Background check applications for all users
To prepare for the transition to the new DHS DQA Provider Portal, the Division of Quality Assurance (DQA) will not accept any new background check applications for entity operators, non-client residents, or other required individuals for new or renewing entity license/certification applications, or for rehabilitation review applicants as of November 22, 2025.
DQA will resume accepting background check applications on December 15, 2025, through the DHS DQA Provider Portal. To prepare for this transition and for more information, visit our webpage. Caregiver background checks completed by entities for employees and contractors are not affected by this transition.
Type
Description
An adult inpatient program means a county operated inpatient unit, general hospital psychiatric unit, or private psychiatric hospital whose primary objective is to provide care and intensive treatment for the mentally ill.
Duration
One year (provisional).
Fees
Fees are paid annually.
| 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 |
Instructions
See Wis. Admin. Code ch. DHS 61; on receipt of an application for initial certification or renewal of certification, the department shall review the application and its supporting documents; designate a representative to conduct an on-site survey of the program. Within 60 days after receiving a completed application for initial certification or renewal of certification, the department shall either certify the program if all requirements for certification are met or deny certification if any requirement has not been met.
The following applications are required for certification of a adult inpatient program:
- Mental Health Inpatient Initial Certification Application - DHS 61.71 and 61.79, F-00547
- Behavioral Health Certification Section: Initial Certification Application, F-62504 (Word) (this is not required if the program is being added to an existing certificate)
- Behavioral Health Services Initial Certification Application - DHS 94 Patient Rights and Resolution of Patient Grievances, F-00273 (this is 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.
Wisconsin statute
Wisconsin Stat. ch. 51, State Alcohol, Drug Abuse, Developmental Disabilities and Mental Health Act
Wisconsin Stat. § 51.61(1)(i), Restraint and Seclusion
Wisconsin administrative code
Wisconsin Admin. Code ch. DHS 12, Caregiver Background Checks
Wisconsin Admin. Code ch. DHS 13, Reporting and Investigation of Caregiver Misconduct
Wisconsin Admin. Code ch. DHS 61, Community Mental Health and Developmental Disabilities
Wisconsin Admin. Code § 61.71, Inpatient Program Standards
Wisconsin Admin. Code ch. DHS 92, Confidentiality of Treatment of Records
Wisconsin Admin. Code ch. DHS 94, Patient Rights and Resolution of Patient Grievances
Program information
Visit the Mental Health Treatment Programs webpage for more information.