Interpretive Memorandum: HFS
75 / HFS 83 Administrative Rule Cross-System Implementation
PDF Version of BQA 01-035
(PDF, 12 KB)
Date: August 20, 2001 -- DSL-BQA-01-035
To: Hospitals HOSP 15,
Apartment Complexes RCAC 14,
Residential Facilities CBRF 16
Community Substance Abuse Services
Providers (see below) CSASP 01
HFS 75.07, Medically Monitored Residential Detoxification Service
(formerly 61.56, Detoxification Receiving Center)
HFS 75.09, Residential Intoxication Monitoring Service (formerly
HFS 61.58, Social Setting Detoxification Program)
HFS 75.11, Medically Monitored Treatment Service (formerly 61.63,
Inpatient Treatment Program)
HFS 75.14, Transitional Residential Treatment Service (formerly HFS
61.66, Extended Care Program-Non Medical or HFS 61.67, Extended Care
From: Vincent Ritacca; Interdepartmental Program and Systems
Development Liaison, Bureau of Substance Abuse Services
Mark Hale, Supervisor, Program Certification Unit, Bureau of Quality
Via: Philip McCullough, Director, Bureau of
Substance Abuse Services
Susan Schroeder, Director, Bureau of Quality Assurance
The purpose of the following interpretive memorandum is to clarify and
resolve certification issues between program certification requirements of
substance abuse services standards in HFS
75 (exit DHFS) and the licensing requirements of community based residential
facilities standards in HFS
83 (exit DHFS).
Current HFS 75 language requires certain substance abuse services to be
offered in either an HFS
124 (exit DHFS) (hospital) environment or an HFS 83 (CBRF) environment in order to
be in compliance with code requirements in HFS 75.07, 75.09, 75.11 and
75.14 levels of care. Patients with substance abuse treatment services
needs who receive services in an inpatient or residential level of care
where the facility does not meet HFS 124 hospital licensure standards
shall have the physical environment, safety and structural protections
that assure their health and safety while receiving treatment.
There are currently a limited number of programs/services that have
been providing approved AODA services in environments that do not meet HFS
75 requirements to either be licensed as an HFS 124 hospital or be
licensed as a HFS 83 CBRF as required by HFS 75 standards. More
specifically, these services do not meet the minimum length of stay
requirements in HFS 83.03 (1) (a) 4 and generally exceed the nursing care
limits in HFS 83.06 (1) (a) 4.
Generally, the intent to reside in HFS
75.07, 75.09 and 75.11 services is less than 28 days and nursing care
can exceed the limitation of three hours of nursing care per patient
per week. Program protocol, therefore, is in conflict
with core requirements outlined in HFS 83.
Since the program components in HFS 75 are
detailed to the intensity of services provided to the patient, there
is no need to require these services to meet the program components of
subchapters I-IV of HFS 83 in order to be certified in HFS 75.07,
75.09 and 75.11.
Services approved under HFS 75.07, 75.09
and 75.11 need to comply with the physical environment, safety and
structural requirements of subchapters V, VI, and, if applicable,
subchapter VII of HFS 83 to be in compliance with the CBRF components
essential to adhere to HFS 75.07 (3), 75.09 (3) and 75.11 (3).
Services approved under HFS 75.14 will not
likely exceed three hours of nursing care per patient per week.
Furthermore, the length of stay will likely exceed 28 days. Therefore,
services approved under HFS 75.14 must meet all of the program
requirements of HFS 83 as a condition for HFS 75 certification, e.g.
The Bureau of Substance Abuse Services and the Bureau of Quality
Assurance concur that utilization of waiver options is relevant to the
aforementioned challenges in the implementation of HFS 75.
Interpretation and Solution
Subchapters V, VI, and VII of HFS 83 contain standards that address the
physical environment, safety and structural requirements in HFS 75
substance abuse services provided in a non-hospital facility setting. The
services affected in HFS 75 are: HFS 75.07, medically monitored
residential detoxification services, HFS 75.09, residential intoxication
monitoring services, and HFS 75.11, medically monitored treatment
services. Facilities certified under subsections HFS 75.07, HFS 75.09, HFS
75.11 must meet subchapters V, VI, and, if applicable VII, of HFS 83 but
could be waived for all other requirements in HFS 83. HFS 75.14, certified
services, must meet all of the requirements in HFS 83.
The Bureau of Quality Assurance (BQA) will issue a waiver only for
subchapters I-IV and approve certification conditionally in HFS 75.07,
75.09 or 75.11 on a facility-by-facility basis. The facility in which the
services are provided must be in compliance with the physical environment,
safety and structural standards of HFS 83.
Elements of a waiver request
The following elements must be addressed in each exception requested by
The code under which an exception is requested.
Justification for the request.
Expected duration of the request not to extend beyond the program’s
If a variance, how the program will meet the regulation under which
the exception is requested.
General statement concerning the impact of the exception on the
delivery of services.
Programmatic Questions or Waiver Requests
For more information on the Waivers and Variances, refer to Memo DSL-BQA-01-015
dated March 22, 2001. It is the responsibility of the service provider to
apply for a waiver of HFS 83 subchapters I-IV to initiate that process
with a request in writing to:
Mark Hale, Supervisor, Program Certification Unit
Bureau of Quality Assurance
1 West Wilson Street, Room 1051
P.O. Box 2969
Madison, WI 53701-2969
Phone (608) 266-0120
Fax (608) 266-5466
Physical Environment Compliance
This memorandum outlines above the physical environment requirements to
meet HFS 75 compliance under HFS 75.07, 75.09 and 75.14. These
requirements must be in place by July 31, 2002 for all service
providers to maintain certification.
The service provider shall provide to the department, construction plan
documentation of their current physical environment to substantiate
compliance. Please contact a Bureau of Quality Assurance representative
from the list below to confirm if a plan review is required. A plan review
typically would not be required for a service provider constructed within
If a plan review is required, please apply to the department through
the forms available on our web site at: http://www.dhs.wisconsin.gov/rl_dsl/
or use Form DSL-2496
(PDF, 50 KB).
If you have questions regarding the physical environment process for
compliance, please contact the appropriate Regional Field Operations
Director listed below (Regional Offices):
83 (exit DHFS) Subchapters V, VI, and VII; Form
(PDF, 50 KB)
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