Chapter DHS 36

DHS 36.03(13)(a) (a) A guardian as defined under s. 54.01 (10), Stats.

DHS 36.03(13)(b) (b) A health care agent as defined in s. 155.01 (4), Stats., if the principal has a finding of incapacity pursuant to s. 155.05 (2), Stats.

DHS 36.03(14) (14) “Medical assistance” means the assistance program under 42 USC 1396 and ss. 49.43 to 49.475 and 49.49 to 49.497, Stats.

DHS 36.03(15) (15) “Mental disorder” means a diagnosis meeting the criteria in the Diagnostic and Statistical Manual of Mental Disorders — Fourth Edition — Text Revision (DSM-IV-TR) excluding the categories of dementia, substance-related disorders, and developmental disability as defined in 42 CFR 435.1009.

DHS 36.03 Note Note: DSM-IV-TR is published by the American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000. DSM-IV-TR may be ordered through http://www.amazon.com/Diagnostic-Statistical-Disorders-Revision-DSM-IV-TR/dp/0890420254 or other sources. The current version of the Diagnostic and Statistical Manual of Mental Disorders, DSM 5 is published by the American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. Washington, DC, American Psychiatric Association, 2013. The DSM 5 may be ordered through http://www.appi.org/Pages/DSM.aspx or other sources.

DHS 36.03(16) (16) “Mental health professional” means a staff member who is qualified under s. DHS 36.10 (2) (g) 1. to 8.

DHS 36.03(17) (17) “Minor” means an individual under the age of 18 years.

DHS 36.03(18) (18) “Natural supports” means a friend, or other person available in the community who may assist consumers seeking stability and independence.

DHS 36.03(19) (19) “Outreach” means identifying and contacting individuals with mental disorders or substance-use disorders to directly engage and link with individuals who need psychosocial rehabilitation services or other mental health or substance-use disorder services, and making referral agreements with psychiatric inpatient units, residential treatment facilities, outpatient treatment clinics and other community treatment and service providers as appropriate.

DHS 36.03(20) (20) “Parent” means a biological parent; an adoptive parent; a husband who has consented to the artificial insemination of his wife under s. 891.40, Stats.; a male who is presumed to be the father under s. 891.41, Stats.; or a male who has been adjudicated the child’s father either under s. 767.89, Stats., or by final order or judgment of a court of competent jurisdiction in another state. “Parent” does not include individuals whose parental rights have been terminated.

DHS 36.03(21) (21) “Primary care giver” means an individual who provides a majority of a consumer’s day-to-day support, shelter, sustenance or nurturing.

DHS 36.03(22) (22) “Psychosocial rehabilitation services” has the same meaning as “psychosocial services” under s. 49.45 (30e), Stats., namely the medical and remedial services and supportive activities provided to or arranged for a consumer by a comprehensive community services program authorized by a mental health professional to assist individuals with mental disorders or substance-use disorders to achieve the individual’s highest possible level of independent functioning, stability and independence and to facilitate recovery.

DHS 36.03(23) (23) “Recovery” means the process of a person’s growth and improvement, despite a history of mental or substance use disorder in attitudes, values, feelings, goals, skills and behavior and is measured by a decrease in dysfunctional symptoms and an increase in maintaining the person’s highest level of health, wellness, stability, self-determination and self-sufficiency.

DHS 36.03(24) (24) “Recovery team” means the group of individuals who are identified to participate in an assessment of the needs of the consumer, service planning and delivery, and evaluation of desired outcomes.

DHS 36.03(25) (25) “Service facilitation” means any activity that ensures the consumer receives assessment services, service planning, service delivery and supportive activities in an appropriate and timely manner.

DHS 36.03(26) (26) “Service facilitator” means a staff member who is qualified under s. DHS 36.10 (2) (g) 1. to 21. and who has the overall responsibility for service facilitation.

DHS 36.03(27) (27) “Service plan” means a written plan of psychosocial services to be provided or arranged for a consumer that is based on an individualized assessment of the consumer.

DHS 36.03(28) (28) “Service provider” means an agency or individual that provides one or more mental health or substance-use treatment or services.

DHS 36.03(28m) (28m) “Signature” or “signed” means a signature that meets the requirements in s. 990.01 (38), Stats.

DHS 36.03(29) (29) “Staff member” means a person employed by a county department, tribe, or contracted agency.

DHS 36.03(30) (30) “Substance abuse professional” means a person who meets the requirements of s. DHS 75.02 (84), a physician knowledgeable in addiction treatment, or a psychologist knowledgeable in psychopharmacology and addiction treatment.

DHS 36.03(31) (31) “Substance-use disorder” means a condition related to the use of alcohol or a drug of abuse listed in the DSM IV-TR.

DHS 36.03(32) (32) “Supportive activities” means actions and events that help address the needs and recovery goals of a consumer.

DHS 36.03(32m) (32m) 

DHS 36.03(32m)(a) (a) “Telehealth” means the use of telecommunications technology by a certified provider to deliver services allowable under this chapter, s. DHS 107.02 (5), and ss. 49.45 (61) and 49.46 (2) (b) 21. to 23., Stats., including assessment, diagnosis, consultation, treatment, or transfer of medically relevant data in a functionally equivalent manner as that of an in-person contact.

DHS 36.03(32m)(b) (b) “Telehealth” may include real-time interactive audio-only communication.

DHS 36.03(32m)(c) (c) “Telehealth” does not include communication between a certified provider and a recipient that consists solely of an electronic mail, text, or facsimile transmission.

DHS 36.03(33) (33) “Tribe” means a federally recognized American Indian tribe or band.

DHS 36.03 History History: CR 04-025: cr. Register October 2004 No. 586, eff. 11-1-04; corrections in (10), (13) (a), (20) and (30) made under s. 13.92 (4) (b) 6. and 7., Stats., Register November 2008 No. 635; CR 20-067: am. (10m), r. (11m) Register December 2021 No. 792, eff. 1-1-22; CR 23-053: cr. (10r), (11m), (28m), (32m) Register September 2023 No. 813, eff. 10-1-23.

subch. II of ch. DHS 36 Subchapter II — Certification

DHS 36.04 DHS 36.04 Certification requirements.

DHS 36.04(1) (1) Application.

DHS 36.04(1)(a) (a) A county department or tribe seeking to operate a certified comprehensive community services program shall apply to the department for certification on an application form provided by the department.

DHS 36.04 Note Note: An application for certification may be obtained by writing to the Behavioral Health Certification Section, Division of Quality Assurance, P.O. Box 2969, Madison, WI 53701-2969.

DHS 36.04(2) (2) Application materials. The application shall be accompanied by all of the following:

DHS 36.04(2)(a) (a) Required fees.

DHS 36.04(2)(b) (b) A copy of the comprehensive community services plan developed under s. DHS 36.07.

DHS 36.04(2)(c) (c) A copy of the personnel policies and procedures developed under s. DHS 36.10 and operational policies developed.

DHS 36.04(2)(d) (d) A copy of any previously approved waiver or variance and information on the current status.

DHS 36.04(2)(e) (e) Any other information required by the department.

DHS 36.04 History History: CR 04-025: cr. Register October 2004 No. 586, eff. 11-1-04.

DHS 36.05 DHS 36.05 Certification process.

DHS 36.05(1) (1) In this section:

DHS 36.05(1)(a) (a) “Deficiency” means the failure to meet a requirement of this chapter.

DHS 36.05(1)(b) (b) “Major deficiency” means a determination by the department that an aspect of the CCS program or the conduct of its personnel does any of the following:

DHS 36.05(1)(b)1. 1. The psychosocial rehabilitation services substantially fail to meet the requirements of this chapter.

DHS 36.05(1)(b)2. 2. Creates a risk of harm to a consumer or violates a consumer right created by this chapter or other state or federal statutes or rules, which may include any one of the following of the following:

DHS 36.05(1)(b)2.a. a. A staff member has had sexual contact or intercourse, as defined in s. 940.225 (5) (b) or (c), Stats., with a consumer.

DHS 36.05(1)(b)2.b. b. A staff member of the CCS has been convicted of consumer abuse under s. 940.285, 940.29 or 940.295, Stats.

DHS 36.05(1)(b)2.c. c. The health or safety of a consumer is in imminent danger because of a failure of the CCS or a CCS staff member to comply with requirements of this chapter or any other applicable local, state or federal statute or regulation.

DHS 36.05(1)(b)3. 3. The CCS has submitted, or caused to be submitted, one or more statements for purposes of obtaining certification under this chapter which the CCS knew or should have known to be false.

DHS 36.05(1)(b)4. 4. A license, certification or required local, state or federal approval of the CCS has been revoked or suspended or has expired.

DHS 36.05(1)(b)5. 5. A staff member has signed a billing statement or other document that represents the CCS staff member as the provider of service when the staff member did not provide the service.

DHS 36.05(1)(b)6. 6. A staff member impedes or has impeded monitoring of the program by the department.

DHS 36.05(1)(b)7. 7. An action or inaction by a staff member constitutes grounds for involuntary termination or suspension from program participation under s. DHS 106.06.

DHS 36.05(2) (2) Initial application. Upon receipt of a complete application for initial certification, the department shall review the application and accompanying materials required under s. DHS 36.04 (2). The department’s designated representative responding to a request for an initial certification shall review CCS personnel policies and procedures and operational policies, and the community services plan developed under s. DHS 36.07.

DHS 36.05(4) (4) Transferability of certification. Certification may only be issued to the CCS specified in the application. A CCS may not transfer or assign its certification to another entity. An applicant or certified CCS shall notify the department of any change in administration, location, name, offered services or any other change that may affect compliance with this chapter no later than the effective date of the change.

DHS 36.05(5) (5) Effective date of certification.

DHS 36.05(5)(a) (a) The date of certification shall be the date that the department determines that an applicant is in compliance with this chapter.

DHS 36.05(5)(b) (b) The department may change the date of certification if the department has made an error in the certification process. A date of certification that is adjusted under this paragraph may not be earlier than the date the department receives a written application under sub. (2) or (3).

DHS 36.05(6) (6) Fees for certification. Fees for certification shall be established by the department.

DHS 36.05(7) (7) Issuance of certification.

DHS 36.05(7)(a) (a) Action on application. Within 60 days after receiving a completed application for initial certification or for renewal of certification, the department shall do one of the following:

DHS 36.05(7)(a)1. 1. Approve the CCS if no deficiencies are found and all of the requirements for certification are met.

DHS 36.05(7)(a)3. 3. Deny certification under sub. (9), if the department finds one or more major deficiencies.

DHS 36.05(9) (9) Denial of certification. A denial of certification shall be in writing and shall contain the reason for the denial and notice of opportunity for a hearing under s. DHS 36.06 (3).

DHS 36.05(10) (10) Duration of certification. A certification remains valid until one of the following occur:

DHS 36.05(10)(a) (a) The certification remains valid until it is revoked or suspended by the department in accordance with s. DHS 36.06 (1).

DHS 36.05(10)(b) (b) The certification becomes invalid due to non-submission of the biennial report or non-payment of biennial fees in accordance with sub. (11).

DHS 36.05(11) (11) Biennial report and fees.

DHS 36.05(11)(a) (a) Every 24 months, on a date determined by the department, the program shall submit a biennial report on the form provided by the department and shall submit payment of certification continuation fees under s. 51.04, Stats.

DHS 36.05(11)(b) (b) The department will send the certification continuation materials to the provider, which the provider is expected to complete and submit to the department according to instructions provided.

DHS 36.05(11)(c) (c) A certification will be suspended or terminated if biennial reports and fees are not submitted prior to the end of the biennial cycle.

DHS 36.05 History History: CR 04-025: cr. Register October 2004 No. 586, eff. 11-1-04; corrections in (1) (b) 7. and (3) (f) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635; CR 22-078: r. (3), (7) (a) 2., (b), (8), cr. (10), (11) Register July 2023 No. 811, eff. 8-1-23.

DHS 36.06 DHS 36.06 Enforcement actions.

DHS 36.06(1) (1) Revocation and suspension. The department may revoke or suspend certification at any time upon written notice to the CCS. The notice shall state the reason for the action and inform the CCS of the opportunity for a hearing under sub. (3).

DHS 36.06(2) (2) Inspections.

DHS 36.06(2)(a) (a) The department may make announced and unannounced inspections of a certified CCS to verify compliance with this chapter, to investigate complaints received regarding the services provided by the CCS, or as part of an investigation into the cause of death of a consumer.

DHS 36.06(2)(b) (b) In making inspections, the department shall seek to minimize any disruption to the normal functioning of the CCS.

DHS 36.06(2)(c) (c) Any authorized officer, employee or agent of the department shall have access to all CCS documents, open and closed consumer records, staff members and consumers at any time to ensure compliance with the requirements of this chapter and other applicable federal and state statutes and regulations.

DHS 36.06(3) (3) Appeals.

DHS 36.06(3)(a) (a) If the department denies, revokes, suspends, or refuses to renew certification, the CCS may request an administrative hearing under ch. 227, Stats. If a timely request for hearing is made on a decision to suspend or revoke or not renew a certification, that action is stayed pending the decision on the appeal except when the department finds that the health, safety or welfare of patients requires that the action take effect immediately. A finding of a requirement for immediate action shall be made in writing by the department.

DHS 36.06(3)(b) (b) A request for hearing shall be submitted in writing to the department of administration’s division of administrative hearings within 30 days after the date of the notice of the department’s action.

DHS 36.06 Note Note: A request for hearing may be delivered in person or mailed to the Division of Hearings and Appeals, 5005 University Avenue, Suite 201, Madison, WI 53707-7875. An appeal may be sent by fax to the Division’s facsimile transmission number at [phone].

DHS 36.06(4) (4) Actions barring service in a ccs. Any person having direct management responsibility for a CCS who was involved in any one of the following may not provide service in or for a certified CCS for a period not to exceed 5 years:

DHS 36.06(4)(a) (a) An act that results in termination of a health care provider certification under s. DHS 106.06.

DHS 36.06(4)(b) (b) An act that results in conviction for a criminal offense related to services provided under s. 632.89, Stats., whether or not the conviction is under appeal.

DHS 36.06(4)(c) (c) An act involving a staff member who removes or destroys consumer service records.

DHS 36.06 History History: CR 04-025: cr. Register October 2004 No. 586, eff. 11-1-04; correction in (4) (a) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635.