Chapter DHS 63

DHS 63.03 History History: Cr. Register, April, 1989, No. 400, eff. 5-1-89; CR 22-078: r. and recr. (6), cr. (7) Register July 2023 No. 811, eff. 8-1-23.

DHS 63.04 DHS 63.04 Termination, suspension or denial of certification.

DHS 63.04(1) (1) Definition. In this section, “suspension” means a temporary withdrawal of certification.

DHS 63.04(2) (2) Termination, suspension, or denial of certification after prior notice and requested hearing. The department may terminate, suspend, or deny a CSP’s certification after providing the CSP with prior written notice of the proposed action which includes the reason for the proposed action and a notice of opportunity for a hearing whenever the department finds that:

DHS 63.04(2)(a) (a) A staff member of the CSP has had sexual contact as defined in s. 940.225 (5) (b), Stats., or sexual intercourse, as defined in s. 940.225 (5) (c), Stats., with a client;

DHS 63.04(2)(b) (b) A staff member requiring professional licensure claimed to be licensed when he or she was not licensed, has had his or her license suspended or revoked, or has allowed his or her license to expire;

DHS 63.04(2)(c) (c) A CSP staff member has been convicted of a criminal offense related to the provision of or claiming reimbursement for services under the medicare program under 42 USC 1395 and 42 CFR 400 to 421, or under this state’s or any other state’s medical assistance program. For purposes of this paragraph, “convicted” means that a judgment of conviction has been entered by a federal, state or local court, regardless of whether an appeal from that judgment is pending;

DHS 63.04(2)(d) (d) A staff member has been convicted of a criminal offense related to the provision of care, treatment or services to a person who is mentally ill, developmentally disabled, alcoholic or drug dependent;

DHS 63.04(2)(e) (e) The program submitted or caused to be submitted statements, for purposes of obtaining certification under this chapter, which it knew, or should have known, to be false;

DHS 63.04(2)(f) (f) The program failed to maintain compliance with one or more of the standards set forth in this chapter;

DHS 63.04(2)(g) (g) Any of the program’s practitioners signed billing or other documents as the provider of service when the service was not provided by the practitioner; or

DHS 63.04(2)(h) (h) There is no documentary evidence in a client’s treatment file that the client received services which were billed for.

DHS 63.04(3) (3) Right to a hearing. In the event that the department denies, terminates, or suspends a certification, a CSP may request a hearing under s. 227.42, Stats. The request for a hearing shall be submitted in writing to and received by the department of administration’s division of hearings and appeals within 30 days after the date on the notice required under sub. (2).

DHS 63.04 Note Note: The mailing address of the Division of Hearings and Appeals is P.O. Box 7875, Madison, WI 53707.

DHS 63.04 History History: Cr. Register, April, 1989, No. 400, eff. 5-1-89; CR 22-078: am. (2) (intro.), (3) Register July 2023 No. 811, eff. 8-1-23.

DHS 63.05 DHS 63.05 Waivers.

DHS 63.05(1) (1) Policy. The department may grant a waiver of any requirement of this chapter when the department determines that granting a waiver would not diminish the effectiveness of the CSP, violate the purposes of the program, or adversely affect clients’ health and welfare. The department may not grant a waiver of clients’ rights under ch. DHS 94 or under other administrative rules, state statutes or federal regulations.

DHS 63.05(2) (2) Waiver. A CSP may submit a request to the department for a waiver of any requirement in this chapter, except a requirement specified under s. DHS 63.08 (1) (a).

DHS 63.05(3) (3) Application. An application for a waiver under sub. (2) shall be made in writing to the department and shall specify:

1. The rule from which the waiver is requested;

2. The time-period for which the waiver is requested;

3. Any alternative action which the CSP proposes;

4. The reason for the request; and

5. Assurances that sub. (1) would be satisfied.

DHS 63.05 Note Note: A request for a waiver should be addressed to the Behavioral Health Certification Section, Division of Quality Assurance, P.O. Box 2969, Madison, WI 53701-2969.

DHS 63.05(4) (4) Grant or denial.

DHS 63.05(4)(a) (a) The department may require additional information from the CSP before acting on a request for a waiver.

DHS 63.05(4)(b) (b) The department shall grant or deny each request for waiver in writing. Notice of denial shall contain the reasons for denial. If a notice of a denial is not issued within 60 days after the receipt of a complete request, the waiver shall be automatically approved.

DHS 63.05(4)(c) (c) The department may impose any conditions on the granting of a waiver which it deems necessary.

DHS 63.05(4)(d) (d) The department may limit the duration of a waiver.

DHS 63.05(4)(e) (e) The department’s decision to grant or deny a waiver shall be final.

DHS 63.05 History History: Cr. Register, April, 1989, No. 400, eff. 5-1-89; correction in (1) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635.

DHS 63.06 DHS 63.06 Personnel.

DHS 63.06(1) (1) Policies.

DHS 63.06(1)(a) (a) A CSP shall have written personnel policies to ensure that employment practices do not discriminate against any employee or applicant for employment on the basis of age, race, religion, color, sexual orientation, marital status, arrest and conviction record, ancestry, creed, national origin, disability, sex or physical condition.

DHS 63.06(1)(b) (b) A CSP shall maintain written documentation of employees’ qualifications and shall make that information available for inspection by clients and by the department.

DHS 63.06(2) (2) Required staff. A CSP shall employ:

DHS 63.06(2)(a) (a) A director, who shall have overall responsibility for the program. The director shall meet the qualifications for any of the program staff listed under sub. (4) (a) 1. to 8.;

DHS 63.06(2)(b) (b) A psychiatrist on a full-time, part-time or consulting basis to provide necessary psychiatric services. The psychiatrist shall meet the qualifications specified under sub. (4) (a) 2.; and

DHS 63.06(2)(c) (c) A clinical coordinator who shall have overall responsibility for and provide direct supervision of the CSP’s client treatment services and supervision of CSP clinical staff. The clinical coordinator shall be a psychiatrist or psychologist or have a master’s degree in social work, clinical psychology or psychiatric mental health nursing or have met equivalent requirements. The coordinator shall have either 3,000 hours of supervised clinical experience in a practice where the majority of clients are adults with chronic mental illness or 1,500 hours of supervised clinical experience in a CSP.

DHS 63.06(3) (3) Staffing ratios. The client-to-staff ratio may not exceed 20 clients to one full-time equivalent staff person, except that the department may permit, in accordance with a request for a waiver under s. DHS 63.05, that the ratio may not exceed 25 clients to one full time equivalent staff person. Only staff who meet the qualifications under subs. (2) and (4) (a) may be counted in the staff-to-client ratio.

DHS 63.06(4) (4) Qualifications.

DHS 63.06(4)(a) (a) CSP staff shall have the following qualifications:

DHS 63.06(4)(a)1. 1. A CSP professional shall have a bachelor’s degree in a behavioral science or a related field with 1,000 hours of supervised post-degree clinical experience with chronically mentally ill persons, or a bachelor’s degree in a field other than behavioral sciences with 2,000 hours of supervised postdegree clinical experience with persons with chronic mental illness;

DHS 63.06(4)(a)2. 2. A psychiatrist shall be a physician licensed under ch. 448, Stats., to practice medicine and surgery and shall have satisfactorily completed 3 years’ residency training in psychiatry in a program approved by the American medical association;

DHS 63.06(4)(a)3. 3. A clinical psychologist shall be licensed under ch. 455, Stats.;

DHS 63.06(4)(a)4. 4. A clinical social worker shall have a master’s degree from a graduate school of social work accredited by the council on social work education;

DHS 63.06(4)(a)5. 5. A registered nurse shall hold a current certificate of registration under ch. 441, Stats., and shall have experience or education related to the responsibilities of his or her position;

DHS 63.06(4)(a)6. 6. Occupational therapists and recreational therapists shall have bachelor’s degrees in their respective professions;

DHS 63.06(4)(a)7. 7. A rehabilitation counselor shall be certified or eligible for certification by the commission on rehabilitation counselor certification;

DHS 63.06(4)(a)8. 8. A vocational counselor shall possess or be eligible for a provisional school counselor certificate and shall have a master’s degree in counseling and guidance; and

DHS 63.06(4)(a)9. 9. A mental health technician shall be a paraprofessional who is employed on the basis of personal aptitude. A mental health technician shall have a suitable period of orientation and in-service training and shall work under the supervision of a clinical coordinator under sub. (2) (c).

DHS 63.06(4)(b) (b) When volunteers are used, they shall be supervised by professional staff under par. (a) 1. to 8. The CSP shall have written procedures for the selection, orientation and inservice training of volunteers.

DHS 63.06(5) (5) Clinical supervision.

DHS 63.06(5)(a) (a) Each CSP shall develop and implement a written policy for clinical supervision of all staff who provide treatment, rehabilitation and support services to CSP clients.

DHS 63.06(5)(b) (b) Clinical supervision of individual CSP staff shall include direct clinical review, assessment and feedback regarding their delivery of treatment, rehabilitation and support services to individual CSP clients and teaching and monitoring of the application of CSP principles and practices.

DHS 63.06(5)(c) (c) Clinical supervision shall be provided by a clinical coordinator meeting the qualifications under s. DHS 63.06 (2) (c) or by staff who meet the qualifications under s. DHS 63.06 (2) (c) and who are designated by the clinical coordinator to provide clinical supervision.

DHS 63.06(5)(d) (d) Clinical supervision shall be accomplished by one or more of the following means:

DHS 63.06(5)(d)1. 1. Individual sessions with staff to review cases, assess performance and give feedback;

DHS 63.06(5)(d)2. 2. Individual sessions in which the supervisor accompanies an individual staff member to meet with individual clients in regularly scheduled sessions or crisis situations and in which the supervisor assesses, teaches and gives feedback regarding the staff member’s performance regarding the particular client;

DHS 63.06(5)(d)2m. 2m. Any other form of professionally recognized method of supervision designed to provide sufficient guidance to assure the delivery of effective services to consumers by the staff member;

DHS 63.06(5)(d)3. 3. Regular client report or review staff meetings and treatment planning staff meetings to review and assess staff performance and provide staff direction regarding individual cases.

DHS 63.06(5)(e) (e) For every 20 clients or every 40 hours of direct service in the CSP, the clinical supervisor shall spend at least 4 hours a week providing supervision.

DHS 63.06(5)(f) (f) Clinical supervision provided to individual CSP staff shall be documented in writing.

DHS 63.06(6) (6) Orientation and training.

DHS 63.06(6)(a) (a) Each CSP shall develop and implement an orientation and training program which all new staff and regularly scheduled volunteers shall complete. The orientation shall include:

DHS 63.06(6)(a)1. 1. Review of the applicable parts of this chapter.

DHS 63.06(6)(a)2. 2. Review of CSP policies.

DHS 63.06(6)(a)3. 3. Review of job responsibilities specified in the job description.

DHS 63.06(6)(a)4. 4. Review of ch. DHS 94, patient rights.

DHS 63.06(6)(a)5. 5. Review of ch. DHS 92, confidentiality of treatment records.

DHS 63.06(6)(a)6. 6. Review of agency’s use of telehealth, including when telehealth can be used and by whom, privacy and security considerations, and the right to decline services provided via telehealth.

DHS 63.06(6)(b) (b) Each CSP shall develop and implement a training plan for all staff, including:

DHS 63.06(6)(b)1. 1. Use of staff meeting time which is set aside for training.

DHS 63.06(6)(b)2. 2. Presentations by community resource staff from other agencies.

DHS 63.06(6)(b)3. 3. Attendance at conferences and workshops.

DHS 63.06(6)(b)4. 4. Discussion and presentation of current principles and methods of treatment, rehabilitation and support services for chronically mentally ill persons.

DHS 63.06 History History: Cr. Register, April, 1989, No. 400, eff. 5-1-89; correction in (6) (a) 4. made under s. 13.93 (2m) (b) 7., Stats., Register December 2004 No. 588; corrections in (6) (a) 4. and 5. made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635; CR 20-068: am. (1) (a) Register December 2021 No. 792, eff. 1-1-22; CR 23-053: am. (5) (d) 1., 2., cr. (5) (d) 2m., am. (6) (a) 1. to 4., cr. (6) (a) 6., am. (6) (b) 1. to 3. Register September 2023 No. 813, eff. 10-1-23.

DHS 63.07 DHS 63.07 Outreach and screening. A CSP shall have written procedures for contacting and identifying persons with chronic mental illness and for having those persons referred to the CSP. The procedures shall include:

DHS 63.07(1) (1) Outreach activities and direct contact with potential CSP clients;

DHS 63.07(2) (2) Outreach referral agreements with psychiatric inpatient units, outpatient units and community service providers; and

DHS 63.07(3) (3) Screening by a clinical coordinator of each person referred to the CSP under sub. (2) to determine whether the person meets the admission criteria in s. DHS 63.08.

DHS 63.07 History History: Cr. Register, April, 1989, No. 400, eff. 5-1-89.

DHS 63.08 DHS 63.08 Criteria for admission.

DHS 63.08(1) (1) Criteria. Admission to a CSP shall be limited to an individual who has chronic mental illness which by history or prognosis requires repeated acute treatment or prolonged periods of institutional care and who exhibits persistent disability or impairment in major areas of community living as evidenced by:

DHS 63.08(1)(a) (a)

DHS 63.08(1)(a)1. 1. A condition of chronic mental illness and a diagnosis listed in the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) within one of the following classification codes:

DHS 63.08(1)(a)1.a. a. 295.1, .2, .3, .6 and .9 - Schizophrenia;

DHS 63.08(1)(a)1.b. b. 296.2, .3, .4, .5, .6 and .7 - Affective disorders;