DHS 40.04 Note
Note: Application materials may be obtained from the Behavioral Health Certification Section, Division of Quality Assurance, PO Box 2969, Madison, WI 53701-2969 or online at
DHSDQAMentalHealthAODA@wisconsin.gov. Completed application materials may be submitted by mail to the Behavioral Health Certification Section, Division of Quality Assurance, PO Box 2969, Madison, WI 53701-2969.
DHS 40.04(1)(b)2.
2.
A program may apply for certification by submitting the following application materials to the department:
1) The age range and characteristics of youth the program proposes to admit and if the program proposes to offer services based on age, the age range and client characteristics for each service.
2) The maximum number of youth that the program proposes to serve at any given time.
3) The hours and days of the year when the program will operate, and the proposed times during the day and week when youth will receive services from the program.
4) The treatment, services and supports, including parent peer specialists when appropriate, that will be offered by the program, and a rationale for how they will help the youth population achieve and sustain positive outcomes. If the program proposes to incorporate specific evidence-based practices in its array of services, a description of those services, the training and certification that its staff members have received or will receive that qualifies them to offer those services, and how those services will be provided. A description of the therapeutic milieu the program proposes to create with the proposed treatment, services and supports, how it will be maintained, its intended therapeutic benefits, and the rationale supporting its use for the youth served by the program. If the program proposes to offer other services within the same facility or program, it shall indicate the process that the program will use in deciding when and how to offer these services, how it will obtain any necessary authorization for these services, and how these services will be funded and regulated.
5) The program's proposal for meeting staffing level requirements in s.
DHS 40.10 (2), the qualifications and roles for each position, and an analysis showing that staffing is adequate to meet the needs of the youth that the program proposes to serve. A description is also required of any specialized training and certification that program staff members have received or will be receiving that will help them better identify and address the specific needs of the youth served by the program.
6) A description of the physical settings indicating where services will be provided and whether these settings will be used for other purposes. Documentation of inspection or permit indicating the state building code requirements have been met, including chs.
SPS 361 to
366, American with Disabilities Act, any applicable local ordinance or municipal building codes, and any additional information requested by the department.
7) If a program is proposing to operate a community-based program in a school, an agreement that describes the school in which the program will be located, the area or areas in the school where program operations will occur, the interactions that the program will have with other school activities and classes, the relationship that the program staff will have with school staff, how program staff and school staff will maintain separate duties, and the activities that youth will be participating in while also receiving services through the program.
8) How the program will participate in care coordination for youth within the community.
9) Where client records will be maintained and how confidentiality requirements of those records will be safeguarded, as required under s.
DHS 40.15.
10) How the program will arrange for food service to any youth who is in the program for four or more hours during a day.
DHS 40.04(1)(c)
(c)
Initial on-site inspection. Upon receipt of all application materials described in sub.
(2), the applicant shall do all of the following:
DHS 40.04(1)(c)1.
1. Permit the department to conduct an on-site inspection of the program's physical settings to determine compliance with this chapter.
DHS 40.04(1)(c)2.
2. Make available for review by the department any documentation necessary to determine compliance with the standards in this chapter.
DHS 40.04(1)(d)1.1. The department shall make a certification determination within 60 days of receiving all completed application materials.
DHS 40.04(1)(d)2.
2. The department may grant certification if all the requirements of this chapter are met.
DHS 40.04(1)(d)3.
3. If the department determines that a program applying for certification does not comply with the requirements of this chapter, has a major deficiency, or the program description is not approved, the department may deny certification. A denial of certification shall be in writing and shall contain the reason for the denial and notice of appeal rights.
DHS 40.04(1)(e)
(e)
Scope of certification. Certification granted by the department shall only be valid for the program described in the application materials.
DHS 40.04(2)(a)
(a)
Notification of changes. A program that has received certification from the department shall notify the department of any change of administration, ownership, program name, required staff, or any other program change that may affect compliance with this chapter before the effective date of the change. A new application will be required if, upon notification, the department determines there is a substantial change in the program.
DHS 40.04 Note
Note: Program notifications should be made to: Behavioral Health Certification Section, Division of Quality Assurance, PO Box 2969, Madison, WI 53701-2969 or by emailing
DHSDQAMentalHealthAODA@wisconsin.gov.
DHS 40.04(2)(b)2.
2. Any program that intends to close shall notify the department in writing at least 30 days before closing and comply with s.
DHS 40.15 (9).
DHS 40.04(2)(c)
(c)
Biennial report and fees. Every 24 months, by the date of renewal, the program shall submit a biennial report on the form provided by the department, and shall submit payment of certification continuation fees for the purpose of renewing certification of the program for two years.
DHS 40.04(2)(d)
(d)
Ongoing on-site inspections. The program shall permit unannounced, on-site inspections of the program by the department to conduct program reviews, to conduct complaint or death investigations involving any aspect of the program, or to determine a program's progress in correcting a deficiency or major deficiency cited by the department. All of the following conditions apply to an on-site inspection:
DHS 40.04(2)(d)1.
1. The department shall use a random selection process for reviewing client records during program reviews.
DHS 40.04(2)(d)2.
2. The department shall conduct client interviews as part of the program review process.
DHS 40.04(2)(e)1.
1. If the department determines that a program has a deficiency, the department shall issue a notice of deficiency to the program. The notice of deficiency may place restrictions on the activities of the program, or suspend or terminate the program's certification.
DHS 40.04(2)(e)2.
2. The program shall submit a plan of correction to the department as indicated in the notice of deficiency. The plan of correction shall identify the specific steps the program will take to correct the deficiency, the timelines within which the corrections will be made, and the staff members who will implement the plan and monitor for future compliance.
DHS 40.04(2)(e)3.
3. If the department determines that the plan of correction submitted by the program does not adequately address deficiencies listed in the notice of deficiency, the department may impose a plan of correction.
DHS 40.04(2)(f)1.1. The department may terminate certification at any time for any major deficiency by issuing a notice of major deficiency to the program. The notice shall specify the reason for the department action and contain appeal information.
DHS 40.04(2)(f)2.
2
. The department may summarily suspend a program's certification if the department determines that immediate action is required to protect the health, safety, or welfare of youth. Notice of suspension may be written or verbal and shall specify the reason for the department action and the date the action becomes effective. Within 10 working days after the order is issued, the department shall either lift the suspension on the program's certification or proceed to terminate the program's certification.
DHS 40.04(2)(g)
(g)
Appeals. If the department denies or terminates certification, the program may request a hearing under ch.
227, Stats.
DHS 40.04(2)(h)
(h)
Reapplication. If an application for certification is denied, the program may not reapply for certification for one year following the date on which certification was denied.
DHS 40.04(2)(i)
(i)
Dissemination of results. Upon completing action on an application for certification, staff of the department shall provide a summary of the results of the process to the applicant, to the subunit within the department responsible for monitoring community mental health programs, and to the department of community programs under s.
51.42, Stats., in the county in which the program is located.
DHS 40.04 History
History: CR 19-018: cr.
Register June 2020 No. 774, eff. 7-1-20; correction in numbering of (2) (b) 1g., 1r. made under s.
13.92 (4) (b) 1., Stats., and correction in (1) (c) (intro.), (2) (a), (b) 2., (c), (d) made under s.
35.17, Stats.,
Register June 2020 No. 774; correction in (2) (b) 1g., 1r. made under s.
13.92 (4) (b) 7., Stats.,
Register December 2020 No. 780.
DHS 40.05(1)(1)
Request. A program may request a waiver or a variance from the department. A request shall be made in writing and include all of the following:
DHS 40.05(1)(b)
(b) The rule provision from which the waiver or variance is requested.
DHS 40.05(1)(c)
(c) The time period for which the waiver or variance is requested.
DHS 40.05(1)(d)
(d) If the request is for a variance, the specific alternative action that the program proposes.
DHS 40.05(1)(e)
(e) The reasons for the request and a supporting justification.
DHS 40.05 Note
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 or emailed to
DHSDQAMentalHealthAODA@wisconsin.gov.
DHS 40.05(2)(a)(a) The department may grant a waiver or variance requested by a program, or may impose additional conditions on the proposed waiver or variance, including limiting their duration, or providing that the waiver or variance may be withdrawn for any of the reasons specified in par.
(b) if the department determines all of the following:
DHS 40.05(2)(a)1.
1. The waiver or variance is not likely to adversely affect the health, safety, or welfare of any youth.
DHS 40.05(2)(a)2.
2. The waiver or variance is likely to improve services, or management and operation of the program, or permit piloting of new services.
DHS 40.05(2)(b)
(b) The department may revoke a waiver or variance granted under par.
(a) if any of the following occurs:
DHS 40.05(2)(b)2.
2. The program notifies the department that it wishes to relinquish the waiver or variance.
DHS 40.05(2)(b)4.
4. The department determines the revocation is necessary to protect the health, safety, or welfare of a youth.
DHS 40.05(3)(am)(am) Within 60 days of the receipt of a request for a waiver or variance, the department shall notify the program in writing of its decision to do any of the following:
DHS 40.05(3)(am)3.
3. Grant the waiver or variance with additional conditions imposed by the department.
DHS 40.05(3)(bm)
(bm) If the department denies a request for a waiver or variance, or revokes a waiver or variance, the department shall notify the program in writing of the reason for the denial or revocation.
DHS 40.05 History
History: CR 19-018: cr.
Register June 2020 No. 774, eff. 7-1-20; correction in numbering in (3) made under s.
13.92 (4) (b) 1., Stats.,
Register June 2020 No. 774.
DHS 40.06
DHS 40.06
Coordination with educational services. DHS 40.06(1)(1)
Programs shall make reasonable efforts to provide care coordination by executing memoranda of understanding or other forms of interagency agreement with local educational agencies or other services or programs that provide services to program youth.
DHS 40.06(2)
(2) This chapter does not modify the educational rights and obligations of the youth in the program, any legal representative, or any local educational agency providing services in coordination with a mental health day treatment program certified under this chapter.
DHS 40.06 History
History: CR 19-018: cr.
Register June 2020 No. 774, eff. 7-1-20.
DHS 40.07(1)(1)
Required policies and procedures. A program shall develop and implement written policies and procedures for:
DHS 40.07(1)(d)
(d) Contents and implementation of individualized treatment plans.
DHS 40.07(1)(e)2.
2. Developmentally appropriate and age-appropriate service planning and delivery.
