The Wisconsin Department of Health Services (DHS) held listening sessions in Milwaukee and Waukesha on June 17 and 20, respectively, seeking input and experiences with Wisconsin’s Community Substance Abuse Standards—DHS 75—as DHS begins an effort to rewrite those rules. WHA General Counsel Matthew Stanford attended the listening sessions and is a member of a DHS advisory committee that will be convened this fall to work on a final proposed rewrite of DHS 75.
The rulemaking is an outgrowth of a recommendation from the Governor’s Task Force on Opioids. During that Task Force, WHA noted concerns from substance abuse providers that Wisconsin’s special substance abuse treatment rules can create costly and unnecessary burdens that are not keeping up with care delivery changes and create barriers to expanding substance abuse treatment services.
Health system substance abuse providers from Advocate Aurora Health, ProHealth Care, and Rogers Behavioral Health attended the listening session, as did several local agency substance abuse providers. Examples of common key themes of the comments provided included:
- The DHS 75 clinical supervision requirements are outdated and often inconsistent with a modern licensed and professionalized substance abuse treatment delivery model.
- The DHS 75 rules frequently require multiple signatures and reviews that create paperwork burden but no meaningful benefit for patient care.
- Separate treatment service-type silos are creating unnecessary barriers to service model flexibility and integration.
- The lengthy time period to get certified by DHS to provide substance abuse services and different interpretations from surveyors is a frustration.
- Current rules are inconsistent with modern technology, including telemedicine and electronic health records.
“Medicaid telehealth regulations really handcuff us as to what technology we are able to utilize day to day,” said one provider. “We actually decided to end our telehealth certification after we got it due to all of the additional hoops,” said another provider.
Consistent with prior listening sessions in Eau Claire and Green Bay on May 21 and 23, providers also universally expressed frustration that the rule regulates as if Wisconsin doesn’t have separate licensing requirements for substance abuse treatment professionals.
“The rule is full of language that doesn’t recognize licensed professionals,” explained a provider. “The rule has requirements that are not in place for any other diagnosis that licensed professionals treat.”
Two final DHS 75 listening sessions will be held in Lac du Flambeau on June 27, and Madison on July 16.
If you have questions or would like more information about these sessions, contact Matthew Stanford at 608-274-1820.