DHS 40.03 Definitions.
In this chapter:
“Certification" means approval by the department under this chapter of a mental health day treatment services program for children.
“Child" means a person under 21 years of age.
“Client" means a child receiving mental health day treatment services from a program.
“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.
“Department" means the Wisconsin department of health services.
“Direct clinical services" means face to face patient contact.
“DSM IV" means the Diagnostic and Statistical Manual of Mental Disorders IV (4th edition) published by the American psychiatric association.
“Full-time client" means a client who is present in the program for 25 or more hours a week.
“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.
“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)
“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.
“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.
“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.
“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
“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.
“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.
“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.
“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:
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
Physical guidance and prompting techniques of brief duration.
“Program" means a mental health day treatment service program for children.
“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.
“Qualified mental health professional" means a program staff member who meets the experiential and educational qualifications identified in s. DHS 40.06 (4) (a)
“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 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
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.
An organization may apply for certification to operate:
The organization shall indicate in its application the level or levels under s. DHS 40.07 (1)
at which it intends to offer services.
On receipt of an application for initial certification or renewal of certification, the department shall:
Designate a representative to conduct an on-site survey of the program, including interviewing program staff.
The department's designated representative shall do all of the following:
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;
Review the results of any grievances filed against the program during any preceding period of certification, pursuant to s. DHS 94.27
Review a randomly selected, representative sample of client records; and
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.
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:
Statements made by the applicant or the applicant's designated agent, authorized administrative personnel and staff members;
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;
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.
The designated representative of the department who reviews the documents under pars. (a)
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
Within 60 days after receiving a completed application for initial certification or renewal of certification, the department shall:
Certify the program if all requirements for certification are met or deny certification if any requirement has not been met;
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
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.
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.
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.
The department may limit the initial certification of a program to a period of one year.
(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.
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.
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.
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.
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.
(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:
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;
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
, or under this state's or any other state's medicaid program under 42 CFR 430
. 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;
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.
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;
The program fails to maintain compliance with or is in substantial noncompliance with one or more of the requirements set forth in this chapter;
A program staff member signed billing or other documents as the provider of service when the service was not provided by the program; or
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.
(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)
DHS 40.04 Note
Note: The mailing address of the Office of Administrative Hearings is P.O. Box 7875, Madison, WI 53707.
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.
(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
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
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:
Strict enforcement of the requirement would result in unreasonable hardship to the provider or to the client; or