Chapter 51

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.

51.036(2)(e)7. 7. The source of payments for patient care, including private payment sources or payment under the Medical Assistance program under subch. IV of ch. 49.

51.036(2)(e)8. 8. Data regarding the county of residence for each patient in counties for which the county’s data is equal to or greater than 20 patients.

51.036(2)(e)9. 9. The estimated number of diversions from the Winnebago Mental Health Institute.

51.036(2)(e)10. 10. A description of the number and type of employees providing staffing during the various times of day, including through the use of telehealth.

51.036(2)(e)11. 11. A description of rules and procedures for determining where to take an individual in need of crisis services if a crisis urgent care and observation facility does not have capacity or otherwise does not accept an individual.

51.036(2)(e)12. 12. The number of repeat clients and readmissions.

51.036(2)(e)13. 13. Utilization of follow-up services, as applicable.

51.036(2)(e)14. 14. The number of transfers to other facilities, including Winnebago Mental Health Institute, hospitals, or other facilities.

51.036(2)(e)15. 15. A description of any injuries, assaults, or other safety-related incidents.

51.036(2)(e)16. 16. A breakdown of funding, including the amounts and sources of funding.

51.036(2)(e)17. 17. The number of clients served.

51.036(2)(e)18. 18. Facility capacity, specifically the number of staffed beds.

51.036(2)(f) (f) Notwithstanding the certification requirements set forth under this subsection, any facility that before March 31, 2024, is providing crisis intervention services that on or after March 31, 2024, would otherwise require certification as a crisis urgent care and observation facility may on and after March 31, 2024, continue to provide these services without obtaining certification from the department under this subsection.

51.036(3) (3) Admissions.

51.036(3)(a) (a) A crisis urgent care and observation facility certified under this section may accept individuals for any of the following services:

51.036(3)(a)1. 1. Voluntary stabilization.

51.036(3)(a)2. 2. Observation and treatment, including for assessments for mental health or substance use disorder.

51.036(3)(a)3. 3. Screening for suicide and violence risk.

51.036(3)(a)4. 4. Medication management and therapeutic counseling.

51.036(3)(b) (b) A crisis urgent care and observation facility certified under this section shall accept an adult individual for emergency detention under s. 51.15 and may accept a youth for emergency detention under s. 51.15. If the facility does not have capacity to accept an adult individual for purposes of emergency detention or if the facility does not accept a youth for purposes of emergency detention, that individual shall be transported to another appropriate facility in accordance with rules established by the department under sub. (4). A county crisis assessment under s. 51.15 (2) (c) is required prior to admission to a crisis urgent care and observation facility for purposes of emergency detention, but the medical clearance requirement under s. 51.15 (2) (b) does not apply to crisis urgent care and observation facility admissions for purposes of emergency detention.

51.036(3)(c) (c) The department shall encourage each crisis urgent care and observation facility certified under this section to operate with the intent to admit individuals for no longer than 5 days, except in exceptional circumstances.

51.036(4) (4) Rules. The department shall promulgate rules to implement this section, including all of the following:

51.036(4)(a) (a) Establishment of the grant program described under sub. (2), including procedures for administration and establishment of criteria for awarding grants.

51.036(4)(b) (b) Establishment of requirements for crisis urgent care and observation facilities to match a portion of any grant awarded by the department under this section, as set forth under sub. (2) (c) 10., and for determining what types of contributions may count toward the matching requirement. The matching requirement established by the department under this paragraph may be fulfilled through in-kind contributions.

51.036(4)(c) (c) Requirements for admitting, holding, and discharging individuals for purposes of emergency detention.

51.036(4)(d) (d) Minimum security requirements for crisis urgent care and observation facilities certified under this section.

51.036(4)(e) (e) Establishment of a target range for the number of beds in a crisis urgent care and observation facility certified under this section.

51.036(4)(f) (f) Establishment of policies and criteria to ensure that law enforcement and other persons authorized to transport or cause transportation of an individual for purposes of emergency detention have clear standards and procedures regarding all of the following:

51.036(4)(f)1. 1. The circumstances under which law enforcement and other persons may bring an individual to a crisis urgent care and observation facility certified under this section.

51.036(4)(f)2. 2. The determination as to which facility law enforcement and other persons authorized to transport or cause transportation of an individual for purposes of emergency detention may take an individual.

51.036(4)(g) (g) Establishment of policies relating to interfacility transfers initiated at a crisis urgent care and observation facility, including how such transfers should occur and who should be involved in such transfers. Barring exigent circumstances that necessitate law enforcement involvement, law enforcement may not transport an individual for purposes of an interfacility transfer from a crisis urgent care and observation facility.

51.036(4)(h) (h) Establishment of procedures to coordinate communication regarding bed availability in a crisis urgent care and observation facility before the arrival of a patient and establishment of a process for determining where to take an individual in need of crisis services if a crisis urgent care and observation facility does not have capacity or otherwise does not accept an individual.

51.036(4)(i) (i) Establishment of policies for coordination between crisis urgent care and observation facilities certified under this section and any facility established or operated with funding received under s. 165.12 from settlement proceeds from the opiate litigation, as defined in s. 165.12 (1), as well as policies to encourage awareness of and communication and coordination with other facilities that provide services similar to those provided by crisis urgent care and observation facilities.

51.036(4)(j) (j) Establishment of procedures to require a crisis urgent care and observation facility to coordinate continuity of care with, when appropriate, a hub-and-spoke health home pilot program for any patient treated at a crisis urgent care and observation facility for a period of 5 or fewer days. The department shall establish procedures for follow-up with other transition facilities in the event that a hub-and-spoke health home pilot program is appropriate but not available.

51.036(4)(k) (k) Establishment of policies and procedures for crisis urgent care and observation facilities that intend to accept both youths and adults, including requirements that youths be treated in a separate part of the facility from adults, policies to address youth-related treatment issues, including parental input, and staff training for youth-specific issues.

51.036(4)(L) (L) Establishment of appropriate staffing level requirements, including policies to ensure the availability of adequate in-person and on-site care.

51.036(4)(m) (m) Establishment of requirements to define the population to be served at a given crisis urgent care and observation facility, including establishment of any minimum age requirements.

51.036(5) (5) Coordination. In accordance with rules established by the department under sub. (4) (i), a crisis urgent care and observation facility certified under this section shall coordinate to the fullest extent possible with any facility established or operated with funding received under s. 165.12 from settlement proceeds from the opiate litigation, as defined in s. 165.12 (1), as well as with other facilities that provide services similar to those provided by crisis urgent care and observation facilities.

51.036 History History: 2023 a. 249.

51.038 51.038 Outpatient mental health clinic certification. Except as provided in s. 51.032, if a facility that provides mental health services on an outpatient basis holds current accreditation from the council on accreditation of services for families and children, the department may accept evidence of this accreditation as equivalent to the standards established by the department, for the purpose of certifying the facility for the receipt of funds for services provided as a benefit to a medical assistance recipient under s. 49.46 (2) (b) 6. f. or 49.471 (11) (k), a community aids funding recipient under s. 51.423 (2) or as mandated coverage under s. 632.89.

51.038 History History: 1987 a. 27; 1997 a. 237; 2007 a. 20.

51.04 51.04 Treatment facility certification. Except as provided in s. 51.032, any treatment facility may apply to the department for certification of the facility for the receipt of funds for services provided as a benefit to a medical assistance recipient under s. 49.46 (2) (b) 6. f. or 49.471 (11) (k) or to a community aids funding recipient under s. 51.423 (2) or provided as mandated coverage under s. 632.89. The department shall annually charge a fee for each certification.

51.04 History History: 1975 c. 224; Stats. 1975 s. 51.44; 1975 c. 430 s. 53m; Stats. 1975 s. 51.04; 1983 a. 27; 1985 a. 29, 176; 1995 a. 27; 1997 a. 237; 2007 a. 20.

51.04 Cross-reference Cross-reference: See also ch. DHS 35, Wis. adm. code.

51.042 51.042 Youth crisis stabilization facilities.

51.042(1) (1) Definitions. In this section:

51.042(1)(a) (a) “Crisis” means a situation caused by an individual’s apparent mental 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.

51.042(1)(b) (b) “Youth crisis stabilization facility” is a treatment facility with a maximum of 8 beds that admits a minor to prevent or de-escalate the minor’s mental health crisis and avoid admission of the minor to a more restrictive setting.

51.042(2) (2) Certification required; exemption.

51.042(2)(a) (a) No person may operate a youth crisis stabilization facility without a certification from the department. The department may limit the number of certifications it grants to operate a youth crisis stabilization facility.

51.042(2)(b) (b) A youth crisis stabilization facility that has a certification from the department under this section is not subject to facility regulation under ch. 48.

51.042(3) (3) Admission of minors. A minor may be admitted to a youth crisis stabilization facility under this section by a court order under s. 51.20 (13) (a) 3. or through the procedure under s. 51.13. No person may transport a minor to a youth crisis stabilization facility for detention under s. 51.15.

51.042(4) (4) Rules. The department may promulgate rules to implement this section.

51.042 History History: 2017 a. 59.

51.043 51.043 Crisis hostels.

51.043(1) (1) Definitions. In this section:

51.043(1)(a) (a) “Crisis hostel” means a mental health stabilization program with a maximum of 15 beds that provides crisis stabilization services to an adult individual to prevent or de-escalate the individual’s mental health crisis and avoid admission of the individual to a more restrictive setting.

51.043(1)(b) (b) “Crisis stabilization services” means optional emergency mental health services that provide short-term, intensive, community-based services to avoid the need for inpatient hospitalization.

51.043(2) (2) Certification required; exemption.

51.043(2)(a) (a) Except as provided in par. (b), no person may operate a crisis hostel without a certification from the department.

51.043(2)(b) (b) If a county has, by March 31, 2024, established a crisis hostel and operates the crisis hostel pursuant only to certification under ch. DHS 34, Wis. Adm. Code, where individuals whose anticipated length-of-stay is longer than 23 hours due to needs outside of crisis stabilization, and crisis stabilization services are provided in a distinct and separate area from where an individual may spend the night, the county may continue to provide crisis stabilization services without obtaining additional residential licensure and is not required to receive a certification under this section. Needs outside of crisis stabilization may include housing insecurity or stability issues necessitating coordination of transportation, advocacy, and housing assistance.

51.043(2)(c) (c) The department may not limit the number of certifications it issues to operate a crisis hostel.

51.043(2)(d) (d) The department shall establish application fees and biennial certification fees.

51.043(2)(e) (e) A crisis hostel operated under par. (a) or (b) is not subject to facility regulation under ch. 50.

51.043(3) (3) Admissions.

51.043(3)(a) (a) An individual 18 years of age or older may be admitted to a crisis hostel to receive crisis stabilization services.

51.043(3)(b) (b) Crisis stabilization services may only be provided at a crisis hostel on a voluntary basis to individuals who are 18 years of age or older. Crisis hostel staff may not admit an individual who is transported to the hostel involuntarily for emergency detention under s. 51.15.

51.043(4) (4) Rules. The department shall promulgate rules to implement this section.

51.043 History History: 2023 a. 249.

51.045 51.045 Availability of inpatient psychiatric and other beds.

51.045(1m) (1m) From the appropriation under s. 20.435 (2) (cm), the department shall award a grant in the amount of $80,000 in fiscal year 2021-22 and $50,000 in each fiscal year thereafter to the entity under contract under s. 153.05 (2m) (a) to develop and operate an Internet site and system to show the availability of inpatient psychiatric beds, peer run respite beds, and crisis stabilization beds statewide. To receive the grant, the entity shall use a password protected Internet site to allow an inpatient psychiatric unit or hospital or a facility, center, or program that has inpatient psychiatric, peer run respite, or crisis stabilization beds to enter all of the following information and to enable any hospital emergency department or person who approves emergency detentions under s. 51.15 (2) (c) in the state to view all of the following information reported to the system:

51.045(1m)(a) (a) The number of available child, adolescent, adult, and geriatric beds, as applicable, that are inpatient psychiatric, peer run respite, or crisis stabilization beds and that are currently available at the hospital, unit, facility, center, or program at the time of reporting.

51.045(1m)(b) (b) Any special information that the hospital, unit, facility, center, or program reports regarding the available beds under par. (a).

51.045(1m)(c) (c) The date the hospital, unit, facility, center, or program reports the information under pars. (a) and (b).

51.045(1m)(d) (d) The location of the hospital, unit, facility, center, or program that is reporting.

51.045(1m)(e) (e) The contact information for admission coordination for the hospital, unit, facility, center, or program.

51.045 History History: 2015 a. 153; 2021 a. 58.

51.047 51.047 Mental health services. From the appropriation under s. 20.435 (5) (fr), the department may not award more than $45,000 in each fiscal year to applying public or nonprofit private entities for the costs of providing certain mental health services to homeless individuals with serious and persistent mental illness. Entities that receive funds awarded by the department under this section shall provide the mental health services required under 42 USC 290cc-24. The amount that the department awards to an applying entity may not exceed 50 percent of the amount of matching funds required under 42 USC 290cc-23.

51.047 History History: 2005 a. 25 s. 908; 2005 a. 264; 2007 a. 45; 2011 a. 32 s. 3461m; Stats.
2011 s. 16.311; 2017 a. 59 s. 132; Stats. 2017 s. 51.047.

51.05 51.05 Mental health institutes.

51.05(1) (1) Designation. The mental health institute located at Mendota is known as the “Mendota Mental Health Institute” and the mental health institute located at Winnebago is known as the “Winnebago Mental Health Institute”. Goodland Hall West, a facility located at Mendota Mental Health Institute, is designated as the “Maximum Security Facility at Mendota Mental Health Institute”. The department shall divide the state by counties into 2 districts, and may change the boundaries of these districts, arranging them with reference to the number of patients residing in them at a given time, the capacity of the institutes and the convenience of access to them.

51.05(2) (2) Admissions authorized by counties. The department may not accept for admission to a mental health institute any resident person, except in an emergency, unless the county department under s. 51.42 in the county where the person has residence authorizes the care under s. 51.42 (3) (as). Patients who are committed to the department under s. 975.01, 1977 stats., or s. 975.02, 1977 stats., or s. 971.14, 971.17, 975.06, or 980.06, admitted by the department under s. 975.17, 1977 stats., or are transferred from a juvenile correctional facility or a secured residential care center for children and youth to a state treatment facility under s. 51.35 (3) or from a jail or prison to a state treatment facility under s. 51.37 (5) are not subject to this subsection.

51.05(3) (3) Admissions authorized by department. Any person who is without a county responsible for his or her care and any person entering this state through the compact established under s. 51.75 may be accepted by the department and temporarily admitted to an institute. Such person shall be transferred to the county department under s. 51.42 for the community where the best interests of the person can best be served, as soon as practicable.

51.05(4) (4) Transfers and discharges. The transfer or discharge of any person who is placed in a mental health institute shall be made subject to s. 51.35.

51.05(5) (5) School activities. If an individual over the age of 2 and under the age of 22 and eligible for special education and related services under subch. V of ch. 115 is committed, admitted or transferred to or is a resident of the Mendota Mental Health Institute or Winnebago Mental Health Institute, the individual shall attend a school program operated by the applicable mental health institute or a school outside the applicable mental health institute which is approved by the department of public instruction. A school program operated by the Mendota Mental Health Institute or Winnebago Mental Health Institute shall be under the supervision of the department of public instruction and shall meet standards prescribed by that agency.

51.05(6) (6) Hearing-impaired individuals. The department shall provide mental health services appropriate for hearing-impaired individuals who are residents of or are committed, admitted or transferred to a mental health institute.