DHS 75.48 (2) Services requirements by level of care, residential |
Code citation and service name | DHS 75.53 Transitional Residential Treatment Service | DHS 75.54 Medically Monitored Residential Treatment Service | DHS 75.55 Medically Managed Inpatient Treatment Service | DHS 75.56 Adult Residential Integrated Behavioral Health Stabilization Service |
SECTION 4. DHS 75.48 (2) (table), row (m) is amended to read:
(m) Treatment plan completion | | | | 1. A preliminary treatment plan is required within 48 hours of admission. A treatment plan may be waived if an individual resides at the facility for less than 48 hours. 2. A treatment plan consistent with ss. DHS 75.24 (13) is required within 4 days of admission. |
SECTION 5. DHS 75.49 (3) is created to read:
DHS 75.49 (3) Applicability.
(a) In this subsection, "co-occurring with the provision of mental health treatment services" means when any of the following occur during the provision of mental health services:
1. A client discloses symptoms of a substance use disorder for which treatment is requested by the current provider versus a referral to a ch. DHS 75 program. 2. A client is clinically assessed to be in need of substance use services but the client declines.
(b) This section shall not apply to outpatient substance use treatment services when co-occurring with the provision of mental health treatment services in any of the following settings:
1. An outpatient mental health clinic certified under ch. DHS 35, providing services in accordance with s. DHS 35.16 (5). 2. A rural health clinic as defined under 42 CFR 491, Subpart A. SECTION 7. DHS 75.50 (4) is created to read:
DHS 75.50 (4) Applicability.
(a) In this subsection, "co-occurring with the provision of mental health treatment services" means when any of the following occur during the provision of mental health services:
1. A client discloses symptoms of a substance use disorder for which treatment is requested by the current provider versus a referral to a ch. DHS 75 program. 2. A client is clinically assessed to be in need of substance use services but the client declines.
(b) This section shall not apply to outpatient substance use treatment services when co-occurring with the provision of mental health treatment services in any of the following settings:
2. A rural health clinic as defined under 42 CFR 491, Subpart A. SECTION 8. DHS 75.51 (1) is amended to read:
DHS 75.51 (1) Service description. In this section, “intensive outpatient treatment service” means a non-residential treatment service totaling at least 9 hours of treatment services per patient per week for adults and at least 6 hours of treatment services per patient per week for minors, in which substance use and mental health treatment personnel provide assessment and treatment for substance use and mental health disorders under the oversight of a medical director. Patients in this setting may receive treatment services for a substance use disorder, a mental health disorder, or both. The intensive outpatient treatment service may choose to provide treatment for only substance use disorders. Intensive outpatient treatment services may include screening, intake, evaluation and diagnosis, medication management, nursing services, case management, drug testing, counseling, individual therapy, group therapy, family therapy, psychoeducation, vocational services, peer support services, recovery coaching, outreach activities, and recovery support services to ameliorate symptoms and restore effective functioning. Intensive outpatient treatment services address patient needs for mental health, psychiatric, or medical services through integrated co-occurring treatment or through coordinated services, consultation, and referrals.
SECTION 9. DHS 75.52 is amended to read:
DHS 75.52 Day treatment or partial hospitalization treatment service. In this section, “day treatment service” or “partial hospitalization service” means a medically-monitored and non-residential substance use and mental health treatment service totaling 15 or more hours of treatment services per patient per week for adults and 12 or more hours of treatment services per patient per week for minors, in which substance use and mental health treatment personnel provide assessment and treatment for substance use and co-occurring mental health disorders under the oversight of a medical director. Patients in this setting may receive treatment services for a substance use disorder, a mental health disorder, or both. The day treatment or partial hospitalization service may choose to provide treatment for only substance use disorders. Day treatment or partial hospitalization services may include screening, intake, evaluation and diagnosis, medication management, nursing services, case management, drug testing, counseling, individual therapy, group therapy, family therapy, psychoeducation, vocational services, peer support services, recovery coaching, outreach activities, and recovery support services, to ameliorate symptoms and restore effective functioning.
SECTION 10. DHS 75.56 (title), (1), (2) (a), (c), and (3) (a), (b) (intro) are amended to read:
DHS 75.56 Adult residential integrated behavioral health stabilization service.
(1) Service description. In this section, “adult residential integrated behavioral health stabilization service” means a residential behavioral health treatment service, delivered under the oversight of a medical director, that provides withdrawal management and intoxication monitoring, as well as integrated behavioral health stabilization services, and includes nursing care on-site for medical monitoring during all hours of operation available on a 24-hour basis. Patients in this setting may receive treatment services for a substance use disorder, a mental health disorder, or both. Adult residential integrated behavioral health stabilization services are appropriate for adult patients whose acute withdrawal signs and symptoms or behavioral health needs are sufficiently severe to require 24-hour care consistent monitoring; however, the full resources of a hospital are not required. Services delivered in this setting may include screening, assessment, intake, evaluation and diagnosis, medical care, observation and monitoring, physical examination, determination of medical stability, medication management, nursing services, case management, drug testing, counseling, individual therapy, group therapy, family therapy, psychoeducation, peer support services, recovery coaching, recovery support services, and crisis intervention services, to ameliorate acute behavioral health symptoms and stabilize functioning.
DHS 75.56 (2) (a) An adult residential integrated behavioral health stabilization service shall develop and implement an orientation program for all staff and volunteers. The orientation shall be designed to ensure that staff and volunteers know and understand all of the following:
DHS 75.56 (2) (c) Staff of an adult residential integrated behavioral health stabilization service shall receive at least 8 hours per year of training on emergency behavioral health services, rules and procedures relevant to the operation of the program, compliance with state and federal regulations, cultural competency in behavioral health services, and current issues in client's rights and services.
DHS 75.56 (3) (a) An adult residential integrated behavioral health stabilization service shall have written policies and procedures for the assessment of safety and consideration of safety risks to the patient and others prior to admitting a patient.
DHS 75.56 (3) (b) An individual with any of the following symptoms, behaviors, or concerns shall be excluded from admission to an adult residential integrated behavioral health stabilization service:
SECTION 11. DHS 75.56 (3) (b) 3. is repealed.
SECTION 12. DHS 75.59 (6) (e) 1. is amended to read:
DHS 75.59 (6) (e) 1. For each patient eligible for admission, the service shall arrange for a comprehensive physical examination and clinically indicated laboratory work-up. The comprehensive physical examination shall be ordered by the service physician on the day of admission and shall include a complete blood count and liver function testing. The service shall test for Hepatitis A, B, C and HIV if the patient gives informed consent in writing. If the patient declines permission to test shall be documented in the patient's record. An updated comprehensive physical examination including lab work shall be completed annually.
SECTION 13. DHS 75.59 (19) (c) is amended to read:
DHS 75.59 (19) (c) Screening. A service shall screen all patients via a risk factor assessment at admission and annually thereafter for viral hepatitis and sexually transmitted diseases and shall ensure that any necessary medical follow-up occurs, either on site or through referral to community medical services. Positive screening results or disease risks must have a management plan that is seen through to completion regardless of whether this is accomplished via services provided directly on-site or by referral and care coordination.
SECTION 14. DHS 75.60 (4) (intro.) and (c) are consolidated, renumbered to DHS 75.60 (4) (intro.), and amended to read:
DHS 75.60 (4) Definition. In this section:, (c) “Primary primary care service” means outpatient general health care services provided by a clinic for regular health care services, preventive care, or for a specific health concern, and includes all of the following:
SECTION 15. DHS 75.60 (4) (a) and (b) are repealed.
SECTION 16. DHS 75.60 (4) (c) 1. to 6. are renumbered DHS 75.60 (a) to (f).
SECTION 17. DHS 75.60 (7) (a) 10. and 11. are repealed.
SECTION 18. DHS 75.60 (8) (intro.) is renumbered DHS 75.60 (8) and amended to read:
DHS 75.60 (8) Intake. An OBOT service shall comply with all of the following requirements: federal and state laws and regulations governing the prescribing of medication for opioid use disorder.
SECTION 19. DHS 75.60 (8) (a) and (b) are repealed.
SECTION 20. DHS 101.13 (12m) is renumbered DHS 101.03 (17wm) and amended to read:
DHS 101.03 (17wm) “AODA Behavioral health day treatment” means alcohol and other drug abuse substance use disorder treatment services provided by a provider certified under s. DHS 105.25 to a recipient who, in the clinical judgement of a qualified treatment professional, is experiencing a problem with alcohol or other drugs and requires intensive services of a prescribed duration, which may include assessment and evaluation, treatment planning, group and individual counseling, recipient education when necessary for effective treatment, and rehabilitative services, to ameliorate or remove the disability and restore effective functioning. SECTION 21. DHS 101.03 (13) and (Note) are renumbered DHS 101.03 (172x) and (Note) and amended to read:
DHS 101.03 (172x) “AODA SUD treatment services” means alcohol and other drug abuse substance use disorder treatment services provided by a provider certified pursuant to s. DHS 105.22 or 105.23 to assist alcoholics and drug abusers individuals with substance use disorder and persons affected by problems related to the abuse of alcohol or drugs substance use. Note: Examples of AODA SUD treatment services are client evaluation, orientation and motivation, treatment planning, consultation and referral, client education, individual counseling, group counseling and crisis intervention
SECTION 22. DHS 101.03 (144) is amended to read:
DHS 101.03 (144) “Psychiatric hospital” or “psychiatric facility” means an institution which is primarily engaged in providing, by or under the supervision of a physician, inpatient psychiatric services for the diagnosis and treatment of mental illness which may include services for the diagnosis and treatment of the abuse of alcohol or other drugs substance use disorder.
SECTION 23. DHS 101.03 (172q) is created to read:
