Chapter 51

51.44 51.44 Early intervention services.

51.44(1) (1) In this section:

51.44(1)(ag) (ag) “Case management services” means activities carried out by a service coordinator to assist and enable a child eligible for early intervention services under this section and the child’s family to receive the rights and services authorized to be provided under the early intervention program under this section.

51.44(1)(ar) (ar) “Individualized family service plan” means a written plan for providing early intervention services to an eligible child and the child’s family.

51.44(1)(b) (b) “Local health department” has the meaning given in s. 250.01 (4).

51.44(1)(c) (c) “Multidisciplinary evaluation” means the process used by qualified professionals to determine eligibility for early intervention services under this section based on the child’s developmental status, the child’s health, physical condition and mental condition or the child’s atypical development.

51.44(1m) (1m) The department is the lead agency in this state for the development and implementation of a statewide system of coordinated, comprehensive multidisciplinary programs to provide appropriate early intervention services under the requirements of 20 USC 1431 to 1444.

51.44(3) (3) 

51.44(3)(a) (a) From the appropriations under s. 20.435 (7) (bt) and (nL) the department shall allocate and distribute funds to counties to provide or contract for the provision of early intervention services to individuals eligible to receive the early intervention services.

51.44(3)(b) (b) Funds that are distributed to counties under par. (a) may not be used to supplant funding from any other source.

51.44(3)(c) (c) No county may contribute less funding for early intervention services under this section than the county contributed for early intervention services in 1999, except that, for a county that demonstrated extraordinary effort in 1999, the department may waive this requirement and establish with the county a lesser required contribution.

51.44(3)(d) (d) From the appropriation under s. 20.435 (7) (bt), the department may pay the nonfederal share of Medical Assistance costs for services provided under s. 49.45 (54) (c).

51.44(4) (4) Each county board of supervisors, except in Milwaukee County, and the Milwaukee County mental health board in Milwaukee County shall designate the appropriate county department under s. 46.21, 46.23 or 51.437, the local health department of the county or another entity as the local lead agency to provide early intervention services under the funding specified in sub. (3).

51.44(5) (5) The department shall do all of the following:

51.44(5)(a) (a) Promulgate rules for the statewide implementation of the program under this section that do all of the following:

51.44(5)(a)1. 1. Specify the population of children who would be eligible for services under the program.

51.44(5)(a)2. 2. Define the term “early intervention services”.

51.44(5)(a)3. 3. Establish personnel standards and a comprehensive plan for the development of personnel providing services in the program.

51.44(5)(a)4. 4. Establish procedures for the resolution of complaints by clients in the program.

51.44(5)(a)5. 5. Specify data collection requirements, including a system for making referrals to service providers.

51.44(5)(a)6. 6. Establish monitoring and supervision authority.

51.44(5)(a)7. 7. Establish policies and procedures for the implementation of individual family services plans and case management services.

51.44(5)(a)8. 8. Develop requirements for local coordination and interagency agreements at state and local levels.

51.44(5)(a)9. 9. Establish requirements for public awareness activities and a statewide directory of services.

51.44(5)(am) (am) Promulgate rules that define the term “service coordinator”.

51.44(5)(b) (b) Ensure that the children eligible for early intervention services under this section receive all of the following services:

51.44(5)(b)1. 1. A multidisciplinary evaluation.

51.44(5)(b)2. 2. An individualized family service plan.

51.44(5)(b)3. 3. Assignment of a service coordinator, as defined by the department by rule, to provide case management services.

51.44(5)(c) (c) Annually, submit to the chief clerk of each house of the legislature for distribution to the legislature under s. 13.172 (2) a report on the department’s progress toward full implementation of the program under this section, including the progress of counties in implementing goals for participation in 5th-year requirements under 20 USC 1431 to 1444.

51.44 History History: 1991 a. 39, 269; 1993 a. 16, 27; 1995 a. 27; 1997 a. 27; 2001 a. 16; 2013 a. 20, 203; 2017 a. 59.

51.44 Cross-reference Cross-reference: See also ch. DHS 90, Wis. adm. code.

51.441 51.441 Comprehensive mental health consultation program. The department shall convene a statewide group of interested persons, including at least one representative of the Medical College of Wisconsin, to develop a concept paper, business plan, and standards for a comprehensive mental health consultation program that incorporates general psychiatry, geriatric psychiatry, addiction medicine and psychiatry, a perinatal psychiatry consultation program, and the child psychiatry consultation program under s. 51.442.

51.441 History History: 2019 a. 9.

51.442 51.442 Child psychiatry consultation program.

51.442(1) (1) In this section, “participating clinicians” include pediatricians, family physicians, nurse practitioners, and physician assistants.

51.442(2) (2) The department shall create and administer a child psychiatry consultation program to assist participating clinicians in providing enhanced care to pediatric patients with mental health care needs, to provide referral support for pediatric patients, and to provide additional services described in this section. The consultation program created under this section is not an emergency referral service.

51.442(3) (3) 

51.442(3)(a) (a) In the period before January 1, 2015, the department shall review proposals submitted by organizations seeking to provide consultation services through the consultation program under this section and shall designate regional program hubs, in a number determined by the department, based on the submitted proposals. The department shall select and provide moneys to organizations to provide consultation services through the consultation program in a manner that maximizes medically appropriate access and services as described under sub. (4).

51.442(3)(b) (b) Beginning on January 1, 2016, the department shall create any additional regional program hubs in order to provide consultation services statewide.

51.442(4) (4) The department shall select qualified organizations to provide consultation program services through the regional hubs. Each regional hub shall make available its own qualified provider or consortium of providers. To be a qualified provider in the program under this section, an organization shall successfully demonstrate it meets all of the following criteria:

51.442(4)(a) (a) The organization has the required infrastructure to be located within the geographic service area of the proposed regional hub.

51.442(4)(b) (b) Any individual who would be providing consulting services through the program is located in this state.

51.442(4)(c) (c) The organization enters into a contract with the department agreeing to satisfy all of the following criteria as a condition of providing services through the consultation program:

51.442(4)(c)1. 1. The organization has at the time of participation in the program a psychiatrist, who is either eligible for certification or certified by the American Board of Psychiatry and Neurology, Inc., for either adult psychiatry or child and adolescent psychiatry or both, and has and maintains additional staff as specified by the department.

51.442(4)(c)2. 2. The organization operates during the normal business hours of Monday to Friday between 8 a.m. and 5 p.m., excluding weekends and holidays.

51.442(4)(c)3. 3. The organization shall be able to provide consultation services as promptly as is practicable.

51.442(4)(c)4. 4. The organization shall provide all of the following services:

51.442(4)(c)4.a. a. Support for participating clinicians to assist in the management of children and adolescents with mental health problems and to provide referral support for pediatric patients.

51.442(4)(c)4.b. b. A triage-level assessment to determine the most appropriate response to each request, including appropriate referrals to other mental health professionals.

51.442(4)(c)4.c. c. When medically appropriate, diagnostic and therapeutic feedback.

51.442(4)(c)4.d. d. Recruitment of other practices in the regional hub’s service territory to the provider’s services.

51.442(4)(c)5. 5. The organization shall have the capability to provide consultation services by telephone, at a minimum.

51.442(5) (5) 

51.442(5)(a) (a) An organization providing consultation services through the consultation program under this section may provide services by teleconference, video conference, voice over Internet protocol, electronic mail, pager, or in-person conference.

51.442(5)(b) (b) The organization providing consultation services through the consultation program under this section may provide any of the following services, which are eligible for funding from the department:

51.442(5)(b)1. 1. Second opinion diagnostic and medication management evaluations conducted either by a psychiatrist or by a social worker or psychologist, or a registered nurse with psychiatric training, either by in-person conference or by teleconference, video conference, or voice over Internet protocol.

51.442(5)(b)2. 2. In-person or Internet site-based educational seminars and refresher courses provided to any participating clinician who uses the consultation program on a medically appropriate topic within child psychiatry.

51.442(6) (6) An organization that provides consultation services through the consultation program under this section shall report to the department any information as requested by the department.

51.442(7) (7) 

51.442(7)(a) (a) The department shall conduct annual surveys of participating clinicians who use the consultation program under this section to assess the amount of pediatric mental health care provided, self-perceived levels of confidence in providing pediatric mental health services, and the satisfaction with the consultations and the educational opportunities provided.

51.442(7)(b) (b) Immediately after a clinical practice group begins using the consultation program under this section and again 6 to 12 months later, the department shall conduct an interview of participating clinicians from that practice group to assess the barriers to and benefits of participation to make future improvements and to determine the participating clinician’s treatment abilities, confidence, and awareness of relevant resources before and after using the consultation program.

51.442 History History: 2013 a. 127.

51.448 51.448 Addiction medicine consultation program.

51.448(1) (1) In this section, “participating clinicians” includes physicians, nurse practitioners, and physician assistants.

51.448(2) (2) Beginning July 1, 2017, the department shall create and administer an addiction medicine consultation program to assist participating clinicians in providing enhanced care to patients with substance use addiction and to provide referral support for patients with a substance abuse disorder, and to provide additional services described in this section. The addiction medicine consultation program created under this section is not an emergency referral service.

51.448(3) (3) The department shall review proposals submitted by organizations seeking to provide consultation services through the addiction medicine consultation program under this section and shall designate sites, in a number determined by the department, based on the submitted proposals. The department shall select and provide moneys to organizations to provide consultation services through the addiction medicine consultation program in a manner that maximizes medically appropriate access and services as described under sub. (4).

51.448(4) (4) The department shall select qualified organizations to provide addiction medicine consultation program services through the sites designated in sub. (3). Each site shall make available its own qualified provider or consortium of providers. To be a qualified provider in the addiction medicine consultation program under this section, an organization shall successfully demonstrate it meets all of the following criteria:

51.448(4)(a) (a) The organization has the required infrastructure to be located within the geographic service area of the proposed site.

51.448(4)(b) (b) Any individual who would be providing consulting services through the addiction medicine consultation program is located in this state.

51.448(4)(c) (c) The organization enters into a contract with the department agreeing to satisfy all of the following criteria as a condition of providing services through the addiction medicine consultation program:

51.448(4)(c)1. 1. The organization has at the time of participation in the addiction medicine consultation program a physician who is board-certified in addiction psychiatry or addiction medicine.

51.448(4)(c)2. 2. The organization operates during the normal business hours of Monday to Friday between 8 a.m. and 5 p.m., excluding holidays.

51.448(4)(c)3. 3. The organization shall be able to provide consultation services as promptly as is practicable.

51.448(4)(c)4. 4. The organization shall provide all of the following services:

51.448(4)(c)4.a. a. Support for participating clinicians to assist in the management of addiction or substance abuse and to provide referral support for patients with a substance use addiction.

51.448(4)(c)4.b. b. A triage-level assessment to determine the most appropriate response to each request, including appropriate referrals to other mental health professionals.

51.448(4)(c)4.c. c. When medically appropriate, diagnostic and therapeutic feedback.

51.448(4)(c)4.d. d. Recruitment of other practices in the site’s service territory to the provider’s services.

51.448(4)(c)5. 5. The organization shall have the capability to provide consultation services by telephone, at a minimum.

51.448(5) (5) 

51.448(5)(a) (a) An organization that provides consultation services through the addiction medicine consultation program under this section may provide services by teleconference, video conference, voice over Internet protocol, electronic mail, pager, or in-person conference.

51.448(5)(b) (b) The organization that provides consultation services through the addiction medicine consultation program under this section may provide any of the following services, which are eligible for funding from the department:

51.448(5)(b)1. 1. Second opinion diagnostic and medication management evaluations conducted either by a physician who is board-certified in addiction psychiatry or addiction medicine or a physician with extensive and documented experience in treating substance use disorders, either by in-person conference or by teleconference, video conference, or voice over Internet protocol.

51.448(5)(b)2. 2. In-person or Internet site-based educational seminars and refresher courses provided to any participating clinician who uses the addiction medicine consultation program on a medically appropriate topic within addiction medicine.

51.448(6) (6) An organization that provides consultation services through the addiction medicine consultation program under this section shall report to the department any information as requested by the department.

51.448(7) (7) An organization that provides consultation services through the addiction medicine consultation program under this section shall do all of the following:

51.448(7)(a) (a) Conduct annual surveys of participating clinicians who use the addiction medicine consultation program under this section to assess the amount of addiction medicine consultation provided, self-perceived levels of confidence in providing addiction medicine services, and the satisfaction with the consultations and the educational opportunities provided.

51.448(7)(b) (b) Immediately after a clinical practice group begins using the addiction medicine consultation program under this section and again 6 to 12 months later, conduct an interview of participating clinicians from that practice group to assess the barriers to and benefits of participation to make future improvements and to determine the participating clinician’s treatment abilities, confidence, and awareness of relevant resources before and after using the addiction medicine consultation program.