Wisconsin Legislature: DHS 36.05(1)(b)

(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.

(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.

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

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

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

(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.

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

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

(32m)

(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.

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

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

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

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.

Subchapter II — Certification

DHS 36.04 Certification requirements.

(1) Application.

(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.

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.

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

(a) Required fees.

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

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

(e) Any other information required by the department.

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

DHS 36.05 Certification process.

(1) In this section:

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

(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:

1. The psychosocial rehabilitation services substantially fail to meet the requirements of this chapter.

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:

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

b. A staff member of the CCS has been convicted of consumer abuse under s. 940.285, 940.29 or 940.295, Stats.

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.

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.

4. A license, certification or required local, state or federal approval of the CCS has been revoked or suspended or has expired.

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.

6. A staff member impedes or has impeded monitoring of the program by the department.

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

(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.

(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.

(5) Effective date of certification.

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

(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).

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

(7) Issuance of certification.

(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:

1. Approve the CCS if no deficiencies are found and all of the requirements for certification are met.

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

(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).

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

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

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

(11) Biennial report and fees.

(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.

(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.

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

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.