to sub. (12). DHS 34.03(12)(a)(a) In the event that the department denies, terminates, or suspends certification, or gives prior notice of its intent to do so, an applicant or program may request a hearing under ch. 227, Stats. DHS 34.03(12)(b)(b) The request for a hearing shall be submitted in writing to and received by the department of administration’s division of hearings and appeals within 30 days after the date on the notice required under sub. (3), (8), (9), (10) or (11). DHS 34.03 NoteNote: The mailing address of the Division of Hearings and Appeals is P.O. Box 7875, Madison, WI 53707.
DHS 34.03(13)(13) Dissemination of results. Upon completing action on an application for certification, staff of the department responsible for certification shall provide a summary of the results of the process to the applicant program, to the subunit within the department responsible for monitoring community mental health programs and to the county department in the county in which the program is located. DHS 34.03(14)(14) Violation and future certification. A person with direct management responsibility for a program and all practitioners of a program who were knowingly involved in an act or acts which served as a basis for immediate termination shall be barred from providing service in a certified program for a period not to exceed 5 years. This applies to the following acts: DHS 34.03(14)(b)(b) Acts which result in conviction for a criminal offense related to services provided under s. 632.89, Stats. DHS 34.03(14)(c)(c) Acts involving an individual staff member who has terminated affiliation with a program and who removes or destroys participant records. DHS 34.03 HistoryHistory: Cr. Register, September, 1996, No. 489, eff. 10-1-96; correction in (12) (b) made under s. 13.93 (2m) (b) 6., Stats., Register, September, 1996, No. 489; correction in (2) (e) and (14) (a) made under s. 13.93 (2m) (b) 7., Stats., Register, April, 2000, No. 532; correction in (11) (a) 3. made under s. 13.93 (2m) (b) 7., Stats., Register October 2004 No. 586; corrections in (2) (b) 2., (e) and (14) (a) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635; CR 22-078: am. (2) (title), (a) (intro.), (3) (a) (intro.), r. and recr. (6), (7), am. (8) (intro.), (10) (a), (f), (g), (12) (a) Register July 2023 No. 811, eff. 8-1-23. DHS 34.04(1)(a)(a) Except as provided in par. (b), the department may grant a waiver of any requirement in this chapter when the department determines that granting the waiver would not diminish the effectiveness of the services provided by the program, violate the purposes of the program or adversely affect clients’ health, safety or welfare, and one of the following applies: DHS 34.04(1)(a)1.1. Strict enforcement of a requirement would result in unreasonable hardship on the provider or on a participant. DHS 34.04(1)(a)2.2. An alternative to a rule, including a new concept, method, procedure or technique, new equipment, new personnel qualifications or the implementation of a pilot project is in the interests of better participant care or program management. DHS 34.04(1)(b)(b) The department may not grant a waiver of client confidentiality or rights under this chapter, ch. DHS 92 or 94 or under other administrative rules, state statutes or federal regulations. DHS 34.04(2)(2) Application. An application for a waiver under this section shall be made in writing to the department and shall specify all of the following: DHS 34.04(2)(e)(e) Assurances that the requested waiver would meet the requirements of sub. (1). DHS 34.04(3)(a)(a) The department may require additional information from the program before acting on the request for a waiver. DHS 34.04(3)(b)(b) The department shall grant or deny each request for wavier in writing. Notice of denial shall contain the reasons for denial. If a notice of a denial is not issued within 60 days after the receipt of a completed request, the waiver shall be automatically approved. DHS 34.04(3)(c)(c) The department may impose any condition on the granting of a waiver which it deems necessary. DHS 34.04(3)(e)(e) No waiver may continue beyond the period of certification without a specific renewal of the waiver by the department. DHS 34.04(3)(f)(f) The department’s decision to grant or deny a waiver shall be final. DHS 34.04 HistoryHistory: Cr. Register, September, 1996, No. 489, eff. 10-1-96; correction in (1) (b) made under s. 13.93 (2m) (b) 7., Stats., Register, April, 2000, No. 532; correction in (1) (b) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635. DHS 34.10(1)(1) A county may operate or contract for the operation of a basic emergency mental health services program. DHS 34.10(2)(2) A basic emergency mental health services program operated by a county or under contract for a county shall comply with subch. I and this subchapter. DHS 34.10 HistoryHistory: Cr. Register, September, 1996, No. 489, eff. 10-1-96. DHS 34.11(1)(1) General. A basic emergency service mental health program shall: DHS 34.11(1)(a)(a) Provide immediate evaluation and mental health care to persons experiencing a mental health crisis. DHS 34.11(1)(b)(b) Make emergency services available within the county’s mental health outpatient programs, mental health inpatient program or mental health day treatment program and shared with the other 2 programs. DHS 34.11(1)(c)(c) Be organized with assigned responsibility, staff and resources so that it is a clearly identifiable program. DHS 34.11(2)(b)(b) Telephone emergency service may be provided by volunteers after they are carefully selected for aptitude and after a period of orientation and with provision for inservice training. DHS 34.11(2)(c)(c) A regular staff member of the program shall be available to provide assistance to volunteers at all times. DHS 34.11(2)(d)(d) Medical, preferably psychiatric, consultation shall be available to all staff members at all times. DHS 34.11(3)(a)(a) Emergency services shall be available 24 hours a day and 7 days a week. DHS 34.11(3)(b)(b) A program shall operate a 24-hour crisis telephone service staffed by mental health professionals or paraprofessionals, or by trained mental health volunteers backed up by mental health professionals. The crisis telephone service shall have a published telephone number, and that number shall be widely disseminated to community agencies and the public. DHS 34.11(3)(c)(c) A program shall provide face to face contact for crisis intervention. Face to face contact for crisis intervention may be provided as a function of the county’s outpatient program during regular hours of outpatient program operation, with an on-call system for face-to-face contact for crisis intervention at all other times. A program shall have the capability of making home visits or seeing patients at other off-headquarter locations, and shall have the resources to carry out on-site interventions when this is clinically desirable. A program may use telehealth in conjunction with in-person services. DHS 34.11(3)(d)(d) When appropriate, emergency service staff may transfer clients to other county mental health programs. DHS 34.11 HistoryHistory: Cr. Register, September, 1996, No. 489, eff. 10-1-96; correction in (2) (a) made under s. 13.93 (2m) (b) 7., Stats., Register October 2004 No. 586; CR 23-053: am. (3) (c) Register September 2023 No. 813, eff. 10-1-23. subch. III of ch. DHS 34Subchapter III — Standards for Emergency Service Programs Eligible for Medical Assistance Program or Other Third Party Reimbursement DHS 34.20(1)(1) A county may operate or contract for the operation of an emergency mental health services program that is eligible for medical assistance program reimbursement or eligible for third-party payments under policies governed by s. 632.89, Stats. DHS 34.20(2)(2) An emergency mental health services program eligible for medical assistance program reimbursement or eligible for third-party payments under policies governed by s. 632.89, Stats., that is operated by a county or under contract for a county shall comply with subch. I and this subchapter. DHS 34.20 HistoryHistory: Cr. Register, September, 1996, No. 489, eff. 10-1-96. DHS 34.21(1)(a)(a) An emergency mental health services program shall have written personnel policies. DHS 34.21(1)(b)(b) A program shall maintain written documentation of employee qualifications and shall make that information available upon request for review by clients and their guardians or parents, where guardian or parent consent is required for treatment, and by the department. DHS 34.21(2)(a)(a) Each employee shall have the ability and emotional stability to carry out his or her assigned duties.
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