Chapter DHS 61

DHS 61.69   Duration of certification for community mental health programs.

DHS 61.695   Biennial report and fees for community mental health programs.

Subchapter IV — Community Mental Health Programs

DHS 61.70   Inpatient program - introduction and definitions.

DHS 61.71   Inpatient program standards.

DHS 61.72   Enforcement of inpatient program standards.

DHS 61.73   Other community program standards - introduction.

DHS 61.75   Day treatment program.

DHS 61.76   Rehabilitation program.

DHS 61.77   Consultation and education program.

DHS 61.78   Additional requirements for programs serving children and adolescents - introduction and personnel.

DHS 61.79   Children and adolescent inpatient program.

DHS 61.80   Children and adolescent outpatient program.

Subchapter V — Outpatient Psychotherapy Clinic Standards

DHS 61.95   Procedures for approval.

DHS 61.96   Required personnel.

Ch. DHS 61 Note Note: Chapter HSS 61 was renumbered chapter HFS 61 under s. 13.93 (2m) (b) 1., Stats., and corrections made under s. 13.93 (2m) (b) 7., Stats., Register, August, 1996, No. 488. Chapter HFS 61 was renumbered to chapter DHS 61 under s. 13.92 (4) (b) 1., Stats., and corrections made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635.

subch. I of ch. DHS 61 Subchapter I — General Provisions

DHS 61.01 DHS 61.01 Introduction. These are standards for a minimum level of services. They are intended to establish a basis to assure adequate services provided by boards and services provided by agencies under contract with the boards.

DHS 61.01 History History: Cr. Register, January, 1980, No. 289, eff. 2-1-80; correction made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635.

DHS 61.02 DHS 61.02 General definitions. The following definitions apply to all standards for community mental health, developmental disabilities, and alcoholism and other drug abuse services.

DHS 61.02(1) (1) “Board” means a board of directors established under s. 51.42, 51.437, or 46.23, Stats.

DHS 61.02(2) (2) “Consultation” means providing assistance to a wide variety of local agencies and individuals. It includes indirect case consultation: the responding to specific requests of consultees to help resolve an individual case management problem or to improve the work function of the consultee. It includes problem related consultation: the providing of assistance to other human service agencies for educational purposes rather than individual case resolution. Consultation includes administrative and program consultation: the providing of assistance to local programs and government agencies in incorporating specific mental health, developmental disabilities and alcohol and other drug abuse principles into their programs.

DHS 61.02(3) (3) “Department” means the department of health services.

DHS 61.02(4) (4) “Education” means the provision of planned, structured learning experiences about a disability, its prevention, and work skills in the field. Education programs should be specifically designed to increase knowledge and to change attitudes and behavior. It includes public education and continuing education.

DHS 61.02(4)(a) (a) Public education is the provision of planned learning experiences for specific lay or consumer groups and the general public. The learning experiences may be characterized by careful organization that includes development of appropriate goals and objectives. Public education may be accomplished through using generally accepted educational methods and materials.

DHS 61.02(4)(b) (b) Continuing education is individual or group learning activities designed to meet the unique needs of board members, agency staffs, and providers in the community-based human service system. Learning activities may also be directed towards the educational goals of related care providers such as health care, social service, public school and law enforcement personnel. The purpose may be to develop personal or occupational potential by acquiring new skills and knowledge as well as heightened sensitivity to human service needs.

DHS 61.02(5) (5) “Employee or position, full-time,” means as defined by the employing board or agency.

DHS 61.02(6) (6) “Public information” means information for public consumption provided through the use of mass media methods about services, programs, and the nature of the disability for which the services and programs are provided. It consists of such activities as writing news releases, news letters, brochures, speaking to civic groups or other assemblies, and use of local radio and television programs. Public information programs should be specifically planned and designed to inform.

DHS 61.02 History History: Cr. Register, January, 1980, No. 289, eff. 2-1-80; emerg. r. and recr. (7), eff. 3-9-89; r. and recr. (7), Register, May, 1989, No. 401, eff. 6-1-89; correction in (3) made under s. 13.93 (2m) (b) 6., Stats., Register, August, 1996, No. 488; correction in (3) made under s. 13.92 (4) (b) 6., Stats., Register November 2008 No. 635.

DHS 61.021 DHS 61.021 Program element definitions.

DHS 61.021(2) (2) “Emergency care I” means all outpatient emergencies including socio-emotional crises, attempted suicides, family crises, etc. Included is the provision of examination, in accordance with s. 51.45 (11) (c), Stats., and if needed, transportation to an emergency room of a general hospital for medical treatment.

DHS 61.021(3) (3) “Emergency care II” means 24 hour emergency services provided on a voluntary basis or under detention, protective custody, and confinement. Services include crisis intervention, acute or sub-acute detoxification, and services for mental health emergencies. Clients are to be assessed, monitored, and stabilized until the emergency situation is abated. Included is the provision of examination, in accordance with s. 51.45 (11) (c), Stats., and transportation, if needed, to an emergency room of a general hospital for medical treatment.

DHS 61.021(4) (4) “Extended care” means a treatment oriented living facility service where supervision, training, and personal care are available and access to programs and medical care is ensured during a 24 hour day. Extended care programs emphasize self care, social skills training, treatment, and recreation for dependent persons with mental disabilities and in need of extended care.

DHS 61.021(4m) (4m) “Functionally equivalent” means a service provided via telehealth where the transmission of information is of sufficient quality as to be the same level of service as an in-person visit. Transmission of voices, images, data, or video must be clear and understandable.

DHS 61.021(5) (5) “Inpatient” means a medically oriented residential service which provides continuous medical services on a 24 hour basis to enable an individual with problems related to mental illness, alcohol and other drug abuse to function without 24 hour medical support services.

DHS 61.021(5)(a) (a) Children or adolescents shall not be placed in adult inpatient services for extended periods of time. Placement of an individual under 18 years of age in an adult program shall be for evaluation purposes only and shall not exceed 21 total days within a 3 month time span.

DHS 61.021(5)(b) (b) Inpatient treatment of individuals under 18 years of age shall be provided in specialized inpatient programs which comply with standards specified in s. DHS 61.79.

DHS 61.021(6) (6) “Intervention” means activities designed to identify individuals in need of mental hygiene services, including initial assessment, to judge the presence of problems, such as mental illness, developmental disabilities, alcohol or other drug abuse. Intervention begins with assessment and includes information and referral services, drop-in service and public information service. Activities which may initiate persons into the service, such as, rendering a judgment about the appropriate source of help, referral and arranging services.

DHS 61.021(7) (7) “Outpatient” means a non-residential program for persons with problems relating to mental illness, developmental disabilities, alcohol or other drug abuse to ameliorate or remove a disability and restore more effective functioning and to prevent regression from present level of functioning. Outpatient service may be a single contact or a schedule of visits. Outpatient program may include, but is not limited to, evaluation, diagnosis, medical services, counseling and aftercare.

DHS 61.021(8) (8) “Prevention” means activities directed toward the general population, or segments of the population, which is designed to increase the level of knowledge about the nature and causes of disabilities, change attitudes and take medical and environmental steps for the purpose of aiding persons before their problems develop into disabilities needing further services. Prevention activities include education services and consultation services.

DHS 61.021(9) (9) “Protective services” means services directed toward preventing or remedying neglect, abuse, or exploitation of children and adults who are unable to protect their own interests.

DHS 61.021(10) (10) “Research and evaluation” means the studying of causes, treatments and alleviations of problems as well as the formal application of techniques to measure the effectiveness of programs through the use of recognized statistical designs and evaluation procedures.

DHS 61.021(11) (11) “Sheltered employment” means non-competitive employment in a workshop, at home, or in a regular work environment for persons with a physical or intellectual disability. An individual with a disability is defined as any person who, by reason of physical or mental defect or alcohol or drug abuse, is or may be expected to be totally or partially incapacitated for remunerative operation.

DHS 61.021(12) (12) “Special living arrangements” means special services in foster family homes, foster care institutions, halfway houses, respite care, community based residential facilities, and other special living arrangements.

DHS 61.021(13) (13) “Systems management” means activities, both internal and external to programs, to effect efficient operation of the service delivery system.

DHS 61.021(13)(a) (a) Internal program management includes administration, objective setting, planning, resource acquisition and allocation and monitoring of staff.

DHS 61.021(13)(b) (b) External activities include interagency coordination, consultation, and comprehensive planning for the purpose of providing an integrated continuum of services to those needing such a system of services.

DHS 61.021(13m) (13m) 

DHS 61.021(13m)(a) (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.

DHS 61.021(13m)(b) (b) “Telehealth” may include real-time interactive audio-only communication.

DHS 61.021(13m)(c) (c) “Telehealth” does not include communication between a certified provider and a recipient that consists solely of an electronic mail, text, or facsimile transmission.

DHS 61.021(14) (14) “Training” means education activities for staff of program which serve or could potentially serve individuals with problems related to mental illness, developmental disabilities, alcohol and other drug abuse, concerning the nature, causes, and treatment of these disabilities for the purpose of better serving clients.

DHS 61.021 History History: Renum. from HSS 61.02 (7) to (20) under s. 13.93 (2m) (b) 1., Stats., Register, August, 1996, No. 488, eff. 9-1-96; correction in (3) made under s. 13.93 (2m) (b) 7., Stats., Register, October, 1999, No. 526; r. (1), Register, July, 2000, No. 535, eff. 8-1-00; CR 20-068: am. (11) Register December 2021 No. 792, eff. 1-1-22; CR 23-053: cr. (4m), (13m) Register September 2023 No. 813, eff. 10-1-23.

DHS 61.022 DHS 61.022 Disability related definitions.

DHS 61.022(2) (2) “Autism” means a severe disorder of communication and behavior manifested during the early stages of life. The autistic child appears to suffer primarily from a pervasive impairment of cognitive or perceptual functioning, or both, the consequences of which may be manifested by limited ability to understand, communicate, learn, and participate in social relationships.

DHS 61.022(3) (3) “Cerebral palsy” means a term applied to a group of permanently disabling symptoms resulting from damage to the developing brain that may occur before, during, or after birth; and that results in loss or impairment of control over voluntary muscles.

DHS 61.022(5) (5) “Developmental disability” has the meaning given in s. 51.01 (5) (a), Stats.

DHS 61.022(7) (7) “Epilepsy” means a disorder of the brain characterized by a recurring excessive neuronal discharge, manifested by transient episodes of motor, sensory, or psychic dysfunction, with or without unconsciousness or convulsive movements. The seizure is associated with marked changes in recorded electrical brain activity.

DHS 61.022(7m) (7m) “Intellectual disability” means subaverage general intellectual functioning that originates during the developmental period and is associated with impairment in adaptive behavior.

DHS 61.022(8) (8) “Mental illness” means mental disease to such extent that a person so afflicted requires care and treatment for his or her own welfare, or the welfare of others, or of the community.

DHS 61.022(8)(a) (a) Mental illness, for purposes of involuntary commitment, means a substantial disorder of thought, mood, perception, orientation, or memory which grossly impairs judgment, behavior, capacity to recognize reality, or ability to meet the ordinary demands of life, but does not include alcoholism.

DHS 61.022(10) (10) “Neurologic conditions” means disease states which require treatment similar to that required for intellectual disabilities.

DHS 61.022(11) (11) “Psychotherapy” means psychotherapy as defined in s. DHS 101.03.

DHS 61.022(12) (12) “Special education” means any education assistance required to provide an appropriate education program for a child with exceptional educational needs and any supportive or related service.

DHS 61.022(13) (13) “Substantial disability” means a level of disability of such severity that, alone or in combination with social, legal, or economic constraints, it requires the provision of specialized services over an extended period of time directed toward the individual’s emotional, social, personal, physical, or economic habilitation and rehabilitation.

DHS 61.022 History History: Renum. from HSS 61.02 (21) to (33) under s. 13.93 (2m) (b) 1., Stats., Register, August, 1996, No. 488; r. (1), (4) and (6), Register, July, 2000, No. 535, eff. 8-1-00; correction in (11) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635; 2019 Wis. Act 1: renum. (9) to (7m) and am., am. (5), (10) Register May 2019 No. 761, eff. 6-1-19; CR 20-068: r. and recr. (5), am. (13) Register December 2021 No. 792, eff. 1-1-22.

DHS 61.03 DHS 61.03 Eligibility.

DHS 61.03(1) (1) A program or service authorized under s. 51.42 or 51.437, Stats., is required to meet these standards in order to be eligible for state grants-in-aid.

DHS 61.03(2) (2) A board organized under s. 51.42, 51.437 or 46.23, Stats., shall submit an annual coordinated plan and budget in accordance with s. 46.031, Stats. The annual coordinated plan and budget shall establish priorities and objectives for the year, intermediate range plans and budgets, and modifications of long range objectives.

DHS 61.03(2)(a) (a) The coordinated plan and budget shall include plans for the provision of needed services pertaining to all program elements.

DHS 61.03(2)(b) (b) The coordinated plan and budget shall include plans for the provision of all 16 elements of developmental disability services.

DHS 61.03(2)(c) (c) The coordinated plan and budget shall include emphasis on special target populations mandated by the department.

DHS 61.03(2)(d) (d) The disability group program elements, services and optional related services are as follows:

ADMINISTRATIVE SERVICE CATEGORY

DHS 61.03 History History: Cr. Register, January, 1980, No. 289, eff. 2-1-80; correction in (2) made under s. 13.93 (2m) (b) 7., Stats., Register, October, 1999, No. 526.

DHS 61.04 DHS 61.04 Administration. The county board of supervisors of any county or combination of counties shall establish a board of directors in accordance with s. 46.23, 51.42 (4) or 51.437, Stats. The board shall appoint a program director.

DHS 61.04 History History: Cr. Register, January, 1980, No. 289, eff. 2-1-80.

DHS 61.05 DHS 61.05 Administrative personnel.

DHS 61.05(1) (1) The board program director is an administrator who has skills and knowledge in budgeting, planning, and program management. Such skills and knowledge are typically acquired during a course of study leading to a master’s degree and 5 years of related work experience in a relevant field.

DHS 61.05(2) (2) The board disability program coordinator shall have skills and knowledge in psychology, social work, rehabilitation, special education, health administration or a related human service field. The skills and knowledge required for appointment are typically acquired during a course of study leading to a master’s degree in one of the above listed fields and at least 4 years of relevant work experience.

DHS 61.05(3) (3) The clinical director of the board program shall be a psychiatrist.

DHS 61.05(4) (4) Additional years of experience in a relevant field may be substituted for the above academic qualifications. The department may approve the employment of individuals with lesser qualifications than stated in this subsection, if the program can demonstrate and document the need to do so. Written documentation of administrative personnel qualifications shall be maintained on file at the board office and available for inspection by the department.

DHS 61.05 History History: Cr. Register, January, 1980, No. 289, eff. 2-1-80.

DHS 61.06 DHS 61.06 Program personnel. Personnel in programs provided or contracted for by a board shall meet the following qualifications. Written documentation of such qualifications shall be maintained on file at the board office and available for inspection by the recipient of treatment services and the department.

DHS 61.06(1) (1) A physician shall be licensed to practice medicine in the state of Wisconsin and shall have skills in that area in which he or she is practicing (i.e. developmental disabilities, alcoholism, chemical dependency, etc.).

DHS 61.06(2) (2) A psychiatrist shall be a physician licensed in the state of Wisconsin and shall have satisfactorily completed 3 years residency training in psychiatry in a program approved by the American medical association.

DHS 61.06(3) (3) A child psychiatrist shall be a physician licensed in the state of Wisconsin and shall have satisfactorily completed a residency training program in child psychiatry approved by the American medical association.