Certification of Waivers and
Variances Submitted to the Program Certification Unit
PDF Version of BQA 01-015
(PDF, 10 KB)
Date: March 22, 2001 DSL-BQA-01-015
To: Certified Mental Health and AODA CMHA - 07
FROM: Otis Woods, Section Chief, Health Services Section, Bureau
of Quality Assurance
cc: Susan Schroeder, Director, Bureau of Quality Assurance
With the promulgation and implementation of Chapter
DHS 75, Wisconsin Administrative Code (exit DHS), relating to the provision of
community substance abuse services, the issue of waivers and variances has
come to the forefront. The purpose of this memorandum is to provide
clarification concerning the requests for waivers and variances submitted
to the Bureau of Quality Assurance.
Periodically, certified programs request exceptions to meeting program
standards. A waiver, if granted, allows the provider to not meet
the requested regulation. A "variance" indicates that the
certified program will meet the regulation in a manner different than what
the regulation requires. For example, the most common request is a waiver
of Chapter HFS 61.97(5), WI Administrative Code, for physician referrals
to certified outpatient mental health programs. To meet this requirement,
certified entities request using the services of a licensed clinical
psychologist in place of a physician. This is actually a variance
permitting them to meet the rule in a different manner.
The following provisions of the Wisconsin Administrative Code permit
exceptions (waivers and variances) to the mental health and substance
abuse standards that are enforced by Program Certification Unit staff:
|
HFS 34.04 |
Emergency Mental Health Service Program |
|
HFS 40.05 |
Mental Health Day Treatment Services for Children |
|
HFS 61.20(3) |
Community Mental Health, Developmental Disabilities, and Alcohol
and Other Drug Abuse Services |
|
HFS 63.05 |
Community Support Programs for Chronically Mentally Ill Persons |
|
HFS 75 |
No specific waiver or variance language. The allowance for an
exception is covered under HFS 61.20(3). |
|
HFS 92 |
Confidentiality of Treatment Records. No waivers or variances of
these standards are permitted. |
|
HFS 94 |
Patient Rights and Resolution of Patient Grievances. No waiver or
variances of these standards are permitted. |
Elements of a variance/waiver request
The Department may grant an exception to program requirements, except
Chapter HFS 92 or Chapter HFS 94, when the Department determines that the
granting of the exception would not diminish the effectiveness of the
services provided by the program or does not adversely affect the health
and safety of the patients served by the program. The following elements
must be addressed in each exception requested by certified entities:
-
The code under which an exception is requested;
-
Justification for the request;
-
Expected duration of the request, not to extend beyond the program’s
certification period;
-
If a variance, how the program will meet the regulation under which
the exception is requested; and,
-
General statement concerning the impact of the exception on the
delivery of services.
The Department has up to 60 calendar days to approve or deny the
request for exception under Chapter HFS 61 and HFS 75. Although a
timeframe for a response is not specified in HFS 34, HFS 40, or HFS 63,
the Department will use the HFS 61 guidelines as a timeframe to respond to
individual requests. Further, the Department may impose conditions on
granting the exception. If the Department fails to act on the request
within 60 calendar days, the exception shall be automatically approved for
the period not to extend beyond the current certification period of the
program. Again, the Department will not consider requests for a variance
or waiver of HFS 92 or HFS 94.
Please submit all requests for exceptions to [updated address]:
Mark Hale
Behavioral Health Certification Section
Bureau of Health Services
Madison, WI 53701-2969
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