DHS 40.03 DHS 40.03Definitions. In this chapter:
DHS 40.03(1) (1) “Certification" means approval by the department under this chapter of a mental health day treatment services program for children.
DHS 40.03(2) (2) “Child" means a person under 21 years of age.
DHS 40.03(3) (3) “Client" means a child receiving mental health day treatment services from a program.
DHS 40.03(4) (4) “Community-based program" means a program providing non-residential mental health day services for children in a free-standing facility not affiliated with a school or a hospital.
DHS 40.03(5) (5) “Department" means the Wisconsin department of health services.
DHS 40.03(6) (6) “Direct clinical services" means face to face patient contact.
DHS 40.03(7) (7) “DSM IV" means the Diagnostic and Statistical Manual of Mental Disorders IV (4th edition) published by the American psychiatric association.
DHS 40.03(8) (8) “Full-time client" means a client who is present in the program for 25 or more hours a week.
DHS 40.03(9) (9) “Guardian" means the person or agency appointed by a court under ch. 54, Stats., to have care, custody, and control of a child in place of a parent of the child, or a legal guardian appointed by a court under ch. 48, Stats., when a parent's rights have been terminated.
DHS 40.03(10) (10) “Hospital-based program" means a program providing mental health day treatment services for children in a facility which is a part of or directly affiliated with a hospital as defined in s. 50.33 (2), Stats.
DHS 40.03(11) (11) “Level I services" means services designed to assist clients whose needs are principally derived from conduct disorders or oppositional disorders and are best met by extended participation in a therapeutic milieu of structured services including individual, group and family counseling, educational support or direct academic instruction and recreational therapy.
DHS 40.03(12) (12) “Level II services" means services designed to assist clients whose needs are principally derived from intransigent and severe mental health disorders and are best met by intense, extended psychiatric or psychotherapeutic treatment in combination with a continuum of other individual and family support services.
DHS 40.03(13) (13) “Level III services" means services designed to assist clients whose needs are principally derived from an acute episode of a mental health disorder and are best met by intense, short-term treatment in a psychiatric or psychotherapeutic setting.
DHS 40.03(14) (14) “Local educational agency" means a school district defined in s. 115.01 (3), Stats., a cooperative educational services agency (CESA) established under ch. 116, Stats., or a county handicapped children's education board (CHCEB) established under s. 115.817, Stats.
DHS 40.03(15) (15) “Mental health day treatment services for children" means non-residential care provided on prescription of a physician in a clinically supervised setting that provides case management and an integrated system of individual, family and group counseling or therapy or other services assembled pursuant to an individually prepared plan of treatment that is based upon a multi-disciplinary assessment of the client and his or her family and is designed to alleviate emotional or behavioral problems experienced by the client related to his or her mental illness or severe emotional disturbance.
DHS 40.03(16) (16) “Mental illness" means a medically diagnosable mental health disorder which is severe in degree and which substantially diminishes a child's ability to carry out activities of daily living appropriate for the child's age.
DHS 40.03(17) (17) “Parent" means a biological parent, a husband who has consented to the artificial insemination of his wife under s. 891.40, Stats., a male who is presumed to be the father under s. 891.41, Stats., or has been adjudicated the child's father either under s. 767.89, Stats., or by final order or judgment of a court of competent jurisdiction in another state, or an adoptive parent.
DHS 40.03(18) (18) “Physical restraint" means any manual method such as basket holds or prone or supine containment or a mechanical device that the individual cannot remove easily and which restricts the freedom of movement or normal range of motion of one or more limbs or the entire body, but not including:
DHS 40.03(18)(a) (a) Mechanical supports used to achieve proper body position, balance or alignment, such as arm splints to reduce contractures or leg braces to support the legs while standing or walking. Mechanical supports are used to enhance independent functioning whereas physical restraints are used to limit independent functioning; or
DHS 40.03(18)(b) (b) Physical guidance and prompting techniques of brief duration.
DHS 40.03(19) (19) “Program" means a mental health day treatment service program for children.
DHS 40.03(20) (20) “Psychotherapy" has the meaning prescribed in s. DHS 101.03 (145).
DHS 40.03(21) (21) “Psychotropic medication" means an antipsychotic, an antidepressant, lithium carbonate or a tranquilizer or any other drug used to treat, manage or control psychiatric symptoms or disordered behavior.
DHS 40.03 Note Note: Examples of drugs other than an antipsychotic or antidepressant, lithium carbonate or tranquilizer used to treat, manage or control psychiatric symptoms or disordered behavior include, but are not limited to, carbamazepine (Tegretol), which is typically used for control of seizures but may be used to treat a bi-polar disorder, and propranolol (Inderal), which is typically used to control high blood pressure but may be used to treat explosive behavior or anxiety states.
DHS 40.03(22) (22) “Qualified mental health professional" means a program staff member who meets the experiential and educational qualifications identified in s. DHS 40.06 (4) (a) to (h).
DHS 40.03(23) (23) “School-based program" means a program providing mental health day services for children in a facility operated by a local educational agency, with the local education agency providing space in the program to offer mental health day services to youth in close coordination with the educational program provided by the local educational agency.
DHS 40.03(24) (24) “Severe emotional disturbance" has the meaning prescribed for “severely emotionally disturbed" in s. DHS 107.32 (1) (a) 2.
DHS 40.03 History History: Cr. Register, August, 1996, No. 488, eff. 9-1-96; corrections in (14), (20) and (24) made under s. 13.93 (2m) (b) 7., Stats., Register January 2004 No. 577; corrections in (5), (9), (17), (20) and (24) made under s. 13.92 (4) (b) 6. and 7., Stats., Register November 2008 No. 635.
DHS 40.04 DHS 40.04Certification.
DHS 40.04(1) (1)Application.
DHS 40.04(1)(a)(a) An organization wanting to be certified to operate a mental health day treatment services program for children shall apply to the department for certification on a form provided by the department and shall include with the application form all other supporting materials requested by the department.
DHS 40.04 Note Note: For a copy of the application form, write Program Certification Unit, Division of Disability and Elder Services, P.O. Box 309, Madison, Wisconsin 53707.
DHS 40.04(1)(b) (b) An organization may apply for certification to operate:
DHS 40.04(1)(b)1. 1. A community-based program;
DHS 40.04(1)(b)2. 2. A school-based program; or
DHS 40.04(1)(b)3. 3. A hospital-affiliated program.
DHS 40.04(1)(c) (c) The organization shall indicate in its application the level or levels under s. DHS 40.07 (1) at which it intends to offer services.
DHS 40.04(2) (2)Certification process.
DHS 40.04(2)(a)(a) On receipt of an application for initial certification or renewal of certification, the department shall:
DHS 40.04(2)(a)1. 1. Review the application and its supporting documents; and
DHS 40.04(2)(a)2. 2. Designate a representative to conduct an on-site survey of the program, including interviewing program staff.
DHS 40.04(2)(b) (b) The department's designated representative shall do all of the following:
DHS 40.04(2)(b)1. 1. Interview a randomly selected, representative sample of present or former clients of the program, if any, provided that the clients indicate a willingness to be contacted;
DHS 40.04(2)(b)2. 2. Review the results of any grievances filed against the program during any preceding period of certification, pursuant to s. DHS 94.27;
DHS 40.04(2)(b)3. 3. Review a randomly selected, representative sample of client records; and
DHS 40.04(2)(b)4. 4. Review program policies and records, and interview program staff to a degree sufficient to ensure that staff have knowledge of the statutes, rules and standards of practice that apply to the program and its clients.
DHS 40.04(2)(c) (c) The certification survey under par. (b) shall be used to determine the extent of the program's compliance with the standards specified in this chapter. Certification decisions shall be based on a reasonable assessment of the program. The indicators by which compliance with the standards is determined shall include:
DHS 40.04(2)(c)1. 1. Statements made by the applicant or the applicant's designated agent, authorized administrative personnel and staff members;
DHS 40.04(2)(c)2. 2. Documentary evidence provided by the applicant;
DHS 40.04(2)(c)3. 3. Answers to questions concerning the implementation of program policies and procedures, as well as examples of implementation provided to assist the department in making a judgment regarding the applicant's compliance with the standards in this chapter;
DHS 40.04(2)(c)4. 4. On-site observations by surveyors from the department;
DHS 40.04(2)(c)5. 5. Reports by clients regarding the program's operations; and
DHS 40.04(2)(c)6. 6. Information from grievances filed by clients.
DHS 40.04(2)(d) (d) The applicant shall make available for review by the designated representative of the department all documentation necessary to establish whether the program is in compliance with the standards in this chapter, including, but not limited to, the written policies and procedures of the program, work schedules of staff, program appointment records, credentials of staff and treatment records.
DHS 40.04(2)(e) (e) The designated representative of the department who reviews the documents under pars. (a) to (d) and interviews clients under par. (b) 1. shall preserve the confidentiality of all client information obtained during the certification process, in compliance with ch. DHS 92.
DHS 40.04(3) (3)Issuance of certification.
DHS 40.04(3)(a)(a) Within 60 days after receiving a completed application for initial certification or renewal of certification, the department shall:
DHS 40.04(3)(a)1. 1. Certify the program if all requirements for certification are met or deny certification if any requirement has not been met;
DHS 40.04(3)(a)2. 2. If the application for certification is denied, provide the applicant reasons in writing for the denial and identify the requirements for certification which the program has not met; and
DHS 40.04(3)(a)3. 3. State in a notice of denial that the applicant has a right to request a hearing on that decision under sub. (8) and a right to submit a plan under par. (b) to correct program deficiencies in order to begin operation of the program.
DHS 40.04(3)(b)1.1. Within 10 days after receiving a notice of denial under par. (a), an applicant may submit to the department a plan to correct program deficiencies.
DHS 40.04(3)(b)2. 2. The plan of correction shall indicate the date on which the applicant will have remedied the deficiencies of the program. Within 60 days after that date, the department shall determine whether the corrections have been made. If the corrections have been made, the department shall certify the program.
DHS 40.04(3)(c) (c) The department may limit the initial certification of a program to a period of one year.
DHS 40.04(4) (4)Content of certification. Certification shall be issued only for the location and program named and may not be transferred or assigned to another program. A program shall notify the department of a change of administration, ownership, program name or any other program change that may affect compliance with this chapter no later than the effective date of the change.
DHS 40.04(5) (5)Effective date of certification.
DHS 40.04(5)(a)(a) The date of certification shall be the date that the department determines, by means of an on-site survey, that an applicant is in compliance with this chapter.
DHS 40.04(5)(b) (b) The department may change the date of certification if the department has made an error in the certification process. A date of certification which is adjusted under this paragraph may not be earlier than the date the written application under sub. (1) was submitted to the department.
DHS 40.04(6) (6)Renewal.
DHS 40.04(6)(a)(a) Certification is valid for a period of 3 years unless sooner suspended or revoked or unless a shorter period of time is specified under the sub. (3) (c) at the time of approval.
DHS 40.04(6)(b) (b) The department shall send written notice of expiration and an application for renewal of certification to a certified program at least 30 days prior to expiration of the certification. If the department does not receive an application for renewal of certification before the expiration date, the program's certification shall be terminated.
DHS 40.04(7) (7)Action against a certified program. The department may terminate, suspend or refuse to renew a program's certification after providing the program with prior written notice of the proposed action which shall include the reason for the proposed action and notice of opportunity for a hearing under sub. (8) whenever the department finds that:
DHS 40.04(7)(a) (a) A program staff member 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 40.04(7)(b) (b) A program staff member who is required to have a professional license 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 40.04(7)(c) (c) A program 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 CFR 400 to 424, or under this state's or any other state's medicaid program under 42 CFR 430 to 456. In 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 40.04(7)(d) (d) A program 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, or has been convicted of a crime against a child under ch. 948, Stats.;
DHS 40.04(7)(e) (e) The program has submitted or caused to be submitted statements, for purposes of obtaining certification under this chapter, which it knew or should have known were false;
DHS 40.04(7)(f) (f) The program fails to maintain compliance with or is in substantial noncompliance with one or more of the requirements set forth in this chapter;
DHS 40.04(7)(g) (g) A program staff member signed billing or other documents as the provider of service when the service was not provided by the program; or
DHS 40.04(7)(h) (h) There is no documentary evidence in a client's treatment file that the client received services for which bills had been submitted to a third-party payer.
DHS 40.04(8) (8)Right to a hearing. If the department denies, terminates, suspends or refuses to renew a certification, an applicant or program 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's office of administrative hearings within 30 days after the date on the notice required under sub. (2) or (6).
DHS 40.04 Note Note: The mailing address of the Office of Administrative Hearings is P.O. Box 7875, Madison, WI 53707.
DHS 40.04(9) (9)Reapplication. If an application for certification is denied, the organization may not reapply for certification for 2 years following the date on which certification was denied.
DHS 40.04(10) (10)Dissemination of results. Upon completing action on an application for certification, staff of the department responsible for certification shall provide a summary of the results of the process to the applicant program, to the subunit within the department responsible for monitoring community mental health programs and to the department under s. 51.42, Stats., in the county in which the program is located.
DHS 40.04 History History: Cr. Register, August, 1996, No. 488, eff. 9-1-96; correction in (2) (e) made under s. 13.93 (2m) (b) 7., Stats., Register January 2004 No. 577; corrections in (2) (b) 2. and (e) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635.
DHS 40.05 DHS 40.05Waivers.
DHS 40.05(1) (1)Policy. The department may grant a waiver of any requirement of this chapter on request when the department determines that granting the waiver would not diminish the effectiveness of the mental health day services program, violate the purposes of the program or adversely affect client health, safety or welfare, and it is determined that:
DHS 40.05(1)(a) (a) Strict enforcement of the requirement would result in unreasonable hardship to the provider or to the client; or
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Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date the chapter was last published.