Section 75.02. Definitions.

  In this chapter:

(1)  "Aftercare" has the meaning prescribed for "continuing care" in this chapter.

(1m)  "Alternative education" means a course of traffic safety instruction that is designed to meet the goals of a group dynamic traffic safety program or a multiple offender traffic safety program for clients that cannot be accommodated by a group dynamic traffic safety program or a multiple offender traffic safety program.

(2)  "Ambulatory detoxification service" means a medically managed or monitored and structured detoxification service, delivered on an outpatient basis, provided by a physician or other service personnel acting under the supervision of a physician.

(3)  "Applicant" means, unless otherwise indicated, a person who has initiated but not completed the intake process.

(4)  "Approved placement criteria" means WI-UPC, ASAM or similar placement criteria that may be approved by the department.

(5)  "ASAM placement criteria" means a set of placement criteria for substance abuse patients published by the American Society of Addiction Medicine.

(7)  "Case management" means an organized process for bringing services, agencies, resources and people together within a planned framework for linking, advocating for and monitoring the provision of appropriate educational, intervention, treatment, or support services to a client with alcohol or other drug abuse problems in a coordinated, efficient and effective manner.

(8)  "Certification" means approval of a service by the department.

(9)  "Certification specialist" means a department employee responsible for certifying a service under this chapter.

(9m)  "Clinical supervision" has the meaning given in s. SPS 160.02 (6) .

(11)  "Clinical supervisor" means any of the following:

(a) An individual who meets the qualifications established in s. SPS 160.02 (7) .

(b) A physician knowledgeable in addiction treatment.

(c) A psychologist knowledgeable in psychopharmacology and addiction treatment.

(12)  "Clinical supervision" means intermittent face-to-face contact provided on or off the site of a service between a clinical supervisor and treatment staff to ensure that each patient has an individualized treatment plan and is receiving quality care. "Clinical supervision" includes auditing of patient files, review and discussion of active cases and direct observation of treatment, and means also exercising supervisory responsibility over substance abuse counselors in regard to at least the following: counselor development, counselor skill assessment and performance evaluation, staff management and administration, and professional responsibility.

(13)  "Consultation" means discussing the aspects of the individual patient's circumstance with other professionals to assure comprehensive and quality care for the patient, consistent with the objectives in the patient's treatment plan or for purposes of making adjustments to the patient's treatment plan.

(14)  "Continuing care" means the stage of treatment in which the patient no longer requires counseling at the intensity described in ss. DHS 75.10 to 75.12 . Continuing care is treatment that follows a treatment plan, is designed to support and sustain the process of recovery and is provided on an outpatient basis and at a frequency agreed upon between the patient and the provider.

(15)  "Counseling" means the application of recognized theories, principles, techniques and strategies to manage and facilitate the progress of diverse patients toward mutually determined treatment goals and objectives using culturally sensitive modalities as described in s. SPS 166.01 (3) or s. MPSW 2.01 (10) .

(16)  "Crisis intervention" means services that respond to a substance abuser's needs during acute episodes that may involve physical distress.

(17)  "Day treatment service" means a medically monitored and structured non-residential treatment service consisting of regularly scheduled sessions of various modalities such as counseling, case management, group or individual therapy, medical services and mental health services, as indicated, by interdisciplinary providers for a scheduled number of sessions per day and week.

(18)  "Department" means the Wisconsin department of health services.

(19)  "Detoxification plan" means a planned procedure based on clinical findings for managing or monitoring withdrawal from alcohol or other drugs.

(20)  "Detoxification service" means any of the services under ss. DHS 75.06 to 75.09 .

(21)  "Discharge planning" means planning and coordination of treatment and social services associated with the patient's discharge from treatment, including the preparation of a discharge summary as required under s. DHS 75.03 (17) .

(21m)  "DSPS" means the Wisconsin department of safety and professional services.

(22)  "DSM-IV" means the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, published by the American Psychiatric Association.

(23)  "Drug detoxification treatment" means the dispensing of a narcotic drug in decreasing doses to a patient to alleviate adverse physiological or psychological effects incidental to the patient's withdrawal from continuous or sustained use of a narcotic drug and as a method of bringing the individual to a narcotic drug-free state.

(24)  "Dually diagnosed" means a patient diagnosed as having a substance use disorder listed in the DSM-IV that is accompanied by dependency, trauma or dementia and a diagnosed mental disorder.

(25)  "Early intervention" means activities that take place with high-risk individuals, families or populations with the goal of averting or interrupting the further progression of problems associated with substance use or abuse. These activities may include problem identification and resolution, referral for screening, specialized education, alternative activities development, social policy development, environmental change, training and development of risk reduction skills.

(26)  "Employee assistance program service" means an intervention service provided to employees by an employer for the purpose of identifying, motivating to seek help and referring for assistance those employees whose job performance is impaired or is at risk of impairment by personal problems, such as medical, family, marital, financial, legal, emotional and substance abuse or dependency problems.

(27)  "FDA" means the U.S. food and drug administration.

(28)  "First priority for services" means that an individual assessed as needing services will be referred immediately to available treatment resources and, in the event there is a waiting list for any treatment resource, the individual will be placed on the waiting list immediately before any person not entitled to first priority for services.

(29)  "Follow-up" means a process used by a treatment provider to periodically assess the referral process and rehabilitation progress of a patient who has completed treatment, has been discharged from treatment or has been referred for concurrent services.

(30)  "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 8 patients.

(31)  "Hospital services" means services typically provided only in a hospital as defined in s. 50.33 (2) , Stats.

(32)  "Incapacitated person" means a person who, as a result of the use of or withdrawal from alcohol or other drugs, is unconscious or has his or her judgment otherwise so impaired that he or she is incapable of making a rational decision, as evidenced objectively by the service using such indicators as extreme physical harm or threats of harm to himself or herself, to any other person or to property.

(33)  "Intake process" means the specific tasks necessary to admit a person to a substance abuse 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.

(33m)  "Intensive supervision" means a program to promote public safety and reduce incarceration and recidivism related to substance abuse that includes all of the following:

(a) Centralized screening, review, evaluation, and monitoring of offenders by caseworkers in coordination with law enforcement, the district attorney, the courts, or the department of corrections.

(b) Community supervision of offenders from the time of arrest and formal charging through adjudication and compliance with court orders.

(c) Coordination of an array of interventions for the offender while under community supervision. Interventions to be coordinated may include any of the following:

1. Assessment.

2. Case management.

3. Alcohol or other drug abuse treatment.

4. Education.

5. Specialized education or skill-building programs.

6. Obtaining an intoxicated driver assessment under ch. DHS 62 .

7. Periodic breath tests or urine analysis.

8. Attendance at victim impact panels.

(d) Programs such as the treatment alternative program under ch. DHS 66 .

(e) A pretrial intervention program under s. 51.49 , Stats.

(f) A corrective sanction program for juveniles under s. 938.533 , Stats., or an intensive supervision program for juveniles under s. 938.534 , Stats., a drug court, or other similar program.

(34)  "Intervention" means a process of interrupting an action or a behavior that is harmful to an individual. "Intervention" may be a formal substance abuse service under s. DHS 75.16 , or may be included in, but is not limited to, an educational program, an employee assistance program, an intoxicated driver assessment or driver safety plan program under ch. DHS 62 , screening procedures under s. DHS 75.03 (10) , or consultation provided to non-substance abuse professionals.

(35)  "Intoxicated person" means a person whose mental or physical functioning, as determined and documented by the service, is substantially impaired as a result of the use of alcohol or other drugs.

(36)  "Level of care" means the intensity and frequency of services provided by a service under ss. DHS 75.06 to 75.15 . "Intensity of services" refers to both the degree of restrictiveness for a patient to participate and to the range of specific services expected, including the involvement of medical professionals in the delivery of care. "Frequency of service" refers to how often the service may be provided or is available to the patient.

(37)  "Licensed practical nurse" means a person who is licensed under s. 441.10 , Stats., as a licensed practical nurse.

(38)  "Maintenance treatment" means the dispensing of a narcotic drug in the treatment of an individual for dependence on heroin or another morphine-like drug.

(39)  "Medical director" means a physician knowledgeable in the practice of addiction medicine, certified in addiction medicine by the American society of addiction medicine or certified in addiction psychiatry by the American board of psychiatry and neurology, who is employed as the chief medical officer for a service.

(40)  "Medical personnel" means a physician, a physician assistant, nurse practitioner or other health care personnel licensed to at least the level of a registered nurse or licensed practical nurse.

(41)  "Medical screening" means the examination conducted by medical personnel of a person to ascertain eligibility for admission to a substance abuse treatment service and to assess the person's medical needs.

(42)  "Medical services" means services designed to address the medical needs of a patient, including a physical examination, evaluating, managing and monitoring health-related risks of withdrawal from alcohol and other substances, administration of medications and emergency medical care.

(43)  "Medical supervision" means regular coordination, direction and inspection by a physician of an individual's exercise of delegation to deliver medical services when the individual is not licensed to administer medical services.

(44)  "Medically directed" means the carrying out of standing orders under the supervision of a physician for delivering the medical aspects of a service, including review and consultation provided to treatment staff in regard to the admission, treatment, transfer and discharge of patients.

(45)  "Medically managed inpatient detoxification service" means a 24-hour per day observation and monitoring service, with nursing care, physician management and all of the resources of a general or specialty inpatient hospital.

(46)  "Medically managed inpatient treatment service" means a service provided in a general or specialty hospital with 24-hour per day nursing care, physician management and all the resources of a hospital approved under ch. DHS 124 .

(47)  "Medically managed services" means services provided or directly managed by a physician.

(48)  "Medically monitored residential detoxification service" means a 24-hour per day service in a residential setting providing detoxification service and monitoring, with care provided by a multi-disciplinary team of service personnel including 24-hour nursing care under the supervision of a physician.

(49)  "Medically monitored services" means services provided under the direction and supervision of a physician. The physician may or may not directly administer care to the patient.

(50)  "Medically monitored treatment service" means a community or hospital based, 24-hour treatment service which provides a minimum of 12 hours of counseling per patient per week, including observation, and monitoring provided by a multi-disciplinary staff under the supervision of a physician.

(51)  "Mental health professional" means an individual with training and supervised clinical experience in the field of mental health who is qualified under appendix B.

(52)  "Mental disorder" means a condition listed in DSM-IV.

(53)  "Narcotic dependent" means an individual who is physiologically and psychologically dependent on heroin or another morphine-like drug to prevent the onset of withdrawal symptoms.

(54)  "Narcotic treatment service for opiate addiction" means an organization that includes a physician who administers or dispenses a narcotic drug to a narcotic addict for treatment or detoxification treatment with a comprehensive range of medical and rehabilitation services and that is approved by the state methadone authority and the designated federal regulatory authority and registered with the U.S. drug enforcement administration to use a narcotic drug for treatment of narcotic addiction.

(55)  "Nurse practitioner" means a registered nurse licensed under ch. 441 , Stats. , and certified by a national certifying body approved by the Wisconsin board of nursing to perform patient services under the supervision and direction of a physician.

(56)  "Outpatient treatment service" means a non-residential treatment service that provides a variety of evaluation, diagnostic, intervention, crisis and counseling services relating to substance abuse in order to ameliorate symptoms and restore effective functioning.

(57)  "Paraprofessional" means an individual hired on the basis of skills and knowledge to perform specific functions in connection with a substance abuse service, who is not licensed, credentialed or otherwise formally recognized as a medical services provider or a mental health professional.

(58)  "Patient" means an individual who has completed the screening, placement and intake process and is receiving substance abuse treatment services.

(59)  "Patient-identifying information" means the name, address, social security number, photograph or similar information by which the identity of a patient can be determined with reasonable accuracy and speed, either directly or by reference to other publicly available information.

(60)  "Patient and family education" means the provision of information to a patient and, as appropriate, to the patient's family, concerning the effects of use and abuse of alcohol or other substances, the dynamics of abuse and dependency and available services and resources.

(61)  "Patient satisfaction survey" means a written questionnaire to be completed by an individual who has participated in a substance abuse service to assess the individual's perception of the effectiveness of the service in meeting his or her needs.

(62)  "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 rest rooms and elevators.

(63)  "Physician" or "service physician" means a person licensed under ch. 448 , Stats. , to practice medicine and surgery, who is certified in addiction medicine by the American society of addiction medicine, certified in addiction psychiatry by the American board of psychiatry and neurology or otherwise knowledgeable in the practice of addiction medicine.

(64)  "Physician assistant" means a person licensed under s. 448.05 (5) , Stats., to perform patient services under the supervision and direction of a physician.

(65)  "Placement criteria summary" means documentation that identifies the treatment service qualifying criteria and severity indicators applicable to a patient, and shall include the interviewer's comments, the patient's statement regarding willingness to accept the level of care placement recommendation, reasons for selecting an alternative level of care placement, if applicable, the name, address and phone number of the agency the patient is being referred to and signatures of the patient and the interviewer.

(66)  "Potentiation" means the increasing of potency and, in particular, the synergistic action of 2 drugs which produces an effect that is greater than the sum of the effect of each drug used alone.

(67)  "Prescription" means a written instruction for preparation and administration of a medication or for treatment that includes the date of the order, the name and address of the prescriber, the patient's name and address and the prescriber's signature.

(68)  "Prevention" has the meaning given in s. SPS 160.02 (21) .

(69)  "Prevention measures" means preventive interventions that use a combination of prevention strategies to affect 3 population groups, as follows:

(a) Universal prevention measures are designed to affect a general population.

(b) Selective prevention measures are designed to target sub-groups of the general population distinguished by age, gender, occupation, culture or other obvious characteristics whose members are at risk for developing substance abuse problems.

(c) Indicated prevention measures are designed to affect persons who, upon substance abuse screening, are found to manifest a risk factor, condition or circumstance of daily living that identifies them individually as at risk for substance abuse and in need of supportive interventions.

(70)  "Prevention service" means an integrated combination of universal, selective and indicated measures that use a variety of strategies in order to prevent substance abuse and its effects.

(70g)  "Prevention specialist" means an individual who meets the qualifications established in s. SPS 160.02 (23) .

(70r)  "Prevention specialist-in-training" means an individual who meets the qualifications established in s. SPS 160.02 (24) .

(71)  "Prevention strategy" means activities targeted to a specific population or the larger community that are designed to be implemented before the onset of problems as a means to prevent substance abuse or its detrimental effects from occurring.

(72)  "Preventive intervention" means any strategy or action directed at a population or person not at the time suffering from any discomfort or disability due to the use of alcohol or another substance but identified as being at high risk to develop problems associated either with his or her own use of alcohol or other substances or another person's use of alcohol or other substance.

(73)  "Primary counselor" means a substance abuse counselor 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.

(74)  "Referral" means the establishment of a link between a patient and another service by providing patient authorized documentation to the other service of the patient's needs and recommendations for treatment services, and includes follow-up within one week as to the disposition of the recommendations.

(75)  "Registered nurse" means a person who is licensed under ch. 441 , Stats. , as a registered nurse.

(76)  "Relapse prevention" means services designed to support the recovery of the individual and to prevent recurrence of substance abuse.

(77)  "Residential intoxication monitoring service" means a service providing 24-hour per day observation by non-medical staff to monitor the resolution of alcohol or sedative intoxication and to monitor alcohol withdrawal.

(78)  "Service" means a structured delivery system, formerly called a program, for providing substance abuse prevention, intervention or treatment services.

(78m)  "Social worker" has the meaning given in s. MPSW 2.01 (16) .

(79)  "Staff development" means activities designed to improve staff competency and job performance which may include the following:

(a) Orientation that includes learning activities that provide understanding of the contextual relationship of concepts, ideas and processes required for job performance.

(b) Education that includes learning activities that provide cognitive information to build the knowledge base required for improving job performance.

(c) Training that includes learning activities that develop knowledge, skills and attitudes aimed at changing behaviors to enhance or improve job performance.

(80)  "Staffing" means a regularly scheduled review of a patient's treatment goals, the treatment strategies and objectives being utilized or proposed, potential amendments to the treatment plan and the patient's progress or lack of progress, including placement criteria for the level of care the patient is in, with participants to include at least the patient's primary counselor and the clinical supervisor, and a mental health professional if the patient is dually diagnosed.

(81)  "State methadone authority" means the department's bureau of prevention, treatment and recovery which is the state agency designated by the governor pursuant to 42 CFR 8.2 to exercise the responsibility and authority within Wisconsin for governing the treatment of narcotic addiction with a narcotic drug.

(82)  "Substance" means a psychoactive agent or chemical which principally affects the central nervous system and alters mood or behavior and may include nicotine if the individual is being treated for abuse of or dependence on alcohol or a controlled substance or a controlled substance analog under ch. 961 , Stats.

(83)  "Substance abuse" means use of alcohol or another substance individually or in combination in a manner that interferes with functioning in any of the following areas of an individual's life: educational, vocational, health, financial, legal, personal relationships or role as a caregiver or homemaker.

(84)  "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) A s. MPSW 1.09 specialty under ch. 457 , Stats. , granted by DSPS.

(85)  "Substance abuse screening" means the process by which a patient is determined appropriate and eligible for service in the substance abuse treatment delivery system.

(86)  "Substance use disorder" means the existence of a diagnosis of "substance dependence" or "substance abuse," listed in DSM-IV, excluding nicotine dependence.

(87)  "Supervised clinical experience" means supervision of a master's level mental health professional in clinical practice by a mental health professional qualified under s. DHS 34.21 (3) (b) 1. to 9. gained after the person being supervised has received a master's degree.

(88)  "Transfer" means the change of a patient from one level of care to another. The change may take place at the same location or by physically moving the patient to a different site for the new level of care.

(89)  "Transitional residential treatment service" means a clinically supervised, peer-supported therapeutic environment with clinical involvement. The service provides substance abuse treatment in the form of counseling equaling between 3 to 11 hours weekly, immediate access to peer support and intensive case management which may include direct education and monitoring in the areas of personal health and hygiene, community socialization, job readiness, problem resolution counseling, housekeeping and financial planning.

(90)  "Treatment" means the planned provision of services that are sensitive and responsive to a patient's age, disability, if any, gender and culture, and that are conducted under clinical supervision to assist the patient through the process of recovery.

(91)  "Treatment plan" or "plan" means identified and ranked goals and objectives and resources agreed upon by the patient, the counselor and the consulting physician to be utilized in facilitation of the patient's recovery.

(92)  "Treatment planning" means the process by which the counselor, the patient and, whenever possible, the patient's family, identify and rank problems needing resolution, establish agreed-upon immediate, short-term and long-term goals and decide on a treatment process and resources to be utilized based upon the severity of the patient's presenting problems.

(93)  "Treatment service" means any service under ss. DHS 75.10 to 75.15 .

(95)  "Withdrawal" means the development of a psychological and physical syndrome caused by the abrupt cessation of or reduction in substance use that has been heavy and prolonged. 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.

(96)  "Withdrawal screening" means the evaluation of a patient's condition as it relates to current or potential withdrawal from alcohol or another substance.

(97)  "WI-UPC" means Wisconsin uniform placement criteria, a placement instrument that yields a placement recommendation as to an appropriate level of care at which a patient should receive services. The criteria determine if a patient is clinically eligible for substance abuse services and then provide a basis for examining the degree of impairment in specific dimensions of the patient's life.

(98)  "WI-UPC assets criteria" means the strengths the patient possesses. Examples are evidence that the patient is free of withdrawal symptoms, the patient is not under the influence of substances, the patient has a supportive and safe living environment and the patient is willing to follow the agreed-upon elements of the treatment plan.

(99)  "WI-UPC needs criteria" means the identified problems or condition of a patient which help in determining the level of intensity of service required for progress in achieving treatment goals and bringing about the patient's recovery.

History: Cr. Register, July, 2000, No. 535 , eff. 8-1-00; CR 06-035 : cr. (1m) and (34m), am. (82), r. and recr. (7) and (34), Register November 2006 No. 611 , eff. 12-1-06; corrections in (18), (33m) (d), (34), (46) and (87) made under s. 13.92 (4) (b) 6. and 7. , Stats., Register November 2008 No. 635 ; CR 09-109 : r. (6), (10), (11) (d) to (f) and (94), am. (7), (11) (a), (15), (68) and (81), cr. (9m), (21m), (70g), (70r) and (78m), r. and recr. (84) Register May 2010 No. 653 , eff. 6-1-10; correction in (9m), (11) (a), (15), (21m), (68), (70g), (70r), (84) (a) to (d), made under s. 13.92 (4) (b) 6. , 7. , Stats., Register November 2011 No. 671 ; correction in (33m) (e) made under s. 13.92 (4) (b) 7. , Stats., Register October 2018 No. 718 .

Note

The publication , Patient Placement Criteria for the Treatment of Substance-Related Disorders , published by the American Society of Addiction Medicine (ASAM), may be consulted at the department's bureau of prevention, treatment and recovery or at the Secretary of State's office or the Legislative Reference Bureau. Send inquires about the ASAM placement criteria to American Society of Addiction Medicine, 4601 N. Park Ave., Suite 101 Upper Arcade, Chevy Chase, MD 20815, or check ASAM's internet site at www.asam.org . Microsoft Windows NT 6.1.7601 Service Pack 1 A medical director of a certified service who is not certified in addiction medicine or in addiction psychiatry is encouraged to work toward and complete the requirements for certification in addiction medicine by the American society of addiction, or work toward and complete the requirements for certification by the American board of psychiatry and neurology in addiction psychiatry. Microsoft Windows NT 6.1.7601 Service Pack 1 A physician providing or supervising addiction treatment in a certified service who is not certified in addiction medicine or in addiction psychiatry is encouraged to work toward and complete the requirements for certification by the American society of addiction medicine in addiction medicine as an addiction specialist, or work toward and complete the requirements for certification by the American board of psychiatry and neurology in addiction psychiatry. Microsoft Windows NT 6.1.7601 Service Pack 1 See Appendix B-8. Microsoft Windows NT 6.1.7601 Service Pack 1 Treatment functions include screening, application of approved placement criteria, intake, orientation, assessment, individualized treatment planning, intervention, individual or group and family counseling, referral, discharge planning, after care or continuing care, recordkeeping, consultation with other professionals regarding the patient's treatment services, recovery and case management, and may include crisis intervention, client education, employment and problem resolution in life skills functioning. Microsoft Windows NT 6.1.7601 Service Pack 1 The publication, Wisconsin Uniform Placement Criteria , may be consulted at the department's bureau of prevention, treatment and recovery, Room 437, 1 W. Wilson Street, Madison, Wisconsin. To request a copy, write Bureau of Prevention, Treatment and Recovery, P.O. Box 7851, Madison, WI 53707-7851. Microsoft Windows NT 6.1.7601 Service Pack 1