Mental Health, Outpatient Mental Health Clinics (Chapter DHS 35) – 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

Outpatient Mental Health Clinics are certified by the Department of Health Services under Wisconsin Administrative Code Chapter DHS 35.

Type

Initial

Description

An Outpatient Mental Health Clinic is a nonresidential program for persons with problems relating to mental illness to ameliorate or remove the disability and restore more effective functioning and to prevent regression from present level of functioning with services including, but not limited to, evaluation, diagnosis, medical services and psychotherapy.

Duration

One year (Provisional)

Fees

Annual Fees:

Services/Programs Amount Branch
Office
Amount
1 $550.00 Tier 1 $200.00
2 $800.00 Tier 2 $500.00
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 35.

Application Process

See Wisconsin Administrative Code Chapter DHS 35.08; 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 an Outpatient Mental Health Clinic:

  • F-00559 (Word) Outpatient Mental Health Clinic Initial Certification Application – Chapters DHS 35.
  • F-62504* CSAS or Mental Health Clinic Initial Certification Application (contact 608-261-0656 for this application).
  • F-00273* (Word) – Behavioral Health Services Initial 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 35, Outpatient Mental Health Clinics
Chapter DHS 92, Confidentiality of Treatment of Records
Chapter DHS 94, Patient Rights and Resolution of Patient Grievances

Additional Information

Visit the Mental Health Treatement Programs website for more information.

Last Revised: December 13, 2017