Section DHS 75.03 - Definitions In this chapter:
(1) "Adult" means an individual aged 18 or older.(2) "Administrative discharge" means discharge of a patient from a service that is initiated by the service for reasons including program policies, behavioral concerns, or provider-initiated termination.(3) "Applicant" means an individual or entity that has requested certification by the department as a community substance use service under this rule.(4) "Approved placement criteria" means ASAM or other similar placement criteria that may be approved by the department.(5) "ASAM" means the American Society of Addiction Medicine.(6) "ASAM placement criteria" means the ASAM Criteria: Treatment Criteria for Addictive, Substance-Related, and Co-Occurring Conditions (3rd ed., Oct. 24, 2013), which is a multi-dimensional set of placement criteria for assessing substance use patient risk and need areas and establishing treatment service level of care.(7) "Assessment update" means the procedure by which a clinical staff of a service, operating within the scope of their practice, gathers relevant information to update prior assessment data, including updated substance use history, mental health symptoms and functioning, newly identified or changing behavioral and physical health needs, and significant psycho-social changes that may impact treatment or overall functioning, including a review of level of care placement criteria, if applicable.(8) "Available on a 24-hour basis" means that the designated staff of a service that is available in-person or on-call, including by phone or other real-time electronic communication.(9) "Behavioral health" means the spectrum encompassing mental health and substance use disorders occurring either independently or simultaneously.(10) "Caregiver" means a person as defined in s. 48.685 (1) (ag) or 50.065 (1) (ag), Stats.(11) "Case management" means the planning and coordination of services to meet an individual's identified health needs, and assistance provided to the individual for engagement in such services to support the individual's overall treatment and recovery.(12) "Certification" means approval of a service by the department's division of quality assurance.(13) "Certified peer specialist" means a person who has lived experience of mental illness or substance use disorders, or both, and has completed a formal training and holds a department certification in the peer specialist model of mental health or substance use disorders support, or both.(14) "Clinical assessment" means the procedure by which a clinical staff of a service, operating within the scope of their practice, gathers relevant information to evaluate the individual's problem areas, symptoms, functioning, readiness for change, resources, and strengths. Clinical assessment of substance use includes information regarding substance use history, current substance use, impact on functioning, and readiness for change for the purpose of evaluating diagnosis of a substance use disorder and informing treatment services. Clinical assessment of mental health includes mental health symptoms, mental status, and functional assessment for the purpose of evaluating diagnosis of a mental health disorder and informing treatment services.(15) "Clinical consultation" means the review of a patient's plan of care or collaborative discussion of specific aspects of a patient's risks, needs, and functioning, between a clinical supervisor and other clinical staff of a service, another licensed professional, or both.(16) "Clinical services" means counseling, assessment, group therapy, family therapy, medication management, or other services that require specialized knowledge and training in the assessment and treatment of mental health and substance use disorders.(17) "Clinical staff" means all substance abuse counselors, mental health professionals, mental health professionals in training, substance abuse counselors in training, qualified treatment trainees, psychologists, or other qualified staff of a service that deliver screening, assessment, or treatment services under this chapter.(18) "Clinical staffing" means the review of a patient's plan of care or collaborative discussion of specific aspects of a patient's risks, needs, and functioning, with other clinical staff of a service.(19) "Clinical supervisor" means any of the following:(a) An individual who meets the qualifications provided in s. SPS 160.02 (7).(b) An individual who meets the qualifications in 2017 Wisconsin Act 262 and is practicing within their scope of their education, training and experience.(20) "Clinical supervision" means the process as defined in s. SPS 160.02 (6).(21) "Collateral" means information, treatment input, or participation obtained from a party that has knowledge of or relationship with a patient, which may include family members, friends, co-workers, recovery peers, health care providers, probation and parole agents, other law enforcement personnel, child welfare workers, referral sources, clinical records, legal records, or professional public databases.(22) "Co-mingled groups" means a therapeutic or psycho-educational group provided by a service that includes mixed population groups, such as gender, age, substance of use, or criminogenic risk.(23) "Continued stay" means the ongoing provision of an appropriately matched level of care service to an individual's needs, as assessed by ASAM or other department-approved placement criteria.(24) "Continuing care" means the stage of treatment in which the patient no longer requires counseling at the intensity described in ss. DHS 75.49 to 75.60. Continuing care is designed to support and sustain the process of long-term recovery, provided on an outpatient basis at a frequency agreed upon between the patient and the provider.(25) "Co-occurring" means a patient diagnosed as having both a substance use disorder and a mental health disorder, as listed in the DSM.(26) "Counseling" means the application of recognized theories, principles, techniques and strategies to facilitate the progress of a patient toward identified treatment goals and objectives.(27) "Crisis intervention" means services that respond to an individual's behavioral health needs during acute episodes that involve significant distress or risk of harm to self or others.(28) "Culturally and linguistically appropriate services" or "CLAS" means that all aspects of a service, from an individual's first contact through discharge, are delivered with consideration for the individual's cultural and language needs.(29) "DEA" means the U.S. drug enforcement administration.(30) "Department" or "DHS" means the Wisconsin department of health services.(31) "Determination of medical stability" means a medical evaluation of a patient, including physical examination, obtaining vital signs, gathering relevant medical history, and applicable laboratory testing, to determine whether a patient's presenting problem is primarily medical in nature, whether serious underlying medical illness exists that would render admission to a behavioral health service unsafe or inappropriate, and any referral needs for additional medical care or follow-up.(32) "Discharge planning" means planning and coordination of treatment and support services associated with the patient's discharge from treatment, including the preparation of a discharge summary as required under s. DHS 75.24 (22).(33) "DSM" means the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, published by the American Psychiatric Association.(34) "DSPS" means the Wisconsin department of safety and professional services.(35) "Dually-credentialed" means a staff of a service that holds licensure and certification as both a mental health professional and a substance abuse counselor, in accordance with professional licensing and credentialing standards established by DSPS. A mental health professional operating within their scope of practice as a substance abuse counselor under DHS 75.03 (86), meets the definition of dually-credentialed.(36) "Entity owner" means an individual or partnership that owns or operates the service, is legally responsible for the service, and has authority to either conduct the policy, actions, and affairs of the service, or appoint a governing authority to conduct the policy, actions, and affairs of the service.(37) "Facility" means the physical building that houses a service, including the rooms, furnishings, and structures therein.(38) "FDA" means the U.S. food and drug administration.(38m) "Functionally equivalent" means a service provided via telehealth where the transmission of information is of sufficient quality as to be the same level of service as an in-person visit. Transmission of voices, images, data, or video must be clear and understandable.(39) "Follow-up" means a process used by a treatment provider to periodically assess the referral process and rehabilitation progress of a patient who has been referred for concurrent or subsequent services.(40) "Governing authority" means the individual or governing body designated by the entity owner that is legally responsible for the operation of a service, and has authority to conduct the policy, actions, and affairs of the service.(41) "Group counseling" means the application of counseling techniques which involve interaction among members of a group consisting of at least 2 patients but not more than 16 patients with a minimum of one counselor for every 10 patients.(42) "Incident report" means a written record of an incident involving patient, visitor, or staff health or safety that occurs at the facility or in the course of providing services in the community. Incident reporting is required for health emergencies, incidents of violence, injuries requiring medical attention, or other extraordinary events that interfere with the provision of services and pose a risk to health or safety.(43) "In-reach," means services that are provided in corrections settings to enhance engagement or to initiate recommended treatment services prior to release from incarceration.(44) "Intake" means the specific tasks necessary to admit a person to a behavioral health service, such as completion of admission forms, notification of patient rights, explanation of the general nature and goals of the service, review of policies and procedures of the service, and orientation.(45) "Integrated treatment" means a service that includes both substance use and mental health assessment and treatment services, provided in the same setting, by appropriately credentialed personnel operating within their scope of practice, with appropriate interventions for both conditions included in one comprehensive treatment plan for each patient diagnosed with a co-occurring disorder or disorders.(46) "Interim services" means services that are provided until an individual is admitted to a substance use treatment program, including education about communicable illnesses, harm-reduction strategies, referral for other services or medical care, and referral for prenatal care for pregnant women; to reduce the adverse health effects of substance use, promote the health of the individual, and reduce the risk of transmission of disease.(47) "Intervention" means a therapeutic technique or activity that is applied as part of an individual's treatment plan to address behavioral health goals and improve functioning.(48) "Knowledgeable in addiction treatment" means a clinical staff who possesses postsecondary coursework, continuing education coursework, or supervised professional experience to establish their training and competence in all of the following domains:(a) Understanding addiction.(b) Knowledge of addiction treatment and interventions.(c) Considerations for special populations in substance use treatment.(d) Assessment of substance use disorders.(e) Pharmacology for addiction treatment.(f) Assessing and responding to safety risks related to substance use and employing harm-reduction strategies in addiction treatment.(49) "Level of care" means the discrete category of patient placement, based on intensity and frequency of treatment provided by a service under ss. DHS 75.15 and 75.49 to 75.60, that is matched to the individual's need based on ASAM or other department-approved placement criteria.(50) "Licensed professional" means a person who holds one of the following licenses or certifications issued by DSPS, but does not include professionals in training under such licenses or certifications:(a) A clinical social worker, licensed marriage and family therapist, or licensed professional counselor under ch. 457, Stats.(b) A psychologist under ch. 455, Stats.(c) A substance abuse counselor or clinical substance abuse counselor under s. 440.88, Stats.(51) "Medical director" means a person who is employed as the chief medical officer of a service, who is also licensed to practice medicine or osteopathy under ch. 448, Stats., and who also possesses any of the following qualifications: (a) A prior certification in addiction medicine by ASAM.(b) A certification in addiction psychiatry by the American Board of Psychiatry and Neurology.(c) A subspecialty certification in addiction medicine by a recognized board of the American Board of Medical Specialties.(d) Completion of a certificate of Added Qualification in Addiction Medicine conferred by the American Osteopathic Association.(dm) A prior certification by the American Board of Addiction Medicine.(e) Completion of an accredited residency or fellowship in addiction medicine or addiction psychiatry.(f) Knowledgeable in addiction treatment and has one year of addiction medicine experience, although certification is preferred.(g) Working toward certification in addiction medicine or addiction psychiatry and has one year of addiction medicine experience, although certification is preferred.(52) "Medical personnel" means a physician, a physician assistant, nurse prescriber or other health care personnel licensed, at a minimum, to the level of a registered nurse or licensed practical nurse.(53) "Medical screening" means the examination conducted by medical personnel of a person to ascertain eligibility for admission to a treatment service under this chapter and to assess the person's medical needs.(54) "Medical services" means services designed to address the medical needs of a patient, which may include a physical examination, evaluating, managing and monitoring health-related risks of withdrawal from alcohol and other substances, administration of medications and behavioral-health related medical care, within the scope of practice of the providing staff member.(55) "Medication-assisted treatment" means the use of FDA-approved medications, in combination with counseling and behavioral therapies, to treat substance use disorders.(56) "Mental health professional" means an individual authorized to practice psychology, marriage and family therapy, professional counseling, or clinical social work, pursuant to ch. 455 or 457, Stats.(57) "Mental health treatment" means the delivery of clinical services for the purpose of addressing a mental health disorder as defined in the DSM.(58) "Minor" means an individual under the age of 18.(59) "Motivational approach" means an interactional technique that uses collaboration and empathy in purposeful communication that enhances an individual's motivation for change.(60) "Nurse prescriber" means an advanced practice nurse authorized under ch. 441 Stats., to issue prescriptions or medication orders.(61) "Nursing director" means a staff of a service that is at least a registered nurse, but may be licensed or certified as a nurse prescriber, physician assistant, or physician.(62) "Nursing services" means behavioral health or medical services, provided by a nurse licensed under ch. 441, Stats., and operating within their scope of practice, that support screening, assessment, and treatment for patients of a service.(63) "Outreach," means services that are provided to enhance engagement or to initiate recommended treatment services.(64) "Patient" or "client," means an individual who is receiving substance use assessment or treatment services, including emergency services described in s. DHS 75.24 (2), or an individual who has completed intake for a service under this chapter. An individual remains a patient of a service until the date of discharge as established in s. DHS 75.24 (22).(65) "Physically accessible" means a facility that persons with functional limitations caused by impairments of sight, hearing, coordination, cognition, or perception, or persons with disabilities that cause them to be semi-ambulatory or non-ambulatory may readily enter, leave, and circulate within, and in which they can use public restrooms and elevators.(66) "Physician" means a person licensed to practice medicine or osteopathy under ch. 448, Stats.(67) "Physician assistant" means a person licensed under ch. 448 Stats.(68) "Placement criteria" means a standardized screening and assessment process or tool, such as ASAM placement criteria, that evaluates social, behavioral health, and physical health dimensions to identify an individual's need and risk level to ensure that services are appropriately matched to the patient's needs at the appropriate time.(69) "Preliminary treatment plan" means an initial plan for care and services that is initiated prior to completion of a comprehensive assessment due to emergent needs of a patient.(70) "Prescriber" means a physician, physician assistant, or nurse prescriber, who is operating within the scope of their license to deliver services under this chapter.(71) "Prescription" means a drug or device ordered by a prescriber for treatment.(72) "Primary counselor" means a substance abuse counselor, mental health professional, or prescriber, who is assigned by the service to develop and implement a patient's individualized treatment program and to evaluate the patient's progress in treatment.(73) "Psychiatrist" means a person who is licensed under ch. 448, Stats., and board-certified or eligible for certification by the American board of psychiatry and neurology.(74) "Psychoeducation" means information provided in a didactic format in either a group or individual setting that relates to health and promotes recovery.(75) "Qualified treatment trainee" or "QTT" means either of the following:(a) A graduate student who is enrolled in an accredited institution in psychology, counseling, marriage and family therapy, social work, nursing, or a closely related field.(b) A person with a graduate degree from an accredited institution and course work in psychology, counseling, marriage and family therapy, social work, nursing, or a closely related field, who has not yet completed the applicable supervised practice requirements described under ch. MPSW 4, 12, or 16, or ch. Psy 2.(76) "Recovery coach" means an individual that works with and supports individuals receiving substance use services to assist with engagement in treatment services or recovery systems, or both.(77) "Referral" means the establishment of a link between a patient and another service by providing documentation of the patient's needs and recommendations for treatment services to the other service.(78) "Registered nurse" means a person who is licensed as a registered nurse under ch. 441, Stats.(79) "Scope" or "scope of practice" means the procedures, actions, and processes that a healthcare practitioner is permitted to undertake in accordance with the terms of their professional license or certification.(80) "Screening" means a process for determining the initial needs and presenting problems of a patient in order to determine what services are indicated and to facilitate linkage or referral to appropriate services.(81) "Service" means a structured delivery system for providing substance use prevention, intervention, or treatment services.(82) "Signature" or "signed" means a signature that meets the requirements in s. 990.01 (38), Stats.(83) "Special population" means an identified group, based on demographic or other specific traits, of patients or prospective patients of a service whose needs require special consideration or attention related to admission practices or service delivery.(84) "Substance" means a psychoactive agent or chemical, including nicotine, which principally affects the central nervous system and alters mood or behavior.(85) "Substance abuse counselor," or "counselor," means any of the following:(a) A clinical substance abuse counselor as defined in s. SPS 160.02 (5).(b) A substance abuse counselor as defined in s. SPS 160.02 (26).(c) A substance abuse counselor-in-training as defined in s. SPS 160.02 (27).(d) An individual who holds a physician, psychologist, clinical social worker, marriage and family therapist, or professional counselor license granted under ch. 448, 455, or 457, Stats., and practices within their scope.(86) "Substance use," or "substance abuse," means the use of any mood-altering substance in a manner that interferes with, or poses a risk of interfering with, an individual's educational, vocational, health, behavioral, financial, legal, or social functioning.(87) "Substance use disorder" means a diagnosis of substance use disorder listed in the DSM.(88) "Substance use treatment" means the delivery of clinical services for the purpose of addressing a substance use disorder as defined in the DSM.(89)(a) "Telehealth" means the use of telecommunications technology by a certified provider to deliver services allowable under this chapter, s. DHS 107.02 (5), and ss. 49.45 (61) and 49.46 (2) (b) 21. to 23., Stats., including assessment, diagnosis, consultation, treatment, or transfer of medically relevant data in a functionally equivalent manner as that of an in-person contact.(b) "Telehealth" may include real-time interactive audio-only communication.(c) "Telehealth" does not include communication between a certified provider and a recipient that consists solely of an electronic mail, text, or facsimile transmission.(90) "Transfer" means the movement of a patient from one level of care to another, which either takes place at the same location or by physically moving the patient to a different site or service for the new level of care.(91) "Transitional-age youth" means youth between the ages of 16 to 24 that are establishing skills related to independence, independent living, vocational and educational development, and addressing the life-stage areas of independence, identity-formation, and autonomy.(93) "Trauma-informed" means an approach that recognizes the contribution of psychologically distressing events to an individual's presenting symptoms and response to interventions, and the strong correlation between trauma and behavioral health disorders. This approach to care emphasizes environmental and personal safety, and trusting and collaborative provider-patient relationships.(94) "Treatment" means the planned provision of services that are responsive to a patient's individual needs to assist the patient through the process of recovery.(95) "Treatment plan" means identified goals, objectives, and resources agreed upon by the patient and the service to be utilized in facilitation of the patient's recovery.(96) "Treatment planning" means the process by which the service and the patient and, whenever possible, the patient's family, consider the patient's presenting problems to identify and prioritize problems needing resolution, establish goals, and decide on interventions and resources to be applied.(97) "Treatment service" means a service provided under ss. DHS 75.49 to 75.60.(98) "Treatment services" means the interventions and resources applied by a service to address the needs and goals identified in a patient's treatment plan.(99) "Unlicensed staff" means any mental health professional in training, a substance abuse counselor in training, a qualified treatment trainee, and any clinical staff of a service that are not fully and independently licensed.(100) "Variance" means the granting of an alternate means of meeting a requirement in this chapter.(101) "Waiver" means the granting of an exemption from a requirement of this chapter.(102) "Withdrawal" means the development of a psychological and physical syndrome caused by the abrupt cessation of or reduction in heavy and prolonged substance use. The symptoms include clinically significant distress or impairment in social, occupational, or other important areas of functioning and are not due to a general medical condition or better accounted for by another mental disorder.(103) "Withdrawal management" means a service, or component of a service, that provides care and interventions to address an individual's physical or psychosocial needs related to acute intoxication or withdrawal. Withdrawal management includes intoxication monitoring, management of acute symptoms, interruption of habitual and compulsive use, and engagement in ongoing treatment services.Wis. Admin. Code Department of Health Services DHS 75.03
Cr. Register, July, 2000, No. 535, eff. 8-1-00; correction in (9) (a) made under s. 13.93(2m) (b) 7, Stats., Register, June, 2001, No. 546; CR 06-035: am. (1), (2), and Table 75.03, Register November 2006 No. 611, eff. 12-1-06; corrections in (1), (3) (e), (4) (b), (7), and (9) (b) (intro.) made under s. 13.92(4) (b) 7, Stats., Register November 2008 No. 635; CR 09-109: am. (2) (a), (h) and (4) (e) Register May 2010 No. 653, eff. 6-1-10; correction in (4) (e) made under s. 13.92(4) (b) 6, 7., Stats., Register November 2011 No. 671.Amended by, Cr. 2017 Wis. Act 262: am. (4) (e) Register April 2018 No. 748, eff. 5/1/2018Adopted by, CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22; correction in (10), (19), (50) (c), (56), (64), (75) (b), (85) (d) made under s. 35.17, Stats., and correction in numbering in (43), (51) (dm) made under s. 13.92(4) (b) 1, Stats., Register October 2021 No. 790, eff. 10/1/2022Amended by, CR 23-053: cr. (38m), renum. (89) to (89) (a) and am., cr. (89) (b), (c) Register September 2023 No. 813, eff. 10-1-23; correction in (89) (a) made under s. 35.17, Stats., Register September 2023 No. 813, eff. 10/1/2023This section is created eff. 10-1-22 by CR 20-047.