Mental Health, Emergency Mental Health Service Programs (Chapter DHS 34) – Initial Certification

Contact Email

Phone

608-261-0656

Fax

608-261-0655
DHS/Division of Quality Assurance
Behavioral Health Certification Section
PO Box 2969
Madison, WI 53701-2969

Emergency Mental Health Service Programs are certified by the Department of Health Services under Wisconsin Administrative Code Chapter DHS 34.

Type

Initial

Description

An Emergency Mental Health Service program means a coordinated system of mental health services, which provides an immediate response to assist a person experiencing a mental health crisis. Outpatient emergencies include socio-emotional crises, attempted suicides, family crises, and if needed, transportation to an emergency room of a general hospital for medical treatment.

Duration

One year (Provisional).

Fees

Annual Fees:

Services/Programs Amount
1 $550.00
2 $800.00
3 $1,000.00
4 $1,175.00
5 $1,350.00
Each additional $100.00
Telehealth (per certificate) $200.00

Prerequisites

See Wisconsin Administrative Code Chapter DHS 34.

Application Process

See Wisconsin Administrative Code Chapter DHS 34.03; On receipt of an application for initial certification or renewal of certification, the department shall do all of the following: 1. Review the application and its supporting documents.  2. Designate a representative to conduct an on-site survey of the program, including interviewing program staff. The certification survey under par. (b) shall be used to determine the extent of the program's compliance with the standards specified in this chapter. Within 60 days after receiving a completed application for initial certification or renewal of certification, the department shall do one of the following; certify the program if all requirements are met, or deny certification if one or more major deficiencies are found. Certification decisions shall be based on a reasonable assessment of the program. 

The following applications are required for certification of an Emergency Mental Health Service Program:

  • F-00551 (Word) Emergency Mental Health Service Program Initial Certification Application – Chapter DHS 34
  • F-62504* CSAS or Mental Health Clinic Initial Certification Application (contact 608-261-0656 for this application)
  • F-00273* (Word) – Behavioral Health Services Renewal Certification Application Chapter DHS 94 – Patient Rights and Resolution of Patient Grievances

*These applications are not required if the program is being added to an existing certificate.

Caregiver Background Check – This process is not required if the program is being added to an existing certificate

A caregiver background check (CBC) is required to be completed for all applicants/legal representatives prior to the approval of any new license, certification or registration of a DQA regulated entity.

  • Review information for Licensee Applicants/License Holder Background Checks found on the Caregiver Background Check Process web page for the completion of the Background Information Disclosure (BID) form and Appendix. Complete either the Online Caregiver Background Check (CBC) process or the manual application process.
  • Also review information on the requirement for Employee Background Checks found on the Caregiver Background Check Process webpage.

WI Statutes

Chapter 51, State Alcohol, Drug Abuse, Developmental Disabilities and Mental Health Act

WI Administrative Code

Chapter DHS 12, Caregiver Background Checks
Chapter DHS 13, Reporting and Investigation of Caregiver Misconduct
Chapter DHS 34, Emergency Mental Health Service Programs
Chapter DHS 92, Confidentiality of Treatment of Records
Chapter DHS 94, Patient Rights and Resolution of Patient Grievances

Additional Information

Visit the Mental Health Treatment Programs website for more information.

Last Revised: December 13, 2017