NOTICE IS HEREBY GIVEN that pursuant to ss.
48.981 (8) (d), Stats., and s.
227.11(2), Stats., and interpreting s.
48.981 (8) (d), Stats., to create ch.
HFS 43, relating to the standards for training required for staff and supervisors involved in the access, initial assessment, and ongoing services delivered to children and families in child abuse and neglect cases, and affecting small businesses.
Hearing Date(s) and Location(s)
Tuesday, August 1, 2006
10:00 a.m. to 2:00 p.m.
Southern Child Welfare Partnership Training Center
455 Science Drive, Suite 110
Madison, WI 53711
DHFS Regional Office, 1853 North Stevens
Rhinelander, WI 54501 – Video conferencing
University of Wisconsin-Green Bay
MAC137
2420 Nicolet Drive
Green Bay, WI 54311-7001- Video conferencing
The hearing site is fully accessible to people with disabilities. If you are hearing impaired, do not speak English or have circumstances that might make communication at a hearing difficult; you require an interpreter or a non-English large print or taped version of the proposed rules, contact the person at the address or telephone number given below at least 10 days before the hearing. With less than 10 days notice, an interpreter may not be available.
Place Where Written Comments May be Submitted
Written comments may be submitted at the public hearing or submitted to the contact person listed below. Comments may also be made using the Wisconsin Administrative Rule Website at
http://adminrules.wisconsin.gov.
Deadline for Comment Submission
The deadline for submitting comments to the Department is 4:30 p.m. on August 8, 2006.
Analysis Prepared by the Department of Health and Family Services
The Department proposes to create ch.
HFS 43 to address training requirements for child protective caseworkers and supervisors involved in the access, initial assessment, and ongoing services delivered to children and families in child abuse and neglect cases.
The Department proposes to establish statewide minimum standards for pre-service training, foundation training, ongoing training, and supervisory training of child protective services staff. This training will include recognizing and responding to domestic violence. In addition proposed ch.
HFS 43 creates a monitoring process that allows the Department to review and approve training plans submitted by affected agencies and monitor compliance by individual staff. The proposed rule will apply to the Department's Bureau of Milwaukee Child Welfare (BMCW), county human or social service departments that provide child protective services, and private child welfare agencies licensed under s.
48.60, Stats., and ch.
HFS 54 which contract with the Department or county human or social services departments to provide child protective services.
The proposed creation of ch.
HFS 43 will not have an affect on the Memorandum of Understanding between the Department and the Department of Corrections that allows the intake training required under s.
48.06 (1), Stats., for intake caseworkers to be provided by the Department of Corrections and the Wisconsin Juvenile Court Intake Association under Ch.
DOC 399.
Effect on Small Business (Initial Regulatory Flexibility Analysis)
Section
48.981 (8) (d) 2., Stats., requires the Department to make training programs available for child protective services caseworkers and supervisors to complete training in child abuse and neglect protective services, unborn child abuse protective services, and on recognizing and appropriately responding to domestic abuse. Section
48.981 (8) (d) 2., Stats., further requires that the Department promulgate rules to monitor compliance with the training requirement. To implement the requirements under s.
48.981 (8) (d) 2., Stats., and to promote statewide consistency, the Department proposes rule requirements for pre-service, foundation, and in-service training for those individuals required under s.
48.981 (8) (d) 1., Stats.
Pre-service training is a web-based curriculum developed by the Training Partnerships that may be delivered by an alternative method. Pre-service training is required for child protective services caseworkers and, in certain circumstances, supervisors who begin employment after the effective date of the proposed rule. Foundation training is a curriculum approved by the Department and identified as essential skills and applications training for child protective services caseworkers and supervisors. It is required to be completed within two years after employment as a child protective services caseworker. In-service training consists of continuing education in child welfare and is taken after the completion of pre-service training. This training requirement is ongoing during the term of employment of child protective services caseworkers and supervisors.
Except in Milwaukee County, child protective services are the legislated responsibility of county human services or social services departments (county department). In Milwaukee County, child protective services are the responsibility of the Department. The proposed rule will apply to child protective services staff of the Department and county human services or social services departments and to child welfare agencies that contract with the Department or county department to provide child protective services. Child placing agencies that are not under contract with the Department or a county department do not provide child protective services. Currently, there are 56 licensed child welfare agencies in Wisconsin. To date, the proposed rules will affect only the 2 agencies that are under currently under contract with the Department to provide child protective services. There are no child placing agencies under contract with a county department to perform child protective services.
In the event that child placing agencies meeting the definition of small businesses under s.
227.114 (1), Stats., contract with either the Department or a county department, the child placing agency will incur training costs for staff who perform child protective services. The costs incurred are a result of the agencies' and staff responsibilities to comply with s.
48.891 (8) (d) 1., Stats., not the proposed rules. The only cost to the agency is for staff time to participate in training. Agencies are not required to develop or conduct training under the proposed rules or s.
48.981 (d) 1., Stats.; however, under the proposed rule, agencies have that option as it is related to pre-service training; otherwise pre-service training is available as web-based training. If an agency decides to conduct its own pre-service training, the costs will extend beyond opportunity costs to possibly include facility rental, trainer fees, and training materials.
Pursuant to the forgoing analysis, the proposed rule will affect any licensed child placing agency that is under contract with the Department or a county department, including those that are small businesses, to provide child protective services. However, the proposed rule will not have a significant economic impact on any of those businesses. In addition, the Department does not believe that the proposed rules will increase costs implicitly imposed under s.
48.981(8) (d) 1., Stats.
Small Business Regulatory Coordinator
Rosie Greer
608-266-1279
Fiscal Estimate
Proposed rule HFS 43 was developed with significant involvement of the Department, the Child Welfare Training Partnerships, county human services and social services departments, and private agencies. Child protective services agencies are required under s.
48.981(8)(d), Stat., to provide training, which is approved by the Department, on the investigation and treatment of child abuse and neglect. Most agencies currently provide and pay for that training. The Department, under s.
48.981(8)(d), Stat., is required to develop rules to monitor compliance with the training requirement.
The costs arising from proposed HFS 43 for monitoring compliance with the statutory requirement for training may be minimal, and can be absorbed by the affected agencies. The Department believes that the information which agencies will be required to enter into e-WiSACWIS or into personal or other records and make available to the Department for monitoring will require minimal time or effort.
Obtaining Copies of Rules and Fiscal Estimate
A copy of the full text of the rules and the fiscal estimate can be obtained at no charge from the Wisconsin Administrative Rules Website at
http://adminrules.wisconsin.gov or by contacting the person listed below.
Contact Person
Christopher Sieck
Statewide Training Coordinator
Division of Children and Family Services
DHFS/DCFS
P.O. Box 8916
Madison, WI 53708-8916
crsieck@wisc.edu
Notice of Hearing
Health and Family Services
(Community Services, Chs.
HFS 30 —
NOTICE IS HEREBY GIVEN that pursuant to Sections
49.45 (10),
51.03 (4) (f),
(g), and
(h) and
(5),
51.04,
51.42 (7) (a) and
(b), and
227.11 (2) (a), Stats., and interpreting 49.45 (10), 51.04, 51.03 (4) (f), (g), and (h) and (5), 51.42 (7) (a) and (b), and 632.89, (2) Stats., Stats., to repeal HFS 105.22 (1) (d) ; to amend HFS 105.22 (1) (c), 105.22 (2) (title), (a) and (b), and (3), 107.13 (2) (a) (intro.) and 1. (intro.), 107.13 (2) (a) 3. a. and b, 4. a. to f., 6., 7. , (b) 1., 4. a. to d., (c) 4. and 6., and (d) 2.; and to create ch.
HFS 35, 105.22 (1) (bm), 107.13 (2) (a) 1. a. to g. and (2m) rules relating to outpatient mental health clinics and affecting small businesses.
Hearing Date(s) and Location(s)
Monday, July 31, 2006 10:00 a.m. to 12:00 p.m. & 1:00 p.m. to 3:00 p.m.
Mendota Mental Health Institute- Conference Center
301 Troy Drive
Madison, WI
Tuesday, August 1, 2006 10:00 a.m. to 12:00 p.m. & 1:00 p.m. to 3:00 p.m.
North Central Health Care Facilities- Lakeview Center
1000 Lakeview Drive
Wausau, WI
Thursday, August 3, 2006 10:00 a.m. to 12:00 p.m. & 1:00 p.m. to 3:00 p.m.
Waukesha Regional Office, Room 151
141 NW Barstow St.
Waukesha, WI
The hearing site is fully accessible to people with disabilities. If you are hearing impaired, do not speak English or have circumstances that might make communication at a hearing difficult; you require an interpreter or a non-English large print or taped version of the proposed rules, contact the person at the address or telephone number given below at least 10 days before the hearing. With less than 10 days notice, an interpreter may not be available.
Place Where Written Comments May be Submitted
Written comments may be submitted at the public hearing or submitted to the contact person listed below. Comments may also be made using the Wisconsin Administrative Rule Website at
http://adminrules.wisconsin.gov.
Deadline for Comment Submission
The deadline for submitting comments to the Department is 4:30 p.m. on August 10, 2006.
Analysis Prepared by the Department of Health and Family Services
The current rules for outpatient mental health clinics are under ss.
HFS 61.91 to
61.98. These regulations address procedures for certification; required personnel; service requirements; and denial, involuntary termination or suspension of certification for outpatient mental health clinics; clinical supervision, clinical collaboration, and clinical consultation; written authorization of psychotherapy by a physician; initial assessments of clients and development of treatment plans; progress notes; discharge summaries; and record keeping. In addition to these requirements, these rules require clinics to ensure continuity of care for persons with mental disorders or alcohol and drug abuse problems by rendering or arranging for the provision of specified services, including but not limited to, residential facility placement; aftercare for continuing treatment in the community to help the patient maintain and improve adjustment following a period of treatment in a facility; and emergency care. Sections
HFS 61.91 to
61.98 have not been comprehensively reviewed and rewritten since May 1981.
Section
HFS 105.22 provides the requirements for medical assistance certification of psychotherapy providers, staffing of outpatient facilities, and medical assistance reimbursement for outpatient psychotherapy services. Section
HFS 107.13 (2) details the medical assistance requirements for covered services for outpatient psychotherapy services, prior authorization and other limits and procedures, and non-covered services under the medical assistance program.
Section
HFS 105.22, was last revised in 1991 and s.
HFS 107.13 (2) has not been comprehensively reviewed and rewritten since March 1986. For outpatient mental health services, Medicaid reimburses psychiatrists, Ph.D. psychologists, advanced practice nurse prescribers with a psychiatric specialty, and outpatient mental health clinics that meet the requirements under proposed s.
HFS 35.04 (2) (c). Proposed s.
HFS 35.04 (2) (c) requires at least one mental health professional to be available to provide outpatient mental health services at least 37.5 hours per week and at least one mental health professional who is a psychiatrist, psychologist or advanced practice nurse prescriber who provides outpatient mental health services to consumers of the clinic at least 4 hours per month. This is not a change from current rules.
The Department proposes to repeal ss.
HFS 61.91 to
61.98 and create ch.
HFS 35 to do all the following:
Eliminate burdensome provisions that do not help to lead to the desired outcomes for persons who receive outpatient mental health services treatment.
Codify, in rule, the statewide variances that have been issued by the Department to outpatient mental health providers.
Increase flexibility for clinic operations including allowing certified clinics to alternatively meet the standards of one of several national accrediting bodies when applying for renewal certification; permitting clinics to provide either clinical supervision, clinical collaboration or clinical consultation as part of the clinic's quality improvement process; allowing mental health professionals to provide the recommendation for psychotherapy for consumers who are not medical assistance recipients; allow persons other than a physician or psychiatrist to provide mental health services; and allow clinics to provide psychotherapy services in the clinic, a branch office, or alternate location.
Establish certification and enforcement processes that are similar in both organization and content to the certification and enforcement processes set out in rules for other certified community mental health programs.
Clarify the minimum staff requirements for a clinic; and the role of professional staff of a clinic, including for persons who prescribe medication within a clinic.
Clarify record keeping requirements for psychotherapy notes.
Establish training requirements for clinic staff.
Add or expand language on admission, assessment, consent for treatment, treatment planning and medication administration; standards for electronic records, and consumer rights.
Incorporate the provisions under s.
50.065, Stats., and chs.
HFS 12 and
13 that require caregiver background checks on clinic staff and reporting of clinic staff misconduct.
Increase consumers' participation in treatment planning resulting in treatment that is recovery-based and consumer-directed.
The Department proposes to revise ss.
HFS 105.22 and
107.13 (2), to ensure that the language in these rules are consistent with the language in the proposed ch.
HFS 35 and that these rules current practices and needs, such as, indexing the number of visits and dollar amounts before a prior authorization is required. Covered services are not proposed to change.
Effect on Small Business (Initial Regulatory Flexibility Analysis)
The Department is required under s.
51.42 (7) (b), Stats., to promulgate rules which govern the administrative structure deemed necessary to administer community mental health services; prescribe standards for qualifications personnel; prescribe standards for quality of professional services; govern eligibility of patients to the end that no person is denied service on the basis of age, race, color, creed, location or inability to pay; and to establish medication procedures to be used in the delivery of mental health services. Section
51.04, Stats., allows treatment facilities to apply to the Department for certification of the facility for the receipt of funds for services provided as a benefit to medical assistance recipients under s.
49.46 (2) (b) 6. f., Stats., or to a community aids funding recipient under s.
51.423 (2), Stats., or provided as mandated private insurance coverage under s.
632.89 (2), Stats. Section
51.42 (7) (a), Stats., requires the Department to review and certify county departments of community programs and community mental health programs to assure that the county department and programs are in compliance with the purpose and intent of s.
51.42 Stats., to enable and encourage counties to develop a comprehensive range of services offering continuity of care; to utilize and expand existing governmental, voluntary and private community resources for provision of services to prevent or ameliorate mental disabilities, including mental illness, developmental disabilities, and alcoholism and drug abuse; to provide for the integration of administration of those services and facilities organized under s.
51.42, Stats., through a county department of community programs; and to authorize state consultative services, review and establishment of standards and grants-in aids for such program of services and facilities.
