Rule-Making Notices (Hearing Notices)

77 Ill. Adm. Code § 2060.401 Levels of Care. Substance abuse treatment shall be offered in varying degrees of intensity based on the level of care in which the patient is placed and the subsequent treatment plan developed for that patient. The level of care provided shall be in accordance with that specified in the ASAM Patient Placement Criteria and with the following:

a) Level 0.5: Early Intervention. An organized service, delivered in a wide variety of settings, for individuals (adult or adolescent) who, for a known reason, are at risk of developing substance-related problems. Early intervention services are considered sub-clinical or pre-treatment and are designed to explore and address problems or risk factors that appear to be related to substance use and to assist the individual in recognizing the harmful consequences of inappropriate substance use. The length of such service varies according to the individual's ability to comprehend the information provided and to use that information to make behavior changes to avoid problems related to substance use or the appearance of new problems that require treatment at another level of care. Early intervention services are for individuals whose problems and risk factors appear to be related to substance use but do not appear to meet any diagnostic criteria for substance related disorders. Examples of individuals who might receive early intervention are at-risk individuals (i.e., family members of an individual who is in treatment or in need of treatment) or DUI offenders classified at a moderate risk level.

b) Level I: Outpatient. Non-residential substance abuse treatment consisting of face-to-face clinical services for adults or adolescents. The frequency and intensity of such treatment shall depend on patient need but shall be a planned regimen of regularly scheduled sessions that average less than nine hours per week.

c) Level II: Intensive Outpatient/Partial Hospitalization. Non-residential substance abuse treatment consisting of face-to-face clinical services for adults or adolescents. The frequency and intensity of such treatment shall depend on patient need but shall be a planned regimen of scheduled sessions for a minimum of nine hours per week.

d) Level III: Inpatient Subacute/Residential. Residential substance abuse treatment consisting of clinical services for adults or adolescents. The frequency and intensity of such treatment shall depend on patient need but shall, except in residential extended care as defined in this Part, include a planned regimen of clinical services for a minimum of 25 hours per week. Inpatient care, with the exception of residential extended care as defined in this Part, shall require staff that are on duty and awake, 24 hours a day, seven days per week. During any work period, if professional staff as defined in Section 2060.309(a) of this Part are not on duty, such staff shall be available on call for consultation relative to any aspect of patient care. Residential extended care shall require staff on duty 24 hours a day, seven days per week and that low intensity treatment services be offered at least five hours per week. Any staff providing clinical services shall meet the requirements for professional staff as defined in Section 2060.309(a) of this part. Individuals who have been in residence for at least three months without relapse may be used to fulfill any remaining staff requirements.

e) Level IV: Medically Managed Intensive Inpatient. Inpatient subacute residential substance abuse treatment for patients whose acute bio/medical/emotional/behavioral problems are severe enough to require medical and nursing care services. Such services are for adults or adolescents and require 24 hours medically directed evaluation, care and treatment and that a physician see the patient daily.

Michigan: MICH. ADMIN. CODE R 325.14201 Establishment or maintenance and operation of program without license prohibited.

Rule 201. A person shall not establish or maintain and operate a substance abuse program unless licensed by the office in accordance with the act and these rules.

MCLS §. 330.3101

B Department of Public Health

1. All the authority, powers, duties, functions and responsibilities of the Licensing of Substance Abuse Programs and the Certification of Substance Abuse Workers in the Division of Program Standards, Evaluation and Data Services of the Center for Substance Abuse Services, including the authority, powers, duties, functions and responsibilities set forth in the relevant parts of Act No. 368 of the Public Acts of 1978, as amended, being Section 333.6231 to 333.6251 of the Michigan Compiled Laws, are hereby transferred from the Department of Public Health to the Director of the Department of Commerce by a Type U transfer, as defined by Section 3 of Act No. 380 of the Public Acts of 1965, as amended, being Section 16.103 of the Michigan Compiled Laws.

MCLS § 333.6231 Rules.

(1) With the assistance of the department, and after consultation with the commission and the committee, the office shall promulgate rules for the administration of this article and the licensing of substance abuse service programs. The rules shall include reasonable criteria for the protection and well-being of individuals receiving services and the rights of recipients of services and shall define financial information. Rules governing recipient rights shall be promulgated not later than 1 year after the effective date of this section.

(2) The rules shall apply to a public or private firm, association, organization, or group offering or purporting to offer specific substance abuse treatment and rehabilitation services or prevention services, and which receives or requests public funds, patient fees, third party payments, or funds through public subscription for the treatment, rehabilitation, or prevention of substance abuse.

(3) The rules shall not apply to an individual currently licensed by this state to provide medical, psychological, or social services. The licensee may voluntarily apply for a license to provide substance abuse treatment and rehabilitation services or prevention services. To receive state or federal funds for substance abuse treatment and rehabilitation services or prevention services, a person shall obtain a license under this part.

Minnesota: Minn. Stat. § 62J.52 Establishment of uniform billing forms.

(c) Services to be billed using the uniform billing form HCFA 1500 include physician services and supplies, durable medical equipment, noninstitutional ambulance services, independent ancillary services including occupational therapy, physical therapy, speech therapy and audiology, home infusion therapy, podiatry services, optometry services, mental health licensed professional services, substance abuse licensed professional services, nursing practitioner professional services, certified registered nurse anesthetists, chiropractors, physician assistants, laboratories, medical suppliers, and other health care providers such as day activity centers and freestanding ambulatory surgical centers.

Iowa: “Counselor" means an individual who, by virtue of education, training or experience, provides treatment, which includes advice, opinion, or instruction to an individual or in a group setting to allow an opportunity for a person to explore the person's problems related directly or indirectly to substance abuse or dependence.

641 IAC 155.1(125)

“Iowa board of substance abuse certification" means the professional certification board that certifies substance abuse counselors and prevention specialists in the state of Iowa.

641 IAC 155.1(125)

“Sole practitioner" means an individual incorporated under the laws of the state of Iowa, or an individual in private practice who is providing substance abuse treatment services independent from a program that is required to be licensed in accordance with Iowa Code section 125.13(1).

641 IAC 155.1(125)

i. Personnel providing screening, evaluations, assessments or treatment shall be certified through the Iowa board of substance abuse certification, or certified by an international certification and reciprocity consortium member board in the states of Illinois, Minnesota, Nebraska, Missouri, South Dakota, and Wisconsin; or be eligible for certification or have education, training, and experience in the substance abuse field.

641 IAC 155.21(8)(a)(15)(i.)

Summary of factual data and analytical methodologies:

The professions had previously been under the authority of the Department of Health and Family Services (under ch. HFS 75), who contracted the regulation and certification of substance abuse professionals to the Wisconsin Certification Board. The Legislative Audit Bureau performed a limited review of the Wisconsin Certification Board and issued a report on May 11, 2005.

The rules proposed represent a re-codification of existing standards for certification developed by the Wisconsin Certification Board. The legislature, under 2005 Wisconsin Act 25 and later amended by 2005 Wisconsin Act 407, set the statutory requirements for the new levels of licensure and mandated that the Department of Regulation and Licensing draft language for certification and regulation of substance abuse professionals.

To assist in promulgation of the rules, the department has held regular meetings with the Substance Abuse Counselors Advisory Committee for recommendations and development of the draft rules. Subsequently, the department promulgated emergency rules effective December 15, 2006 which includes chs. RL 160 to 163 and chs. RL 166 to 168 (the department had promulgated chs. RL 164 and 165 as permanent rules on January 1, 2007). As the emergency rules were promulgated in December of 2006, the final permanent rules (below) are essentially a redraft of the emergency rules, with changes made for errors in the initial drafting, changes in timelines for effective dates of applicability and minor policy changes where prudent - again at the recommendation of the advisory committee.

Analysis and supporting documents used to determine effect on small business or in preparation of economic impact report: The Department of Regulation and Licensing, based upon the advice of the advisory committee is proposing changes to the existing standards of certification and regulation of substance abuse professionals. The department, to minimize impact on the profession, and preserve the experiential pathway into the profession, has attempted to minimize drastic changes, and make changes only where the advice of the committee and the protection of the public are preserved.

These proposed rules will affect the existing 4,631 credential holders regulated by the department (Database count of in state active and inactive substance abuse credential holders, as of February 2007). These credential holders may operate at state departmental locations (e.g. Department of Corrections) as well as state certified AODA treatment clinics under ch. HFS 75 (DHFS). An unknown number of certificate holders are likely to be operating in public, not-for-profit private treatment centers and for-profit treatment centers.

There were significant “grandparenting" provisions within the statutes that will ensure that existing (active and renewal) certificate holders will not lose their certification upon transfer if they do not meet the requirements for the new certificate (e.g. higher educational requirements). The grandparenting provisions do not apply for new applicants after December 15, 2006. Those who applied (new applicants) after December 15, 2006 were under the jurisdiction of the department, and as such were to meet the requirements specified in our rules. Additionally, the department has instituted substantial grace periods for 12 month grace periods for supervision of substance abuse counselors which would allow clinics one year's time for the supervisors to attain appropriate credentials required for supervision in their clinics.

The department is proposing changes as follows:

Educational Standards:

The proposed rules require a minimum of an associate's degree in a behavior science to qualify for the clinical level counselor, and by requirement, qualification for supervisory certification. This is an increase in educational requirements; however, an underlying degree is often a standard for professional requirements. This may prevent existing non-clinical substance abuse counselors from accessing higher levels of credentials until they achieve the underlying degree; however, the advisory committee has recommended that for protection of the public, a minimum of an associate's degree in a related behavioral science should be instituted.

The proposed rules reduce the required level of continuing education from 48 hours in the biennium to 40 for both substance abuse counselors and clinical substance abuse counselors. This is a reduction for applicable credential holders.

* The proposed rules eliminate the existing system of pre-certification education and training from multiple and separate sources, including Wisconsin Certification Board accredited programs, endorsed trainings, seminars and home study (etc.), and require that the core training for the effective treatment of substance use disorder treatment be obtained from comprehensive and cohesive programs.

Note* The changes to the educational structure may be the primary area effecting the practice of small business. As per above, companies that self reportedly operate as a small business do sell home study programs and trainings to the Wisconsin substance abuse professional education market. One such business, Laban's Trainings of Pennsylvania (http://www.last-homestudy.com 3 employees, unknown earnings), sells home study programs to the AODA counselor community nationwide. They were an endorsed trainer of the WCB, prior to the transference of AODA regulation from the WCB to the DRL, and home study programs such as theirs could be counted for over 200 hours of the 360 hours of training required. The remainder was required to come from association sponsored workshops, seminars and school-based coursework. Under the new rules, program providers like Laban's still have access to the certificate holders through the offering of continuing education programs required for recertification. For substance abuse counselors, that means 40 hours of continuing education is required in the biennium (a reduction from 48 hours to 40). In addition, Laban's and other home study providers may still access the market held by "comprehensive program providers" because the rules are written to restrict individuals from assembling their own education from untracked or uncoordinated sources, however, the rules allow those program providers to assemble the comprehensive program of 360 hours that they provide to their students. This may include a local provider which could source a 3rd party such as Laban's to supplement the coursework requirement.

Practice Restrictions. The proposed rules contain scope of practice and restrictions which include:

Restrictions on the practice of substance abuse counselors-in-training: This credential does not assure competency; therefore, a clinical supervisor will be required to authorize the in-training counselor to provide functions when adequately trained.

The supervision of in-training counselors may not be done by clinical supervisors-in-training.

Clinical supervisors will be legally and ethically responsible for the practice of their supervisees, shall have the authority and responsibility to provide emergency consultation, interrupt/stop unsafe practice and to terminate the supervised relationship if necessary.

New definitions of who may provide supervision or qualify as a clinical supervisor: Supervision may only be provided by those with exemptions under the statutes (psychologists, psychiatrists, clinical substance abuse supervisors, or ch. 457, Stats., credential holders who have obtained a clinical supervision certification via their specialty AODA certification under s. MPSW 1.09).

These changes may affect small business; however, where standards were increased, the department is proposing grace periods for these requirements. Additionally, these changes were seen as necessary to achieve the minimal competency required for safe practice and protection of the public.

Section 227.137, Stats., requires an “agency" to prepare an economic impact report before submitting the proposed rule-making order to the Wisconsin Legislative Council. The Department of Regulation and Licensing is not included as an “agency" in this section.

Anticipated costs incurred by private sector:

The department finds that this rule has no significant fiscal effect on the private sector.

Fiscal Estimate

The Department estimates that this rule will require staff time in the Divisions of Management Services, Professional Credentialing, Office of Legal Counsel and Office of Examinations. The one-time salary and fringe costs in the Division of Professional Credentialing, Office of Legal Counsel and Office of Examinations are estimates at $22,900. The on-going salary, fringe, supplies and services costs in the Division of Professional Credentialing, Division of Board Services and the Office of Examinations are estimated at $77,300.

Effect on Small Business

These proposed rules will have no significant economic impact on small businesses, as defined in s. 227.114 (1), Stats. The Department's Regulatory Review Coordinator may be contacted by email at [e-mail], or by calling [phone].

Agency Contact Person

Pamela Haack, Paralegal, Department of Regulation and Licensing, Office of Legal Counsel, 1400 East Washington Avenue, Room 152, P.O. Box 8935, Madison, Wisconsin 53708-8935. Telephone: [phone]. Email: [e-mail].

Place where comments are to be submitted and deadline for submission

Comments may be submitted to Pamela Haack, Paralegal, Department of Regulation and Licensing, 1400 East Washington Avenue, Room 152, P.O. Box 8935, Madison, Wisconsin 53708-8935, or by email at [e-mail]. Comments must be received on or before June 1, 2007 to be included in the record of rule-making proceedings.

Notice of Hearing

Workforce Development

(Unemployment Insurance, Chs. DWD 100-150)

[CR 07-038]

NOTICE IS HEREBY GIVEN that pursuant to ss.108.04 (13), 108.09 (1), 108.14 (2), and 227.11 (2) (a), Stats., the Department of Workforce Development proposes to hold a public hearing to consider rules relating to unemployment insurance benefit reports filed by employers and affecting small businesses.

Hearing Information

Wednesday, May 30, 2007 at 1:30 p.m.

G.E.F. 1 Building, H306

201 E. Washington Avenue

Madison, WI

Interested persons are invited to appear at the hearing and will be afforded the opportunity to make an oral presentation of their positions. Persons making oral presentations are requested to submit their facts, views, and suggested rewording in writing.

Visitors to the GEF 1 building are requested to enter through the left East Washington Avenue door and register with the customer service desk. The entrance is accessible via a ramp from the corner of Webster Street and East Washington Avenue. If you have special needs or circumstances regarding communication or accessibility at the hearing, please call [phone] at least 10 days prior to the hearing date. Accommodations such as ASL interpreters, English translators, or materials in audiotape format will be made available on request to the fullest extent possible.

Analysis Prepared by the Department of Workforce Development

Statutory authority: Note: Complaint forms are available from the Department of Regulation and Licensing, Division of Enforcement, 1400 East Washington Avenue, P.O. Box 8935, Madison, Wisconsin 53708, or from the department's website at: http://drl.wi.gov

Statutes interpreted: Sections 108.04 (13), 108.09 (1), and 108.14 (2), Stats.

Related statute or rule: NA

Explanation of agency authority. Section 108.09 (1), Stats., provides that each employer that is notified of a benefit claim shall promptly inform the department in writing as to any eligibility question in objection to the claim together with the reasons for the objection.

Section 108.04 (13) (c), Stats., provides that if an employer, after notice of a benefit claim, fails to file an objection to the claim under s. 108.09 (1), any benefits allowable under any resulting benefit computation shall, unless the department applies a provision of this chapter to disqualify the claimant, be promptly paid.

Section 108.04 (13) (f), Stats., provides that if benefits are erroneously paid because the employer fails to file a report required by this chapter, fails to provide correct and complete information on the report, fails to object to the benefit claim under s. 108.09 (1), Stats., or aids and abets the claimant in an act of concealment, the employer is at fault.

Section 108.14 (2), Stats., provides that the department may require from any employing unit which employs one or more individuals to perform work in this state any reports on employment, wages, hours and related matters which it deems necessary to carry out Chapter 108, Stats. The department may also adopt and enforce all rules which it finds necessary or suitable to carry out the chapter.

Summary of the proposed rule. Chapter DWD 123 requires certain reports to be filed by an employer to assist the department in determining a claimant's benefit claim. The current rule contains information that is obsolete and confusing. The proposed rule will update and clarify Chapter DWD 123 to include descriptions and filing procedures for the following benefit reports used by the department:

Separation Notice. The department sends a separation notice to an employer when a new benefit claim is initiated and the employer is identified as having employed the claimant in the base or lag period of the claim, or when a benefit claim is resumed and the employer is identified as having employed the claimant after the last claimed week. The employer must complete and return the separation notice to the department if any information on the notice is incorrect; there is vacation, dismissal, or holiday pay assigned to any period beyond the claimant's last day of work; there is an eligibility issue that applies to the claimant that is not identified on the separation notice; or the claimant did not work for the employer.

Wage Verification/Eligibility Report. The department sends the wage verification/eligibility report to an employer while a benefit claim is in progress to verify partial wages earned from the employer as reported by the claimant on weekly claim certifications and to verify the claimant's continuing eligibility for benefits. The employer must complete and return the wage verification/eligibility report to the department if information on the form report is missing or incorrect; an eligibility issue applies to the claim; or the claimant did not work for the employer.

Urgent Request For Wages. The department sends the urgent request for wages to an employer when the claimant reports having been paid wages by the employer during the base period or an alternate base period, and the department has no record of such wages. The employer must complete and return the urgent request for wages to the department.

The filing requirements for the benefit reports in the proposed rule provide that a report is considered to be filed when it is completed and returned to the department within the time limit and with the department location specified on the report. Returning an incomplete report, even if it is received within the time limit, constitutes a failure to file the required report. Failure to file the required report is considered an admission by the employer that no eligibility question exists regarding that claimant. Eligibility issues raised after the due date of a required report will be resolved pursuant to ss. 108.09 (2) (b) and 108.04 (13), Stats.

The proposed rule will repeal information on the following obsolete reports:

Work Record Report (form UC-203). This form was used to collect wage data on a claim-by-claim basis before the implementation of quarterly wage reporting.

Final Work Record Report. This form was used when an employer ceased to have employees, had gone out of business, or terminated coverage under the unemployment insurance program without providing the department with satisfactory assurance that the employer would promptly file a Work Record Report (UC-203) if the department requested it.

The proposed rule will also repeal a provision on the Urgent Request for Wages in Chapter 111, regarding quarterly wage reports, and create a new provision in Chapter DWD 123, regarding benefit reports. The requirement that a employer pay a $15 fee for tardy filing of the Urgent Request for Wages will be repealed. The department has not enforced this provision recently due to the administrative inefficiency of collecting the fee.

Summary of factual data and analytical methodologies. The department has changed the type of benefit reports required from employers with the implementation of the quarterly wage reporting and other procedural changes. The proposed rule updates and clarifies Chapter DWD 123 to reflect these changes.

Comparison with rules in adjacent states. Iowa, Michigan, and Illinois have unemployment insurance benefit rules similar to Wisconsin regarding reports that notify employers of the filing of a claim, request wage and separation information, and allow employers to notify the states of possible ineligibility of claimants. Minnesota does not have unemployment insurance benefit rules.

Effect on small businesses. The proposed rule affects small businesses but does not have a significant economic impact on a substantial number of small businesses. The DWD Small Business Regulatory Coordinator is Jennifer Jirschele, [phone], [e-mail].

Analysis used to determine effect on small business. The reports provide information on claimants' employment separations, dates of work, wages and other payments, and other issues that may be disqualifying. Most of the information is required by Chapter 108, Stats.

Fiscal Impact