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Last updated December 2003
Chapter 51 – State Alcohol,
Drug Abuse, Developmental Disabilities and Mental Health Act
51.001 Legislative policy.
(1) It is the policy of the state to
assure the provision of a full range of treatment and rehabilitation services
in the state for all mental disorders and developmental disabilities and for
mental illness, alcoholism and other drug abuse. There shall be a unified
system of prevention of such conditions and provision of services which will
assure all people in need of care access to the least restrictive treatment
alternative appropriate to their needs, and movement through all treatment
components to assure continuity of care, within the limits of available state
and federal funds and of county funds required to be appropriated to match
state funds.
(2) To protect personal liberties, no
person who can be treated adequately outside of a hospital, institution or
other inpatient facility may be involuntarily treated in such a facility.
51.01 Definitions. As used in this chapter, except where
otherwise expressly provided:
(1) "Alcoholic" means a
person who is suffering from alcoholism.
(1m) "Alcoholism" is a disease
which is characterized by the dependency of a person on the drug alcohol, to
the extent that the person's health is substantially impaired or endangered or
his or her social or economic functioning is substantially disrupted.
(2) "Approved treatment
facility" means any publicly or privately operated treatment facility or
unit thereof approved by the department for treatment of alcoholic, drug
dependent, mentally ill or developmentally disabled persons.
(2g)
(a) "Brain injury" means any injury to the
brain, regardless of age at onset, whether mechanical or infectious in origin,
including brain trauma, brain damage and traumatic head injury, the results of
which are expected to continue indefinitely, which constitutes a substantial
handicap to the individual, and which directly results in any 2 or more of the
following:
1. Attention impairment.
2. Cognition impairment.
3. Language impairment.
4. Memory impairment.
5. Conduct disorder.
6. Motor disorder.
7. Any other neurological dysfunction.
(am) "Brain injury" includes any injury to
the brain under par.
(a) that is vascular in origin if received by a person prior to his or her
attaining the age of 22 years.
(b) "Brain injury" does not include
alcoholism, Alzheimer's disease as specified under s.
46.87 (1) (a) or the infirmities of aging as specified under s.
55.01 (3).
(3) "Center for the
developmentally disabled" means any facility which is operated by the
department and which provides services including, but not limited to, 24-hour
treatment, consultation, training and education for developmentally disabled
persons.
(3g) "Chronic mental illness" means a mental illness which is
severe in degree and persistent in duration, which causes a substantially
diminished level of functioning in the primary aspects of daily living and an
inability to cope with the ordinary demands of life, which may lead to an
inability to maintain stable adjustment and independent functioning without
long-term treatment and support and which may be of lifelong duration.
"Chronic mental illness" includes schizophrenia as well as a wide
spectrum of psychotic and other severely disabling psychiatric diagnostic
categories, but does not include infirmities of aging or a primary diagnosis of
mental retardation or of alcohol or drug dependence.
(3n) "Community mental health
program" means a program to provide community-based outpatient mental
health services that is operated by or under contract with a county department
of community programs or that requests payment for the services under the
medical assistance program or under benefits required under s.
632.89 (2).
(3s) "Community support program"
means a coordinated care and treatment system which provides a network of
services through an identified treatment program and staff to ensure ongoing
therapeutic involvement and individualized treatment in the community for
persons with chronic mental illness.
(4) "Conditional transfer"
means a transfer of a patient or resident to a less restrictive environment for
treatment which is made subject to conditions imposed for the benefit of the
patient or resident.
(a) "Developmental disability" means a
disability attributable to brain injury, cerebral palsy, epilepsy, autism,
Prader-Willi syndrome, mental retardation, or another neurological condition
closely related to mental retardation or requiring treatment similar to that
required for mental retardation, which has continued or can be expected to
continue indefinitely and constitutes a substantial handicap to the afflicted
individual. "Developmental disability" does not include
senility which is primarily caused by the process of aging or the infirmities
of aging.
(b) "Developmental disability", for purposes
of involuntary commitment, does not include cerebral palsy or epilepsy.
(6) "Director" means the
person in charge of a state treatment facility, state or local treatment
center, or approved private facility.
(7) "Discharge" of a patient
who is under involuntary commitment orders means a termination of custody and
treatment obligations of the patient to the authority to which the patient was
committed by court action. The "discharge" of a patient who is
voluntarily admitted to a treatment program or facility means a termination of
treatment obligations between the patient and the treatment program or
facility.
(8) "Drug dependent" means a
person who uses one or more drugs to the extent that the person's health is
substantially impaired or his or her social or economic functioning is
substantially disrupted.
(9) "Hospital" has the
meaning given under s.
50.33.
(10)
"Inpatient facility" means a public or private hospital or unit of a
hospital which has as its primary purpose the diagnosis, treatment and
rehabilitation of mental illness, developmental disability, alcoholism or drug
abuse and which provides 24-hour care.
(11) "Law
enforcement officer" means any person who by virtue of the person's office
or public employment is vested by law with the duty to maintain public order or
to make arrests for crimes while acting within the scope of the person's
authority.
(12)
"Mental health institute" means any institution operated by the
department for specialized psychiatric services, research, education, and which
is responsible for consultation with community programs for education and
quality of care.
(13)
(a)
"Mental illness" means mental disease to such extent that a person so
afflicted requires care and treatment for his or her own welfare, or the
welfare of others, or of the community.
(b)
"Mental illness", for purposes of involuntary commitment, means a substantial
disorder of thought, mood, perception, orientation, or memory which grossly
impairs judgment, behavior, capacity to recognize reality, or ability to meet
the ordinary demands of life, but does not include alcoholism.
(14)
"Residence", "legal residency" or "county of
residence" has the meaning given under s.
49.001 (6).
(14k)
"Secured child caring institution" has the meaning given in s.
938.02 (15g).
(14m)
"Secured correctional facility" has the meaning given in s.
938.02 (15m).
(14p)
"Secured group home" has the meaning given in s.
938.02 (15p).
(15)
"State treatment facility" means any of the institutions operated by
the department for the purpose of providing diagnosis, care or treatment for
mental or emotional disturbance, developmental disability, alcoholism or drug
dependency and includes but is not limited to mental health institutes.
(16)
"Transfer" means the movement of a patient or resident between
approved treatment facilities or to or from an approved treatment facility and
the community.
(17)
"Treatment" means those psychological, educational, social, chemical,
medical or somatic techniques designed to bring about rehabilitation of a
mentally ill, alcoholic, drug dependent or developmentally disabled person.
(18)
"Treatment director" means the person who has primary responsibility
for the treatment provided by a treatment facility. The term includes the
medical director of a facility.
(19)
"Treatment facility" means any publicly or privately operated
facility or unit thereof providing treatment of alcoholic, drug dependent,
mentally ill or developmentally disabled persons, including but not limited to
inpatient and outpatient treatment programs, community support programs and
rehabilitation programs.
51.02 Council on mental health.
(1) The
council on mental health shall have the following duties:
(a)
Advise the department, the legislature and the governor on the use of state and
federal resources and on the provision and administration of programs for
persons who are mentally ill or who have other mental health problems, for
groups who are not adequately served by the mental health system, for the
prevention of mental health problems and for other mental health related
purposes.
(b) Provide
recommendations to the department on the expenditure of federal funds received
under the community mental health block grant under 42 USC 300x to 300x-9 and
participate in the development of and monitor and evaluate the implementation
of, the community mental health block grant plan.
(c) Review
all departmental plans for services affecting persons with mental illness and
monitor the implementation of the plans.
(d) Serve
as an advocate for persons with mental illness.
(f) Consult
with the department in the development of a model community mental health plan
under s.
51.42 (7) (a) 9., and review and advise the department on community mental
health plans submitted by counties under s.
51.42 (3) (ar) 5.
(g) Promote
the development and administration of a delivery system for community mental
health services that is sensitive to the needs of consumers of the services.
(h) Review
and comment on the human services and community programs board member training
curriculum developed by the department under s.
51.42 (7) (a) 3m.
(2) The
secretary shall submit all departmental plans affecting persons with mental
illness to the council for its review. The council shall provide its
recommendations to the secretary within such time as the secretary may require.
51.03 Department; powers and duties.
(a)
"Early intervention" means action to hinder or alter a person's
mental disorder or abuse of alcohol or other drugs in order to reduce the
duration of early symptoms or to reduce the duration or severity of mental
illness or alcohol or other drug abuse that may result.
(b)
"Individualized service planning" means a process under which a
person with mental illness or who abuses alcohol or other drugs and, if a
child, his or her family, receives information, education and skills to enable
the person to participate mutually and creatively with his or her mental health
or alcohol or other drug abuse service provider in identifying his or her
personal goals and developing his or her assessment, crisis protocol, treatment
and treatment plan. "Individualized service planning" is
tailored to the person and is based on his or her strengths, abilities and
needs.
(c)
"Prevention" means action to reduce the instance, delay the onset or
lessen the severity of mental disorder, before the disorders may progress to
mental illness, by reducing risk factors for, enhancing protections against and
promptly treating early warning signs of mental disorder.
(d)
"Recovery" means the process of a person's growth and improvement,
despite a history of mental illness or alcohol or other drug abuse, in
attitudes, feelings, values, goals, skills and behavior and is measured by a
decrease in dysfunctional symptoms and an increase in maintaining the person's
highest level of health, wellness, stability, self-determination and
self-sufficiency.
(e)
"Stigma" means disqualification from social acceptance, derogation,
marginalization and ostracism encountered by persons with mental illness or
persons who abuse alcohol or other drugs as the result of societal negative
attitudes, feelings, perceptions, representations and acts of discrimination.
(1r) The
department through its authorized agents may visit or investigate any treatment
facility to which persons are admitted or committed under this chapter.
(2) No
later than 14 days after the date of a death reported under s.
51.64 (2) (a), the department shall investigate the death.
(3)
(a)
Beginning on September 1, 1996, the department shall collect and analyze
information in this state on each of the following:
1.
The number of commitments initiated under s.
51.15 or 51.20
(1).
2. The
number of commitments ordered under s.
51.20 (13).
3. The
number of, cost of and paying sources for days of inpatient mental health
treatment that result from the commitments initiated under subd.
1. or ordered under subd.
2.
5. The
number of persons who are receiving care and treatment under community support
programs voluntarily or under commitments ordered under s.
51.20 (13).
6. The
number of persons for whom guardians are appointed under s.
880.33 (4m).
(b)
By April 1, 1997, and annually by that date for 3 years thereafter, the
department shall submit a report to the legislature under s.
13.172 (2) on the information collected under par.
(a).
(4) Within
the limits of available state and federal funds, the department may do all of
the following:
(a)
Promote the creation of coalitions among the state, counties, providers of
mental health and alcohol and other drug abuse services, consumers of the
services and their families and advocates for persons with mental illness and
for alcoholic and drug dependent persons to develop, coordinate and provide a
full range of resources to advance prevention; early intervention; treatment;
recovery; safe and affordable housing; opportunities for education, employment
and recreation; family and peer support; self-help; and the safety and
well-being of communities.
(b) In
cooperation with counties, providers of mental health and alcohol and other
drug abuse services, consumers of the services, interested community members
and advocates for persons with mental illness and for alcoholic and drug
dependent persons, develop and implement a comprehensive strategy to reduce
stigma of and discrimination against persons with mental illness, alcoholics
and drug dependent persons.
(c) Develop
and implement a comprehensive strategy to involve counties, providers of mental
health and alcohol and other drug abuse services, consumers of the services and
their families, interested community members and advocates for persons with
mental illness and for alcoholic and drug dependent persons as equal
participants in service system planning and delivery.
(d) Promote
responsible stewardship of human and fiscal resources in the provision of
mental health and alcohol and other drug abuse services.
(e) Develop
and implement methods to identify and measure outcomes for consumers of mental
health and alcohol and other drug abuse services.
(f) Promote
access to appropriate mental health and alcohol and other drug abuse services
regardless of a person's geographic location, age, degree of mental illness,
alcoholism or drug dependency or availability of personal financial resources.
(g) Promote
consumer decision making to enable persons with mental illness and alcohol or
drug dependency to be more self-sufficient.
(h) Promote
use by providers of mental health and alcohol and other drug abuse services of
individualized service planning, under which the providers develop written
individualized service plans that promote treatment and recovery, together with
service consumers, families of service consumers who are children and advocates
chosen by consumers.
(5) The
department shall ensure that providers of mental health and alcohol and other
drug abuse services who use individualized service plans, as specified in sub.
(4) (h), do all of the following in using a plan:
(a)
Establish meaningful and measurable goals for the consumer.
(b) Base
the plan on a comprehensive assessment of the consumer's strengths, abilities,
needs and preferences.
(c) Keep
the plan current.
(d) Modify
the plan as necessary.
51.032 Denial and revocations of
certification or approval based on tax delinquency.
(1) Except
as provided in sub.
(1m), the department shall require each applicant to provide the department
with his or her social security number, if the applicant is an individual, or
the applicant's federal employer identification number, if the applicant is not
an individual, as a condition of issuing any of the following:
(a)
A certification issued under s.
51.038.
(b) A
certification issued under s.
51.04.
(c) A
certification issued under rules required under s.
51.42 (7) (b) 11.
(d) A
certification issued under rules required under s.
51.421 (3) (a).
(e) An
approval issued under s.
51.45 (8).
(1m) If an
individual who applies for a certification or approval under sub.
(1) does not have a social security number, the individual, as a condition of
obtaining the certification or approval, shall submit a statement made or
subscribed under oath or affirmation to the department that the applicant does
not have a social security number. The form of the statement shall be
prescribed by the department of workforce development. A certification or
approval issued in reliance upon a false statement submitted under this
subsection is invalid.
(2) The
department may not disclose any information received under sub.
(1) to any person except to the department of revenue for the sole purpose of
requesting certifications under s.
73.0301.
(3) Except
as provided in sub.
(1m), the department shall deny an application for the issuance of a
certification or approval specified in sub.
(1) if the applicant does not provide the information specified in sub.
(1).
(4) The
department shall deny an application for the issuance of a certification or
approval specified in sub.
(1) or shall revoke a certification or approval specified in sub.
(1) if the department of revenue certifies under s.
73.0301 that the applicant for or holder of a certification or approval is
liable for delinquent taxes.
(5) An
action taken under sub.
(3) or (4)
is subject to review only as provided under s.
73.0301 (2) (b) and (5).
51.038 Outpatient mental health clinic
certification.
Except as
provided in s.
51.032, if a facility that provides mental health services on an outpatient
basis holds current accreditation from the council on accreditation of services
for families and children, the department may accept evidence of this
accreditation as equivalent to the standards established by the department, for
the purpose of certifying the facility for the receipt of funds for services
provided as a benefit to a medical assistance recipient under s.
49.46 (2) (b) 6. f., a community aids funding recipient under s.
51.423 (2) or as mandated coverage under s.
632.89.
51.04 Treatment facility
certification.
Except as
provided in s.
51.032, any treatment facility may apply to the department for certification of
the facility for the receipt of funds for services provided as a benefit to a
medical assistance recipient under s.
49.46 (2) (b) 6. f. or to a community aids funding recipient under s.
51.423 (2) or provided as mandated coverage under s.
632.89. The department shall annually charge a fee for each
certification.
51.05 Mental health institutes.
(1) Designation.
The mental health institute located at Mendota is known as the "Mendota
Mental Health Institute" and the mental health institute located at
Winnebago is known as the "Winnebago Mental Health Institute".
Goodland Hall West, a facility located at Mendota Mental Health Institute, is
designated as the "Maximum Security Facility at Mendota Mental Health
Institute". The department shall divide the state by counties into 2
districts, and may change the boundaries of these districts, arranging them
with reference to the number of patients residing in them at a given time, the
capacity of the institutes and the convenience of access to them.
(2) Admissions
authorized by counties. The department may not accept for admission
to a mental health institute any resident person, except in an emergency,
unless the county department under s.
51.42 in the county where the person has legal residency authorizes the care,
as provided in s.
51.42 (3) (as). Patients who are committed to the department under s.
975.01, 1977 stats., or s. 975.02, 1977 stats., or s.
971.14, 971.17,
975.06
or 980.06,
admitted by the department under s. 975.17, 1977 stats., or are transferred
from a secured correctional facility, a secured child caring institution or a
secured group home to a state treatment facility under s.
51.35 (3) or from a jail or prison to a state treatment facility under s.
51.37 (5) are not subject to this section.
(3) Admissions
authorized by department. Any person who is without a county
responsible for his or her care and any person entering this state through the
compact established under s.
51.75 may be accepted by the department and temporarily admitted to an
institute. Such person shall be transferred to the county department
under s.
51.42 for the community where the best interests of the person can best be
served, as soon as practicable.
(3g) Expense
reduction. The department shall annually reduce by $500,000 the
amount by which accumulated expenses of providing care to patients of the
mental health institutes exceed the accumulated revenues from providing that
care, until the accumulated revenues of the mental health institutes are in
balance with the accumulated expenses of the mental health institutes.
(3m) Revenues
and expenditures; reports. Notwithstanding s.
20.903 (1), the department shall implement a plan that is approved by the
department of administration to assure that there are sufficient revenues, as
projected by the department of health and family services, to cover anticipated
expenditures under the appropriation under s.
20.435 (2) (gk) for the purpose of reimbursing the provision of care to
patients of the Mendota Mental Health Institute or the Winnebago Mental Health
Institute and to ensure that the department complies with sub.
(3g). The department of health and family services shall make reports to
the department of administration every 3 months, beginning on October 1, 1993,
concerning the implementation of this plan. The department of health and family
services shall make reports to the joint committee on finance by December 31 of
each year that identify the change, during the preceding fiscal year, in the
amount by which the accumulated expenses of providing care to patients of the
mental health institutes exceed the accumulated revenues from providing that
care; describe the actions taken by the department during the preceding fiscal
year to reduce that amount; and describe the actions that the department is
taking during the current year to reduce that amount.
(4) Transfers
and discharges. The transfer or discharge of any person who is placed
in a mental health institute shall be made subject to s.
51.35.
(5) School
activities. If an individual over the age of 2 and under the age of
22 and eligible for special education and related services under subch.
V of ch. 115 is committed, admitted or transferred to or is a resident of the
Mendota Mental Health Institute or Winnebago Mental Health Institute, the
individual shall attend a school program operated by the applicable mental
health institute or a school outside the applicable mental health institute
which is approved by the department of public instruction. A school
program operated by the Mendota Mental Health Institute or Winnebago Mental
Health Institute shall be under the supervision of the department of public
instruction and shall meet standards prescribed by that agency.
(6) Hearing-impaired
individuals. The department shall provide mental health services
appropriate for hearing-impaired individuals who are residents of or are
committed, admitted or transferred to a mental health institute.
51.06 Centers for the developmentally
disabled.
(1) Purpose.
The purpose of the northern center for developmentally disabled, central center
for developmentally disabled and southern center for developmentally disabled
is to provide services needed by developmentally disabled citizens of this
state that are otherwise unavailable to them, and to return those persons to
the community when their needs can be met at the local level.
(1m) Services. Services to be provided
by the department at centers for the developmentally disabled shall include:
(a)
Education within the requirements of sub.
(2), training, habilitative and rehabilitative services to those persons placed
in its custody.
(b)
Development-evaluation services to citizens through county departments under ss.
51.42 and 51.437.
(c)
Assistance to such community boards in meeting the needs of developmentally
disabled citizens.
(d)
Services for individuals with developmental disability who are also diagnosed
as mentally ill or who exhibit extremely aggressive and challenging behaviors.
(a)
In addition to services provided under sub.
(1m), the department may, when the department determines that community
services need to be supplemented, authorize a center for the developmentally
disabled to offer short-term residential services, dental and mental health
services, therapy services, psychiatric and psychological services, general
medical services, pharmacy services, and orthotics.
(b)
Services under this subsection may be provided only under contract between the
department and a county department under s.
46.215, 46.22,
46.23,
51.42,
or 51.437,
a school district, or another public or private entity within the state to
persons referred from those entities, at the discretion of the department.
The department shall charge the referring entity all costs associated with
providing the services. Unless a referral is made, the department may not
offer services under this subsection to the person who is to receive the
services or to his or her family. The department may not impose a charge
for services under this subsection upon the person receiving the services or
upon his or her family. Any revenues received under this subsection shall
be credited to the appropriation account under s.
20.435 (2) (g).
(c)
1.
Services under this subsection are governed by subchapter XVI of ch. 48
and ss. 50.03,
50.032,
50.033,
50.034 (1)
to (3),
50.035,
50.04,
50.09,
51.04,
51.42 (7) (b),
and 51.61,
for the application of which the services shall be considered to be provided by
a private entity, by rules promulgated under those statutes, and by the terms
of the contract between the department, except that, in the event of a conflict
between the contractual terms and the statutes or rules, the services shall
comply with the contractual, statutory, or rules provision that is most protective
of the service recipient's health, safety, welfare, or rights.
2. Sections
46.03 (18), 46.10,
51.15 (2),
51.20 (13)
(c) 1., and 51.42 (3)
(as) and zoning or other ordinances or regulations of the county,
city, town, or village in which the services are provided or the facility is
located do not apply to the services under this subsection.
3. The
department may not be required, by court order or otherwise, to offer services
under this subsection.
(d)
A residential facility operated by a center for the developmentally disabled
that is authorized by the department under this subsection may not be
considered to be a hospital, as defined in s.
50.33 (2), an inpatient facility, a state treatment facility, or a treatment
facility.
(2) School
activities. If an individual over the age of 2 years and under the
age of 22 years and eligible for special education and related services under subch.
V of ch. 115 is admitted to, is placed in or is a resident of a center, the
individual shall attend a school program operated by the center or a school
outside the center which is approved by the department of public
instruction. A school program operated by the center shall be under the supervision
of the department of public instruction and shall meet standards prescribed by
that agency.
(3) Admission.
(a)
Subject to par.
(b), individuals under the age of 22 years shall be placed only at the central
center for the developmentally disabled unless the department authorizes the
placement of the individual at the northern or southern center for the
developmentally disabled.
(b) An
individual may be placed at or transferred to a center for the developmentally
disabled for services under sub.
(1m) (d) only after all of the following conditions are met:
1.
The department determines that a licensed bed and other necessary resources are
available to provide services to the individual.
2. The
department and the county of residence of the individual agree on a maximum discharge
date for the individual.
(4) Transfer
or discharge. The transfer or discharge of any person who is placed
in a center for the developmentally disabled shall be made subject to s.
51.35.
(5) Surcharge
for extended intensive treatment. The department may impose on a
county a progressive surcharge for services under sub.
(1m)(d) that an individual receives after the maximum discharge date for the
individual that was agreed upon under sub.
(3) (b) 2. The surcharge is 10% of the amount paid for the individual's
services under s.
49.45 during any part of the first 6-month period following the maximum
discharge date, and increases by 10% of the amount paid for the individual's
services under s.
49.45 during any part of each 6-month period thereafter. Any revenues
received under this subsection shall be credited to the appropriation account
under s.
20.435 (2) (gL).
(6) Sale
of assets or real property at Northern Center for the Developmentally Disabled.
The department may maintain the Northern Center for the Developmentally
Disabled for the purpose specified in sub.
(1), but may sell assets or real property of the Northern Center for the
Developmentally Disabled. If there is any outstanding public debt used to
finance the acquisition, construction, or improvement of any property that is
sold under this subsection, the department shall deposit a sufficient amount of
the net proceeds from the sale of the property in the bond security and
redemption fund under s.
18.09 to repay the principal and pay the interest on the debt, and any premium
due upon refunding any of the debt. If the property was purchased with federal
financial assistance, the department shall pay to the federal government any of
the net proceeds required by federal law. If there is no such debt outstanding
and there are no moneys payable to the federal government, or if the net
proceeds exceed the amount required to be deposited or paid under this
subsection, the department shall credit the net proceeds or remaining net
proceeds to the appropriation account under s.
20.435 (2) (gk).
(1) The
department may establish a system of outpatient clinic services in any
institution operated by the department.
(2) It is
the purpose of this section to:
(a)
Provide outpatient diagnostic and treatment services for patients and their
families.
(b) Offer
precommitment and preadmission evaluations and studies.
(3) The department may provide outpatient services only to patients contracted for with county departments under ss. 51.42 and 51.437 in accordance with s. 46.03 (18), except for those patients whom the department finds to be nonresidents of this state and persons receiving services under contracts under s. 46.043. The full and actual cost less applicable collections of services contracted for with county departments under s. 51.42 or 51.437 shall be charged to the respective county department under s. 51.42 or 51.437. The state shall provide the services required for patient care only if no outpatient services are funded by the department in the county or group of counties served by the respective county department under