DSL Memo Series
2002-16
October 15, 2002
STATE OF WISCONSIN
Department of Health and Family Services
Division of Supportive Living
To:
Area Administrators/Assistant Area Administrators
Bureau Directors
BQA Community Programs Licensing Specialists
Consumer Organizations
County Departments of Community Programs
County Departments of Development Disabilities
County Departments of Human Services
County Departments of Social Services
Certified Crisis Programs
Certified Community Support Programs
Mental Health Council
NAMI Wisconsin and Local Chapters
Program Office Directors
Tribal Chairpersons/Human Services Facilitators
From:
Sinikka McCabe, Administrator
Background
Section 51.42 (1)(b), Stats., requires every county to provide
emergency mental health services to persons experiencing a mental health
crisis or who are in a situation likely to become a mental health crisis
if supportive services are not available. The requirements of s.
51.42(1)(b) Stats., are detailed in Wisconsin's Administrative Code, HFS
34, Subchapter III, Emergency Mental Health Services Programs. However,
the language in HFS 34 does not address whether more than one provider may
establish an emergency mental health program within a single county.
Therefore, the Department of Health and Family Services is providing an
interpretation of HFS 34, Subchapter III.
HFS 34 Interpretation
When Chapter HFS 34, Subchapter III, Standards for Emergency Program
Eligibility for Medical Assistance Programs or other Third Party
Reimbursement was envisioned and promulgated, it was intended that there
would be one certified emergency mental health program developed to
provide a comprehensive system of emergency care to meet the unique needs
of each county. Under section HFS 34.22 Services, the rule states:
(1) PLAN FOR COORDINATION OF SERVICES. (a) Each emergency mental
health services program shall prepare a written plan for providing
coordinated emergency mental health services within the county.
The plan must include an analysis of the mental health service needs of
the county's residents; communication, mechanisms, agreements and
collaboration between service providers; procedures for exchange and
release of confidential information and description of the roles of staff.
Under HFS 34.01 Authority, scope and purpose the rule states:
Section 51.42 (1)(b), Stats., requires every county to provide
emergency mental health services to persons within the county in need of
those services.…A county may comply with s. 51.42 (1)(b), Stats., by
operating or contracting for the operation of an emergency mental health
program certified under this subchapter and either subch. II or III.
Also, under HFS 34.10 Applicability, the rule states:
A county may operate or contract for the operation of an emergency
mental health services program.
Only one HFS 34 program certificate will be issued per county. If a
county chooses to comply with chapter 51.42 (1)(b) by contracting for an
emergency mental health services program, the county still retains
authority and responsibility for oversight of these services. The program
certification may reside with a clinic or other entity that actually
provides the services. However, the certification is only valid because
the county authorizes the service agreement through their contractual
arrangement with the service provider. In this situation, the actual
certification lists both the contracted service provider and the county.
If a clinic or other entity is certified to provide emergency mental
health services for one county it may not use that same certification to
provide services to another county. That clinic or other entity, in
partnership with the second county, must obtain a separate HFS 34
certification for each county that contracts with them to provide
emergency mental health services.
Regardless whether the county or another entity is certified under HFS
34, Wisconsin Medicaid pays only county agencies for crisis intervention
services. The county is responsible to ensure that the county and its
contracted entities meet all Medicaid state and federal regulations. Also
if Medicaid certified, the county needs to provide the non-federal share
of Medical Assistance. Please contact Christine Wolf at
(608) 266-9195 with any Medicaid questions.
Summary
HFS 34 was developed to achieve a coordinated mental health crisis
response system in each county under the umbrella of a single HFS 34
certification per county. The department encourages county agencies and
contracted mental health providers to use creative and innovative
approaches to providing emergency mental health crisis intervention and
stabilization services while meeting the standards in
HFS 34. Additional resources and services may be connected to the county's
single certified program as part of a coordinated plan that utilizes
interagency agreements, contracts and memoranda of understanding. The
result should be seamless response to the emergency mental health service
needs of county residents.
REGIONAL OFFICE CONTACT:
BQA Certification Staff
CENTRAL OFFICE CONTACTS:
George Hulick
Bureau of Community Mental Health
Division of Supportive Living
1 W. Wilson St., P.O. Box 7851
Madison, WI 53707-7851
608.266.0907
e-mail: hulicgh@wisconsin.gov
Mark Hale
Bureau of Quality Assurance
Division of Supportive Living
1 W. Wilson St., P.O. Box 2969
Madison, WI 53701-2969
608.266.0120
e-mail: Halemd@wisconsin.gov
cc:
Mark Hale, Bureau of Quality Assurance
Chris Wolf, Bureau of Fee-For-Service, Health Care Benefits
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