Section DHS 61.20 - Enforcement(1) COMPLIANCE REQUIRED FOR STATE FUNDING. All board operated or board contracted programs provided by a 51.42/51.437 board shall meet standards and be provided in a non-discriminatory manner as prescribed in ss. DHS 61.10 and 61.14. The department may discontinue state funding of a program when it does not meet standards as established by departmental administrative rules and after the board has had reasonable notice and opportunity for hearing by the department as provided in ch. 227, Stats.(2) PROVISIONAL APPROVAL. When a program does not comply with standards, the department may allow a compliance period of 6 months. After 6 months, the board's program shall comply with standards or the board shall have demonstrated and documented significant attempts toward compliance. Additional provisional approvals for 3 month periods may be granted.(3) WAIVER. (a) If a board believes its program should not have to comply with a standard, it may request a waiver. The request shall be in writing to the department. It shall identify the standard and explain why noncompliance would not diminish the effectiveness of its program.(b) If the program holds current accreditation issued by the joint commission on accreditation of hospitals, the requirement to meet these standards may be waived by the department. The accreditation by JCAH must be for an appropriate category such as adult psychiatric inpatient, children and adolescents inpatient, alcoholism and drug abuse, developmental disabilities, or community mental health standards.(c) The department may grant exceptions to any of the rules for community mental health, developmental disabilities and alcohol and other drug abuse standards. This may be done only when the department is assured that granting the exceptions maintains equal or higher quality of services provided.(4) INTERPRETATION. If a board disagrees with the department's interpretation of a standard, it may appeal in writing to the department. The appeal shall identify the standard, describe the department's interpretation, describe the board's interpretation, and define the problem caused by the different interpretations.(5) DECERTIFICATION OR TERMINATION. (a) All proceedings set out herein shall comply with ch. 227, Stats.(b) Approval of programs may be denied or suspended with prior notice of denial and a summary of the basis for denial or suspension without prior hearing whenever the department determines that:1. Any of the programs' licenses or required local, state or federal approvals have been revoked, suspended or have expired; or2. The health or safety of a recipient is in imminent danger because of the knowing failure of the program to comply with those rules or any other applicable local, state or federal law or regulation.(c) Within 5 days, excluding weekends and legal holidays, after receipt of notice of suspension (under sub. (2)), any program may demand and shall be entitled to receive a hearing, unless waived in writing, within 14 days of the demand in writing, and be given a decision on suspension.(d) A program's certification may be terminated, with notice of proposed termination, and a summary of the basis of the proposed termination, and with notice of an opportunity for a hearing to respond to the findings contained in the summary within 10 days and before termination shall become effective. Failure to demand such hearings in writing within 20 days of the time of the required notice, correctly addressed, is placed in the United States mail, shall constitute waiver of the right to such hearing. Termination of certification shall be based on the following grounds: 1. Any of the program's licenses or required local, state of federal approvals have been revoked, suspended, or have expired.2. The program or its agents has or have been convicted of federal or state criminal statute violations for conduct performed under the Medical Assistance Program.3. The program submitted or caused to be submitted false statements, for purposes of obtaining certification under these rules, which it knew, or should have known, to be false.4. The program failed to maintain compliance to standards for which it was certified.5. The program has failed to abide by the Federal Civil Rights Act of 1964 in providing services.(e) Certification for programs that do not submit biennial reports and fees required under s. DHS 61.695 by the end of the biennial cycle will be terminated without right to a hearing. Thereafter, a new application for certification must be submitted.Wis. Admin. Code Department of Health Services DHS 61.20
Cr. Register, January, 1980, No. 289, eff. 2-1-80.Amended by, CR 22-078: am. (5) (e) Register July 2023 No. 811, eff. 8/1/2023