Chapter 51

51.03(1g)(c) (c) “Prevention” means action to reduce the instance, delay the onset or lessen the severity of mental disorder, before the disorders may progress to mental illness, by reducing risk factors for, enhancing protections against and promptly treating early warning signs of mental disorder.

51.03(1g)(d) (d) “Recovery” means the process of a person’s growth and improvement, despite a history of mental illness or alcohol or other drug abuse, in attitudes, feelings, values, 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.

51.03(1g)(e) (e) “Stigma” means disqualification from social acceptance, derogation, marginalization and ostracism encountered by persons with mental illness or persons who abuse alcohol or other drugs as the result of societal negative attitudes, feelings, perceptions, representations and acts of discrimination.

51.03(1r) (1r) The department through its authorized agents may visit or investigate any treatment facility to which persons are admitted or committed under this chapter.

51.03(2) (2) No later than 14 days after the date of a death reported under s. 51.64 (2) (a), the department shall investigate the death.

51.03(3) (3) 

51.03(3)(a) (a) Beginning on September 1, 1996, the department shall collect and analyze information in this state on each of the following:

51.03(3)(a)1. 1. The number of commitments initiated under s. 51.15 or 51.20 (1).

51.03(3)(a)2. 2. The number of commitments ordered under s. 51.20 (13).

51.03(3)(a)3. 3. The number of, cost of and paying sources for days of inpatient mental health treatment that result from the commitments initiated under subd. 1. or ordered under subd. 2.

51.03(3)(a)5. 5. The number of persons who are receiving care and treatment under community support programs voluntarily or under commitments ordered under s. 51.20 (13).

51.03(3)(a)6. 6. The number of individuals authorized to consent to involuntary administration of psychotropic medication under s. 55.14 (8) or for whom guardians were appointed under s. 880.33 (4m), 2003 stats.

51.03(3)(b) (b) By April 1, 1997, and annually by that date for 3 years thereafter, the department shall submit a report to the legislature under s. 13.172 (2) on the information collected under par. (a).

51.03(4) (4) Within the limits of available state and federal funds, the department may do all of the following:

51.03(4)(a) (a) Promote the creation of coalitions among the state, counties, providers of mental health and alcohol and other drug abuse services, consumers of the services and their families and advocates for persons with mental illness and for alcoholic and drug dependent persons to develop, coordinate and provide a full range of resources to advance prevention; early intervention; treatment; recovery; safe and affordable housing; opportunities for education, employment and recreation; family and peer support; self-help; and the safety and well-being of communities.

51.03(4)(b) (b) In cooperation with counties, providers of mental health and alcohol and other drug abuse services, consumers of the services, interested community members and advocates for persons with mental illness and for alcoholic and drug dependent persons, develop and implement a comprehensive strategy to reduce stigma of and discrimination against persons with mental illness, alcoholics and drug dependent persons.

51.03(4)(c) (c) Develop and implement a comprehensive strategy to involve counties, providers of mental health and alcohol and other drug abuse services, consumers of the services and their families, interested community members and advocates for persons with mental illness and for alcoholic and drug dependent persons as equal participants in service system planning and delivery.

51.03(4)(d) (d) Promote responsible stewardship of human and fiscal resources in the provision of mental health and alcohol and other drug abuse services.

51.03(4)(e) (e) Develop and implement methods to identify and measure outcomes for consumers of mental health and alcohol and other drug abuse services.

51.03(4)(f) (f) Promote access to appropriate mental health and alcohol and other drug abuse services regardless of a person’s geographic location, age, degree of mental illness, alcoholism or drug dependency or availability of personal financial resources.

51.03(4)(g) (g) Promote consumer decision making to enable persons with mental illness and alcohol or drug dependency to be more self-sufficient.

51.03(4)(h) (h) Promote use by providers of mental health and alcohol and other drug abuse services of individualized service planning, under which the providers develop written individualized service plans that promote treatment and recovery, together with service consumers, families of service consumers who are children and advocates chosen by consumers.

51.03(5) (5) The department shall ensure that providers of mental health and alcohol and other drug abuse services who use individualized service plans, as specified in sub. (4) (h), do all of the following in using a plan:

51.03(5)(a) (a) Establish meaningful and measurable goals for the consumer.

51.03(5)(b) (b) Base the plan on a comprehensive assessment of the consumer’s strengths, abilities, needs and preferences.

51.03(5)(c) (c) Keep the plan current.

51.03(5)(d) (d) Modify the plan as necessary.

51.03(6) (6) 

51.03(6)(a) (a) In this subsection, “licensed treatment professional” means a physician who has completed a residence in psychiatry; a psychologist; a private practice school psychologist who is licensed under ch. 455; a marriage and family therapist who is licensed under s. 457.10 or 457.11; a professional counselor who is licensed under s. 457.12 or 457.13 or who is exercising the professional counselor privilege to practice, as defined in s. 457.50 (2) (s), in this state; an advanced practice social worker who holds a certificate under s. 457.08 (2); an independent social worker who is licensed under s. 457.08 (3); a clinical social worker who is licensed under s. 457.08 (4); or any of these individuals who is practicing under a currently valid training or temporary license or certificate granted under applicable provisions of ch. 457. “Licensed treatment professional” does not include an individual whose license, certificate, or privilege is suspended, revoked, or voluntarily surrendered, or whose license, certificate, or privilege is limited or restricted, when practicing in areas prohibited by the limitation or restriction.

51.03(6)(b) (b) The department may not require a mental health clinic or an individual licensed treatment professional who is otherwise authorized to provide outpatient mental health services at a school to designate the school site as a clinic office in order to provide outpatient mental health services at a school.

51.03 History History: 1975 c. 430; 1989 a. 336; 1995 a. 292; 1999 a. 9; 2005 a. 264, 387; 2007 a. 20, 45; 2011 a. 32; 2015 a. 294; 2021 a. 131; 2023 a. 55.

51.032 51.032 Denial and revocations of certification or approval based on delinquent taxes or unemployment insurance contributions.

51.032(1) (1) Except as provided in sub. (1m), the department shall require each applicant to provide the department with his or her social security number, if the applicant is an individual, or the applicant’s federal employer identification number, if the applicant is not an individual, as a condition of issuing any of the following:

51.032(1)(a) (a) A certification issued under s. 51.038.

51.032(1)(b) (b) A certification issued under s. 51.04.

51.032(1)(c) (c) A certification issued under rules required under s. 51.42 (7) (b) 11.

51.032(1)(d) (d) A certification issued under rules required under s. 51.421 (3) (a).

51.032(1)(e) (e) An approval issued under s. 51.45 (8).

51.032(1m) (1m) If an individual who applies for a certification or approval under sub. (1) does not have a social security number, the individual, as a condition of obtaining the certification or approval, shall submit a statement made or subscribed under oath or affirmation to the department that the applicant does not have a social security number. The form of the statement shall be prescribed by the department of children and families. A certification or approval issued in reliance upon a false statement submitted under this subsection is invalid.

51.032(2) (2) The department may not disclose any information received under sub. (1) to any person except to the department of revenue for the sole purpose of requesting certifications under s. 73.0301 and to the department of workforce development for the sole purpose of requesting certifications under s. 108.227.

51.032(3) (3) Except as provided in sub. (1m), the department shall deny an application for the issuance of a certification or approval specified in sub. (1) if the applicant does not provide the information specified in sub. (1).

51.032(4) (4) The department shall deny an application for the issuance of a certification or approval specified in sub. (1) or shall revoke a certification or approval specified in sub. (1) if the department of revenue certifies under s. 73.0301 that the applicant for or holder of a certification or approval is liable for delinquent taxes or if the department of workforce development certifies under s. 108.227 that the applicant for or holder of a certification or approval is liable for delinquent unemployment insurance contributions.

51.032(5) (5) An action taken under sub. (3) or (4) is subject to review only as provided under s. 73.0301 (2) (b) and (5) or s. 108.227 (5) and (6), whichever is applicable.

51.032 History History: 1997 a. 237; 1999 a. 9; 2007 a. 20; 2013 a. 36.

51.036 51.036 Crisis urgent care and observation facilities.

51.036(1) (1) Definitions. In this section:

51.036(1)(a) (a) “Crisis” means a situation caused by an individual’s apparent mental or substance use disorder that results in a high level of stress or anxiety for the individual, persons providing care for the individual, or the public and that is not resolved by the available coping methods of the individual or by the efforts of those providing ordinary care or support for the individual.

51.036(1)(b) (b) “Crisis urgent care and observation facility” means a treatment facility that admits an individual to prevent, de-escalate, or treat the individual’s mental health or substance use disorder and includes the necessary structure and staff to support the individual’s needs relating to the mental health or substance use disorder.

51.036(2) (2) Certification required; exemption; grants.

51.036(2)(a) (a) The department shall establish a certification process for crisis urgent care and observation facilities and a grant program to award grants to develop and support crisis urgent care and observation facilities. No person may operate a crisis urgent care and observation facility without a certification from the department. The department may make announced and unannounced inspections and complaint investigations of crisis urgent care and observation facilities as it deems necessary, at reasonable times and in a reasonable manner. The department may limit the number of certifications it grants to operate crisis urgent care and observation facilities. The department shall, using the department’s division of the state into regions by county, include statewide geographic consideration in its evaluation of applications for certification under this section to ensure geographic diversity among the regions in the location of crisis urgent care and observation facilities certified under this section.

51.036(2)(b) (b)

51.036(2)(b)1. 1. A crisis urgent care and observation facility certified under this section is not subject to facility regulation under ch. 50, unless otherwise required due to the facility’s licensure or certification for other services or purposes. A crisis urgent care and observation facility is not a hospital subject to approval under ss. 50.32 to 50.39 and nothing in this subsection limits services a hospital may provide under ch. 50.

51.036(2)(b)2. 2. Notwithstanding par. (d), the department shall promote certification and encourage any facility that is licensed as a hospital under ch. 50 and provides services consistent with those described in par. (c) 1. to 9. to apply for certification under this section. The requirements under this section may not be construed to prohibit, limit, or otherwise interfere with services provided by a county or a hospital or other facility that are provided consistent with the facility’s existing licensure or certification, whether the facility is publicly or privately funded.

51.036(2)(b)3. 3. Notwithstanding s. 150.93, any hospital that expands psychiatric bed capacity to accommodate admissions under this section may increase its approved bed capacity by the number of psychiatric beds added under this subdivision.

51.036(2)(b)4. 4. The department shall take into account the geography of hospital facilities granted certification under subd. 2. when considering certification applications for other crisis urgent care and observation facilities.

51.036(2)(c) (c) Subject to par. (d), the department may grant a certification to a crisis urgent care and observation facility that specifies in an application the level of care the facility can provide to patients and demonstrates in the application its ability to do all of the following:

51.036(2)(c)1. 1. Accept referrals for crisis services for adults and, if applicable, for youth, including any of the following:

51.036(2)(c)1.a. a. Involuntary patients brought under s. 51.15.

51.036(2)(c)1.b. b. Voluntary patients for services arriving as walk-ins or brought by law enforcement, emergency medical responders or emergency medical services practitioners, or county crisis personnel.

51.036(2)(c)2. 2. Abstain from having a requirement for medical clearance before admission assessment.

51.036(2)(c)3. 3. Provide assessments for physical health, substance use disorder, and mental health.

51.036(2)(c)4. 4. Provide screening for suicide and violence risk.

51.036(2)(c)5. 5. Provide medication management and therapeutic counseling.

51.036(2)(c)6. 6. Provide coordination of services for basic needs.

51.036(2)(c)7. 7. Provide for the safety and security of both the staff and the patients.

51.036(2)(c)8. 8. Have adequate staffing 24 hours a day, 7 days a week, including through use of telehealth, as described under s. 49.45 (61), with a multidisciplinary team that includes, as needed, psychiatrists or psychiatric nurse practitioners, physician assistants, nurses, licensed clinicians capable of completing assessments, peers with lived experience, and other appropriate staff.

51.036(2)(c)9. 9. Allow for voluntary and involuntary treatment of individuals in crisis as a means to avoid unnecessary placement of those individuals in hospital inpatient beds and allow for an effective conversion to voluntary stabilization when warranted in the same setting.

51.036(2)(c)10. 10. Contribute, from at least one nonstate, federal, or 3rd-party revenue source, an amount, as determined by the department, in addition to any grant awarded by the department under this section.

51.036(2)(d) (d) Before the department may grant certification to a facility under this section, the department shall submit the proposal for certification to the joint committee on finance for approval. If the cochairpersons of the joint committee on finance do not notify the department within 14 working days after the date of the submittal under this paragraph that the committee has scheduled a meeting for the purpose of reviewing the proposal, the department may grant certification of that facility as described in the proposal. If, within 14 working days after the date of the submittal under this paragraph, the cochairpersons of the committee notify the department that the committee has scheduled a meeting for the purpose of reviewing the proposal, the department may grant certification of that facility only upon approval by the committee. When submitting a proposal regarding certification of a facility under this paragraph, the department shall provide the joint committee on finance with all of the following information about the facility proposed for certification:

51.036(2)(d)1. 1. The department’s rationale for selecting the facility.

51.036(2)(d)2. 2. Where the facility is to be located.

51.036(2)(d)3. 3. A specific description of the entity that will be awarded certification.

51.036(2)(d)4. 4. A description of how the funding for the facility will work.

51.036(2)(d)5. 5. The timeline of the facility for accepting patients.

51.036(2)(d)6. 6. The distance from the facility to the nearest hospital.

51.036(2)(d)7. 7. A description of the facility’s plan for staffing, including staff on call.

51.036(2)(d)8. 8. The number of beds in the facility.

51.036(2)(d)9. 9. A description of the facility’s admission, hold, and discharge policies.

51.036(2)(d)10. 10. Security considerations for patients and staff at the facility.

51.036(2)(d)11. 11. The estimated population to be served.

51.036(2)(d)12. 12. The estimated number of diversions from the Winnebago Mental Health Institute had the facility been operating the past 5 years.

51.036(2)(d)13. 13. Policies that ensure the facility has the capacity to assess physical health needs and deliver care for most minor physical health challenges, while also having an identified process in order to transfer an individual to a facility with more medically staffed services if needed.

51.036(2)(e) (e) No later than June 30 of each year, beginning by June 30, 2025, the department shall submit to the joint committee on finance and to the chief clerk of each house of the legislature, for distribution to the appropriate standing committees under s. 13.172 (3), a report regarding crisis urgent care and observation facilities under this section, including information relating to all of the following:

51.036(2)(e)1. 1. Applications for certification received by the department.

51.036(2)(e)2. 2. The number of admissions, including both voluntary and involuntary admissions.

51.036(2)(e)3. 3. Data regarding how patients are arriving for admission, including through transport by law enforcement, family, emergency medical responders or emergency medical services practitioners, or county crisis personnel.

51.036(2)(e)4. 4. Average wait times, including for admission, treatment, discharge, and any other significant aspect of services provided by a crisis urgent care and observation facility.

51.036(2)(e)5. 5. The length of patient stays.

51.036(2)(e)6. 6. The time of day patients are admitted.