DHS 36.05(1)(b)2. 2. Creates a risk of harm to a consumer or violates a consumer right created by this chapter or other state or federal statutes or rules, which may include any one of the following of the following:
DHS 36.05(1)(b)2.a. a. A staff member has had sexual contact or intercourse, as defined in s. 940.225 (5) (b) or (c), Stats., with a consumer.
DHS 36.05(1)(b)2.b. b. A staff member of the CCS has been convicted of consumer abuse under s. 940.285, 940.29 or 940.295, Stats.
DHS 36.05(1)(b)2.c. c. The health or safety of a consumer is in imminent danger because of a failure of the CCS or a CCS staff member to comply with requirements of this chapter or any other applicable local, state or federal statute or regulation.
DHS 36.05(1)(b)3. 3. The CCS has submitted, or caused to be submitted, one or more statements for purposes of obtaining certification under this chapter which the CCS knew or should have known to be false.
DHS 36.05(1)(b)4. 4. A license, certification or required local, state or federal approval of the CCS has been revoked or suspended or has expired.
DHS 36.05(1)(b)5. 5. A staff member has signed a billing statement or other document that represents the CCS staff member as the provider of service when the staff member did not provide the service.
DHS 36.05(1)(b)6. 6. A staff member impedes or has impeded monitoring of the program by the department.
DHS 36.05(1)(b)7. 7. An action or inaction by a staff member constitutes grounds for involuntary termination or suspension from program participation under s. DHS 106.06.
DHS 36.05(2) (2)Initial application. Upon receipt of a complete application for initial certification, the department shall review the application and accompanying materials required under s. DHS 36.04 (2). The department's designated representative responding to a request for an initial certification shall review CCS personnel policies and procedures and operational policies, and the community services plan developed under s. DHS 36.07.
DHS 36.05(3) (3)Application for renewal.
DHS 36.05(3)(a)(a) The department shall send written notice of the expiration of certification and an application for renewal of certification to a certified CCS at least 90 days before expiration of the certification. If the department does not receive a complete application for renewal of certification before the expiration date, the certification shall terminate on the expiration date of the certification. A CCS that wishes to renew an expired certification shall apply as required in s. DHS 36.04.
DHS 36.05(3)(b) (b) Before applying for renewal of certification, a CCS shall review the continuing appropriateness of its comprehensive community services plan. The CCS shall revise the plan based on feedback of department representatives and consultation with and input received from staff members, consumers, family members, service providers and interested members of the public. The revised plan shall include responses to information derived from the quality improvement activities under s. DHS 36.08, and the coordination committee under s. DHS 36.09.
DHS 36.05(3)(c) (c) Upon receipt of a complete application for renewal of certification, the department shall review the application and designate a representative to conduct an on-site survey of the CCS.
DHS 36.05(3)(d) (d) The survey conducted under par. (c) shall be used to determine whether the CCS is in compliance with the standards specified in this chapter.
DHS 36.05(3)(e) (e) The CCS shall make available for review by the department's designated representative any documentation requested to determine whether the CCS is in compliance with the standards of this chapter, including all of the following:
DHS 36.05(3)(e)1. 1. The CCS plan, policies and procedures.
DHS 36.05(3)(e)2. 2. Staff member work schedules.
DHS 36.05(3)(e)3. 3. CCS appointment records.
DHS 36.05(3)(e)4. 4. Staff member credentials and service records, and supervision records.
DHS 36.05(3)(e)5. 5. Additional information that the CCS believes will help surveyors understand the CCS operations, policies, and procedures.
DHS 36.05(3)(e)6. 6. The results of consumer satisfaction surveys, coordination committee recommendations, and descriptions of any modification of the CCS program shall be made available for review by the department.
DHS 36.05(3)(e)7. 7. Any other information requested by the department.
DHS 36.05(3)(f) (f) Any designated representative of the department who reviews documents or who conducts an interview under this chapter shall preserve the confidentiality of the information reviewed or obtained in compliance with s. 51.30, Stats., ch. DHS 92, Health Insurance Portability and Accountability Act (HIPAA), and as applicable, 42 CFR Part 2.
DHS 36.05(4) (4)Transferability of certification. Certification may only be issued to the CCS specified in the application. A CCS may not transfer or assign its certification to another entity. An applicant or certified CCS shall notify the department of any change in administration, location, name, offered services or any other change that may affect compliance with this chapter no later than the effective date of the change.
DHS 36.05(5) (5)Effective date of certification.
DHS 36.05(5)(a)(a) The date of certification shall be the date that the department determines that an applicant is in compliance with this chapter.
DHS 36.05(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 that is adjusted under this paragraph may not be earlier than the date the department receives a written application under sub. (2) or (3).
DHS 36.05(6) (6)Fees for certification. Fees for certification shall be established by the department.
DHS 36.05(7) (7)Issuance of certification.
DHS 36.05(7)(a)(a) Action on application. Within 60 days after receiving a completed application for initial certification or for renewal of certification, the department shall do one of the following:
DHS 36.05(7)(a)1. 1. Approve the CCS if no deficiencies are found and all of the requirements for certification are met.
DHS 36.05(7)(a)2. 2. Issue a provisional certification under sub. (8), if the applicant has one or more deficiencies, that do not meet the definition of a major deficiency.
DHS 36.05(7)(a)3. 3. Deny certification under sub. (9), if the department finds one or more major deficiencies.
DHS 36.05(7)(b) (b) Duration of certification. The department may limit the initial certification of a CCS to one year. Certification may be renewed for up to 3 years provided the CCS has applied for renewal and the CCS continues to meet the requirements for certification. Certification is subject to suspension, revocation, or refusal to renew as specified in s. DHS 36.06.
DHS 36.05(8) (8)Provisional certification.
DHS 36.05(8)(a)(a) If the department determines that the CCS has one or more deficiencies that do not meet the definition of a major deficiency, the department shall issue a notice of deficiency to the CCS and offer the CCS provisional certification.
DHS 36.05(8)(b) (b) If a CCS wishes to operate under a provisional certification, the CCS shall submit a plan of correction to the department within 30 days of the date of the notice of deficiency. The plan of correction shall identify the specific steps the CCS will take to correct the deficiency and the timeline within which the corrections will be made. If a CCS does not wish to operate under a provisional certification, the department shall issue a denial of certification under sub. (9).
DHS 36.05(8)(c) (c) If the department approves the plan of correction it shall provisionally certify the CCS and establish an expiration date for the provisional certification.
DHS 36.05(8)(d) (d) Before a provisional certification expires, the department may conduct an on site inspection of the CCS to determine whether the proposed corrections have been made. Upon completion of an inspection, or in place of an inspection, the department shall do one of the following:
DHS 36.05(8)(d)1. 1. If the CCS has accomplished the goals of the plan of correction and made the required corrections, withdraw the notice of deficiency and certify the CCS under sub. (7) (a) 1.
DHS 36.05(8)(d)2. 2. Extend the provisional certification if substantial progress is made towards correcting deficiencies previously cited.
DHS 36.05(8)(d)3. 3. If a deficiency cited in the notice of deficiency has not been corrected, the goals of the plan of correction have not been accomplished, or a major deficiency is found, deny certification under sub. (9).
DHS 36.05(9) (9)Denial of certification. A denial of certification shall be in writing and shall contain the reason for the denial and notice of opportunity for a hearing under s. DHS 36.06 (3).
DHS 36.05 History History: CR 04-025: cr. Register October 2004 No. 586, eff. 11-1-04; corrections in (1) (b) 7. and (3) (f) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635.
DHS 36.06 DHS 36.06Enforcement actions.
DHS 36.06(1) (1)Revocation and suspension. The department may revoke or suspend certification at any time upon written notice to the CCS. The notice shall state the reason for the action and inform the CCS of the opportunity for a hearing under sub. (3).
DHS 36.06(2) (2)Inspections.
DHS 36.06(2)(a)(a) The department may make announced and unannounced inspections of a certified CCS to verify compliance with this chapter, to investigate complaints received regarding the services provided by the CCS, or as part of an investigation into the cause of death of a consumer.
DHS 36.06(2)(b) (b) In making inspections, the department shall seek to minimize any disruption to the normal functioning of the CCS.
DHS 36.06(2)(c) (c) Any authorized officer, employee or agent of the department shall have access to all CCS documents, open and closed consumer records, staff members and consumers at any time to ensure compliance with the requirements of this chapter and other applicable federal and state statutes and regulations.
DHS 36.06(3) (3)Appeals.
DHS 36.06(3)(a)(a) If the department denies, revokes, suspends, or refuses to renew certification, the CCS may request an administrative hearing under ch. 227, Stats. If a timely request for hearing is made on a decision to suspend or revoke or not renew a certification, that action is stayed pending the decision on the appeal except when the department finds that the health, safety or welfare of patients requires that the action take effect immediately. A finding of a requirement for immediate action shall be made in writing by the department.
DHS 36.06(3)(b) (b) A request for hearing shall be submitted in writing to the department of administration's division of administrative hearings within 30 days after the date of the notice of the department's action.
DHS 36.06 Note Note: A request for hearing may be delivered in person or mailed to the Division of Hearings and Appeals, 5005 University Avenue, Suite 201, Madison, WI 53707-7875. An appeal may be sent by fax to the Division's facsimile transmission number at (608) 264-9885.
DHS 36.06(4) (4)Actions barring service in a ccs. Any person having direct management responsibility for a CCS who was involved in any one of the following may not provide service in or for a certified CCS for a period not to exceed 5 years:
DHS 36.06(4)(a) (a) An act that results in termination of a health care provider certification under s. DHS 106.06.
DHS 36.06(4)(b) (b) An act that results in conviction for a criminal offense related to services provided under s. 632.89, Stats., whether or not the conviction is under appeal.
DHS 36.06(4)(c) (c) An act involving a staff member who removes or destroys consumer service records.
DHS 36.06 History History: CR 04-025: cr. Register October 2004 No. 586, eff. 11-1-04; correction in (4) (a) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635.
DHS 36.065 DHS 36.065Waivers and variances.
DHS 36.065(1) (1)Definitions. As used in this section:
DHS 36.065(1)(a) (a) “Waiver" means the grant of an exemption from a non-statutory requirement of this chapter.
DHS 36.065(1)(b) (b) “Variance" means the granting of an alternate requirement in place of a non-statutory requirement of this chapter.
DHS 36.065(2) (2)Waivers or variances.
DHS 36.065(2)(a)(a) An application for a waiver or a variance may be made at any time. Each request shall be made in writing to the department and shall include all of the following:
DHS 36.065(2)(a)1. 1. Identification of the rule provision from which the waiver or variance is requested.
DHS 36.065(2)(a)2. 2. The time period for which the waiver or variance is requested.
DHS 36.065(2)(a)3. 3. If the request is for a variance, the specific alternative action that the CCS proposes.
DHS 36.065(2)(a)4. 4. The reasons for the request.
DHS 36.065(2)(a)5. 5. Supporting justification.
DHS 36.065(2)(a)6. 6. Any other information requested by the department.
DHS 36.065 Note Note: An application for a waiver or variance should be addressed to the Behavioral Health Certification Section, Division of Quality Assurance, P.O. Box 2969, Madison, WI 53701-2969.
DHS 36.065(2)(b) (b) A waiver or variance may be granted if the department finds that the waiver or variance will not adversely affect the health, safety, or welfare of any consumer and any one of the following applies:
DHS 36.065(2)(b)1. 1. Strict enforcement of a requirement would result in unreasonable hardship on the CCS or on a consumer.
DHS 36.065(2)(b)2. 2. An alternative to a rule, including new concepts, methods, procedures, techniques, equipment, personnel qualifications, or the conducting of pilot projects is in the interest of better care or management.
DHS 36.065(2)(c) (c) A determination on a request for a waiver or variance shall be made to the CCS in writing. If the decision is to deny the waiver or variance, the reason for the denial shall be included in the notice.
DHS 36.065(2)(d) (d) The terms of a variance may be modified upon agreement between the department and the CCS. The department may impose any condition on a waiver or variance which the department deems necessary.
DHS 36.065(2)(e) (e) The department may limit the duration of any waiver or variance.
DHS 36.065(2)(f) (f) The department may revoke a waiver or variance if any one of the following occurs:
DHS 36.065(2)(f)1. 1. The waiver or variance adversely affects the health, safety or welfare of a consumer.
DHS 36.065(2)(f)2. 2. The CCS has failed to comply with the variance as granted.
DHS 36.065(2)(f)3. 3. The CCS notifies the department that it wishes to relinquish the waiver or variance.
DHS 36.065(2)(f)4. 4. There is a change in applicable law.
DHS 36.065(2)(f)5. 5. For any other reason necessary to protect the health, safety, and welfare of a consumer.
DHS 36.065 History History: CR 04-025: cr. Register October 2004 No. 586, eff. 11-1-04.
subch. III of ch. DHS 36 Subchapter III — Comprehensive Community Services Program
DHS 36.07 DHS 36.07Comprehensive community services plan. Each CCS program shall have a written plan that shall include all of the following:
DHS 36.07(1) (1) A description of the organizational structure. The description shall include all of the following:
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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.