Wisconsin Administrative Code

DHS 68.01 Introduction. (1) AUTHORITY AND PURThis chapter is promulgated pursuant to ss. 46.87 and 227.11 (2) (a), Stats., section 3023 (28m) of 1985 Wis. Act 29, and 2015 Wis. Act 273 to establish procedures and criteria for distributing funds for the provision of service paymen…

DHS 68.02 Definitions. In this chapter: (1) “Administering agency” means any of the following: (a) The county agency selected by the county board under s. 46.87 (3) (c), Stats. (b) The agency selected by a tribal government under s. 46.87 (3) (d), Stats. (c) A private nonprofit o…

DHS 68.03 Allocation of funds. Each administering agency shall receive no less than $5,000 per year in funds available under s. 20.435 (7) (b) and (o), Stats. History: Cr. Register, March, 1989, No. 399, eff. 4-1-89; corrections made under s. 13.93 (2m) (b) 7., Stats., Register, …

DHS 68.04 Selection and reporting responsibilities of administering agencies. (1) ADMINISTRATION BY COUNTY AGENCY OR TRIBE. (a) Letter of intent. A county board or tribal government may apply to serve as the administering agency by submitting to the department an initial letter o…

DHS 68.05 Program budget requirement; county, tribal, or nonprofit agency. (1) An administering agency shall annually prepare a budget for the program and shall submit the budget to the department each year by November 30. This budget shall be part of either the proposed budget r…

DHS 68.06 Allowable use of funds. (1) PURPOSES. As permitted by s. 46.87 (5), Stats., the administering agency may use allocated funds for any of the following purposes: (a) To pay for the cost of goods and services provided to or purchased for or by households and for limited tr…

DHS 68.07 Client eligibility. In accordance with s. 46.87 (5), Stats., the administering agency of each county or tribe shall determine the eligibility of each household that applies to participate in that county or tribe’s program by establishing that the household or person mee…

DHS 68.08 Determination of need. The amount paid or expended for each person diagnosed with dementia may not exceed $4,000 in any calendar year. For the purpose of calculating the funds to be paid to or expended for a household or indi- 4 vidual participating in the program, the …

DHS 68.09 Method of payment. The payment by an administering agency for goods and services shall be made using one or more of the following methods: (1) Payment made to a service provider on behalf of the person with dementia or the person’s caregiver. (2) Payment made to a servi…

DHS 68.10 Hearing. (1) JURISDICTION. Any household or individual participating in the program or caregiver may appeal the following actions by an administering agency: (a) Denial of an application to participate in a program. (b) The calculation of funds to be paid to or expended…

DHS 68.11 Exceptions to requirements. The department may grant an exception to an administering agency of any requirement made of the administering agency under this chapter, except a requirement under s. DHS 68.03 or 68.10 (2), if the department is convinced that an alternative …

DHS 72.01 Authority and purpose. This chapter is promulgated under ss. 46.482 (2) and (3), 49.45 (10) and (30j) (b), 49.471 (12), 51.04, 51.61, and 227.11 (2) (a), Stats., to establish certification criteria for reimbursement under the medical assistance program for all of the fo…

DHS 72.02 Applicability. This chapter shall apply to all of the following seeking reimbursement under the medical assistance program for recovery support services: (1) A publicly or privately operated facility, clinic, or organization providing peer recovery support services, coo…

DHS 72.03 Definitions. In this chapter: (1) XBehavioral healthY means the spectrum encompassing mental health and substance use disorders occurring either independently or simultaneously. (2) XCertificationY means the approval of the service by the department[s division of qualit…

DHS 72.04 Peer recovery support services. (1) Peer recovery coaches may provide peer recovery support services in accordance with this subchapter to individuals with mental health or substance use challenges in any of the following: (a) Substance use overdose treatment program ce…

DHS 72.05 Training, orientation, and continuing education requirements. (1) GENERAL REQUIREMENTS. Training, orientation, and continuing education is required for all peer recovery coaches. All programs covered under s. DHS 72.04 (1) are required to provide orientation to peer rec…

DHS 72.06 Supervision of peer recovery coaches. (1) GENERAL SUPERVISION REQUIREMENT. A peer recovery coach shall provide peer recovery support services under the supervision of a competent mental health professional. Supervision may be provided in an individual session between th…

DHS 72.07 Documentation. Peer recovery coaches must document all peer recovery support services delivered by retaining all of the following records: (1) Service provider notes. (2) Documentation of the participant[s progress toward goals and changes to treatment plan. (3) Dischar…

DHS 72.08 Exemption. The certification requirements in this subchapter shall not apply to any of the following: (1) An emergency mental health service program certified under ch. DHS 34. (2) An outpatient mental health clinic certified under ch. DHS 35. (3) A comprehensive commun…

DHS 72.085 Application requirements and policies. DHS 72.09 Program statement. DHS 72.10 Required policies and procedures. DHS 72.11 General qualifications. DHS 72.12 Orientation, training, and continuing education. DHS 72.13 Participant rights. DHS 72.14 Participant service reco…

DHS 72.09 Program statement. A substance use overdose treatment program shall complete a statement that describes the treatment and services provided by the program. The program statement must include all of the following: (1) A description of the substance use overdose treatment…

DHS 72.10 Required policies and procedures. A substance use overdose treatment program certified under this chapter shall have written personnel policies and procedures that describe all of the following: (1) Clinical assessment and treatment planning procedures. (2) Care coordin…

DHS 72.11 General qualifications. (1) Supervisors and staff licensed or certified by the department of safety and professional services to provide behavioral health services must follow the current scope of practice established by applicable rules. (2) Each staff member shall hav…

DHS 72.12 Orientation, training, and continuing education. All personnel must receive relevant orientation, training, and education. The substance use overdose treatment program shall have a designee who is responsible for informing the staff of all expected orientation, on-going…

DHS 72.13 Participant rights. (1) The substance use overdose treatment program shall comply with the participant rights and grievance resolution procedures in s. 51.61, Stats., and ch. DHS 94. (2) The substance use overdose treatment program administrator shall ensure that the pa…

DHS 72.14 Participant service records. (1) The substance use overdose treatment program shall maintain in a central location a service record for each participant. Each record shall include sufficient information to demonstrate that the program has an accurate understanding of th…

DHS 72.15 Discharge summary. Within 30 days after a participant[s date of discharge the substance use overdose treatment program shall prepare a discharge summary and enter it into the participant file. The discharge summary shall be signed and dated by a competent mental health …

DHS 73.01 Authority and purpose. This chapter is promulgated under the authority of ss. 46.277 (5) (d) 1n. b. and (5r), and 227.11 (2) (a), Stats., to establish certain standards and procedures related to assessments, case plans, service agreements, participant payment of service…

DHS 73.02 Applicability. This chapter applies to county departments and private non-profit agencies with which the department contracts to provide home and community-based services through a medical assistance waiver, and to vendors providing assessments, case plans or supportive…

DHS 73.03 Definitions. In this chapter: (1) XAssessmentY means a process for determining a person[s functional abilities and disabilities and the person[s need for and preferences in regard to medical and social long-term community support services. (2) XCase managerY means an em…

DHS 73.04 Assessment and case plan. (1) ASSESSMENT. Within the limits of state and federal funds, a county department shall carry out an assessment of any person residing in a nursing home who wants to be assessed for eligibility to receive support services within the community r…

DHS 73.06 Development of service agreements. (1) REQUIREMENT FOR NEGOTIATED AGREEMENT. Except when a county department expects services to be provided for less than 30 days, after an assessment and case plan have been completed and within 2 weeks after the initiation of service b…

DHS 73.08 Supervisory review of payment decisions. (1) The county department shall develop and implement written procedures for supervisory review of staff decisions regarding the competence of a participant to receive funds to pay a service provider and appropriateness of the le…

DHS 73.09 Documentation that services have been provided. (1) If a participant or the participant[s representative employs a service provider, the county department shall verify the type and amount of service for which reimbursement is sought. A verification form developed and av…

DHS 73.10 Individual hardship exceptions to limits on funding for CBRF care. (1) LIMITATION ON FUNDING. Each county shall annually establish limits on spending for services for persons who reside in CBRFs from the allocations received under s. 46.277 (5), Stats., for community lo…

DHS 73.11 Criteria for determination of the infeasibility of in-home services. (1) A county may use long-term support funds under s. 46.277, Stats., to provide services to a person residing in a CBRF if the county department or aging unit has determined that all 5 conditions unde…

DHS 75.01 Authority and purpose. This chapter is promulgated under the authority of ss. 46.973 (2) (c), 51.42 (7) (b), 51.4224, and 51.45 (8) and (9), Stats., to establish standards for community substance use prevention and treatment services under ss. 51.42 and 51.45, Stats. Se…

DHS 75.02 Applicability. (1) This chapter shall apply to all of the following: (a) A publicly or privately operated facility providing substance use treatment services, in accordance with ss. 51.01 (19) and 51.45 (8) (c), Stats. (b) A publicly or privately operated facility provi…

DHS 75.03 Definitions. In this chapter: (1) “Adult” means an individual aged 18 or older. (2) “Administrative discharge” means discharge of a patient from a service that is initiated by the service for reasons including program policies, behavioral concerns, or provider-initiated…

DHS 75.04 Application requirements. An application for initial certification shall be on a form provided by the department and shall be accompanied by all of the following: (1) Service policies and procedures required by this chapter. (2) All fees required under ss. 51.04 and 51.…

DHS 75.05 Department action. (1) INITIAL CERTIFICATION. (a) Within 60 days after receipt of a complete application, the department shall review the application and either approve or deny the certification. (b) A certification issued by the department shall be only for persons nam…

DHS 75.06 Biennial forms and fees. (1) Every 24 months, on a date determined by the department, the service shall submit the biennial forms provided by the department, and shall submit payment of the certification continuation fees under ss. 51.04 and 51.45 (8) (a), Stats., excep…

DHS 75.07 Change of ownership. (1) CHANGE OF OWNERSHIP. A change of ownership of a service occurs when the service does any of the following: (a) Removes, adds, or substitutes an individual as a partner in the association, dissolving the existing partnership and creating a new pa…

DHS 75.08 Agency closure. (1) Any service that intends to close shall provide written notice to each client by mail or electronic mail to the client’s last known address, to each client’s legal representative, if applicable, and the department at least 30 days before closing. The…

DHS 75.09 Ongoing compliance and enforcement actions. (1) INSPECTIONS. (a) The department may make announced and unannounced inspections of a certified service to verify compliance with this chapter, to investigate complaints received regarding the services provided, or as part o…

DHS 75.10 Investigation, notification, and reporting requirements. (1) DEATH REPORTING. (a) Patient death related to physical restraint, psychotropic medication, or suicide. No later than 24 hours after a service becomes aware of the death of a patient, the service shall report t…

DHS 75.11 General records and retention. (1) The service shall retain all records required under this chapter for 7 years, unless otherwise specified in subs. (2) and (3). (2) Client records shall be retained as specified in ch. DHS 92 and in 42 CFR part 2. (3) Employee records s…

DHS 75.12 Telehealth services. (1) All requirements in this chapter shall also be applicable to telehealth services delivered under this chapter. (2) Services delivered through telehealth shall be of sufficient quality to be functionally equivalent.

DHS 75.13 Waivers and variances. (1) EXCEPTION TO A REQUIREMENT. (a) The department may grant a waiver or variance if the department determines that the proposed waiver or variance will not jeopardize the health, safety, welfare, or rights of any client. (b) A written request for…

DHS 75.14 Prevention service. (1) SERVICE DESCRIPTION. A prevention service makes use of universal, selective, and indicated prevention services as defined by s. DHS 75.14 (3). Prevention services may be focused on reducing behaviors and actions that increase the risk of misusing…