These are rules for the 781 outpatient mental health clinics in the state that are certified by the Department under s. 51.42 (7) (b), Stats. The order renumbers and updates current rules found in ss. HFS 61.91 to 61.98 that were last revised in 1984.
Department certification of a clinic is a condition for the purchase of clinic services by counties with state community services funds, for reimbursement of the clinic by the Medical Assistance program for the costs of providing outpatient mental health services to Medical Assistance recipients, and for reimbursement of the clinic by private insurers required under s. 632.89, Stats., to cover outpatient mental health services under group insurance policies that provide coverage for any outpatient treatment.
The revised rules give more flexibility to clinics by permitting a clinic to meet standards of one of 2 specified national accrediting organizations in lieu of the standards in the rules and permitting Masters-level clinicians on a clinic's staff to offer one of 4 national professional listings in place of the requirement for 3000 hours of supervised clinical experience. The revised rules also add orientation and inservice training requirements, but without specification of the number of hours; require compliance with new statutes and rules on performing uniform background checks on applicants for employment and reporting instances of staff abuse or neglect of a patient or misappropriation of a patient's property; require assignment of responsibility for clinic operations and the treatment program, without thereby affecting the minimum required professional staffing of a clinic; and make the certification process and enforcement provisions similar to those in new rules for other community mental health programs.
The revised rules will not affect the expenditures or revenues of state government or local governments. About 28 of the clinics are directly operated by county governments. The costs of purchased and reimbursed services should not be affected by the rule changes. Some of the changed requirements either represent economies and efficiencies for state government or are largely already in effect as good management practices in the clinics. Others are statute-made changes or are clarifications.
Initial Regulatory Flexibility Analysis
These orders update, renumber and expand rules on the basis of which the Department certifies community mental health inpatient treatment programs, adult day treatment programs and outpatient clinic programs under s. 51.42 (7), Stats. The proposed new rules replace current rules in subch. IV of ch. HFS 61, Wis. Adm. Code.
Department certification of a program is a condition for public funding of services, including for reimbursement by Medicaid, and, since November 1992, for mandated coverage by private group health insurance policies.
There are currently 49 certified inpatient programs, all of which are operated by hospitals. None of the 45 Wisconsin hospitals with a certified mental health inpatient treatment program is a small business as “small business" is defined in s. 227.114 (1) (a), Stats.
There are currently 52 certified adult day treatment programs. Not more than one or 2 are operated by or as a small business as “small business" is defined in s. 227.114 (1) (a), Stats.
There are currently 781 certified clinic programs. About half of them are small businesses as “small business" is defined in s. 227.114 (1) (a), Stats.
Adult Day Treatment Programs
The revised rules for adult day treatment programs add:
• Professional staff qualifications;
• A detailed certification process;
• Special staffing requirements for programs serving clients who also have substance abuse treatment needs or are developmentally disabled;
• Staff training requirements;
• Minimum hours of operation;
• Staffing levels by purpose of admission (for stabilization services, restorative services or maintenance services);
• Criteria for admission;
• Requirements relating to consent for treatment, suicide prevention, administration of psychotropic medications, early termination of services and preparation of a discharge summary; and
• Sections on client rights and obtaining indications of client satisfaction with the quality and outcomes of services.
Outpatient Clinic Programs
The revised rules for outpatient clinic programs:
• Permit a clinic to meet, alternatively, the standards of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) or the Council on Accreditation of Services for Families and Children (CASFC);
• Establish a detailed certification process which includes actions taken against certified programs and permits issuance of provisional certification pending correction of minor deficiencies;
• Add that clinics are to follow uniform procedures under ch. HFS 12 for checking the backgrounds of prospective new employes;
• Modify minimum professional staffing of a clinic to consist of a clinic administrator, a clinical coordinator qualified under s. HFS 35.07 (3) (b) 1. to 8., a psychiatrist and a mental health professional qualified under s. HFS 35.07 (3) (b) 2. to 8.;
• Add training requirements for clinic staff;
• Permit Master's-level clinicians to offer one of four national professional registry listings in place of the requirement for 3000 hours of supervised clinical experience;
• Add or expand rule language on admission, assessment, consent for treatment, treatment planning and medications administration; and
• Add sections on client rights and obtaining information about client satisfaction with treatment.
No new professional skills are needed by programs for them to comply with the revised requirements for program certification. Many of the new requirements are recognized industry and professional good management practices.
Notice of Hearing
Psychology Examining Board
Notice is hereby given that pursuant to authority vested in the Psychology Examining Board in ss. 15.08 (5) (b) and 227.11 (2), Stats., and interpreting s. 455.045, Stats., the Psychology Examining Board will hold a public hearing at the time and place indicated below to consider an order to amend ss. Psy 2.08 and 3.10, relating to re-examinations.
Hearing Information
December 7, 1999 Room 180
Tuesday 1400 East Washington Ave.
9:15 a.m. MADISON, WI
Written Comments
Interested persons are invited to present information at the hearing. Persons appearing may make an oral presentation but are urged to submit facts, opinions and argument in writing as well. Facts, opinions and argument may also be submitted in writing without a personal appearance by mail addressed to the Department of Regulation and Licensing, Office of Administrative Rules, P.O. Box 8935, Madison, Wisconsin 53708. Written comments must be received by December 20, 1999, to be included in the record of rule-making proceedings.
Analysis Prepared by the Dept. of Regulation and Licensing
Statutes authorizing promulgation: ss. 15.08 (5) (b) and 227.11 (2)
Statute interpreted: s. 455.045
Under s. Psy 2.08, an applicant for licensure as a psychologist or school psychologist may currently sit for the examinations required by the Board an indefinite number of times. This has resulted in a few applicants who have been reexamined as many as ten times without receiving a passing grade. The objective of this rule is to require that after failing to achieve a passing grade on any examination after four tries, the applicant be required to apply to the Board for permission to be reexamined a fourth time, and to demonstrate further education or training as the Board may require.
When an applicant has taken the national Examination for the Professional Practice of Psychology or the Examination on the Practice of School Psychology on four occasions and failed each time, there arises a presumption that the applicant may not be properly prepared to engage in the independent practice of psychology or school psychology until he or she receives further education or training. This rule would require that as a condition for being reexamined a fourth time, such applicants would be required to receive permission from the Board and to demonstrate to the Board that they have received further remedial education or training which in the opinion of the Board addresses those areas in which the applicant has shown weakness.
The Medical Examining Board has had a similar rule in place since 1976 and has found it to be an effective tool in assisting applicants to effectively address those areas of weakness which have caused repeated examination failures.
Text of Rule
SECTION 1. Psy 2.08 is amended to read:
Psy 2.08 Reexamination. An applicant who fails
an examination may apply for reexamination to achieve a passing grade in the examinations required under this chapter may apply for reexamination on forms provided by the board and pay the appropriate fee for each reexamination as required in s. 440.05, Stats. An applicant who fails to achieve a passing grade may be reexamined 3 times at not less than 3-month intervals. If the applicant fails to achieve a passing grade on the third reexamination, the applicant shall not be admitted to any further examination until the applicant reapplies to the board for permission to be reexamined and presents evidence satisfactory to the board of further professional training or education as the board may prescribe or approve following its evaluation of the applicant's specific case.
SECTION 2. Psy 3.10 is amended to read:
Psy 3.10 Reexamination. An applicant who fails
an examination may apply for reexamination to achieve a passing grade in the examinations required under this chapter may apply for reexamination on forms provided by the board and pay the appropriate fee for each reexamination as required in s. 440.05, Stats. An applicant who fails to achieve a passing grade may be reexamined 3 times at not less than 3-month intervals. If the applicant fails to achieve a passing grade on the third reexamination, the applicant shall not be admitted to any further examination until the applicant reapplies to the board for permission to be reexamined and presents evidence satisfactory to the board of further professional training or education as the board may prescribe or approve following its evaluation of the applicant's specific case.
Fiscal Estimate
1. The anticipated fiscal effect on the fiscal liability and revenues of any local unit of government of the proposed rule is: $0.00.
2. The projected anticipated state fiscal effect during the current biennium of the proposed rule is: $0.00.
3. The projected net annualized fiscal impact on state funds of the proposed rule is: $0.00.
Initial Regulatory Flexibility Analysis
These proposed rules will be reviewed by the Department through its Small Business Review Advisory Committee to determine whether there will be an economic impact on a substantial number of small businesses, as defined in s. 227.114 (1) (a), Stats.
Copies of Rule and Contact Information
Copies of this proposed rule are available without cost upon request to:
Pamela Haack
Department of Regulation and Licensing
Office of Administrative Rules
1400 East Washington Avenue, Room 171
P.O. Box 8935
Madison, WI 53708
Telephone (608) 266-0495
Notice of Hearings
Transportation
Notice is hereby given that pursuant to ss. 85.51 and 348.25 (3), Stats., and interpreting ss. 85.51 and 348.26 (2), Stats., the Department of Transportation will hold public hearings at the following locations to consider the creation of ch. Trans 320, Wis. Adm. Code, relating to calculation of fees for special events, security, traffic enforcement and escort services.
Hearing Information
November 30, 1999 DSP Dist. 4 Headquarters
Tuesday 2805 Martin Ave.
1:30 P.M. Wausau, WI
December 1, 1999 Room 144-B
Wednesday Hill Farms State Trans. Bldg.
12:30 P.M. 4802 Sheboygan Ave.
Madison, WI
