Chapter DHS 36

DHS 36.05(1)(a) (a) “Deficiency” means the failure to meet a requirement of this chapter.

DHS 36.05(1)(b) (b) “Major deficiency” means a determination by the department that an aspect of the CCS program or the conduct of its personnel does any of the following:

DHS 36.05(1)(b)1. 1. The psychosocial rehabilitation services substantially fail to meet the requirements of this chapter.

DHS 36.05(1)(b)2. 2. Creates a risk of harm to a consumer or violates a consumer right created by this chapter or other state or federal statutes or rules, which may include any one of the following of the following:

DHS 36.05(1)(b)2.a. a. A staff member has had sexual contact or intercourse, as defined in s. 940.225 (5) (b) or (c), Stats., with a consumer.

DHS 36.05(1)(b)2.b. b. A staff member of the CCS has been convicted of consumer abuse under s. 940.285, 940.29 or 940.295, Stats.

DHS 36.05(1)(b)2.c. c. The health or safety of a consumer is in imminent danger because of a failure of the CCS or a CCS staff member to comply with requirements of this chapter or any other applicable local, state or federal statute or regulation.

DHS 36.05(1)(b)3. 3. The CCS has submitted, or caused to be submitted, one or more statements for purposes of obtaining certification under this chapter which the CCS knew or should have known to be false.

DHS 36.05(1)(b)4. 4. A license, certification or required local, state or federal approval of the CCS has been revoked or suspended or has expired.

DHS 36.05(1)(b)5. 5. A staff member has signed a billing statement or other document that represents the CCS staff member as the provider of service when the staff member did not provide the service.

DHS 36.05(1)(b)6. 6. A staff member impedes or has impeded monitoring of the program by the department.

DHS 36.05(1)(b)7. 7. An action or inaction by a staff member constitutes grounds for involuntary termination or suspension from program participation under s. DHS 106.06.

DHS 36.05(2) (2) Initial application. Upon receipt of a complete application for initial certification, the department shall review the application and accompanying materials required under s. DHS 36.04 (2). The department’s designated representative responding to a request for an initial certification shall review CCS personnel policies and procedures and operational policies, and the community services plan developed under s. DHS 36.07.

DHS 36.05(4) (4) Transferability of certification. Certification may only be issued to the CCS specified in the application. A CCS may not transfer or assign its certification to another entity. An applicant or certified CCS shall notify the department of any change in administration, location, name, offered services or any other change that may affect compliance with this chapter no later than the effective date of the change.

DHS 36.05(5) (5) Effective date of certification.

DHS 36.05(5)(a) (a) The date of certification shall be the date that the department determines that an applicant is in compliance with this chapter.

DHS 36.05(5)(b) (b) The department may change the date of certification if the department has made an error in the certification process. A date of certification that is adjusted under this paragraph may not be earlier than the date the department receives a written application under sub. (2) or (3).

DHS 36.05(6) (6) Fees for certification. Fees for certification shall be established by the department.

DHS 36.05(7) (7) Issuance of certification.

DHS 36.05(7)(a) (a) Action on application. Within 60 days after receiving a completed application for initial certification or for renewal of certification, the department shall do one of the following:

DHS 36.05(7)(a)1. 1. Approve the CCS if no deficiencies are found and all of the requirements for certification are met.

DHS 36.05(7)(a)3. 3. Deny certification under sub. (9), if the department finds one or more major deficiencies.

DHS 36.05(9) (9) Denial of certification. A denial of certification shall be in writing and shall contain the reason for the denial and notice of opportunity for a hearing under s. DHS 36.06 (3).

DHS 36.05(10) (10) Duration of certification. A certification remains valid until one of the following occur:

DHS 36.05(10)(a) (a) The certification remains valid until it is revoked or suspended by the department in accordance with s. DHS 36.06 (1).

DHS 36.05(10)(b) (b) The certification becomes invalid due to non-submission of the biennial report or non-payment of biennial fees in accordance with sub. (11).

DHS 36.05(11) (11) Biennial report and fees.

DHS 36.05(11)(a) (a) Every 24 months, on a date determined by the department, the program shall submit a biennial report on the form provided by the department and shall submit payment of certification continuation fees under s. 51.04, Stats.

DHS 36.05(11)(b) (b) The department will send the certification continuation materials to the provider, which the provider is expected to complete and submit to the department according to instructions provided.

DHS 36.05(11)(c) (c) A certification will be suspended or terminated if biennial reports and fees are not submitted prior to the end of the biennial cycle.

DHS 36.05 History History: CR 04-025: cr. Register October 2004 No. 586, eff. 11-1-04; corrections in (1) (b) 7. and (3) (f) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635; CR 22-078: r. (3), (7) (a) 2., (b), (8), cr. (10), (11) Register July 2023 No. 811, eff. 8-1-23.

DHS 36.06 DHS 36.06 Enforcement actions.

DHS 36.06(1) (1) Revocation and suspension. The department may revoke or suspend certification at any time upon written notice to the CCS. The notice shall state the reason for the action and inform the CCS of the opportunity for a hearing under sub. (3).

DHS 36.06(2) (2) Inspections.

DHS 36.06(2)(a) (a) The department may make announced and unannounced inspections of a certified CCS to verify compliance with this chapter, to investigate complaints received regarding the services provided by the CCS, or as part of an investigation into the cause of death of a consumer.

DHS 36.06(2)(b) (b) In making inspections, the department shall seek to minimize any disruption to the normal functioning of the CCS.

DHS 36.06(2)(c) (c) Any authorized officer, employee or agent of the department shall have access to all CCS documents, open and closed consumer records, staff members and consumers at any time to ensure compliance with the requirements of this chapter and other applicable federal and state statutes and regulations.

DHS 36.06(3) (3) Appeals.

DHS 36.06(3)(a) (a) If the department denies, revokes, suspends, or refuses to renew certification, the CCS may request an administrative hearing under ch. 227, Stats. If a timely request for hearing is made on a decision to suspend or revoke or not renew a certification, that action is stayed pending the decision on the appeal except when the department finds that the health, safety or welfare of patients requires that the action take effect immediately. A finding of a requirement for immediate action shall be made in writing by the department.

DHS 36.06(3)(b) (b) A request for hearing shall be submitted in writing to the department of administration’s division of administrative hearings within 30 days after the date of the notice of the department’s action.

DHS 36.06 Note Note: A request for hearing may be delivered in person or mailed to the Division of Hearings and Appeals, 5005 University Avenue, Suite 201, Madison, WI 53707-7875. An appeal may be sent by fax to the Division’s facsimile transmission number at [phone].

DHS 36.06(4) (4) Actions barring service in a ccs. Any person having direct management responsibility for a CCS who was involved in any one of the following may not provide service in or for a certified CCS for a period not to exceed 5 years:

DHS 36.06(4)(a) (a) An act that results in termination of a health care provider certification under s. DHS 106.06.

DHS 36.06(4)(b) (b) An act that results in conviction for a criminal offense related to services provided under s. 632.89, Stats., whether or not the conviction is under appeal.

DHS 36.06(4)(c) (c) An act involving a staff member who removes or destroys consumer service records.

DHS 36.06 History History: CR 04-025: cr. Register October 2004 No. 586, eff. 11-1-04; correction in (4) (a) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635.

DHS 36.065 DHS 36.065 Waivers and variances.

DHS 36.065(1) (1) Definitions. As used in this section:

DHS 36.065(1)(a) (a) “Waiver” means the grant of an exemption from a non-statutory requirement of this chapter.

DHS 36.065(1)(b) (b) “Variance” means the granting of an alternate requirement in place of a non-statutory requirement of this chapter.

DHS 36.065(2) (2) Waivers or variances.

DHS 36.065(2)(a) (a) An application for a waiver or a variance may be made at any time. Each request shall be made in writing to the department and shall include all of the following:

DHS 36.065(2)(a)1. 1. Identification of the rule provision from which the waiver or variance is requested.

DHS 36.065(2)(a)2. 2. The time period for which the waiver or variance is requested.

DHS 36.065(2)(a)3. 3. If the request is for a variance, the specific alternative action that the CCS proposes.

DHS 36.065(2)(a)4. 4. The reasons for the request.

DHS 36.065(2)(a)5. 5. Supporting justification.

DHS 36.065(2)(a)6. 6. Any other information requested by the department.

DHS 36.065 Note Note: An application for a waiver or variance should be addressed to the Behavioral Health Certification Section, Division of Quality Assurance, P.O. Box 2969, Madison, WI 53701-2969.

DHS 36.065(2)(b) (b) A waiver or variance may be granted if the department finds that the waiver or variance will not adversely affect the health, safety, or welfare of any consumer and any one of the following applies:

DHS 36.065(2)(b)1. 1. Strict enforcement of a requirement would result in unreasonable hardship on the CCS or on a consumer.

DHS 36.065(2)(b)2. 2. An alternative to a rule, including new concepts, methods, procedures, techniques, equipment, personnel qualifications, or the conducting of pilot projects is in the interest of better care or management.

DHS 36.065(2)(c) (c) A determination on a request for a waiver or variance shall be made to the CCS in writing. If the decision is to deny the waiver or variance, the reason for the denial shall be included in the notice.

DHS 36.065(2)(d) (d) The terms of a variance may be modified upon agreement between the department and the CCS. The department may impose any condition on a waiver or variance which the department deems necessary.

DHS 36.065(2)(e) (e) The department may limit the duration of any waiver or variance.

DHS 36.065(2)(f) (f) The department may revoke a waiver or variance if any one of the following occurs:

DHS 36.065(2)(f)1. 1. The waiver or variance adversely affects the health, safety or welfare of a consumer.

DHS 36.065(2)(f)2. 2. The CCS has failed to comply with the variance as granted.

DHS 36.065(2)(f)3. 3. The CCS notifies the department that it wishes to relinquish the waiver or variance.

DHS 36.065(2)(f)4. 4. There is a change in applicable law.

DHS 36.065(2)(f)5. 5. For any other reason necessary to protect the health, safety, and welfare of a consumer.

DHS 36.065 History History: CR 04-025: cr. Register October 2004 No. 586, eff. 11-1-04.

subch. III of ch. DHS 36 Subchapter III — Comprehensive Community Services Program

DHS 36.07 DHS 36.07 Comprehensive community services plan. Each CCS program shall have a written plan that shall include all of the following:

DHS 36.07(1) (1) A description of the organizational structure. The description shall include all of the following:

DHS 36.07(1)(a) (a) Responsibilities of the staff members assigned to the functions described in s. DHS 36.10 (2) (e).

DHS 36.07(1)(b) (b) Policies and procedures to implement a quality improvement plan consistent with the requirements in s. DHS 36.08.

DHS 36.07(1)(c) (c) Policies and procedures to establish a coordination committee and work with a coordination committee consistent with the requirements in s. DHS 36.09.

DHS 36.07(1)(d) (d) Criteria for recruiting and contracting with providers of psychosocial rehabilitation services.

DHS 36.07(1)(e) (e) Policies and procedures for updating and revising the CCS plan to ensure that it accurately identifies current services provided and any changes in policies and procedures of the CCS.

DHS 36.07(2) (2) A written summary detailing the recommendations of the coordination committee made under s. DHS 36.09 (3) (a) and a written response by the CCS to the coordination committee’s recommendations.

DHS 36.07(3) (3) A description of the currently available mental health, substance-use disorder, crisis services, and other services in the county or tribe and how the CCS will interface and enhance these services. The description shall include policies and procedures for developing and implementing collaborative arrangements and interagency agreements addressing all of the following:

DHS 36.07(3)(a) (a) Processes necessary to include the CCS in planning to support consumers who are discharged from a non-CCS program or facilities that include inpatient psychiatric or substance-use treatment, a nursing home, residential care center, day treatment provider, jail or prison.

DHS 36.07(3)(b) (b) The role of the CCS when an emergency protective placement is being sought under s. 55.135, Stats., and when protective services or elder abuse investigations are involved.

DHS 36.07(3)(c) (c) The role of the CCS when the CCS provides services in conjunction with any other care coordination service including protective services, integrated services projects, and schools.

DHS 36.07(3)(d) (d) The role of the CCS when a consumer is living in the community under a ch. 51, Stats., commitment.

DHS 36.07(3)(e) (e) Establishing contracts and agreements with community agencies providing psychosocial rehabilitation services.

DHS 36.07(3)(f) (f) Establishing contracts when a needed service is not available in the existing array of services.

DHS 36.07(3)(g) (g) Arrangements with the county or tribal emergency services program to ensure identification and referral of CCS consumers who are in crisis.