This chapter shall apply to all of the following:
A publicly or privately operated facility providing substance use treatment services approved by the state opioid treatment authority.
A substance use service that receives funds under ch. 51
, Stats., is funded through the department as the federally designated single state agency for substance use services, receives substance abuse prevention and treatment funding or other funding specifically designed for providing services under ss. DHS 75.14
, where certification is required by a contract with the department.
A publicly or privately operated service that requests certification by the department.
The provision of substance use treatment services to a patient in the state of Wisconsin via telehealth, regardless of the location of the program or facility, shall constitute the practice of substance use services in the state of Wisconsin and shall meet the requirements of this chapter.
This chapter shall not apply to a general medical service that delivers substance use treatment services as an adjunct to general medical care, unless that service meets the definition of a “program” under 42 CFR 2.11
DHS 75.02 History
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22. DHS 75.03
DHS 75.03 Definitions.
In this chapter:
“Adult” means an individual aged 18 or older.
“Administrative discharge” means discharge of a patient from a service that is initiated by the service for reasons including program policies, behavioral concerns, or provider-initiated termination.
“Applicant” means an individual or entity that has requested certification by the department as a community substance use service under this rule.
“Approved placement criteria” means ASAM or other similar placement criteria that may be approved by the department.
“ASAM” means the American Society of Addiction Medicine.
“ASAM placement criteria” means the ASAM Criteria: Treatment Criteria for Addictive, Substance-Related, and Co-Occurring Conditions (3rd ed., Oct. 24, 2013), which is a multi-dimensional set of placement criteria for assessing substance use patient risk and need areas and establishing treatment service level of care.
“Assessment update” means the procedure by which a clinical staff of a service, operating within the scope of their practice, gathers relevant information to update prior assessment data, including updated substance use history, mental health symptoms and functioning, newly identified or changing behavioral and physical health needs, and significant psycho-social changes that may impact treatment or overall functioning, including a review of level of care placement criteria, if applicable.
“Available on a 24-hour basis” means that the designated staff of a service that is available in-person or on-call, including by phone or other real-time electronic communication.
“Behavioral health” means the spectrum encompassing mental health and substance use disorders occurring either independently or simultaneously.
“Case management” means the planning and coordination of services to meet an individual's identified health needs, and assistance provided to the individual for engagement in such services to support the individual's overall treatment and recovery.
“Certification” means approval of a service by the department's division of quality assurance.
“Certified peer specialist” means a person who has lived experience of mental illness or substance use disorders, or both, and has completed a formal training and holds a department certification in the peer specialist model of mental health or substance use disorders support, or both.
“Clinical assessment” means the procedure by which a clinical staff of a service, operating within the scope of their practice, gathers relevant information to evaluate the individual's problem areas, symptoms, functioning, readiness for change, resources, and strengths. Clinical assessment of substance use includes information regarding substance use history, current substance use, impact on functioning, and readiness for change for the purpose of evaluating diagnosis of a substance use disorder and informing treatment services. Clinical assessment of mental health includes mental health symptoms, mental status, and functional assessment for the purpose of evaluating diagnosis of a mental health disorder and informing treatment services.
“Clinical consultation” means the review of a patient's plan of care or collaborative discussion of specific aspects of a patient's risks, needs, and functioning, between a clinical supervisor and other clinical staff of a service, another licensed professional, or both.
“Clinical services” means counseling, assessment, group therapy, family therapy, medication management, or other services that require specialized knowledge and training in the assessment and treatment of mental health and substance use disorders.
“Clinical staff” means all substance abuse counselors, mental health professionals, mental health professionals in training, substance abuse counselors in training, qualified treatment trainees, psychologists, or other qualified staff of a service that deliver screening, assessment, or treatment services under this chapter.
“Clinical staffing” means the review of a patient's plan of care or collaborative discussion of specific aspects of a patient's risks, needs, and functioning, with other clinical staff of a service.
“Clinical supervisor” means any of the following:
“Collateral” means information, treatment input, or participation obtained from a party that has knowledge of or relationship with a patient, which may include family members, friends, co-workers, recovery peers, health care providers, probation and parole agents, other law enforcement personnel, child welfare workers, referral sources, clinical records, legal records, or professional public databases.
“Co-mingled groups” means a therapeutic or psycho-educational group provided by a service that includes mixed population groups, such as gender, age, substance of use, or criminogenic risk.
“Continued stay” means the ongoing provision of an appropriately matched level of care service to an individual's needs, as assessed by ASAM or other department-approved placement criteria.
“Continuing care” means the stage of treatment in which the patient no longer requires counseling at the intensity described in ss. DHS 75.49
. Continuing care is designed to support and sustain the process of long-term recovery, provided on an outpatient basis at a frequency agreed upon between the patient and the provider.
“Co-occurring” means a patient diagnosed as having both a substance use disorder and a mental health disorder, as listed in the DSM.
“Counseling” means the application of recognized theories, principles, techniques and strategies to facilitate the progress of a patient toward identified treatment goals and objectives.
“Crisis intervention” means services that respond to an individual's behavioral health needs during acute episodes that involve significant distress or risk of harm to self or others.
“Culturally and linguistically appropriate services” or “CLAS” means that all aspects of a service, from an individual's first contact through discharge, are delivered with consideration for the individual's cultural and language needs.
“DEA” means the U.S. drug enforcement administration.
“Department” or “DHS” means the Wisconsin department of health services.
“Determination of medical stability” means a medical evaluation of a patient, including physical examination, obtaining vital signs, gathering relevant medical history, and applicable laboratory testing, to determine whether a patient's presenting problem is primarily medical in nature, whether serious underlying medical illness exists that would render admission to a behavioral health service unsafe or inappropriate, and any referral needs for additional medical care or follow-up.
“Discharge planning” means planning and coordination of treatment and support services associated with the patient's discharge from treatment, including the preparation of a discharge summary as required under s. DHS 75.24 (22)
“DSM” means the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, published by the American Psychiatric Association.
“DSPS” means the Wisconsin department of safety and professional services.
“Dually-credentialed” means a staff of a service that holds licensure and certification as both a mental health professional and a substance abuse counselor, in accordance with professional licensing and credentialing standards established by DSPS. A mental health professional operating within their scope of practice as a substance abuse counselor under DHS 75.03 (86), meets the definition of dually-credentialed.
“Entity owner” means an individual or partnership that owns or operates the service, is legally responsible for the service, and has authority to either conduct the policy, actions, and affairs of the service, or appoint a governing authority to conduct the policy, actions, and affairs of the service.
“Facility” means the physical building that houses a service, including the rooms, furnishings, and structures therein.
“FDA” means the U.S. food and drug administration.
“Follow-up” means a process used by a treatment provider to periodically assess the referral process and rehabilitation progress of a patient who has been referred for concurrent or subsequent services.
“Governing authority” means the individual or governing body designated by the entity owner that is legally responsible for the operation of a service, and has authority to conduct the policy, actions, and affairs of the service.
“Group counseling” means the application of counseling techniques which involve interaction among members of a group consisting of at least 2 patients but not more than 16 patients with a minimum of one counselor for every 10 patients.
“Incident report” means a written record of an incident involving patient, visitor, or staff health or safety that occurs at the facility or in the course of providing services in the community. Incident reporting is required for health emergencies, incidents of violence, injuries requiring medical attention, or other extraordinary events that interfere with the provision of services and pose a risk to health or safety.
“In-reach,” means services that are provided in corrections settings to enhance engagement or to initiate recommended treatment services prior to release from incarceration.
“Intake” means the specific tasks necessary to admit a person to a behavioral health service, such as completion of admission forms, notification of patient rights, explanation of the general nature and goals of the service, review of policies and procedures of the service, and orientation.
“Integrated treatment” means a service that includes both substance use and mental health assessment and treatment services, provided in the same setting, by appropriately credentialed personnel operating within their scope of practice, with appropriate interventions for both conditions included in one comprehensive treatment plan for each patient diagnosed with a co-occurring disorder or disorders.
“Interim services” means services that are provided until an individual is admitted to a substance use treatment program, including education about communicable illnesses, harm-reduction strategies, referral for other services or medical care, and referral for prenatal care for pregnant women; to reduce the adverse health effects of substance use, promote the health of the individual, and reduce the risk of transmission of disease.
“Intervention” means a therapeutic technique or activity that is applied as part of an individual's treatment plan to address behavioral health goals and improve functioning.
“Knowledgeable in addiction treatment” means a clinical staff who possesses postsecondary coursework, continuing education coursework, or supervised professional experience to establish their training and competence in all of the following domains:
Considerations for special populations in substance use treatment.
Assessing and responding to safety risks related to substance use and employing harm-reduction strategies in addiction treatment.
“Level of care” means the discrete category of patient placement, based on intensity and frequency of treatment provided by a service under ss. DHS 75.15
, that is matched to the individual's need based on ASAM or other department-approved placement criteria.
“Licensed professional” means a person who holds one of the following licenses or certifications issued by DSPS, but does not include professionals in training under such licenses or certifications:
A clinical social worker, licensed marriage and family therapist, or licensed professional counselor under ch. 457
A substance abuse counselor or clinical substance abuse counselor under s. 440.88
“Medical director” means a person who is employed as the chief medical officer of a service, who is also licensed to practice medicine or osteopathy under ch. 448
, Stats., and who also possesses any of the following qualifications:
A certification in addiction psychiatry by the American Board of Psychiatry and Neurology.
A subspecialty certification in addiction medicine by a recognized board of the American Board of Medical Specialties.
Completion of a certificate of Added Qualification in Addiction Medicine conferred by the American Osteopathic Association.
A prior certification by the American Board of Addiction Medicine.
Completion of an accredited residency or fellowship in addiction medicine or addiction psychiatry.
Knowledgeable in addiction treatment and has one year of addiction medicine experience, although certification is preferred.
Working toward certification in addiction medicine or addiction psychiatry and has one year of addiction medicine experience, although certification is preferred.
DHS 75.03 Note
Note: If a service is not able to secure a medical director who meets the requirement of 1 year of addiction medicine experience, as documented through the service's recruitment efforts, the service may utilize a medical director who has a specific plan to acquire equivalent training and skills within 4 months after beginning employment.
“Medical personnel” means a physician, a physician assistant, nurse prescriber or other health care personnel licensed, at a minimum, to the level of a registered nurse or licensed practical nurse.
“Medical screening” means the examination conducted by medical personnel of a person to ascertain eligibility for admission to a treatment service under this chapter and to assess the person's medical needs.
“Medical services” means services designed to address the medical needs of a patient, which may include a physical examination, evaluating, managing and monitoring health-related risks of withdrawal from alcohol and other substances, administration of medications and behavioral-health related medical care, within the scope of practice of the providing staff member.
“Medication-assisted treatment” means the use of FDA-approved medications, in combination with counseling and behavioral therapies, to treat substance use disorders.
“Mental health professional” means an individual authorized to practice psychology, marriage and family therapy, professional counseling, or clinical social work, pursuant to ch. 455
“Mental health treatment” means the delivery of clinical services for the purpose of addressing a mental health disorder as defined in the DSM.