Wisconsin Legislature: DHS 36.065(2)(b)

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 Enforcement actions.

(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).

(2) Inspections.

(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.

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

(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.

(3) Appeals.

(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.

(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.

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 (608) 264-9885.

(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:

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

(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.

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.

DHS 36.065 Waivers and variances.

(1) Definitions. As used in this section:

(a) “Waiver” means the grant of an exemption from a non-statutory requirement of this chapter.

(b) “Variance” means the granting of an alternate requirement in place of a non-statutory requirement of this chapter.

(2) Waivers or variances.

(a) An application for a waiver or a variance may be made at any time. Each request shall be made in writing to the department and shall include all of the following:

1. Identification of the rule provision from which the waiver or variance is requested.

2. The time period for which the waiver or variance is requested.

3. If the request is for a variance, the specific alternative action that the CCS proposes.

4. The reasons for the request.

5. Supporting justification.

6. Any other information requested by the department.

Note: An application for a waiver or variance should be addressed to the Behavioral Health Certification Section, Division of Quality Assurance, P.O. Box 2969, Madison, WI 53701-2969.

(b) A waiver or variance may be granted if the department finds that the waiver or variance will not adversely affect the health, safety, or welfare of any consumer and any one of the following applies:

1. Strict enforcement of a requirement would result in unreasonable hardship on the CCS or on a consumer.

2. An alternative to a rule, including new concepts, methods, procedures, techniques, equipment, personnel qualifications, or the conducting of pilot projects is in the interest of better care or management.

(c) A determination on a request for a waiver or variance shall be made to the CCS in writing. If the decision is to deny the waiver or variance, the reason for the denial shall be included in the notice.

(d) The terms of a variance may be modified upon agreement between the department and the CCS. The department may impose any condition on a waiver or variance which the department deems necessary.

(e) The department may limit the duration of any waiver or variance.

(f) The department may revoke a waiver or variance if any one of the following occurs:

1. The waiver or variance adversely affects the health, safety or welfare of a consumer.

2. The CCS has failed to comply with the variance as granted.

3. The CCS notifies the department that it wishes to relinquish the waiver or variance.

4. There is a change in applicable law.

5. For any other reason necessary to protect the health, safety, and welfare of a consumer.

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

Subchapter III — Comprehensive Community Services Program

DHS 36.07 Comprehensive community services plan. Each CCS program shall have a written plan that shall include all of the following:

(1) A description of the organizational structure. The description shall include all of the following:

(a) Responsibilities of the staff members assigned to the functions described in s. DHS 36.10 (2) (e).

(b) Policies and procedures to implement a quality improvement plan consistent with the requirements in s. DHS 36.08.

(c) Policies and procedures to establish a coordination committee and work with a coordination committee consistent with the requirements in s. DHS 36.09.

(d) Criteria for recruiting and contracting with providers of psychosocial rehabilitation services.

(e) Policies and procedures for updating and revising the CCS plan to ensure that it accurately identifies current services provided and any changes in policies and procedures of the CCS.

(2) A written summary detailing the recommendations of the coordination committee made under s. DHS 36.09 (3) (a) and a written response by the CCS to the coordination committee’s recommendations.

(3) A description of the currently available mental health, substance-use disorder, crisis services, and other services in the county or tribe and how the CCS will interface and enhance these services. The description shall include policies and procedures for developing and implementing collaborative arrangements and interagency agreements addressing all of the following:

(a) Processes necessary to include the CCS in planning to support consumers who are discharged from a non-CCS program or facilities that include inpatient psychiatric or substance-use treatment, a nursing home, residential care center, day treatment provider, jail or prison.

(b) The role of the CCS when an emergency protective placement is being sought under s. 55.135, Stats., and when protective services or elder abuse investigations are involved.

(c) The role of the CCS when the CCS provides services in conjunction with any other care coordination service including protective services, integrated services projects, and schools.

(d) The role of the CCS when a consumer is living in the community under a ch. 51, Stats., commitment.

(e) Establishing contracts and agreements with community agencies providing psychosocial rehabilitation services.

(f) Establishing contracts when a needed service is not available in the existing array of services.

(g) Arrangements with the county or tribal emergency services program to ensure identification and referral of CCS consumers who are in crisis.

(4)

(a) A description of an array of psychosocial rehabilitation services and service providers to be available through the CCS. The services and service providers shall be determined by all of the following:

1. Identifying anticipated service needs of potential consumers, including minors and the elderly, that are based upon the assessment domains identified in s. DHS 36.16 (4).

2. Identifying treatment interventions to address the needs identified in subd. 1. Treatment interventions for minors and elderly consumers shall be identified separately from other consumers.

(b) The description in par. (a) shall include the methods that the CCS will use to identify and contract with service providers.

(5) Policies and procedures developed for each of the following:

(a) Consumer records that meet the requirements in s. DHS 36.18.

(b) Confidentiality requirements of this chapter.

(d) Consumer rights that meet the requirements of s. DHS 36.19.

(e) Monitoring compliance with this chapter and applicable state and federal law.

(f) Receiving and making referrals.

(g) Communication to the consumer of services offered by the CCS, costs to the consumer, grievance procedure, and requirements for informed consent for medication and treatment.

(h) Ensuring that a consumer’s cultural heritage and primary language are considered as primary factors when developing the consumer’s service plan and that activities and services are accessible in a language in which the consumer is fluent.

(i) Providing orientation and training that meets the requirements in s. DHS 36.12.

(j) Outreach services.

(k) Application and screening.

(L) Recovery team development and facilitation.

(m) Assessment.

(n) Service planning.

(o) Service coordination, referrals, and collaboration.

(p) Advocacy for the consumer.

(q) Support and mentoring for the consumer.

(r) Discharge planning and facilitation.

(s) Monitoring and documentation.

(t) Policy on telehealth, including when telehealth can be used and by whom, patient privacy and information security considerations, and the right to decline services provided via telehealth.

History: CR 04-025: cr. Register October 2004 No. 586, eff. 11-1-04; correction in (3) (b) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635; CR 23-053: cr. (5) (t) Register September 2023 No. 813, eff. 10-1-23.

DHS 36.08 Quality improvement.

(1) The CCS shall develop and implement a quality improvement plan to assess consumer satisfaction and progress toward desired outcomes identified through the assessment process.

(2)