Type
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 |
Instructions
See Wis. Admin. Code § 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:
- Emergency Mental Health Service Program Initial Certification Application - DHS 34, F-00551
- Behavioral Health Certification Section: Initial Certification Application, F-62504* (Word)
- Behavioral Health Services Initial Certification Application - DHS 94 Patient Rights and Resolution of Patient Grievances, F-00273*
* 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.
Wisconsin statute
Wisconsin Stat. ch. 51, State Alcohol, Drug Abuse, Developmental Disabilities and Mental Health Act
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 34, Emergency Mental Health Service Programs
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.