DHS 75

DHS 75 Community Substance Use Service Standards

Wisconsin Administrative Code Chapter DHS 75 establishes certification standards for community substance use prevention, intervention, and treatment services, covering the full continuum from outpatient and intensive outpatient to residential, partial hospitalization, withdrawal management, and opioid treatment programs. Operators must obtain and maintain department certification, comply with staffing, recordkeeping, facility, and clinical service requirements, and follow prescribed procedures for changes of ownership, agency closure, and ongoing compliance inspections. The chapter also sets definitions and general provisions applicable across all certified substance use service levels.

Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
1 DEPARTMENT OF HEALTH SERVICES DHS 75.03
Chapter DHS 75
COMMUNITY SUBSTANCE USE SERVICE STANDARDS
Subchapter I — General Provisions
DHS 75.01 Authority and purpose.
DHS 75.02 Applicability.
DHS 75.03 Definitions.
Subchapter II — Certification
DHS 75.04 Application requirements.
DHS 75.05 Department action.
DHS 75.06 Biennial forms and fees.
DHS 75.07 Change of ownership.
DHS 75.08 Agency closure.
DHS 75.09 Ongoing compliance and enforcement actions.
DHS 75.10 Investigation, notification, and reporting requirements.
DHS 75.11 General records and retention.
DHS 75.12 Telehealth services.
DHS 75.13 Waivers and variances.
Subchapter III — Prevention and Intervention Service Requirements
DHS 75.14 Prevention service.
DHS 75.15 Intervention service and intoxicated driver services.
Subchapter IV — Treatment Service General Requirements
DHS 75.16 Applicability of treatment service general requirements.
DHS 75.17 Governing authority or entity owner requirements.
DHS 75.18 General requirements for service staff.
DHS 75.19 Personnel requirements.
DHS 75.20 Patient case records.
DHS 75.21 Confidentiality.
DHS 75.22 Services for minors.
DHS 75.23 Service levels of care.
DHS 75.24 Service operations.
DHS 75.25 Outcome monitoring and quality improvement plan.
Subchapter V — Residential Service Facility Requirements
DHS 75.26 Applicability.
DHS 75.27 Organizational requirements.
DHS 75.28 Definitions.
DHS 75.29 Application for initial certification.
DHS 75.30 Fit and qualified standards.
DHS 75.31 Services for non-ambulatory or semi-ambulatory patients.
DHS 75.32 General facility requirements.
DHS 75.33 Residential personnel requirements.
DHS 75.34 Residential service records.
DHS 75.35 Residential services for minors.
DHS 75.36 Residential services for parents with residing minors.
DHS 75.37 Emergency medical care for residents.
DHS 75.38 Seclusion and restraints.
DHS 75.39 Medications.
DHS 75.40 Infection control program.
DHS 75.41 Food service.
DHS 75.42 Physical environment.
DHS 75.43 Safety.
DHS 75.44 Guests and visitors.
DHS 75.45 Building design.
DHS 75.46 Requirements for new construction, remodeling, additions, or newly-
certified existing structures.
Subchapter VI — Additional Requirements for Treatment Service Levels of 
Care
DHS 75.47 Applicability of other requirements.
DHS 75.48 Service requirements by level of care tables.
DHS 75.49 Outpatient substance use treatment service.
DHS 75.50 Outpatient integrated behavioral health treatment service.
DHS 75.51 Intensive outpatient treatment service.
DHS 75.52 Day treatment or partial hospitalization treatment service.
DHS 75.53 Transitional residential treatment service.
DHS 75.54 Medically monitored residential treatment service.
DHS 75.55 Medically managed inpatient treatment.
DHS 75.56 Adult residential integrated behavioral health stabilization service.
DHS 75.57 Residential withdrawal management service.
DHS 75.58 Residential intoxication monitoring service.
Subchapter VII — Opioid Treatment Programs and Office-Based Opioid 
Treatment 
DHS 75.59 Opioid treatment program.
DHS 75.60 Office-based opioid treatment.
Note: Chapter HFS 75 was renumbered to chapter DHS 75 under s. 13.92 (4) (b) 
1., Stats., and corrections made under s. 13.92 (4) (b) 7., Stats., Register November 
2008 No. 635. Chapter DHS 75 was reprinted Register December 2010 No. 660 to 
reflect a Note revision in s. DHS 75.03 (24). Chapter DHS 75 as it existed on Octo-
ber 31, 2021, is repealed and a new Chapter DHS 75 is created Register October 
2021 No. 790, effective October 1, 2022.
Subchapter I — General Provisions
DHS 75.01 Authority and purpose. This chapter is 
promulgated under the authority of ss. 46.973 (2) (c), 51.42 (7) 
(b), 51.4224, and 51.45 (8) and (9), Stats., to establish standards 
for community substance use prevention and treatment services 
under ss. 51.42 and 51.45, Stats. Sections 51.42 (1) and 51.45 (1) 
and (7), Stats., provide that a full continuum of substance use ser-
vices be available to Wisconsin citizens.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22; correction 
in numbering made under s. 13.92 (4) (b) 1., Stats., Register October 2021 No. 790.
DHS 75.02 Applicability. (1) This chapter shall apply to 
all of the following:
(a) A publicly or privately operated facility providing sub-
stance use treatment services, in accordance with ss. 51.01 (19) 
and 51.45 (8) (c), Stats. 
(b) A publicly or privately operated facility providing sub-
stance use treatment services approved by the state opioid treat-
ment authority.
(c) A substance use service that receives funds under ch. 51, 
Stats., is funded through the department as the federally desig-
nated single state agency for substance use services, receives sub-
stance abuse prevention and treatment funding or other funding 
specifically designed for providing services under ss. DHS 75.14 
to 75.15, where certification is required by a contract with the 
department.
(d) An intoxicated driver service described in s. DHS 75.15. 
(e) A publicly or privately operated service that requests certi-
fication by the department.
(2) The provision of substance use treatment services to a pa-
tient in the state of Wisconsin via telehealth, regardless of the lo-
cation of the program or facility, shall constitute the practice of 
substance use services in the state of Wisconsin and shall meet 
the requirements of this chapter.
(3) This chapter shall not apply to a general medical service 
that delivers substance use treatment services as an adjunct to 
general medical care, unless that service meets the definition of a 
“program” under 42 CFR 2.11.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
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 re-
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 75.03 WISCONSIN ADMINISTRATIVE CODE 2
quested certification by the department as a community sub-
stance 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-Oc-
curring Conditions (3rd ed., Oct. 24, 2013), which is a multi-di-
mensional 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 prac-
tice, 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 inde-
pendently 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 coordina-
tion 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 de-
partment’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 cer-
tification in the peer specialist model of mental health or sub-
stance 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 prac-
tice, gathers relevant information to evaluate the individual’s 
problem areas, symptoms, functioning, readiness for change, re-
sources, and strengths. Clinical assessment of substance use in-
cludes information regarding substance use history, current sub-
stance 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 func-
tional 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 super-
visor and other clinical staff of a service, another licensed profes-
sional, 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 as-
sessment and treatment of mental health and substance use 
disorders.
(17) “Clinical staff” means all substance abuse counselors, 
mental health professionals, mental health professionals in train-
ing, 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 pa-
tient’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 Wis-
consin Act 262 and is practicing within their scope of their educa-
tion, training and experience.
(20) “Clinical supervision” means the process as defined in s. 
SPS 160.02 (6).
(21) “Collateral” means information, treatment input, or par-
ticipation obtained from a party that has knowledge of or rela-
tionship with a patient, which may include family members, 
friends, co-workers, recovery peers, health care providers, proba-
tion 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-ed-
ucational group provided by a service that includes mixed popu-
lation groups, such as gender, age, substance of use, or crimino-
genic risk.
(23) “Continued stay” means the ongoing provision of an ap-
propriately 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 de-
scribed 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 pa-
tient 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 theo-
ries, 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.
Note: CLAS standards are available from the U.S. Department of Health and 
Human Services at https://thinkculturalhealth.hhs.gov/assets/pdfs/EnhancedNa-
tionalCLASStandards.pdf.
(29) “DEA” means the U.S. drug enforcement 
administration.
(30) “Department” or “DHS” means the Wisconsin depart-
ment 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 lab-
oratory testing, to determine whether a patient’s presenting prob-
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
3 DEPARTMENT OF HEALTH SERVICES DHS 75.03
lem 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 dis-
charge summary as required under s. DHS 75.24 (22).
(33) “DSM” means the Diagnostic and Statistical Manual of 
Mental Disorders, 5th edition, text revision, 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 profes-
sional and a substance abuse counselor, in accordance with pro-
fessional 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 ser-
vice, 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 ser-
vice, 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 suffi-
cient 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 rehabilita-
tion progress of a patient who has been referred for concurrent or 
subsequent services.
(40) “Governing authority” means the individual or govern-
ing 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 commu-
nity. Incident reporting is required for health emergencies, inci-
dents 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 correc-
tions 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 ad-
mission 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 creden-
tialed personnel operating within their scope of practice, with ap-
propriate interventions for both conditions included in one com-
prehensive 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-reduc-
tion strategies, referral for other services or medical care, and re-
ferral for prenatal care for pregnant women; to reduce the adverse 
health effects of substance use, promote the health of the individ-
ual, 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 clini-
cal 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 sub-
stance 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 pro-
vided 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 depart-
ment-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 Ad-
diction Medicine conferred by the American Osteopathic 
Association.
(dm) A prior certification by the American Board of Addic-
tion Medicine.
(e) Completion of an accredited residency or fellowship in ad-
diction 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 ad-
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 75.03 WISCONSIN ADMINISTRATIVE CODE 4
diction psychiatry and has one year of addiction medicine experi-
ence, although certification is preferred.
Note: If a service is not able to secure a medical director who meets the require-
ment of 1 year of addiction medicine experience, as documented through the ser-
vice’s recruitment efforts, the service may utilize a medical director who has a spe-
cific plan to acquire equivalent training and skills within 4 months after beginning 
employment.
(52) “Medical personnel” means a physician, a physician as-
sistant, nurse prescriber or other health care personnel licensed, 
at a minimum, to the level of a registered nurse or licensed practi-
cal nurse.
(53) “Medical screening” means the examination conducted 
by medical personnel of a person to ascertain eligibility for ad-
mission 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 ex-
amination, evaluating, managing and monitoring health-related 
risks of withdrawal from alcohol and other substances, adminis-
tration 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 be-
havioral therapies, to treat substance use disorders.
(56) “Mental health professional” means an individual autho-
rized to practice psychology, marriage and family therapy, profes-
sional 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 tech-
nique that uses collaboration and empathy in purposeful commu-
nication 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 medica-
tion 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 receiv-
ing substance use assessment or treatment services, including 
emergency services described in s. DHS 75.24 (2), or an individ-
ual who has completed intake for a service under this chapter. An 
individual remains a patient of a service until the date of dis-
charge as established in s. DHS 75.24 (22).
(65) “Physically accessible” means a facility that persons 
with functional limitations caused by impairments of sight, hear-
ing, coordination, cognition, or perception, or persons with dis-
abilities that cause them to be semi-ambulatory or non-ambula-
tory 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 crite-
ria, that evaluates social, behavioral health, and physical health 
dimensions to identify an individual’s need and risk level to en-
sure 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 compre-
hensive 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 li-
cense to deliver services under this chapter.
(71) “Prescription” means a drug or device ordered by a pre-
scriber for treatment.
(72) “Primary counselor” means a substance abuse coun-
selor, mental health professional, or prescriber, who is assigned 
by the service to develop and implement a patient’s individual-
ized 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 di-
dactic 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 insti-
tution 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 insti-
tution 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 re-
quirements 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 as-
sist 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 li-
cense 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 provid-
ing 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, in-
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
5 DEPARTMENT OF HEALTH SERVICES DHS 75.05
cluding 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, clini-
cal social worker, marriage and family therapist, or professional 
counselor license, or an advanced practice social worker certifi-
cate or independent social worker certificate 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, voca-
tional, health, behavioral, financial, legal, or social functioning.
(87) “Substance use disorder” means a diagnosis of sub-
stance 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 elec-
tronic 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 loca-
tion or by physically moving the patient to a different site or ser-
vice 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, in-
dependent living, vocational and educational development, and 
addressing the life-stage areas of independence, identity-forma-
tion, and autonomy.
(93) “Trauma-informed” means an approach that recognizes 
the contribution of psychologically distressing events to an indi-
vidual’s presenting symptoms and response to interventions, and 
the strong correlation between trauma and behavioral health dis-
orders. This approach to care emphasizes environmental and per-
sonal 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 pa-
tient 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 fam-
ily, consider the patient’s presenting problems to identify and pri-
oritize 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 re-
sources applied by a service to address the needs and goals identi-
fied in a patient’s treatment plan.
(99) “Unlicensed staff” means any mental health profes-
sional in training, a substance abuse counselor in training, a qual-
ified 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 psychologi-
cal 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, oc-
cupational, or other important areas of functioning and are not 
due to a general medical condition or better accounted for by an-
other mental disorder.
(103) “Withdrawal management” means a service, or com-
ponent of a service, that provides care and interventions to ad-
dress an individual’s physical or psychosocial needs related to 
acute intoxication or withdrawal. Withdrawal management in-
cludes intoxication monitoring, management of acute symptoms, 
interruption of habitual and compulsive use, and engagement in 
ongoing treatment services.
History: 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; 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; CR 23-067: 
am. (85) (d) Register April 2025 No. 832, eff. 5-1-25; CR 25-055: am. (33) Regis-
ter February 2026 No. 842, eff. 3-1-26.
Subchapter II — Certification
DHS 75.04 Application requirements. An application 
for initial certification shall be on a form provided by the depart-
ment and shall be accompanied by all of the following:
(1) Service policies and procedures required by this chapter.
(2) All fees required under ss. 51.04 and 51.45 (8) (a), Stats.
(3) Additional information needed for certification that is re-
quested by the department.
Note: Certification information and applications can be found at: 
https://www.dhs.wisconsin.gov/regulations/aoda/certification.htm.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.05 Department action. (1) INITIAL CERTIFI-
CATION. (a) Within 60 days after receipt of a complete applica-
tion, the department shall review the application and either ap-
prove or deny the certification.
(b) A certification issued by the department shall be only for 
persons named in the application. A certification may not be 
transferred or assigned without following the change of owner-
ship provisions in s. DHS 75.07.
(c) A certification is valid until suspended or revoked by the 
department, except for opioid treatment programs.
(d) Opioid treatment programs shall be certified in accor-
dance with s. 51.4224 (2), Stats.
(2) CERTIFICATION DENIAL. The department shall deny a cer-
tification to any applicant who does not substantially comply 
with any provision of this chapter, or who is not fit and qualified 
as specified in s. DHS 75.30, or who has failed to pay any fee or 
any outstanding amounts due to the department. The department 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 75.05 WISCONSIN ADMINISTRATIVE CODE 6
shall provide the reasons for denial and the process for appeal of 
the denial in a written notice to the applicant.
(3) CERTIFICATION SUSPENSION OR REVOCATION. The de-
partment may suspend or revoke certification for any of the rea-
sons and under the conditions specified under ss. 51.032 and 
51.45 (8) (a) , Stats., or for failure to comply with this chapter. 
The department shall provide the reasons for suspension or revo-
cation and the process for appeal of the suspension or revocation 
in a written notice to the applicant.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22; correction 
in (2) made under s. 13.92 (4) (b) 7., Stats., Register October 2021 No. 790.
DHS 75.06 Biennial forms and fees. (1) Every 24 
months, on a date determined by the department, the service shall 
submit the biennial forms provided by the department, and shall 
submit payment of the certification continuation fees under ss. 
51.04 and 51.45 (8) (a) , Stats., except for opioid treatment pro-
grams under s. DHS 75.59.
(2) For opioid treatment programs, the service shall submit 
required reports in accordance with s. 51.4223, Stats.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.07 Change of ownership. (1) CHANGE OF 
OWNERSHIP. A change of ownership of a service occurs when the 
service does any of the following:
(a) Removes, adds, or substitutes an individual as a partner in 
the association, dissolving the existing partnership and creating a 
new partnership.
(b) Removes, adds, or substitutes any member in a limited lia-
bility company.
(c) Makes a change in a corporate structure under which the 
same corporation no longer continues to be responsible for mak-
ing operational decisions or for the consequences of those 
decisions.
(2) DUTIES OF THE TRANSFEROR. (a) The transferor shall no-
tify the department within 30 days before the change of owner-
ship of a service and shall include the name and contact informa-
tion of the transferee.
(b) The transferor remains responsible for the operation of the 
service until the department issues certification to the transferee, 
unless the service voluntarily closes and relocates all clients.
(c) The transferor shall disclose to the transferee any existing 
department waiver, variance, or outstanding deficiencies. The 
transferee shall apply for continuation of any existing waivers or 
variances, if necessary.
(d) The transferor shall follow the requirements for transfer-
ring financial responsibility under ch. 51, Stats.
(e) The transferor shall notify a client or client’s legal repre-
sentative no less than 7 days in advance of the transfer of 
ownership.
(3) DUTIES OF THE TRANSFEREE. When there is a change of 
ownership, the transferee shall notify the department of the trans-
fer, and shall submit a complete application as required under s. 
DHS 75.04 at least 30 days prior to the final transfer date.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22; CR 25-
055: am. (2) (e) Register February 2026 No. 842, eff. 3-1-26.
DHS 75.08 Agency closure. (1) Any service that in-
tends to close shall provide written notice to each client by mail 
or electronic mail to the client’s last known address, to each 
client’s legal representative, if applicable, and the department at 
least 30 days before closing. The notice shall include the client’s 
right to obtain treatment records as prescribed in s. DHS 92.05 
and ch. DHS 94.
(2) The service shall provide assistance to clients for continu-
ity of necessary services, including written notice of alternate 
service providers.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.09 Ongoing compliance and enforcement 
actions. (1) INSPECTIONS. (a) The department may make an-
nounced and unannounced inspections of a certified service to 
verify compliance with this chapter, to investigate complaints re-
ceived regarding the services provided, or as part of an investiga-
tion into the cause of death of a client.
(b) To ensure compliance with this chapter and other applica-
ble statutes and regulations, the department shall have access to 
all service documents, open and closed client records, and staff 
member files at any time.
(2) ENFORCEMENT. (a) Statement of deficiency. Upon deter-
mining that the service is in violation of any requirement of this 
chapter, the department shall promptly serve a statement of defi-
ciency to the governing authority or entity owner or designated 
representative of the service. 
(b) Plan of correction. 1. Within 10 business days of receipt 
of the statement of deficiency, the service shall submit a plan of 
correction to the department for approval, detailing how the ser-
vice will correct the violation or how the service has corrected 
the violation. The department may require that a plan of correc-
tion be submitted for approval within a shorter specified time for 
violations the department determines may be harmful to the 
health, safety, welfare, or rights of clients.
2. The department may require the service to modify the pro-
posed plan of correction before the department approves the plan 
of correction.
3. Failure to submit an approved plan of correction shall be 
grounds for denial, suspension, or revocation of the certification.
(3) APPEALS. (a) If the department denies, revokes, sus-
pends, or refuses to renew certification, the service may request 
an administrative hearing under ch. 227, Stats.
(b) A request for a hearing shall be received in writing to the 
department of administration’s division of hearings and appeals 
within 10 days after the date of the notice of the department’s ac-
tion under s. DHS 75.05.
(c) If a timely request for hearing is made, the department’s 
decision to revoke, suspend, or refuse to renew certification is 
stayed pending the outcome of the appeal, unless the department 
finds that the health, safety or welfare of patients requires that the 
action take effect immediately. A finding of a requirement for 
immediate action shall be made in writing by the department.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.10 Investigation, notification, and report-
ing requirements. (1) DEATH REPORTING. (a) Patient death 
related to physical restraint, psychotropic medication, or suicide. 
No later than 24 hours after a service becomes aware of the death 
of a patient, the service shall report the death to the department if 
there is reasonable cause to believe the death was related to the 
use of a physical restraint or psychotropic medication, or was a 
suicide.
(b) Patient death related to an accident or injury. When a pa-
tient dies as a result of an incident or accident at the service loca-
tion not related to the use of a physical restraint, psychotropic 
medication, or suicide, the service shall send a report to the de-
partment within 3 working days of the patient’s death.
Note: Information and forms for statutorily reportable deaths and reporting pro-
cedures can be found at: https://www.dhs.wisconsin.gov/regulations/report-
death/definitions.htm. 
(2) INVESTIGATING AND REPORTING ABUSE, NEGLECT, OR 
MISAPPROPRIATION OF PROPERTY. (a) Caregiver abuse or ne-
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
7 DEPARTMENT OF HEALTH SERVICES DHS 75.14
glect. 1. When a service receives a report of an allegation of 
abuse or neglect of a client, or misappropriation of property at the 
service location, the service shall take immediate steps to ensure 
the safety of all clients.
2. The service shall investigate and document any allegation 
of abuse or neglect of a client, or misappropriation of property by 
a caregiver. If the service’s investigation concludes that the al-
leged abuse or neglect of a client or misappropriation of property 
meets the definition of abuse or neglect of a client, or of misap-
propriation of property, the service shall report the incident to the 
department on a form provided by the department, within 7 cal-
endar days from the date the service knew or should have known 
about the abuse, neglect, or misappropriation of property. The 
service shall maintain documentation of any investigation.
(b) Other reporting. Filing a report under sub. (1) or (2) does 
not relieve the service or other person of any obligation to report 
an incident to any other authority, including law enforcement, the 
coroner and DSPS.
(3) NOTIFICATION OF CHANGES AFFECTING A CLIENT. (a) 
The service shall immediately notify the client’s legal representa-
tive, as applicable, when there is an incident or injury to the client 
or a significant change in the client’s physical or mental 
condition.
(b) The service shall immediately notify the client’s legal rep-
resentative, as applicable, when there is an allegation of physical, 
sexual, or mental abuse, or neglect of a client. The service shall 
notify the client’s legal representative within 72 hours when there 
is an allegation of misappropriation of property.
(c) The service shall give the client or the client’s legal repre-
sentative, as applicable, a 30-day written notice of any change in 
charges for services that will be in effect for more than 30 days.
(4) DOCUMENTATION. All written reports required under this 
section shall include, at a minimum, the time, date, place, indi-
viduals involved, details of the occurrence, and the action taken 
by the provider to ensure clients’ health, safety and well-being.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.11 General records and retention. (1) The 
service shall retain all records required under this chapter for 7 
years, unless otherwise specified in subs. (2) and (3).
(2) Client records shall be retained as specified in ch. DHS 92 
and in 42 CFR part 2.
(3) Employee records shall be retained for 3 years following 
an employee’s separation from employment at the service.
(4) A service shall have a written policy and procedure for 
administrative review and maintenance of records related to inci-
dent reports.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22; correction 
in (1) made under ss. 13.92 (4) (b) 4. and 35.17, Stats., and correction in (2) made 
under s. 35.17, Stats., Register October 2021 No. 790.
DHS 75.12 Telehealth services. (1) All requirements 
in this chapter shall also be applicable to telehealth services de-
livered under this chapter.
(2) Services delivered through telehealth shall be of sufficient 
quality to be functionally equivalent.
History: CR 20-047: cr. Register October 2021 No. 790 , eff. 10-1-22; CR 23-
053: am. (2) Register September 2023 No. 813, eff. 10-1-23.
DHS 75.13 Waivers and variances. (1) EXCEPTION 
TO A REQUIREMENT. (a) The department may grant a waiver or 
variance if the department determines that the proposed waiver or 
variance will not jeopardize the health, safety, welfare, or rights 
of any client.
(b) A written request for a waiver or variance shall be sent to 
the department on a form provided by the department and in-
cludes justification that the waiver or variance will not adversely 
affect the health, safety, or welfare of any client for the requested 
action.
(c) A written request for a variance shall include a description 
of an alternative means planned to meet the intent of the 
requirement.
(d) In considering whether to approve a waiver or variance, 
the department will consider whether the requested waiver or 
variance increases patient access to care or sufficiently supports 
the efficient and economic operation of a service.
(2) RESCINDING WAIVER OR VARIANCE. The department may 
rescind a waiver or variance if any of the following occurs:
(a) The department determines the waiver or variance has ad-
versely affected the health, safety, or welfare of a client.
(b) The service fails to comply with any of the conditions of 
the waiver or variance as granted.
(c) Rescinding the waiver or variance is required by federal or 
state law.
(d) There is no longer sufficient justification that the waiver 
or variance increases patient access to care or sufficiently sup-
ports the efficient and economic operation of a service.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
Subchapter III — Prevention and Intervention Service 
Requirements
DHS 75.14 Prevention service. (1) SERVICE DESCRIP-
TION. A prevention service makes use of universal, selective, and 
indicated prevention services as defined by s. DHS 75.14 (3) . 
Prevention services may be focused on reducing behaviors and 
actions that increase the risk of misusing substances or being af-
fected by another person’s substance use.
(2) APPLICABILITY. This section shall apply to prevention 
services when required by contract with the department, or when 
a prevention service requests certification.
(3) DEFINITIONS. In this section:
(a) “Prevention” has the meaning given in s. SPS 160.02 (21).
(b) “Prevention domain” refers to content areas that profes-
sionals working in substance use prevention shall be knowledge-
able in. The prevention domains include any of the following:
1. Planning and evaluation.
2. Prevention education and service delivery.
3. Communication.
4. Community organization.
5. Public policy and environmental change.
6. Professional growth and responsibility, including ethics.
(c) “Prevention service” means the organized application of 
strategies and interventions that are provided to reduce the overall 
harms and burden of substance use for an identified community 
or group.
(d) “Prevention strategy” means activities targeted to a spe-
cific population or the larger community that are designed to be 
implemented before the onset of problems as a means to prevent 
substance use or its detrimental effects from occurring.
(e) “Target population” means the identified community or 
group that a prevention strategy is aimed to impact.
(f) “Universal, selective, and indicated prevention strategy” 
means different levels of risk that are addressed through commu-
nity-based substance use prevention efforts, where universal pre-
vention efforts focus on general audiences who have not been 
identified based on substance use-related risk, selective preven-
tion efforts focus on audiences with known risk factors for a sub-
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 75.14 WISCONSIN ADMINISTRATIVE CODE 8
stance use-related problem, and indicated prevention efforts fo-
cus on audiences who are already experiencing a substance use-
related problem.
(4) GENERAL REQUIREMENTS. (a) Governing authority or 
entity owner. The governing authority or entity owner of a ser-
vice shall do all of the following:
1. Designate a member or representative of the governing 
body that is legally responsible for the operation of a service that 
has the authority to conduct the policy, actions, and affairs of the 
service, to complete the entity owner background check and to be 
the entity owner responsible for a service.
2. Appoint a service director whose qualifications, authority, 
and duties are defined in writing.
3. Establish written policies and procedures for the operation 
of the service and exercise general direction over the service, to 
ensure the following:
a. Compliance with local, state and federal laws.
b. That no person will be denied service or discriminated 
against on the basis of sex, race, color, creed, sexual orientation, 
disability, or age, in accordance with 45 CFR part 92 and Title VI 
of the Civil Rights Act of 1964, as amended, 42 USC. 2000d, Ti-
tle IX of the Education Amendments of 1972, 20 USC 1681-
1686 and s. 504 of the Rehabilitation Act of 1973, as amended, 
29 USC 794, and the Americans with Disabilities Act of 1990, as 
amended, 42 USC 12101-12213.
(b) Caregiver background check. At the time of hire, employ-
ment, or contract, and every 4 years after, the service shall con-
duct and document a caregiver background check following the 
procedures in ch. DHS 12 and s. 50.065, Stats. A service shall 
not employ or contract with a person who has been convicted of a 
crime or offense, or has a governmental finding of misconduct, 
found in ch. DHS 12 and s 50.065, Stats., unless the person has 
been approved under the department's rehabilitation process as 
defined in ch. DHS 12.
(c) Personnel records. Employee records shall be available 
upon request at the service for review by the department. A sepa-
rate record for each employee shall be maintained, kept current, 
and at a minimum, include:
1. A written job description including duties, responsibilities 
and qualifications required for the employee.
2. Beginning date of employment.
3. Qualifications based on education or experience. 
4. A completed caregiver background check following proce-
dures under s. 50.065, Stats., and ch. DHS 12.
5. A copy of a signed statement regarding confidentiality of 
client information.
6. Documentation of any required training.
7. A copy of any required licenses or certifications.
(d) Confidentiality. A service shall have written policies, pro-
cedures, and staff training to ensure compliance with confiden-
tiality provisions of 42 CFR part 2, 45 CFR parts 164 and 170, s. 
51.30, Stats., and ch. DHS 92. Each staff member shall sign a 
statement acknowledging responsibility to maintain confidential-
ity of personal information about persons served.
(5) REQUIRED PERSONNEL. (a) Prevention professional. A 
professional employed by the service shall be knowledgeable and 
skilled in areas of substance use prevention, including prevention 
domains, prevention services, and program implementation.
(b) Training. Staff shall receive ongoing training to improve 
skills and knowledge in the prevention domains and in the imple-
mentation of prevention services.
(6) OPERATION OF THE PREVENTION SERVICE. (a) Strategies 
employed by the prevention service. A prevention service shall 
utilize at least one of the following recognized best practices for 
evidence-based substance use prevention:
1. ‘Comprehensive approach.’ A prevention service shall 
employ a comprehensive approach that targets universal, selec-
tive, and indicated populations, and uses strategies which seek to 
prevent substance use and its effects.
2. ‘Information dissemination.’ The prevention service shall 
provide awareness and knowledge of the nature and extent of the 
identified problem and generate knowledge and awareness of 
available prevention services via one-way communication with 
the public. Examples of methods that may be used to carry out 
this strategy include the following:
a. Operation of an information clearinghouse.
b. Development and distribution of a resource directory.
c. Media campaigns.
d. Development and distribution of brochures.
e. Radio and TV public service announcements.
f. Speaking engagements.
g. Participation in health fairs and other health promotion 
activities.
3. ‘Education.’ The prevention service shall provide two-
way communication between staff and a client or clients, that is 
directed towards affecting critical life and social skills, including 
decision-making, refusal skills, critical analysis, and systematic 
judgment abilities. Examples of activities that may be conducted 
and methods used in carrying out this strategy include the 
following:
a. Classroom or small group sessions.
b. Parenting and family management classes.
c. Peer leader or helper programs.
d. Education programs for youth groups.
e. Groups for children with family members who use 
substances.
4. ‘Alternative activities.’ The prevention service shall pro-
vide activities that assist in building resiliency and exclude alco-
hol, tobacco, and other drug use to targeted populations. The as-
sumption is that constructive and healthy activities offset the at-
traction to, or otherwise meet the needs that may be fulfilled by, 
alcohol, tobacco, and other drugs. Alternative activities also pro-
vide a means of character-building and may promote healthy rela-
tionships between youth and adults, in that participants may in-
ternalize the values and attitudes of the individuals involved in 
establishing the prevention services objectives. Examples of ac-
tivities that may be promoted or conducted under this strategy in-
clude the following:
a. Drug-free dances and parties.
b. Youth or adult leadership activities.
c. After-school activities such as participation in athletic ac-
tivities, music lessons, art clubs or the school newspaper.
d. Community drop-in centers.
e. Community service activities.
5. ‘Problem identification and stand-alone referral.’ The 
prevention service shall implement methods to identify individu-
als who have demonstrated at-risk behavior, such as illegal or 
age-inappropriate use of tobacco or alcohol, or first use of illicit 
drugs, and determine if the individual’s behavior can be reversed 
through education. This strategy does not include activities de-
signed to determine if a person is in need of treatment. Examples 
of activities that may be conducted and methods used in carrying 
out this strategy include the following:
a. Employee assistance programs.
b. Student assistance programs.
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
9 DEPARTMENT OF HEALTH SERVICES DHS 75.15
c. Educational programs for individuals charged with driving 
while under the influence or driving while intoxicated.
6. ‘Environmental.’ The prevention service shall establish 
community standards, codes, and attitudes, aimed at reducing the 
prevalence of at-risk behavior among the general population. Ex-
amples of methods that may be used in carrying out this strategy 
include the following:
a. Promoting the establishment and review of policies for 
schools, government, and civic groups related to the use of alco-
hol, tobacco, and drugs.
b. Providing technical assistance to communities to maxi-
mize local enforcement procedures governing availability and 
distribution of alcohol, tobacco, and other drugs.
c. Reduce youth alcohol, tobacco, and drug exposure by 
modifying alcohol and tobacco advertising practices.
d. Supporting local enforcement procedures to limit violent 
behavior.
e. Establishing policies that create opportunities for youth to 
become involved in their communities.
7. ‘Community-based process.’ The prevention service shall 
implement processes that enhance the ability of the community 
to more effectively provide prevention services for behaviors that 
lead to substance use. Activities under this strategy include orga-
nizing, planning, enhancing the efficiency and effectiveness of 
services implementation, interagency collaboration, coalition 
building and networking. Examples of activities that may be 
conducted and methods used in carrying out this strategy include 
the following:
a. Community and volunteer training, such as neighborhood 
action training and training of key people in the system.
b. Systematic planning in the above prevention strategy 
areas.
c. Multi-agency coordination and collaboration.
d. Facilitating access to services and funding.
e. Active participation in a community prevention coalition.
(c) Goals and objectives. A prevention service shall have 
written operational goals and objectives that specify the strategies 
by which they will be achieved and the target population served.
(d) Documentation of coordination. A prevention service 
shall provide written documentation of coordination with other 
human service agencies, organizations or services that share sim-
ilar goals.
(e) Records. A prevention service shall maintain records on 
the number of individuals served by implementation of each pre-
vention strategy and retain records necessary for meeting certifi-
cation and funding requirements.
(7) PREVENTION SERVICE EVALUATION. (a) Prevention eval-
uation outcomes. A prevention service shall have an evaluation 
process that measures the outcomes of the services provided.
(b) Prevention evaluation by consumers. A prevention ser-
vice shall evaluate the views of consumers about the services 
they are provided and shall adjust goals and objectives 
accordingly.
(c) Prevention service written policy. A prevention service 
shall have a written policy and a defined process to provide indi-
viduals with the opportunity to express opinions regarding ongo-
ing services, staff, and the methods by which individual preven-
tion activities are offered.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22; correction 
in (1) made under s. 13.92 (4) (b) 7., Stats., and correction in (4) (a) 3. b., (d) made 
under s. 35.17, Stats., Register October 2021 No. 790; CR 25-055: am. (4) (a) 3. b., 
(b), renum. (6) (a) to (6) (a) (intro.) and am., renum. (6) (b) 1. to 7. to be (6) (a) 
1. to 7. Register February 2026 No. 842, eff. 3-1-26; correction in (4) (b) made 
under s. 35.17, Stats., and(6) (a) (title) created under s. 13.92 (4) (b) 2., Stats., 
Register February 2026 No. 842.
DHS 75.15 Intervention service and intoxicated 
driver services. (1) SERVICE DESCRIPTION FOR AN INTER-
VENTION SERVICE. Intervention services are delivered in a wide 
variety of settings and are designed to explore and address risk 
factors that appear to be related to substance use, to assist the in-
dividual in recognizing the consequences of harmful substance 
use, and to provide information for individuals to make behav-
ioral changes. Intervention services may include screening, brief 
intervention and referral, psychoeducational services, pre-treat-
ment intervention groups, case management, health education, 
outreach and in-reach programs, problem identification, informa-
tion dissemination, alternative education, intoxicated driver as-
sessments, and support services provided to reduce the effects of 
substance-related concerns by identifying and engaging the indi-
vidual to change behavior or to participate in treatment or other 
wellness services.
(2) APPLICABILITY. This section shall apply to any of the 
following:
(a) Intervention services, as required by contract with the 
department.
(b) Intoxicated driver services.
(c) An intervention service that requests certification.
(3) SERVICE DESCRIPTION FOR INTOXICATED DRIVER SER-
VICES. Intoxicated driver intervention services are specific ser-
vices within the Intoxicated Driver Program under ch. DHS 62, 
utilized to reduce risk of reoccurrence of impaired driving. These 
services include intoxicated driver assessments, driver safety 
planning and monitoring, and alternative education services.
(4) DEFINITIONS. In this section:
(a) “Alternative education” means a course of traffic safety in-
struction that is designed to meet the goals of a group dynamic 
traffic safety program or a multiple offender traffic safety pro-
gram for clients that cannot be accommodated by a group dy-
namic traffic safety program or multiple offender traffic safety 
program.
(b) “Intervention service” means a service provided to an in-
dividual who, at the time of screening and assessment, does not 
appear to meet the criteria for a diagnosis of substance use disor-
der or for referral to treatment services but is at risk of developing 
problems related to substance use.
(5) GENERAL REQUIREMENTS FOR INTERVENTION SERVICES 
AND INTOXICATED DRIVER SERVICES. (a) Governing authority 
or entity owner. The governing authority or entity owner of a ser-
vice shall do all of the following:
1. Designate a member or representative of the governing 
body that is legally responsible for the operation of a service that 
has the authority to conduct the policy, actions, and affairs of the 
service, to complete the entity owner background check and to be 
the entity owner responsible for a service.
2. Appoint a service director whose qualifications, authority, 
and duties are defined in writing.
3. Establish written policies and procedures for the operation 
of the service and exercise general direction over the service. 
Policies and procedures must be written to insure all of the 
following:
a. Compliance with local, state, and federal laws.
b. That no person will be denied service or discriminated 
against on the basis of sex, race, color, creed, sexual orientation, 
disability, or age, in accordance with 45 CFR part 92 and Title VI 
of the Civil Rights Act of 1964, as amended, 42 USC 2000d, Title 
XI of the Education Amendments of 1972, 20 USC 1681-1686 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 75.15 WISCONSIN ADMINISTRATIVE CODE 10
and s. 504 of the Rehabilitation Act of 1973, as amended, 29 USC 
794, and the Americans with Disabilities Act of 1990, as 
amended, 42 USC 12101-12213.
(b) Caregiver background check. At the time of hire, employ-
ment, or contract, and every 4 years after, the service shall con-
duct and document a caregiver background check following the 
procedures in ch. DHS 12 and s. 50.065, Stats. A service shall 
not employ or contract the service if the person has been con-
victed of the crimes or offenses, or has a governmental finding of 
misconduct, found in ch. DHS 12 and s. 50.065, Stats., unless the 
person has been approved under the department's rehabilitation 
process, as defined in ch. DHS 12.
(c) Personnel records. Employee records shall be available 
upon request at the service for review by the department. A sepa-
rate record for each employee shall be maintained, kept current, 
and at a minimum, include:
1. A written job description including duties, responsibilities 
and qualifications required for the employee.
2. Beginning date of employment.
3. Qualifications based on education or experience.
4. A completed caregiver background check following proce-
dures under s. 50.065, Stats., and ch. DHS 12.
5. A copy of a signed statement regarding confidentiality of 
client information.
6. Documentation of any required training.
7. A copy of any required licenses or certifications.
(d) Confidentiality. A service shall have written policies, pro-
cedures and staff training to ensure compliance with confiden-
tiality provisions of 42 CFR part 2 , 45 CFR parts 164 and 170, 
and s. 51.30, Stats., and ch. DHS 92. Each staff member shall 
sign a statement acknowledging his or her responsibility to main-
tain confidentiality of personal information about persons 
served.
(e) Policies, procedures, and service description. A service 
shall develop written policies, procedures, and service descrip-
tions for each intervention service to be provided.
(f) Submissions to department. The service shall submit each 
service description, along with written policies and procedures, 
to the department with the initial certification application, and 
submit any updates to the department when needed.
(g) Staff knowledge and training. Service staff shall have 
knowledge, training, and experience in the service which they are 
responsible for providing, including substance use intervention, 
screening, and referral.
(h) Referral. The service shall develop and maintain a written 
record of certified substance use treatment resources for referral, 
and shall refer clients as indicated for further assessment and 
treatment services. 
(i) Evaluation. The service shall have an evaluation plan that 
includes goals of the service, measurable outcomes and objec-
tives related to the service goals, and an annual report of progress 
related to goals and objectives that is available to the department 
and the public.
(6) LOCATION OF SERVICE DELIVERY. An intervention ser-
vice, other than an intoxicated driver service designated under s. 
DHS 62.04, may be provided in a variety of settings, such as clin-
ical offices, schools, workplaces, community centers, or an indi-
vidual’s home, with the length of service varying according to the 
type of activity and needs of the individual. An intervention ser-
vice that provides services in community settings shall ensure the 
following:
(a) All requirements of this chapter are able to be met in the 
setting. 
(b) The service shall have written policies and procedures 
concerning community-based service delivery.
(c) The service shall provide annual training for all staff that 
deliver services in the community regarding in-home and com-
munity safety, and avoiding sexual or other exploitative relation-
ships with clients. A record of each training shall be available to 
the department upon request.
(7) CASE RECORDS FOR PERSONS RECEIVING INTERVENTION 
SERVICES. (a) A service shall keep a case record for every person 
receiving intervention services, except where the only contact is 
made by telephone.
(b) A case record prepared under this subsection shall include 
all of the following information: 
1. The individual’s name, address, phone contact informa-
tion, date of birth, and relevant demographic information.
2. The individual’s admission date.
3. Substance use information about the individual and the 
reason for referral.
4. The results of any screening completed.
5. A sufficient assessment of the individual’s dimensional 
risk and severity of need to determine preliminary level of care.
6. Service recommendations, referrals, and follow-up ser-
vices and activities completed for the individual.
7. Documentation of each contact the service has with the 
client or a collateral source.
(8) ADDITIONAL REQUIREMENTS FOR INTOXICATED DRIVER 
SERVICES. (a) If an intervention service is designated by a 
county human service board under s. DHS 62.04 as an intoxi-
cated driver assessment facility, the intervention service shall 
also comply with the requirements under ch. DHS 62.
(b) A public or private treatment facility designated by a 
county as the intoxicated driver program assessment service shall 
be certified under this section prior to conducting intoxicated 
driver program assessments.
(c) In addition to sub. (7) (b), a case record for an intoxicated 
driver assessment service shall include a copy of the department-
approved intoxicated driver assessment tools, the driver safety 
plan, progress reports, and verification of service completion or 
evidence of noncompliance.
(9) ALTERNATIVE EDUCATION PROGRAMS FOR INTOXICATED 
DRIVERS. (a) General. 1. Alternative education programs shall 
be modeled after group dynamic traffic safety and multiple of-
fender traffic safety program. An alternative education program 
shall be conducted in a constructive, interactive, and trusting at-
mosphere and that include all of the following as part of its 
curriculum:
a. Review and discussion of operating while intoxicated laws 
and penalties.
b. Discussion of the central causes and consequences of op-
erating while intoxicated.
c. Discussion of the effects of alcohol and substances on the 
mind, body, and driving ability.
d. Discussion of the psycho-social factors involved in sub-
stance use.
e. Education about blood alcohol concentration.
f. Education about substance use and substance use disor-
ders, and where participants are in regards to severity of sub-
stance use.
g. Education about, and assistance in developing and follow-
ing a personal change plan.
2. In addition to the content and objectives under subd. 1., 
programs in lieu of a multiple offender traffic safety program 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
11 DEPARTMENT OF HEALTH SERVICES DHS 75.18
shall involve concerned others, such as a spouse, parent, adult rel-
ative, or other appropriate person approved by the instructor, and 
shall provide education on basic skills in the areas of stress-re-
duction, substance use refusal, interpersonal communication, and 
anger management.
3. Classroom instruction time for programs that are in lieu of 
group dynamic traffic safety programs shall be a minimum of 16 
hours.
4. Classroom instruction time for programs that are in lieu of 
multiple offender traffic safety programs shall be a minimum of 
24 hours, including a group-oriented follow-up session. The 
group-oriented follow-up session shall be held within 3 months 
after completion of the initial 23 hours of the program. If a par-
ticipant’s residence is 60 miles or more from the site of the 
group-oriented follow-up session, the follow-up session may be 
conducted by telephone with the participant and a concerned 
other, such as a spouse, parent, adult relative, or other appropriate 
person.
5. Classroom instruction time may not exceed 8 hours per 
day.
6. A report of course completion or non-completion shall be 
submitted to the intoxicated driver assessment facility designated 
under s. DHS 62.04 (1) for each client assessed by that facility.
7. The effectiveness of alternative education programs shall 
be evaluated by administering pretests and posttests of knowledge 
gained by participants, changed attitudes of participants, and par-
ticipant satisfaction surveys.
(b) Instructor qualifications. Instructors conducting alterna-
tive education shall have the following qualifications:
1. Substance use service experience equal to one of the 
following:
a. Two years of employment experience or a comparable 
amount of experience and education in the area of substance use 
counseling, assessment, education, or treatment, or related fields 
such as student assistance program director or employee assis-
tance program director.
b. Completed a minimum of a one-semester, 3-credit, 45-
hour course in the areas of substance use disorder education or 
treatment from an accredited college or university.
2. Group process experience equal to one of the following:
a. Two years of employment experience in group process 
work or group counseling as a treatment or education 
professional.
b. Completed a minimum of a one-semester, 3-credit, 45-
hour course in the area of group work methods, group counseling 
or group process from an accredited college or university.
c. Bachelor’s or master’s degree in guidance counseling, psy-
chology, behavioral studies or social work.
3. Hold a valid driver’s license from the state of Wisconsin or 
from the jurisdiction in which the person resides. Programs hav-
ing nonresident instructors shall maintain a record of the nonres-
ident’s driver’s license and traffic conviction status in the past 12 
months.
4. Possess a satisfactory driving record as defined under s. 
Trans 106.02 (11).
a. An individual may not be employed as an instructor until 6 
months after the date of any traffic conviction that results in an 
accumulation of 7 or more points against the individual’s driver’s 
license, or until 12 months from the date of an operating while in-
toxicated conviction under s. 23.33, 30.68, 346.63, 350.101, 
940.09, or 940.25, Stats., or an order under s. 343.305, Stats.
b. Instructors under this section are not eligible to receive a 
3-point reduction by completing a traffic safety course. 
c. Once employed as an instructor under this section, an indi-
vidual’s failure to maintain a satisfactory driving record shall re-
sult in the suspension of the individual’s instruction duties for 6 
months from the date of conviction for a violation which places 
the point total over 6 points or for 12 months from the date of an 
operating while intoxicated conviction. If additional points are 
incurred or the individual is convicted of operating while intoxi-
cated during the suspension period, the individual’s instruction 
duties shall be suspended for 12 months from the date of convic-
tion for a violation which results in points or for 24 months from 
the date of an operating while intoxicated conviction.
5. Instructors shall document receiving a minimum of 6 
hours of continuing education in a related area, approved by the 
department, during each 12 months that the individual is em-
ployed as an instructor under this section. This training may in-
clude formal courses awarding credits or continuing education 
units, workshops, seminars, or correspondence courses.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22; correction 
in (5) (a) 2. b., (8) (a), (9) (b) 4. a. made under s. 35.17, Stats., and correction in (8) 
(c) made under s. 13.92 (4) (b) 7. , Stats., Register October 2021 No. 790; CR 25-
055: am. (5) (b) Register February 2026 No. 842, eff. 3-1-26; correction in (5) 
(b) made under s. 35.17, Stats., Register February 2026 No. 842.
Subchapter IV — Treatment Service General 
Requirements
DHS 75.16 Applicability of treatment service gen-
eral requirements. This subchapter establishes general re-
quirements that apply to the 11 types of community substance 
use treatment services under ss. DHS 75.49 to 75.59. General re-
quirements apply to all treatment services certified under this 
chapter, unless otherwise specified.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22; correction 
made under s. 35.17, Stats., Register October 2021 No. 790.
DHS 75.17 Governing authority or entity owner re-
quirements. (1) GOVERNING AUTHORITY OR ENTITY OWNER 
REQUIREMENTS. The governing authority or entity owner of a 
service shall do all of the following:
(a) Designate a member or representative of the governing 
body that is legally responsible for the operation of a service that 
has the authority to conduct the policy, actions, and affairs of the 
service, to complete the entity owner background check and to be 
the entity owner responsible for a service.
(b) Appoint a service director whose qualifications, authority, 
and duties are defined in writing.
(c) Establish written policies and procedures for the operation 
of the service and exercise general direction over the service, in-
cluding the following:
1. Ensure compliance with local, state, and federal laws.
2. Ensure compliance with patient rights requirements as 
specified in this chapter and in ch. DHS 94 and s. 51.61, Stats.
3. Ensure that no person will be denied service or discrimi-
nated against on the basis of sex, race, color, creed, sexual orien-
tation, disability, or age, in accordance with 45 CFR part 92 and 
Title VI of the Civil Rights Act of 1964, as amended, 42 USC 
2000d, Title XI of the Education Amendments of 1972, 20 USC 
1681-1686 and s. 504 of the Rehabilitation Act of 1973, as 
amended, 29 USC 794, and the Americans with Disabilities Act 
of 1990, as amended, 42 USC 12101-12213.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22; correction 
in (1) (c) 3. made under s. 35.17, Stats., Register October 2021 No. 790.
DHS 75.18 General requirements for service staff. 
(1) SERVICE DIRECTOR. (a) A service shall have a service 
director. 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 75.18 WISCONSIN ADMINISTRATIVE CODE 12
(b) The service director shall be responsible for all of the 
following:
1. Administration and overall operation of the service.
2. Ensuring that appropriate policies and procedures for the 
service are developed and carried out in compliance with this 
chapter.
3. Administrative oversight of the job performance and ac-
tions of service staff members.
4. Compliance with regulations governing the care and treat-
ment of patients and the standards of practice for behavioral 
health professions.
(c) Unless otherwise specified for a specific level of care, the 
service director, or staff member designated by the director to be 
responsible for the operation of the service, shall be readily avail-
able, at all times the service is in operation. That person may pro-
vide direct counseling or other duties consistent with their scope 
of practice, in addition to being responsible for the service 
operation.
(2) CLINICAL SUPERVISOR. (a) A service shall have a clinical 
supervisor, either on staff or through a contracted agreement, to 
provide clinical supervision or clinical consultation to clinical 
staff of a service, as required within this chapter, and consistent 
with applicable professional licensure and certification 
requirements.
(b) The clinical supervisor is responsible for professional de-
velopment of clinical staff, and for ensuring delivery of appropri-
ate clinical services to patients of a service.
(c) Any staff who provides clinical supervision shall be a clin-
ical supervisor, as defined in s. DHS 75.03 (19). A clinical super-
visor who is on staff of the service and meets the requirements of 
a substance abuse counselor or mental health professional may 
provide direct counseling services in addition to supervisory 
responsibilities.
(3) SUBSTANCE ABUSE COUNSELORS. A service shall have a 
substance abuse counselor, as defined in s. DHS 75.03 (85) , 
available during the hours of operation of clinical services. 
(4) PRESCRIBERS. A service may have prescribers that pro-
vide medical services and clinical consultation services. The ser-
vice shall ensure appropriate training and oversight of 
prescribers.
(5) NURSES. A service may have nurses that provide nursing 
services to support mental health and substance use treatment. 
The service shall ensure appropriate training and oversight of 
nursing staff.
(6) MENTAL HEALTH PROFESSIONALS. (a) A service may 
have mental health professionals or prescribers that deliver men-
tal health treatment services. All staff who provide mental health 
treatment, except prescribers knowledgeable in psychiatry, shall 
meet the appropriate qualifications under ch. 455 or ch. 457, 
Stats.
(b) For service levels of care in ss. DHS 75.49 to 75.59 that re-
quire a mental health professional, the role of substance abuse 
counselor and mental health professional may be occupied by the 
same individual with appropriate credentialing, and providing 
they are operating within the scope of their practice.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22; correction 
in (2) (c), (3), (6) (a) made under s. 35.17, Stats., Register October 2021 No. 790.
DHS 75.19 Personnel requirements. (1) CAREGIVER 
BACKGROUND CHECK. At the time of hire, employment, or con-
tract, and every 4 years after, the service shall conduct and docu-
ment a caregiver background check following the procedures in s. 
50.065, Stats., and ch. DHS 12. A service shall not employ or 
contract the service if the person has been convicted of the crimes 
or offenses, or has a governmental finding of misconduct, found 
in s. 50.065, Stats., and ch. DHS 12, unless the person has been 
approved under the department’s rehabilitation process, as de-
fined in ch. DHS 12.
(2) PERSONNEL RECORDS. Employee records shall be avail-
able upon request at the service for review by the department. A 
separate record for each employee shall be maintained, kept cur-
rent, and at a minimum, include:
(a) A written job description including duties, responsibilities 
and qualifications required for the employee.
(b) Beginning date of employment.
(c) Qualifications based on education or experience.
(d) A completed caregiver background check following proce-
dures under s. 50.065, Stats., and ch. DHS 12.
(e) A copy of a signed statement regarding confidentiality of 
client information.
(f) Documentation of any required training.
(g) A copy of any required licenses or certifications.
(3) CLINICAL SUPERVISION. A service shall have written 
policies and procedures for the provision of clinical supervision 
to unlicensed staff, qualified treatment trainees, and recovery 
support staff. Clinical supervision for substance abuse coun-
selors, mental health professionals in-training, and qualified 
treatment trainees shall be in accordance with requirements in ch. 
SPS 162, chs. MPSW 4, 12, and 16, and ch. Psy 2. A record of 
clinical supervision shall be made available to the department 
upon request.
(4) STAFF DEVELOPMENT. (a) A service shall have written 
policies and procedures for determining staff training needs, for-
mulating individualized training plans, and documenting the 
progress and completion of staff development goals.
(b) The requirements in this subsection may be met through 
documentation on an employee’s annual performance evaluation 
that addresses professional development goals.
(c) Minimum training requirements for clinical staff include 
all of the following: 
1. Assessment and management of suicidal individuals.
2. Safety planning for behavioral health emergencies.
3. Assessment and treatment planning for co-occurring 
disorders.
(d) Documentation of training shall be made available to the 
department upon request.
(e) Documented training for areas identified in par. (c) shall 
occur within 2 months of hire for new clinical staff, unless the 
service is able to provide documentation of the staff member’s 
previous training, professional education, or supervised experi-
ence addressing these areas.
(5) UNIVERSAL PRECAUTIONS. A service shall have written 
policies and procedures for infection control and prevention that 
adheres to federal occupational safety and health administration 
bloodborne pathogens standards in 29 CFR 1910.1030.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22; correction 
in (3), (4) (e) made under s. 35.17, Stats., Register October 2021 No. 790.
DHS 75.20 Patient case records. (1) GENERAL 
TREATMENT SERVICE CASE RECORDS. (a) With respect to general 
treatment service case records, the service shall do all of the 
following:
1. Maintain a case record for each patient. 
2. The service director or another designated staff member 
shall be responsible for the maintenance and security of patient 
case records.
3. Safeguard and maintain patient case records in accordance 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
13 DEPARTMENT OF HEALTH SERVICES DHS 75.22
with applicable state and federal security requirements, including 
all applicable security requirements specified in ch. DHS 92, 42 
CFR part 2 , 45 CFR parts 164 and 170, and ss. 146.816 and 
146.82, Stats.
4. Maintain each case record in a format that provides for 
consistency and facilitates information retrieval.
5. Whenever an edit to a signed entry in a patient’s case 
record is made, the service shall document the date of the edit, 
the name of the individual making the edit, and a brief statement 
about the reason for the edit, if the prior version of the edited in-
formation is not retained by the service.
(b) A patient’s case record shall include all of the following:
1. The patient’s name, physical residence, address, and 
phone contact information.
2. The patient’s date of birth, self-identified gender, and self-
identified race or ethnic origin.
3. Consent for treatment forms signed by the patient or the 
patient’s legal guardian, if applicable, that are maintained in ac-
cordance with s. DHS 94.03.
4. An acknowledgment by the patient or the patient’s legal 
guardian, if applicable, that the service policies and procedures 
were explained to the patient or the patient’s legal guardian.
5. A copy of the signed and dated patient notification that 
was reviewed with and provided to the patient or the patient’s le-
gal guardian, if applicable, which identifies patient rights, and ex-
plains provisions for confidentiality and the patient’s recourse in 
the event that the patient’s rights have been abused.
6. Results of all screening, examinations, tests, and other as-
sessment information.
7. A completed copy of the standardized placement criteria 
and level of care assessment at admission, and subsequent re-
views of level of care placement criteria.
8. Treatment plans, including all reviews and updates to the 
treatment plan.
9. Records for any medications prescribed or administered 
by the service, including any medication consent records required 
by s. DHS 94.09.
10. Copies of any incident reports or documentation of med-
ication errors applicable to the patient.
11. Records for any medical services provided by the 
service.
12. Reports from referring sources, as applicable.
13. Records of any referrals by the service, including docu-
mentation that referral follow-up activities occurred.
14. Correspondence relevant to the patient’s care and treat-
ment, including dated summaries of relevant telephone or elec-
tronic contacts and letters.
15. Consents authorizing disclosure of specific information 
about the patient.
16. Progress notes that include documentation of all services 
provided.
17. Clinical consultation and staffing notes, as applicable.
18. Any safety plans developed during the patient’s 
treatment.
19. Documentation of each transfer from one level of care to 
another. Documentation shall identify the applicable criteria 
from ASAM or other department-approved placement criteria, 
and shall include the dates the transfer was recommended and 
initiated.
20. Discharge documentation.
(c) For patients that discharge from a service and are subse-
quently re-admitted, a new case record shall be established for 
each episode of care.
(d) A patient’s case record shall be maintained in accordance 
with ch. DHS 92.
(e) If the service discontinues operations or is taken over by 
another service, records containing patient identifying informa-
tion shall be turned over to the replacement service, as permitted 
by applicable state and federal confidentiality requirements.
(2) CASE RECORDS FOR PERSONS RECEIVING ONLY SCREEN-
ING AND REFERRAL. A treatment service shall have a written pol-
icy and procedure regarding case records for individuals that re-
ceive only screening, consultation, or referral services. The pol-
icy and procedure shall include:
(a) Information to be obtained for phone and in-person 
screening, consultation, or referral.
(b) Assurance that screening includes an individual’s preg-
nancy status.
(c) Assurance that screening, consultation, and referral proce-
dures address individual risks and needs.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22; correction 
in (1) (a) 3., (b) 3., 9. made under s. 35.17, Stats., Register October 2021 No. 790.
DHS 75.21 Confidentiality. A service shall have written 
policies, procedures and staff training to ensure compliance with 
applicable confidentiality provisions of 42 CFR part 2 , 45 CFR 
parts 164 and 170, ss. 51.30, 146.816 and 146.82, Stats., and ch. 
DHS 92. Each staff member shall sign a statement acknowledg-
ing responsibility to maintain confidentiality of personal infor-
mation about persons served.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22; correction 
made under s. 35.17, Stats., Register October 2021 No. 790.
DHS 75.22 Services for minors. (1) APPLICATION. A 
service under this chapter that delivers treatment services to mi-
nors shall identify within their application to the department each 
level of care that will provide treatment services for minors.
(2) STATUTORY REQUIREMENTS. A service that delivers 
treatment services to minors shall adhere to all applicable re-
quirements outlined in ss. 51.13, 51.138, 51.14, 51.47 and 51.48, 
Stats.
(3) FAMILY INVOLVEMENT. Services for minors shall include 
the involvement of a parent, guardian, or other family members 
whenever possible. 
(4) STAFF QUALIFICATIONS. Staff delivering services to mi-
nors shall have training, experience, or education specific to the 
treatment of substance use and mental health for minors and shall 
practice within their scope. A record of relevant training, experi-
ence, or education shall be documented in the personnel record.
(5) STAFF TRAINING. A service that delivers treatment ser-
vices to minors shall provide training to clinical staff in the areas 
of adolescent development, family systems, child abuse and ne-
glect, and involuntary treatment laws for minors, unless the ser-
vice is able to provide documentation of the staff member’s pre-
vious training, professional education, or supervised experience 
addressing these areas. A record of required training shall be 
documented in the personnel record.
(6) SEPARATION OF SERVICES. Services for minors shall be 
separate from adult services, with the exception of specialized 
groups addressing the needs of transitional-age youth. Services 
for transitional-age youth shall be separate from other services 
for minors or adults. 
(7) POLICIES AND PROCEDURES. A service that delivers treat-
ment services to minors shall have written policies and proce-
dures to address specific safety needs of minors, including con-
sideration of vulnerability related to adult populations served 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 75.22 WISCONSIN ADMINISTRATIVE CODE 14
within the facility, adequacy of supervision for service delivery, 
and services addressing specific needs of youth.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.23 Service levels of care. (1) SERVICE LEV-
ELS OF CARE. (a) Services delivered under this chapter shall ad-
here to standardized levels of care as defined in this chapter. A 
service shall apply the ASAM criteria or other department-ap-
proved placement criteria to determine the appropriate level of 
care, and services shall be delivered consistent with that level of 
care.
(b) A service shall not deliver or purport to deliver a service 
for which they do not possess certification by the department un-
der this chapter.
(2) USE OF ASAM OR OTHER DEPARTMENT-APPROVED PLACE-
MENT CRITERIA. (a) A service shall utilize ASAM placement 
criteria or other department-approved placement criteria to deter-
mine the level of care that is matched to a patient’s needs and risk 
level.
(b) In order to be approved by the department, other place-
ment criteria must include all of the following:
1. A multi-dimensional assessment tool that captures behav-
ioral health, physical health, readiness for change, social risk lev-
els and directly correlates risk level to service levels of care based 
on frequency and intensity of the service.
2. Proof that the criteria is accepted and utilized within pro-
fessional organizations in the field of healthcare and allows for 
consistency of interpretation across settings and providers.
Note: Copies of the ASAM Criteria: Treatment Criteria for Addictive, Sub-
stance-Related, and Co-Occurring Conditions (published October 24, 2013) are on 
file in the department’s division of care and treatment services and the legislative 
reference bureau, and may be obtained from ASAM at 11400 Rockville Pike, Suite 
200, Rockville, MD 20852, or https://www.asam.org/asam-criteria/text.
(3) LEVEL OF CARE TRANSFER. A service that offers more 
than one level of care under this chapter shall identify in the clin-
ical record which level of care the patient is receiving based on 
the clinical assessment. When a level of care transfer is com-
pleted as indicated by assessment or treatment plan review, the 
service shall document the level of care transfer in the record and 
shall thereafter meet the service requirements for the indicated 
level of care.
(4) CONCURRENT SERVICES. (a) If a patient is receiving ser-
vices in more than one level of care at a given time, the service 
shall adhere to all applicable standards for each level of care, and 
to the level of care standard with the highest requirement when 
more than one apply.
(b) If a patient is receiving services in more than one level of 
care at a given time, the patient shall be listed on a roster or pa-
tient list for each level of care in which they receive services.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.24 Service operations. (1) SCREENING. (a) 
A service shall complete an initial screening for an individual that 
presents for services. The screening shall include all of the 
following:
1. Sufficient assessment of dimensional risk and severity of 
need to determine preliminary level of care.
2. A determination of the patient’s needs for immediate ser-
vices related to withdrawal risk, acute intoxication, overdose risk, 
induction of pharmacotherapy, or emergency medical needs.
3. An assessment of the patient’s suicide risk.
(b) A screening is preliminary, and is either confirmed or 
modified based on completion of the full assessment and ASAM 
or other department-approved level of care placement criteria.
(c) The screening completed under this subsection may be 
combined with a more comprehensive assessment.
(2) EMERGENCY SERVICES. If a need is identified for imme-
diate services related to withdrawal, acute intoxication, overdose, 
or other reason, the service may initiate treatment prior to com-
pletion of the comprehensive assessment or treatment plan. The 
patient’s record for emergency services shall include documenta-
tion of all of the following:
(a) A preliminary treatment plan for the patient.
(b) A consent for services to be received, signed by the patient 
or the patient’s legal guardian.
(c) A progress note for all services delivered to the patient.
(d) A reason for the initiation of emergency services and a 
completed initial screening that evaluates biomedical, mental 
health, and substance use indicators, and guides decision-making 
regarding the initial level of care placement and referral.
(3) AFTER HOURS EMERGENCY RESPONSE. A service shall 
have a written policy and procedure for how the clinic will pro-
vide or arrange for, the provision of services to address a patient’s 
behavioral health emergency or crisis during hours when its of-
fices are closed, or when staff members are not available to pro-
vide behavioral health services.
(4) SAFETY PLANNING. (a) When a patient’s pattern of be-
havior or acute symptoms of a substance use or mental health dis-
order indicate the likelihood for significant, imminent harm to the 
individual or others, including affected family members, the ser-
vice shall develop a safety plan within 24 hours of the contact.
(b) The service shall have written policies and procedures that 
outline the requirements and process for safety planning.
(5) OPIOID OVERDOSE REVERSAL. (a) A service shall have 
Naloxone on-site at each facility and branch location, to be ad-
ministered in the event of an opioid overdose.
(b) Naloxone medication shall be maintained and unexpired, 
and shall be stored in an accessible location.
(c) The service shall have written policies and procedures for 
administration of Naloxone by service staff.
(d) The service shall train all staff in recognition of overdose 
symptoms and administration of Naloxone.
(e) Administration of Naloxone by the service to any individ-
ual shall be documented in the clinical record or in a facility inci-
dent report.
(6) SERVICE DELIVERY FOR INTOXICATED INDIVIDUALS. A 
service shall have written policies and procedures regarding clin-
ically-appropriate response and services for individuals that 
present with symptoms of acute intoxication, withdrawal, or at 
risk of withdrawal. The policies and procedures shall include the 
following:
(a) The process for obtaining medical consultation, when 
indicated.
(b) The process for admitting the patient to a higher level of 
care, withdrawal management service, or direct linkage to medi-
cal services, when indicated.
(c) The process for ensuring the safety of an intoxicated indi-
vidual or persons experiencing withdrawal, including an individ-
ual operating while intoxicated.
(d) The process for follow-up and treatment engagement after 
an intervention for acute intoxication or withdrawal.
(7) TOBACCO USE DISORDER TREATMENT AND SMOKE-FREE 
FACILITY. A service shall have written policies outlining the ser-
vice’s approach to assessment and treatment for concurrent to-
bacco use disorders, and the facility’s policy regarding a smoke-
free environment.
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
15 DEPARTMENT OF HEALTH SERVICES DHS 75.24
(8) CULTURALLY AND LINGUISTICALLY APPROPRIATE SER-
VICES. A service shall have a written policy and procedure for as-
sessing the cultural and linguistic needs of the population to be 
served, and to ensure that services are responsive and appropriate 
to the cultural and linguistic needs of the community to be 
served.
(9) INTAKE AND ADMISSION. (a) A service shall have written 
policies and procedures for intake, including all of the following:
1. A written consent for treatment, which shall be signed by 
the prospective patient before admission is completed.
2. Information concerning communicable illnesses, such as 
sexually transmitted infections, hepatitis, tuberculosis, and HIV, 
and shall refer patients with communicable illness for treatment 
when appropriate.
3. Policies regarding admission of a patient under court or-
der, that shall be in accordance with ss. 51.15, 51.20, and 51.45 
(12), Stats.
4. A method for informing the patient about, and obtaining 
the patient’s signed acknowledgment of having been informed 
and understanding all of the following:
a. The general nature and purpose of the service.
b. Patient rights and the protection of privacy provided by 
confidentiality laws.
c. Service regulations governing patient conduct, the types of 
infractions that result in corrective action or discharge from the 
service, and the process for review or appeal.
d. The hours during which services are available.
e. Procedures for follow-up after discharge.
f. Information about the cost of treatment, who will be billed, 
and the accepted methods of payment if the patient will be billed.
g. Sources of collateral information that may be used for 
screening and assessment.
(b) If the patient is seeking treatment related to opioid use, 
and the service does not provide medication-assisted treatment 
for patients with opioid use disorders, the service shall provide 
information about the benefits and effectiveness of medication as 
an effective treatment for opioid use disorders. If the patient is 
not already receiving medication treatment, the service shall ob-
tain the patient’s written consent to participate in non-medication 
treatment, shall provide a referral to a service that offers medica-
tion-assisted treatment for opioid use disorders.
(10) FIRST PRIORITY FOR SERVICES. (a) A service shall pri-
oritize admission in the following order:
1. First, pregnant women who inject drugs.
2. Second, pregnant women that use drugs or alcohol.
3. Third, persons who inject drugs.
4. All others.
(b) When a waitlist exists for services for pregnant women, 
the service shall either initiate interim services or notify the de-
partment within 2 business days.
(c) When a waitlist exists for services for individuals who in-
ject drugs, the service shall either initiate interim services or no-
tify the department within 14 business days.
(11) CLINICAL ASSESSMENT. (a) Clinical staff of a service, 
operating within the scope of their knowledge and practice, shall 
assess each patient through interviews, information obtained dur-
ing intake, counselor observation, and collateral information.
(b) The service shall promote assessments that are trauma-
informed.
(c) If a comprehensive clinical assessment has been con-
ducted by a referring substance use treatment service and is less 
than 90 days old, the assessment may be utilized in lieu of con-
ducting another one.
(d) Information for the assessment shall include the following:
1. The clinical staff’s evaluation of the patient, and docu-
mentation of psychological, social, and physiological signs and 
symptoms of substance use and/or mental health disorders, based 
on criteria in the DSM.
2. The summarized results of all psychometric, cognitive, 
vocational, and physical examinations provided as part of the 
assessment.
3. History of substance use that includes all of the following: 
a. Substances used.
b. Duration of use for each substance.
c. Frequency and amount of use.
d. Method of administration.
e. Status of use immediately prior to entering into treatment.
f. Consequences and effects of use.
g. Withdrawal and overdose history.
4. Documentation about the current mental and physical 
health status of the patient.
5. Psychosocial history information shall include all of the 
following areas that relate to the patient’s presenting problem:
a. Family.
b. Significant relationships.
c. Legal.
d. Social.
e. Financial.
f. Education.
g. Employment.
h. Treatment history.
i. Other factors that appear to have a relationship to the pa-
tient’s substance use and physical and mental health.
6. The clinical assessment shall include any collateral infor-
mation gathered during the clinical assessment. Collateral infor-
mation may include one or more of the following:
a. Review of Wisconsin Prescription Drug Monitoring Pro-
gram database.
b. Records of the patient’s legal history.
c. Information from referral sources.
d. Consultation with the patient’s physician or other medical 
or behavioral health provider.
e. Consultation with department of corrections or child pro-
tective services when applicable.
f. Information from the patient’s family or significant others. 
g. Results of toxicology testing.
7. Level of care recommendation based on ASAM or other 
department-approved placement criteria.
(e) If no collateral information is obtained to inform the as-
sessment, the service shall document the reason for not including 
collateral information.
(f) The clinical staff’s recommendations for treatment shall 
be included in a summary of the assessment that is consistent 
with diagnosis and level of care placement criteria.
(g) If an assessing substance abuse counselor identifies symp-
toms of a mental health disorder during the assessment process, 
the substance abuse counselor shall refer the individual to an ap-
propriately credentialed provider for a comprehensive mental 
health assessment, unless the substance abuse counselor is also a 
licensed mental health professional.
(h) If the assessing clinical staff identifies symptoms of a 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 75.24 WISCONSIN ADMINISTRATIVE CODE 16
physical health problem during the assessment process, the ser-
vice shall refer the individual for a physical health assessment 
conducted by medical personnel.
(i) If the assessing clinical staff identifies that an individual is 
pregnant at the time of the assessment, the service shall make a 
referral for prenatal care or ensure that the patient is already re-
ceiving prenatal care, and document efforts to coordinate care 
with prenatal care providers.
(j) In the event that the assessed level of care is not available, 
a service shall:
1. Document accurately the level of care indicated by the 
clinical assessment.
2. Indicate on the treatment plan what alternative level of 
care is available or agreed upon.
3. Identify on the treatment plan what efforts will be made to 
access the appropriate level of care, additional services or sup-
ports that will be offered to bridge the gap in level of care, and on-
going assessment for clinical needs and level of care review.
(k) For assessments completed by a substance abuse coun-
selor in-training or a graduate student QTT, the assessment and 
recommendations shall be reviewed and signed by the clinical su-
pervisor within 7 days of the assessment date.
(L) For a patient receiving mental health services under s. 
DHS 75.50 or 75.56 who does not have a co-occurring substance 
use disorder, the requirement for ASAM or other department-ap-
proved level of care placement criteria is not required.
(12) REFERRAL. (a) A service shall have written policies and 
procedures for referring patients to other service providers and 
for coordinating care with other providers.
(b) Policies and procedures shall include a description of fol-
low-up activities to be completed to support that recommended 
care is received. 
(c) Follow-up shall occur within one week of the referral.
(13) TREATMENT PLAN. (a) Clinical staff of a service shall 
develop a treatment plan for each patient. 
(b) A patient’s treatment plan shall represent an agreement 
between the service and the patient regarding needs identified in 
the clinical assessment, the patient’s identified treatment goals, 
and treatment interventions and resources to be applied.
(c) When feasible, the treatment plan shall be developed in 
collaboration and with input from the patient’s family or signifi-
cant other, or other supportive persons identified by the patient.
(d) The treatment plan shall be signed by the patient, the pri-
mary counselor, and other behavioral health clinical staff, identi-
fied in the treatment plan.
(e) A treatment plan completed by a substance abuse coun-
selor in-training or a graduate student QTT shall be reviewed and 
signed by the clinical supervisor within 14 days of the develop-
ment of the plan or the next treatment plan review, whichever is 
earlier.
(f) The content of the treatment plan shall describe the identi-
fied needs and specify individualized treatment goals that are ex-
pressed in behavioral and measurable terms.
(g) The treatment plan shall specify each intervention applied 
to reach the treatment goals.
(h) The treatment plan shall be reviewed at the interval re-
quired by the patient’s level of care or based on the patient’s 
needs and clinical indication. The review shall be documented 
with a summary of progress and the signature of the patient and 
primary counselor.
(i) The treatment plan review shall include an updated level of 
care assessment which follows ASAM or other department-ap-
proved placement criteria and recommends continued stay, trans-
fer, or discharge.
(j) An updated treatment plan shall be established during the 
review if there is a change in the patient’s needs, goals, or inter-
ventions and resources to be applied. The updated treatment plan 
shall be signed by the patient, the primary counselor, and any 
other behavioral health clinical staff identified in the treatment 
plan.
(k) Treatment plan reviews and updates completed by a sub-
stance abuse counselor in-training or graduate student QTT shall 
be reviewed and signed by the clinical supervisor within 14 days 
of the review and update.
(L) For patients with co-occurring disorders receiving ser-
vices under ss. DHS 75.50, 75.51, 75.52, 75.54, 75.55, 75.56, and 
75.59 service shall assign dually-credentialed clinicians when-
ever possible. When this is not possible, the service shall ensure 
that mental health needs and substance use needs are included in 
the treatment plan, and met by appropriately credentialed 
personnel.
(m) For a patient receiving mental health services under s. 
DHS 75.50 or 75.56 who does not have a co-occurring substance 
use disorder, the requirement for ASAM or other department-ap-
proved level of care placement criteria and review is not required.
(14) CLINICAL CONSULTATION. (a) A service shall have a 
written policy and procedure that outlines the structure for clini-
cal consultation. 
(b) Clinical consultation applies to all clinical staff of a 
service.
(c) Clinical consultation shall be documented in the patient’s 
case record.
(d) Clinical consultation for unlicensed staff shall be com-
pleted with a clinical supervisor and shall be documented with 
the clinical supervisor’s signature. Clinical consultation for li-
censed professionals may occur with a clinical supervisor or an-
other licensed professional who is a staff of the service.
(e) Clinical consultation is required for any of the following:
1. When a patient’s substance use or mental health poses a 
significant risk to the individual, their family, or the community.
2. When a safety plan has been developed, per s. DHS 75.24 
(4).
3. When an individual’s symptoms, pattern of substance use, 
risk level, or placement criteria indicate transfer to a higher level 
of care. 
(f) When a safety plan requires ongoing monitoring, clinical 
consultation shall be completed at clinically-determined intervals 
until the risk level is reduced or appropriately managed with ser-
vices or collateral supports. 
(g) When the recommended level of care cannot be deter-
mined, or is not available, or the individual has declined the rec-
ommended level of care, clinical consultation shall be completed 
at clinically-determined intervals until the appropriate level of 
care is determined, or obtained, or the individual’s risk level 
decreases. 
(15) CLINICAL STAFFING. (a) A service shall have a written 
policy and procedure that outlines the structure for clinical 
staffing.
(b) Clinical staffing applies to all clinical staff of a service, 
and includes the clinical supervisor and medical personnel. Clin-
ical staffing is facilitated at intervals appropriate to the individ-
ual’s needs and as prescribed based on the level of care.
(c) For clinical staffing required under ss. DHS 75.49 to 
75.59, the following shall apply: 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
17 DEPARTMENT OF HEALTH SERVICES DHS 75.24
1. Clinical staffing shall include the clinical supervisor of the 
service.
2. Clinical staffing shall include a patient’s prescriber or 
medical personnel, if applicable.
3. Clinical staffing may be combined with treatment plan re-
view and level of care review. 
4. Clinical staffing shall be documented in the patient’s clin-
ical record.
(16) PROGRESS NOTES. (a) A service shall document in the 
patient’s record each contact the service has with a patient or with 
a collateral source. 
(b) Notes shall be entered by the staff member providing the 
service to document the content of the contact with the patient or 
a collateral source; or, if notes are entered by a designee, this 
must be specified.
(c) Progress notes shall include chronological documentation 
of treatment that is directly related to the patient’s treatment plan, 
and documentation of the patient’s response to treatment.
(d) The person making the entry shall sign and date the note, 
and if a designee, shall indicate who provided the service.
(17) GROUP COUNSELING. (a) A service may offer group 
counseling.
(b) A service shall have written policies and procedures re-
garding group counseling that include, at minimum, the 
following: 
1. Participant confidentiality.
2. Group rules for safety.
3. Consideration of needs related to special populations or 
considerations for co-mingled groups.
4. Assurance that groups are trauma-informed.
(c) Each group therapy contact shall be documented as a 
progress note in each patient’s case record.
(18) FAMILY SERVICES. (a) When requested by a patient’s af-
fected family member or significant other, the service shall offer 
or refer for supportive services, such as counseling, support 
groups, or education.
(b) A service shall involve a patient’s family members and 
significant others in assessment, treatment planning, transfers of 
care, safety planning, and discharge whenever feasible. 
(c) A service shall have written policies and procedures to ad-
dress confidentiality, conflicts of interest, and ethics related to 
family services. 
(19) MEDICAL SERVICES. (a) All medical services provided 
under this chapter shall be provided by appropriately credentialed 
staff operating within their scope of practice, 
(b) Prescribers providing substance use treatment services or 
supervision of substance use treatment services shall be knowl-
edgeable in addiction treatment. 
(c) For medical needs of a patient that exceed the scope of the 
service under this chapter, the service shall coordinate with ap-
propriate medical providers. 
(d) A service may offer medication management for treatment 
of substance use disorders or mental health disorders. A service 
shall have written policies and procedures for medication man-
agement services, including: 
1. Prescribing policies and practices. 
2. Prescriber checks and use of the Wisconsin Prescription 
Drug Monitoring Program database.
3. Procedures for obtaining and updating patient consents for 
medications received.
4. Procedures for reporting and reviewing medication errors 
via facility incident reports or other documentation.
(e) When a patient’s treatment includes medication manage-
ment, it shall be documented as a goal in the patient’s treatment 
plan. The treatment plan shall be signed by the prescriber.
(f) If a patient is prescribed medication as part of the treat-
ment plan, the service shall obtain a separate consent that indi-
cates that the prescriber has explained to the patient, or the pa-
tient’s legal representative, if applicable, the nature, risks and 
benefits of the medication and that the patient, or legal represen-
tative, understands the explanation and consents to the use of the 
medication.
(g) A service shall maintain medication records that allow for 
ongoing monitoring of any medication prescribed or adminis-
tered by the service, and documentation of any adverse drug reac-
tions or medication errors. Medication orders shall specify the 
name of the medication, dose, route of administration, frequency 
of administration, name of the prescriber who prescribed the 
medication, prescriber signature, and staff administering the 
medication, if applicable.
(h) A service that receives, stores, or dispenses medications 
shall have written policies and procedures regarding storage, dis-
pensing, and disposal of medications, including:
1. Patient name, medication name, amount of medication, 
dosage, date of receipt, and date of dispensing or disposal.
2. Safeguards to prevent the diversion of medication.
(i) A non-residential service that receives, stores, or dispenses 
medications shall comply with 21 CFR 1301.72. The medication 
storage area shall be clean, and shall be separated by a wall from 
any restroom, cleaning products, or any food-preparation or stor-
age area.
(j) A residential service under ss. DHS 75.53 to 75.58, shall 
follow the requirements for medication storage provided in s. 
DHS 75.39.
(20) DRUG TESTING SERVICES. (a) A service shall have writ-
ten policies and procedures for drug testing, breath analysis, and 
toxicology services. Patients of a service shall be informed of 
these policies and procedures upon admission. 
(b) A service may utilize drug testing information in conjunc-
tion with patient self-report, behavioral observations, collateral 
information, and clinical assessment to make determinations re-
garding patient care. 
(c) A service shall have a method for obtaining confirmation 
of drug testing results. 
(d) A service shall inform patients of the costs for drug testing 
services. 
(e) A service shall obtain informed consent before releasing 
patient drug testing results. The service is responsible for ensur-
ing that the patient understands possible consequences of disclo-
sure of drug testing information. 
(21) TRANSFER. If the service transfers a patient to another 
provider or if a change is made in the patient’s level of care, the 
transfer or change in the level of care shall be documented in the 
patient’s case record. A transfer summary shall be entered into 
the patient’s case record, including the following:
(a) The date of the transfer.
(b) A completed copy of the standardized placement criteria 
and level of care recommended.
(c) Documentation of communication and follow-up that en-
sures continuity of care from one provider or level of care to 
another. 
(22) DISCHARGE. (a) A patient may be discharged from a 
service for any of the following reasons:
1. Successful completion of recommended services and 
treatment plan goals.
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 75.24 WISCONSIN ADMINISTRATIVE CODE 18
2. No longer meeting placement criteria for any level of care 
in the substance use treatment system. 
3. Patient discontinuation of services.
4. Administrative discharge.
5. Death of the patient. 
(b) A service shall have written policies and procedures for 
the service director’s review of administrative discharge or dis-
charges due to patient dissatisfaction or attrition.
(c) A service shall have written policies and procedures for 
the service director’s review of discharges due to patient death 
from overdose. 
(d) A discharge summary shall be entered into the patient’s 
case record, including the following:
1. A completed copy of the standardized placement criteria 
and level of care indicated.
2. Recommendations regarding care after discharge.
3. A description of the reasons for discharge.
4. The patient’s treatment status and condition at discharge.
5. A final evaluation of the patient’s progress toward the 
goals identified in the treatment plan.
(e) The discharge summary shall include a notation indicating 
the reason that any items from par. (d) were not able to be pro-
vided at discharge, if applicable.
(23) CONTINUING CARE SERVICES. (a) An outpatient sub-
stance use treatment service under s. DHS 75.49 or an outpatient 
integrated behavioral health treatment service under s. DHS 
75.50 may provide ongoing recovery monitoring, continuing care, 
aftercare, or behavioral health check-ups at the outpatient level of 
care. 
(b) A patient who has completed services and been dis-
charged may continue contact with the provider at agreed upon 
intervals without completing a new clinical assessment, intake, or 
treatment plan. 
(c) Each contact with a patient in continuing care service shall 
be documented in a progress note.
(d) If, during the provision of continuing care services, there 
is indication that a higher level of care or additional services may 
be needed due to substance use relapse or other behavioral, men-
tal, or physical health indicators, the service shall complete an 
updated level of care placement criteria screening or updated 
mental health assessment and make appropriate referrals and 
transfers of care. 
(e) The continuing care service shall obtain valid and updated 
releases of information for any referrals or collateral communica-
tions regarding patients in continuing care. 
(f) Continuing care services may not provide medical 
services.
(g) The death of a patient in continuing care services shall be 
subject to reporting as specified in s. DHS 75.10 (1).
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22; correction 
in (11) (b), (13) (m), (14) (e) 2., (g) made under s. 35.17, Stats., and correction in 
numbering in (21) made under s. 13.92 (4) (b) 1., Stats., Register October 2021 No. 
790; CR 23-053: am. (12) (a) Register September 2023 No. 813, eff. 10-1-23; CR 
25-055: am. (11) (d) 6. (intro.) Register February 2026 No. 842, eff. 3-1-26.
DHS 75.25 Outcome monitoring and quality im-
provement plan. (1) A service shall have a written plan for 
monitoring outcomes and improving service quality, which in-
cludes all of the following:
(a) Measurable goals relating to service quality, participant 
satisfaction, and outcomes.
(b) Related initiatives for service improvement and key indi-
cators of identified goals and outcomes.
(c) An annual report that summarizes the service’s quality im-
provement activities and program outcomes. The report shall be 
available to patients and their families, the public, and the depart-
ment upon request.
(2) A service shall have a process for collecting, analyzing, 
and reporting a patient’s demographic and outcome data. At min-
imum, the following data shall be recorded at admission and 
discharge:
(a) The patient’s living situation.
(b) The patient’s substance use.
(c) The patient’s employment status and education.
(d) The patient’s arrests within the past 30 days.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22; correction 
in numbering in sub. (2) made under s. 13.92 (4) (b ) 1., Stats., Register October 
2021 No. 790.
Subchapter V — Residential Service Facility 
Requirements
DHS 75.26 Applicability. (1) This subchapter applies to 
residential services certified under ss. DHS 75.53 to 75.58.
(2) A residential service that is approved as a hospital under 
ch. DHS 124 is not required to meet the requirements in this 
subchapter.
(3) A residential service that is approved under ch. DHS 83 as 
a community-based residential facility meets the facility require-
ments outlined in ss. DHS 75.29 , 75.30, 75.33, 75.34, 75.40, 
75.41, 75.45, and 75.46.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.27 Organizational requirements. Before op-
erating or expanding a residential service, a facility shall meet all 
residential facility requirements included in this subchapter. 
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.28 Definitions. In this subchapter:
(1) “Ambulatory” means the ability to walk without difficulty 
or help.
(2) “Non-ambulatory” means a person who is unable to walk, 
but who may be mobile with the help of a wheelchair or other 
mobility devices.
(3) “Semi-ambulatory” means a person who is able to walk 
with difficulty or only with the assistance of an aid such as 
crutches, cane, or walker.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.29 Application for initial certification. (1) 
In order to meet the requirements in ss. DHS 75.30 to 75.46, an 
application for initial licensure as a residential service shall be on 
a form provided by the department, and shall be accompanied by 
all of the following:
(a) A floor plan specifying dimensions of the facility, exits, 
and planned room usage.
(b) An explanation of the 24-hour staffing pattern for the 
service.
(c) A statement indicating whether the service will provide 
treatment services for patients that are non-ambulatory or semi-
ambulatory. If a service provides treatment services for patients 
that are non-ambulatory or semi-ambulatory, the floor plan shall 
include ramped exits to grade.
(d) Municipal zoning approval or occupancy permit.
(e) The results of an approved fire inspection completed 
within the last 12 months.
(f) Fireplace and chimney inspections completed within the 
last 12 months, if applicable.
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
19 DEPARTMENT OF HEALTH SERVICES DHS 75.37
(g) The results of furnace inspection completed within the last 
12 months.
(h) The results of smoke and heat detector inspection com-
pleted within the last 12 months.
(i) The results of sprinkler inspection completed within the 
last 12 months.
(j) Well water test results completed within the last 12 
months, if applicable.
(k) Building emergency evacuation plan.
(L) A disaster recovery plan in the case of flood, gas leak, 
electrical outage, or other emergency.
(m) Service policies and procedures.
(n) All required fees.
(o) Evidence that the applicant has 60 days of projected oper-
ating funds in reserve.
(p) Any additional information requested by the department.
(2) A residential service shall not make changes to service 
specifications under sub. (1) (a) to (c) without prior notification 
to the department.
(3) A residential service shall provide updated documents 
from sub. (1) upon department request. 
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.30 Fit and qualified standards. (1) ELIGI-
BILITY. An applicant may not be certified unless the department 
determines the applicant is fit and qualified to operate a service.
(2) STANDARDS. In determining whether an applicant is fit 
and qualified, the department shall consider all of the following:
(a) Compliance history. The applicant’s history of compli-
ance with Wisconsin or any other state’s licensing requirements 
and with any federal certification requirements, including any li-
cense or certification revocation or denial.
(b) Criminal history. The applicant’s arrest history and crim-
inal records, including whether any crime is substantially related 
to the care of a client, as provided in s. DHS 12.06.
(c) Financial history. The applicant’s financial stability, in-
cluding outstanding debts or amounts due to the department or 
other government agencies, including unpaid forfeitures and fines 
and bankruptcies.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.31 Services for non-ambulatory or semi-
ambulatory patients. (1) A residential service that provides 
treatment services for patients that are non-ambulatory shall meet 
the requirements under subchs. IX, X, XI of ch. DHS 83 for class 
A non-ambulatory and class C non-ambulatory facilities.
(2) A residential service that provides treatment services for 
patients that are semi-ambulatory shall meet the requirements un-
der subchs. IX, X, and XI of ch. DHS 83 for class A semi-ambu-
latory and class C semi-ambulatory facilities.
(3) A residential service shall not provide treatment services 
for non-ambulatory or semi-ambulatory patients unless certified 
by the department under this chapter or under ch. DHS 83 to do 
so. A residential service shall be understood as serving only am-
bulatory patients unless specified within the service application 
and certification.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.32 General facility requirements. (1) 
HOURS OF OPERATION. A residential service shall operate 24 
hours per day, 7 days per week.
(2) GENERAL. The facility of the residential service shall be 
constructed and maintained so that it is functional for assessment 
and treatment and for the delivery of health services appropriate 
to the needs of the community and with due regard for protecting 
the health and safety of the patients.
(3) CAPACITY. No residential service shall have more resi-
dents at any given time than the maximum capacity indicated on 
the department-approved certification.
(4) PHYSICAL SEPARATION. A residential service facility 
shall be physically separated from other entities, programs, and 
services. A residential service facility’s living areas shall be sepa-
rate and secure from non-resident entry and use.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.33 Residential personnel requirements. 
(1) STAFF ORIENTATION AND TRAINING. A residential service 
shall meet the staff training and orientation requirements in ss. 
DHS 83.19 to 83.21 and 83.23 to 83.25. A service shall maintain 
documentation of required training in each staff member’s per-
sonnel record.
(2) STAFFING. A residential service shall meet the staffing 
requirements under s. DHS 83.36.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.34 Residential service records. A residential 
service shall meet the requirements for general records under s. 
DHS 83.13.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.35 Residential services for minors. (1) A 
residential service that provides services to minors shall maintain 
physically separate and secure living areas for minors and adults, 
unless there is a documented clinical need for an exception to this 
age requirement for transitional age youth, and this exception is 
approved by the service director.
(2) A residential service that provides services to minors 
shall have a written policy and procedure for addressing the edu-
cational needs of each participating minor.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.36 Residential services for parents with re-
siding minors. A residential service that allows for minors to 
reside at the facility while their parent or guardian receives treat-
ment services at the facility, shall ensure the following:
(1) The service shall have written policies and procedures 
that address the safety of residing minors, supervision of residing 
minors, family services and supports, and behavioral expecta-
tions and interventions for residing minors.
(2) A residing family shall not share a bedroom with other 
residents of the service.
(3) A service with residing minors shall have a written policy 
and procedure for addressing the educational needs of each resid-
ing minor.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.37 Emergency medical care for residents. 
(1) A residential service shall have written policies and proce-
dures for training staff members in life-sustaining techniques, 
which may include cardiopulmonary resuscitation, use of an au-
tomated external defibrillator, and emergency first aid.
(2) A residential service shall have a written plan for the pro-
vision of emergency medical care for patients.
(3) A residential service shall have a written plan for the pro-
vision of emergency transportation for patients needing emer-
gency medical services.
(4) Residential service staff shall be trained to implement the 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 75.37 WISCONSIN ADMINISTRATIVE CODE 20
plan for emergency medical care and emergency transportation 
within 14 days of hire and annually thereafter.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.38 Seclusion and restraints. (1) A service 
under this chapter is prohibited from the use of seclusion or re-
straints, unless the service meets all requirements outlined in s. 
51.61 (1) (i), Stats.
(2) A service under this chapter is prohibited from the use of 
seclusion or restraint as part of a treatment program, except in 
emergency situations as provided in s. 51.61 (1) (i), Stats.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.39 Medications. A residential service shall 
meet the requirements for medications under s. DHS 75.24 (19) 
or 83.37, whichever standard is higher. The medication storage 
area shall be clean, and shall be separated by a wall from any re-
stroom, cleaning products, or any food-preparation or storage 
area.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22; correction 
made under s. 35.17, Stats., Register October 2021 No. 790.
DHS 75.40 Infection control program. A residential 
service shall meet the requirements for an infection control pro-
gram under s. DHS 83.39.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.41 Food service. A residential service shall 
meet the requirements for food service under s. DHS 83.41.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.42 Physical environment. (1) A residential 
service shall meet the requirements for physical environment un-
der ss. DHS 83.43 to 83.46.
(2) A residential service that provides physical examinations 
or medical services shall have a patient examination or medical 
room. The patient examination or medical room shall contain all 
of the following:
(a) A wall that physically separates the patient examination or 
medical room from other bedrooms, living areas, staff areas, or 
facility common areas.
(b) A curtain for privacy.
(c) A functioning sink that is equipped with appropriate 
equipment and supplies for infection prevention.
(d) A medical examination table.
(3) A residential service that has a patient examination or 
medical room shall have written policies and procedures in place 
to ensure the room is appropriate for physical examinations or 
medical services. These polices shall, at minimum, contain pro-
visions for all of the following:
(a) Removal of soiled linens after each use.
(b) Cleaning of surfaces, equipment, and floors after each 
use.
(c) Designating the room as an examination or medical room 
and prohibiting non-medical uses of the room.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.43 Safety. (1) A residential service shall meet 
the requirements for safety under ss. DHS 83.47 to 83.51.
(2) A residential service shall have written policies and pro-
cedures for ensuring that the facility and staffing arrangements 
are adequate for the needs of the population to be served. Policies 
and procedures shall include:
(a) Safety of facility entrances and exits.
(b) Facility design such as ligature risk prevention, tamper-re-
sistant electrical outlets, control of sharps, impact resistant glass, 
and anchoring of furniture.
(c) Search of patients and property.
(d) Levels of staff observation required to address patient 
needs.
(e) Co-mingled populations. 
(3) Policies and procedures shall be reviewed annually, and 
any required modifications shall be completed.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.44 Guests and visitors. A residential service 
shall have written policies and procedures regarding guests and 
visitors. Policies and procedures shall include:
(1) Areas prohibited from guest and visitor access.
(2) Procedures to ensure confidentiality for service patients.
(3) Management of risks such as the delivery of drugs or alco-
hol by guests and visitors, the possession or delivery of weapons 
or other contraband by guests and visitors, or potential violent 
behavior of guests or visitors.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.45 Building design. A residential service shall 
meet the requirements for building design under ss. DHS 83.52 to 
83.61.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.46 Requirements for new construction, re-
modeling, additions, or newly-certified existing struc-
tures. A residential service shall meet the requirements for 
building design under ss. DHS 83.62 to 83.64.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
Subchapter VI — Additional Requirements for Treat-
ment Service Levels of Care
DHS 75.47 Applicability of other requirements. (1) 
RELATIONSHIP TO TREATMENT SERVICE GENERAL REQUIRE-
MENTS. The requirements for a treatment service provided in 
subch. IV apply to this subchapter as the minimum standards for 
any service in this subchapter. If a requirement in any section of 
this subchapter is inconsistent with, or poses a more restrictive 
standard than a similar provision in subch. IV, the requirement is 
this subchapter shall control.
(2) RELATIONSHIP TO RESIDENTIAL SERVICE FACILITY RE-
QUIREMENTS. The requirements for a residential treatment ser-
vice provided in subch. V apply to this subchapter as the mini-
mum standards for residential services under this subchapter. If a 
requirement regarding any residential services in this subchapter 
is inconsistent with, or poses a more restrictive standard than a 
similar provision in subch. V, the requirement is this subchapter 
shall control.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.48 Service requirements by level of care 
tables. (1) Table 75.48 (1) establishes additional requirements 
for outpatient levels of care.
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
21 DEPARTMENT OF HEALTH SERVICES DHS 75.48
DHS 75.48 (1) Service requirements by level of care, outpatient 
DHS 75.49 Outpatient 
Substance Use 
Treatment Service 
DHS 75.50 Outpatient 
Integrated Behavioral 
Health Treatment 
Service
DHS 75.51 Intensive 
Outpatient Treatment 
Service
DHS 75.52 Day 
Treatment or Partial 
Hospitalization 
Treatment Service
(a) Adult 
services 
frequency 
requirements
Is less than 9 hours of 
treatment services per pa-
tient per week.
Is less than 9 hours of 
treatment services per pa-
tient per week.
At least 9 hours of treat-
ment services per patient 
per week.
1. At least 15 hours of 
treatment services per pa-
tient per week.
2. At least one hour of in-
dividual counseling per 
week.
3. The maximum amount 
of time between clinical 
services shall not exceed 
72 hours in any 7-day 
period.
(b) Minor 
services 
frequency 
requirements
Is less than 6 hours of 
treatment services per pa-
tient per week.
Is less than 6 hours of 
treatment services per pa-
tient per week.
At least 6 hours of treat-
ment services per patient 
per week.
1. At least 12 hours of 
treatment services per pa-
tient per week.
2. At least one hour of in-
dividual counseling per 
week.
3. The maximum amount 
of time between clinical 
services shall not exceed 
72 hours in any 7-day 
period.
(c) Service di-
rector 
requirements
Service director or an 
identified designee must 
be available on-site dur-
ing the hours of operation 
of clinical services.
(d) Medical di-
rector 
requirements
Required either as an em-
ployee of the service or 
through a written agree-
ment to provide medical 
oversight and consultation 
regarding clinical opera-
tions of the service. 
Required either as an em-
ployee of the service or 
through a written agree-
ment to provide medical 
oversight and consulta-
tion regarding clinical op-
erations of the service. 
(e) Substance 
abuse 
counselor 
requirements
Required to be available 
on-site during the hours of 
on-site operation of clini-
cal services.
Required to be available 
on-site during the hours 
of on-site operation of 
clinical services.
(f) Mental 
health 
professional 
requirements
Required to be available 
during the hours of opera-
tion of clinical services. 
Required either as an em-
ployee of the service or 
through a written agree-
ment, to provide coordi-
nated and concurrent ser-
vices for the treatment of 
patients with co-occurring 
mental health disorders. 
Required to be available 
during the hours of oper-
ation of clinical services. 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 75.48 WISCONSIN ADMINISTRATIVE CODE 22
DHS 75.48 (1) Service requirements by level of care, outpatient (Continued)
DHS 75.49 Outpatient 
Substance Use 
Treatment Service 
DHS 75.50 Outpatient 
Integrated Behavioral 
Health Treatment 
Service
DHS 75.51 Intensive 
Outpatient Treatment 
Service
DHS 75.52 Day 
Treatment or Partial 
Hospitalization 
Treatment Service
(g) Additional 
personnel 
requirements
Requires at least one full-
time counselor for every 
15 patients enrolled in 
the service.
(h) Assessment 
completion
Required by the third 
appointment.
Required by the third 
appointment.
Required by the third 
appointment.
Required by the third 
appointment.
(i) Use of prior 
assessment 
For returning patients, an 
assessment update shall 
be completed if 90 days 
have passed since the ini-
tial assessment. If one 
year has passed, a new 
comprehensive assess-
ment is required. 
For returning patients, an 
assessment update shall be 
completed if 90 days have 
passed since the initial 
comprehensive assess-
ment. If one year has 
passed, a new comprehen-
sive assessment is 
required.
For returning patients, an 
assessment update shall be 
completed if 90 days have 
passed since the initial 
comprehensive assess-
ment. If six months have 
passed, a new comprehen-
sive assessment is 
required.
1. A new assessment, less 
than 30 days old, is re-
quired for each admis-
sion. 
2. If a comprehensive as-
sessment has been con-
ducted by a referring sub-
stance use treatment 
provider and is less than 
30 days old, the assess-
ment may be utilized.
(j) Updated as-
sessment, con-
tinuously en-
rolled patients
An assessment update 
shall be completed not 
less than once per year. 
An assessment update 
shall be completed not less 
than once per year. 
An assessment update 
shall be completed not less 
than once per year.
(k) Intake 
completion
Required by the end of 
the session following the 
assessment.
Required by the end of the 
session following the 
assessment.
Required by the end of the 
session following the 
assessment.
Required by the end of 
the session following the 
assessment.
(L) Treatment 
plan 
completion
Required before the sec-
ond session following the 
assessment.
Required before the sec-
ond session following the 
assessment.
Required before the sec-
ond session following the 
assessment.
Required before the sec-
ond session following the 
assessment.
(m) Treatment 
plan review 
frequency
Required every 90 days or 
6 treatment sessions, 
whichever is longer, un-
less there is a clinical rea-
son to review more 
frequently.
Required every 90 days or 
6 treatment sessions, 
whichever is longer, un-
less there is a clinical rea-
son to review more 
frequently.
Required every 14 days, 
unless there is a clinical 
reason to review more 
frequently. 
Required every 14 days, 
unless there is a clinical 
reason to review more 
frequently.
(n) Clinical 
staffing 
 Required every 14 days for 
each patient.
Required every 14 days 
for each patient.
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
23 DEPARTMENT OF HEALTH SERVICES DHS 75.48
DHS 75.48 (1) Service requirements by level of care, outpatient (Continued)
DHS 75.49 Outpatient 
Substance Use 
Treatment Service 
DHS 75.50 Outpatient 
Integrated Behavioral 
Health Treatment 
Service
DHS 75.51 Intensive 
Outpatient Treatment 
Service
DHS 75.52 Day 
Treatment or Partial 
Hospitalization 
Treatment Service
(o) Additional 
requirements 
for discharge or 
transfer
Summary required within 
30 days after the dis-
charge or transfer date.
Summary required within 
30 days after the discharge 
or transfer date.
Summary required within 
30 days after the discharge 
or transfer date.
Summary required within 
14 days after the dis-
charge or transfer date.
(p) Operational 
requirements
A service shall provide 
services at times that allow 
most patients to maintain 
employment or attend 
school.
1. A service shall make 
efforts to provide ser-
vices at times that allow 
patients to maintain em-
ployment or attend 
school. 
2. Service staff members 
shall be trained in life-
sustaining techniques and 
emergency first aid. Doc-
umentation of training 
shall be available to the 
department upon request.
(2) Table 75.48 (2) establishes additional requirements for residential levels of care.
DHS 75.48 (2) Service requirements by level of care, residential 
DHS 75.53 Transitional 
Residential Treatment 
Service 
DHS 75.54 Medically 
Monitored Residential 
Treatment Service
DHS 75.55 Medically 
Managed Inpatient 
Treatment Service
DHS 75.56 Adult 
Residential Integrated 
Behavioral Health 
Stabilization Service 
(a) Required 
treatment 
services
At least 6 hours of treat-
ment services per patient 
per week.
1. At least 20 hours of 
treatment services per pa-
tient per week.
2. At least one hour of in-
dividual counseling per 
patient per week.
1. At least 12 hours of 
treatment services per 
patient per week.
2. At least one hour of 
individual counseling 
per patient per week. 
(b) Service 
director 
requirements
Service director or an 
identified designee must 
be available on-site during 
hours of operation.
Service director or an 
identified designee must 
be available on-site dur-
ing hours of operation.
(c) Medical 
director
Required either as an em-
ployee of the service or 
through a written agree-
ment, to provide medical 
oversight and consultation 
regarding the clinical oper-
ations of the service.
Required to provide 
medical oversight and 
consultation regarding 
the clinical operations 
of the service.
Required either as an 
employee of the service 
or through a written 
agreement, to provide 
medical oversight and 
consultation regarding 
the clinical operations of 
the service.
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 75.48 WISCONSIN ADMINISTRATIVE CODE 24
DHS 75.48 (2) Service requirements by level of care, residential (Continued)
DHS 75.53 Transitional 
Residential Treatment 
Service 
DHS 75.54 Medically 
Monitored Residential 
Treatment Service
DHS 75.55 Medically 
Managed Inpatient 
Treatment Service
DHS 75.56 Adult 
Residential Integrated 
Behavioral Health 
Stabilization Service 
(d) Physician 
requirements
Requires a prescriber 
knowledgeable in addic-
tion treatment available to 
provide medical and clini-
cal consultation, either as 
an employee of the service 
or through a written 
agreement.
1. Requires a physician 
available to provide 
consultation, medica-
tion management, and 
medication-assisted 
treatment services.
2. Requires a consulting 
psychiatrist, or a con-
sulting clinical psychol-
ogist licensed under ch. 
455, Stats., who will be 
available as needed, 
with a written agree-
ment to that effect.
1. Requires a psychiatrist 
either as an employee of 
the service or through a 
written agreement, to 
provide treatment ser-
vices for patients with 
mental health disorders. 
2. Requires a prescriber 
knowledgeable in addic-
tion treatment available 
on a 24-hour basis.
(e) Substance 
abuse counselor 
requirements
Required to be available 
on-site during the hours of 
on-site operation of clini-
cal services.
(f) Mental health 
professional 
requirements
Required either as an em-
ployee of the service or 
through written agree-
ment, to provide coordi-
nated and concurrent ser-
vices for the treatment of 
individuals with co-occur-
ring mental health 
disorders.
Required to be available 
during the hours of opera-
tion of clinical services.
Required to be available 
during the hours of op-
eration of clinical 
services.
Required to be available 
during the hours of oper-
ation of clinical services.
(g) Nurse 
requirements
Requires a registered 
nurse or prescriber to be 
available on-site on a 24-
hour basis.
(h) Counselor- 
patient ratio 
requirements
At least one full-time sub-
stance abuse counselor for 
every 15 patients enrolled 
in the service.
At least one full-time 
substance abuse coun-
selor for every 10 pa-
tients enrolled in the 
service.
At least one full-time 
counselor for every 10 
patients enrolled in the 
service.
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
25 DEPARTMENT OF HEALTH SERVICES DHS 75.48
DHS 75.48 (2) Service requirements by level of care, residential (Continued)
DHS 75.53 Transitional 
Residential Treatment 
Service 
DHS 75.54 Medically 
Monitored Residential 
Treatment Service
DHS 75.55 Medically 
Managed Inpatient 
Treatment Service
DHS 75.56 Adult 
Residential Integrated 
Behavioral Health 
Stabilization Service 
(i) Assessment 
completion
1. Required at the time of 
or prior to admission. 
2. If a comprehensive as-
sessment has been con-
ducted by a referring sub-
stance use treatment 
provider and is less than 30 
days old, the assessment 
may be utilized in lieu of 
conducting another one.
1. Required at the time of 
or prior to admission.
2. If a comprehensive as-
sessment has been con-
ducted by a referring sub-
stance use treatment 
provider and is less than 
30 days old, the assess-
ment may be utilized in 
lieu of conducting another 
one.
1. Required within 4 
days of admission. 
2. Use of prior assess-
ment under DHS 75.24 
(11) (c) shall not apply. 
1. Required within 4 days 
of admission.
2. Use of prior assess-
ment under DHS 75.24 
(11) (c) shall not apply.
(j) Additional
assessment
requirements
1. For patients continu-
ously enrolled in services, 
an assessment
update shall be completed 
not less than every
six months.
2. The service shall have
a written and documented 
procedure for
reviewing assessments
and level of care place-
ment during clinical con-
sultation or clinical
supervision that occurs
within 7 days of the
assessment
A physician, physician as-
sistant, registered nurse, or 
clinical supervisor shall 
review and sign the assess-
ment and level of care 
placement within 7 days of 
the assessment.
A prescriber shall re-
view and co−sign the 
assessment and level of 
care placement within 2 
working days following 
the assessment.
The clinical assessment 
and level of care place-
ment shall be reviewed at 
the next clinical consul-
tation staffing following 
the assessment
(k) Intake 
requirements
Intake shall be completed 
within 24 hours of 
admission.
Intake shall be completed 
within 24 hours of 
admission.
1. Intake shall be com-
pleted within 24 hours 
of admission, or as soon 
as the patient is able to 
complete the intake. 
2. Admission shall be by 
order of a physician. 
The physician’s referral 
shall be in writing or in-
dicated by the physi-
cian’s signature on the 
placement criteria 
summary. 
3. Admission is appro-
priate only if the person 
to be admitted is deter-
mined appropriate for 
placement in this level 
of care by the applica-
tion of ASAM or other 
department-approved 
placement criteria. 
Intake shall be com-
pleted within 24 hours of 
admission, or as soon as 
the patient is able to 
complete the intake.
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 75.48 WISCONSIN ADMINISTRATIVE CODE 26
DHS 75.48 (2) Service requirements by level of care, residential (Continued)
DHS 75.53 Transitional 
Residential Treatment 
Service 
DHS 75.54 Medically 
Monitored Residential 
Treatment Service
DHS 75.55 Medically 
Managed Inpatient 
Treatment Service
DHS 75.56 Adult 
Residential Integrated 
Behavioral Health 
Stabilization Service 
(L) Medical 
screening 
requirements
1. Required no later than 7 
days after the patient’s ad-
mission to identify health 
problems and to screen for 
communicable illnesses, 
unless there is documenta-
tion that a screening was 
completed less than 90 
days prior to admission. 
Medical screening shall be 
documented in the pa-
tient’s case record.
2. A patient continuously 
enrolled in treatment shall 
receive an annual follow-
up medical screening. 
Required no later than 7 
days after the patient’s ad-
mission to identify health 
problems and screen for 
communicable illnesses, 
unless there is documenta-
tion that a screening was 
completed less than 30 
days prior to admission. 
Medical screening shall be 
documented in the pa-
tient’s case record.
Required no later than 
24 hours after the pa-
tient’s admission to 
identify health prob-
lems and to screen for 
communicable ill-
nesses. Medical screen-
ing shall be documented 
in the patient case 
record.
1. Required no later than 
12 hours after the pa-
tient’s admission to iden-
tify health problems and 
to screen for communi-
cable illnesses. Medical 
screening shall be docu-
mented in the patient 
case record.
2. A physician shall re-
view and document the 
medical status of a pa-
tient within 72 hours af-
ter admission.
(m) Treatment 
plan 
completion
Required within one week 
of admission.
Required within 5 days of 
admission.
1. A preliminary treat-
ment plan is required 
within 48 hours of 
admission. 
2. A treatment plan con-
sistent with ss. DHS 
75.24 (13) is required 
within 4 days of 
admission. 
1. A preliminary treat-
ment plan is required 
within 48 hours of 
admission. 
2. A treatment plan con-
sistent with ss. DHS 
75.24 (13) is required 
within 4 days of 
admission.
(n) Treatment 
plan review 
frequency
Required every 6 weeks, 
unless there is a clinical 
reason to review more 
frequently.
Required weekly, unless 
there is a clinical reason to 
review more frequently.
Required daily. Required daily.
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
27 DEPARTMENT OF HEALTH SERVICES DHS 75.48
DHS 75.48 (2) Service requirements by level of care, residential (Continued)
DHS 75.53 Transitional 
Residential Treatment 
Service 
DHS 75.54 Medically 
Monitored Residential 
Treatment Service
DHS 75.55 Medically 
Managed Inpatient 
Treatment Service
DHS 75.56 Adult 
Residential Integrated 
Behavioral Health 
Stabilization Service 
(o) Additional 
treatment plan 
requirements
The patient’s treatment 
plan shall include a pre-
liminary discharge plan 
outlining step down ser-
vices and a plan for ongo-
ing support. The discharge 
plan shall be reviewed and 
updated weekly, in con-
junction with the treat-
ment plan.
The preliminary and on-
going treatment plans 
shall include a prelimi-
nary discharge plan out-
lining step down ser-
vices and a plan for on-
going support. The dis-
charge plan shall be re-
viewed and updated in 
conjunction with the 
treatment plan.
1. The preliminary and 
ongoing treatment plans 
shall include a determi-
nation and ongoing re-
view of the level of ob-
servation needed to ad-
dress the patient’s needs 
and any safety concerns.
2. The preliminary and 
ongoing treatment plans 
shall include a prelimi-
nary discharge plan out-
lining step down services 
and a plan for ongoing 
support. The discharge 
plan shall be reviewed 
and updated in conjunc-
tion with the treatment 
plan.
(p) Clinical 
staffing 
frequency
Required every 30 days for 
each patient.
Required every 7 days for 
each patient.
Required daily for each 
patient.
Required daily for each 
patient.
(q) Additional re-
quirements for 
discharge or 
transfer
Summary required within 
14 days after the discharge 
or transfer date.
1. Summary required 
within 14 days after the 
discharge or transfer date.
2. The service shall facili-
tate linkage and referral 
for follow-up and addi-
tional services that are 
consistent with the pa-
tient’s ASAM placement 
criteria or other depart-
ment-approved level of 
care placement criteria.
1. Summary required 
within 48 hours after the 
discharge or transfer 
date. 
2. The service shall fa-
cilitate linkage and re-
ferral for follow-up and 
additional services that 
are consistent with the 
patient’s ASAM place-
ment criteria or other 
department-approved 
level of care placement 
criteria.
1. Summary required 
within 48 hours after the 
discharge or transfer 
date. 
2. The service shall facil-
itate linkage and referral 
for follow-up and addi-
tional services that are 
consistent with the pa-
tient’s ASAM placement 
criteria or other depart-
ment-approved level of 
care placement criteria.
3. Documentation of 
linkage and follow-up 
shall be reviewed and 
signed by the clinical 
supervisor.
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 75.48 WISCONSIN ADMINISTRATIVE CODE 28
DHS 75.48 (2) Service requirements by level of care, residential (Continued)
DHS 75.53 Transitional 
Residential Treatment 
Service 
DHS 75.54 Medically 
Monitored Residential 
Treatment Service
DHS 75.55 Medically 
Managed Inpatient 
Treatment Service
DHS 75.56 Adult 
Residential Integrated 
Behavioral Health 
Stabilization Service 
(r) Operational 
requirements
Before operating or ex-
panding a medically 
managed inpatient treat-
ment service, the ser-
vice shall be approved 
as a hospital under ch. 
DHS 124.
1. The service shall have 
written agreements with 
community behavioral 
health service providers 
or systems to provide 
care after the patient is 
discharged from the 
service. 
2. The service shall 
maintain an automated 
external defibrillator de-
vice on-site and shall 
train staff in its use. Doc-
umentation of training 
shall be available to the 
department upon 
request.
(3) Table 75.48 (3) establishes additional requirements for residential withdrawal management levels of care.
DHS 75.48 (3) Service Requirements by Level of Care, Withdrawal Management 
DHS 75.57 Residential Withdrawal 
Management Service
DHS 75.58 Residential Intoxication 
Monitoring Service
(a) Exemptions from general 
requirements
1. This service is exempt from the require-
ments of s. DHS 75.24 (11) regarding 
assessment.
2. This service is exempt from the require-
ments of s. DHS 75.24 (13) regarding treat-
ment planning.
1. This service is exempt from ss. DHS 
75.18 (2) requiring a clinical 
supervisor.
2. This service is exempt from the re-
quirements of s. DHS 75.24 (11) re-
garding assessment.
3. This service is exempt from the re-
quirements of s. DHS 75.24 (13) re-
garding treatment planning.
(b) Medical director Required either as an employee of the ser-
vice or through a written agreement, to 
provide medical oversight and consultation 
regarding the clinical operations of the 
service.
(c) Physician requirements Available on a 24-hour basis.
(d) Nurse requirements Registered nurse available on-site on a 24-
hour basis.
(e) Additional personnel requirements Requires a substance abuse counselor to 
provide consultation for each patient prior 
to discharge.
1. Requires at least one staff person 
trained in the recognition of with-
drawal symptoms available on-site on 
a 24-hour basis.
2. Requires a substance abuse coun-
selor to provide consultation for each 
patient prior to discharge.
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
29 DEPARTMENT OF HEALTH SERVICES DHS 75.49
DHS 75.48 (3) Service Requirements by Level of Care, Withdrawal Management (Continued)
DHS 75.57 Residential Withdrawal 
Management Service
DHS 75.58 Residential Intoxication 
Monitoring Service
(f) Additional assessment requirements Each patient shall receive sufficient assess-
ment of dimensional risk and severity of 
need to determine preliminary level of care 
and appropriate referral for continuing 
services.
Each patient shall receive sufficient as-
sessment of dimensional risk and 
severity of need to determine prelimi-
nary level of care and appropriate re-
ferral for continuing services.
(g) Intake completion requirement Within 24 hours of admission, or as soon 
as the patient is able to complete the intake.
Within 24 hours of admission, or as 
soon as the patient is able to complete 
the intake.
(h) Medical screening requirements 1. Required no later than 12 hours after the 
patient’s admission to identify health prob-
lems and to screen for communicable ill-
nesses. Medical screening shall be docu-
mented in the patient case record.
2. A physician shall review and document 
the medical status of a patient within 72 
hours after admission.
Each patient shall be screened by med-
ical personnel before admission to the 
service, unless the service has docu-
mentation of the patient’s current 
physical condition.
(i) Additional treatment plan requirements Each patient shall have a written plan, 
completed prior to discharge, for step down 
or transfer to ongoing treatment services 
and that addresses discharge needs and on-
going supports. The plan shall be reviewed 
and signed by the clinical supervisor.
Each patient shall have a written plan, 
completed prior to discharge, for link-
age and referral to ongoing treatment 
services and that addresses discharge 
needs and ongoing supports. 
(j) Clinical staffing frequency Required daily for each patient. Required daily for each patient.
(k) Additional requirements for discharge 
or transfer
1. Summary required within 48 hours after 
the discharge or transfer date. 
2. The service shall facilitate linkage for 
follow-up and additional services that are 
consistent with the patient’s assessment of 
dimensional risk and severity of need. 
3. Documentation of linkage and follow-up 
shall be reviewed and signed by the clinical 
supervisor.
1. Summary required within 48 hours 
after the discharge or transfer date. 
2. The service shall facilitate linkage 
and referral for follow-up and addi-
tional services that are consistent with 
the patient’s assessment of dimen-
sional risk and severity of need. 
(L) Operational requirements 1. The service shall have written agree-
ments with community behavioral health 
service providers or systems to provide 
care after the patient is discharged from the 
service. 
2. The service shall maintain an automated 
external defibrillator device on-site and 
shall train staff in its use. Documentation 
of training shall be available to the depart-
ment upon request.
1. The service shall have written 
agreements with community behav-
ioral health service providers or sys-
tems for referral after the patient is dis-
charged from the service. 
2. The service shall maintain an auto-
mated external defibrillator device on-
site and shall train staff in its use. Doc-
umentation of training shall be avail-
able to the department upon request.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22; correction in (2) (d) made under s. 35.17, Stats., Register October No 790; CR 25-055: am. (2) (j) 
Register February 2026 No. 842, eff. 3-1-26.
DHS 75.49 Outpatient substance use treatment 
service. (1) SERVICE DESCRIPTION. In this section, “outpa-
tient substance use treatment service” means a non-residential 
treatment service totaling less than 9 hours of treatment services 
per patient per week for adults and less than 6 hours of treatment 
services per patient per week for minors, in which substance use 
treatment personnel provide screening, assessment, and treatment 
for substance use disorders. Outpatient substance use treatment 
services may include intake, evaluation and diagnosis, medica-
tion management, nursing services, case management, drug test-
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 75.49 WISCONSIN ADMINISTRATIVE CODE 30
ing, counseling, individual therapy, group therapy, family therapy, 
psychoeducation, vocational services, peer support services, re-
covery coaching, outreach activities, and recovery support ser-
vices to ameliorate symptoms and restore effective functioning.
(2) LOCATION OF SERVICE DELIVERY. (a) An outpatient sub-
stance use treatment service may provide services at one or more 
offices. If a service provides outpatient substance use treatment 
services at more than one office, all of the following shall apply:
1. The service shall designate one office as its main office.
2. All notices under this chapter will be sent to the main 
office.
3. Each office providing the service shall comply with the 
applicable requirements of this chapter.
4. The service shall adopt written policies and procedures to 
ensure that the service director is able to carry out the oversight 
and other responsibilities specified under s. DHS 75.18 (1) with 
respect to all other offices.
(b) A service may provide outpatient substance use treatment 
services in the community or other locations, provided all re-
quirements of this chapter are able to be met in the setting.
(c) A service that provides outpatient substance use treatment 
services in the community shall have written policies and proce-
dures for community-based service delivery.
(d) A service that provides outpatient substance use treatment 
services in the community shall provide annual training for all 
staff that deliver services in the community regarding in-home 
and community safety, and avoiding sexual or other exploitative 
relationships with patients. A record of each training shall be 
available to the department upon request.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22; correction 
in (2) (b) made under s. 35.17, Stats., Register October 2021 No. 790.
DHS 75.50 Outpatient integrated behavioral health 
treatment service. (1) SERVICE DESCRIPTION. In this sec-
tion, “outpatient integrated behavioral health treatment service” 
means a non-residential treatment service totaling less than 9 
hours of treatment services per patient per week for adults, and 
less than 6 hours of treatment services per patient per week for 
minors, in which substance use and mental health treatment per-
sonnel provide screening, assessment and treatment for substance 
use and mental health disorders. Patients in this setting may re-
ceive treatment services for a substance use disorder, a mental 
health disorder, or both. Outpatient integrated behavioral health 
treatment services may include intake, evaluation and diagnosis, 
medication management, nursing services, case management, 
drug testing, counseling, individual therapy, group therapy, fam-
ily therapy, psychoeducation, vocational services, peer support 
services, recovery coaching, outreach activities, and recovery 
support services to ameliorate symptoms and restore effective 
functioning.
(2) COMBINED CERTIFICATION. Certification for this level of 
care shall not be located with s. DHS 75.49 outpatient substance 
use treatment service or with a ch. DHS 35 community mental 
health treatment service at the same service location.
(3) LOCATION OF SERVICE DELIVERY. (a) An outpatient inte-
grated behavioral health treatment service may provide services 
at one or more offices. If a service provides outpatient substance 
use treatment services at more than one office, all of the follow-
ing shall apply:
1. The service shall designate one office as its main office.
2. All notices under this chapter will be sent to the main 
office.
3. Each office providing the service shall comply with the 
applicable requirements of this chapter.
4. The service shall adopt written policies and procedures to 
ensure that the service director is able to carry out the oversight 
and other responsibilities specified under s. DHS 75.18 (1) with 
respect to all other offices.
(b) A service may provide outpatient integrated behavioral 
health treatment services in the community or other locations, 
provided all requirements of this chapter are able to be met in the 
setting.
(c) A service that provides outpatient integrated behavioral 
health treatment services in the community shall have written 
policies and procedures for community-based service delivery.
(d) A service that provides outpatient integrated behavioral 
health treatment services in the community shall provide annual 
training for all staff that deliver services in the community re-
garding in-home and community safety, and avoiding sexual or 
other exploitative relationships with patients. A record of each 
training shall be available to the department upon request.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.51 Intensive outpatient treatment service. 
(1) SERVICE DESCRIPTION. In this section, “intensive outpatient 
treatment service” means a non-residential treatment service to-
taling at least 9 hours of treatment services per patient per week 
for adults and at least 6 hours of treatment services per patient per 
week for minors, in which substance use treatment personnel pro-
vide assessment and treatment for substance use disorders under 
the oversight of a medical director. Intensive outpatient treatment 
services may include screening, intake, evaluation and diagnosis, 
medication management, nursing services, case management, 
drug testing, counseling, individual therapy, group therapy, fam-
ily therapy, psychoeducation, vocational services, peer support 
services, recovery coaching, outreach activities, and recovery 
support services to ameliorate symptoms and restore effective 
functioning. Intensive outpatient treatment services address pa-
tient needs for mental health, psychiatric, or medical services 
through integrated co-occurring treatment or through coordinated 
services, consultation, and referrals.
(2) LOCATION OF SERVICE DELIVERY. (a) An intensive out-
patient treatment service may provide case management and out-
reach services in the community or other locations, provided all 
requirements of this chapter are able to be met in that setting.
(b) A service that provides intensive outpatient case manage-
ment and outreach services in the community shall have written 
policies and procedures for community-based service delivery.
(c) A service that provides intensive outpatient case manage-
ment and outreach services in the community shall provide an-
nual training for all staff that deliver services in the community 
regarding in-home and community safety and avoiding sexual or 
other exploitative relationships with patients. A record of each 
training shall be available to the department upon request.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.52 Day treatment or partial hospitalization 
treatment service. In this section, “day treatment service” or 
“partial hospitalization service” means a medically-monitored 
and non-residential substance use treatment service totaling 15 or 
more hours of treatment services per patient per week for adults 
and 12 or more hours of treatment services per patient per week 
for minors, in which substance use and mental health treatment 
personnel provide assessment and treatment for substance use 
and co-occurring mental health disorders under the oversight of a 
medical director. Day treatment or partial hospitalization ser-
vices may include screening, intake, evaluation and diagnosis, 
medication management, nursing services, case management, 
drug testing, counseling, individual therapy, group therapy, fam-
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
31 DEPARTMENT OF HEALTH SERVICES DHS 75.56
ily therapy, psychoeducation, vocational services, peer support 
services, recovery coaching, outreach activities, and recovery 
support services, to ameliorate symptoms and restore effective 
functioning.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.53 Transitional residential treatment ser-
vice. In this section, “transitional residential treatment service” 
means a residential substance use treatment service totaling 6 or 
more hours of treatment services per patient per week, in which 
substance use treatment personnel provide assessment and treat-
ment for substance use disorders in a structured and recovery-
supportive 24-hour residential setting, under the oversight of a 
physician or a prescriber knowledgeable in addiction, providing 
medical supervision and clinical consultation. Transitional resi-
dential treatment services may include screening, intake, evalua-
tion and diagnosis, medication management, nursing services, 
case management, drug testing, counseling, individual therapy, 
group therapy, family therapy, psychoeducation, vocational ser-
vices, peer support services, recovery coaching, outreach activi-
ties, and recovery support services, to ameliorate symptoms and 
restore effective functioning.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.54 Medically monitored residential treat-
ment service. In this section, “medically monitored residential 
treatment service” means a residential substance use treatment 
service totaling 20 or more hours of treatment services per pa-
tient per week, in which substance use and mental health treat-
ment personnel provide assessment and treatment for substance 
use disorders and co-occurring mental health disorders, under the 
oversight of a medical director. Medically monitored residential 
treatment services may include screening, intake, evaluation and 
diagnosis, medication management, nursing services, case man-
agement, drug testing, counseling, individual therapy, group ther-
apy, family therapy, psychoeducation, vocational services, peer 
support services, recovery coaching, outreach activities, and re-
covery support services, to ameliorate symptoms and restore ef-
fective functioning. Medically monitored residential treatment 
services are delivered in a 24-hour clinical residential setting. 
This level of care is appropriate for patients who require a 24-
hour supportive treatment environment to develop sufficient re-
covery skills and address functional limitations to prevent immi-
nent relapse or dangerous substance use.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.55 Medically managed inpatient treatment. 
In this section, “medically managed inpatient treatment service” 
means an inpatient substance use treatment service delivered un-
der the oversight of a medical director in a hospital setting, and 
includes 24-hour nursing care, physician management, and the 
availability of sufficient resources to respond to an acute medical 
or behavioral health emergency. A medically managed inpatient 
treatment service is appropriate for patients whose acute biomed-
ical, emotional, behavioral, and cognitive problems are so severe 
that they require primary medical and nursing care. Services de-
livered in this setting may include screening, assessment, intake, 
evaluation and diagnosis, medical care, observation and monitor-
ing, physical examination, medication management, nursing ser-
vices, case management, drug testing, counseling, individual 
therapy, group therapy, family therapy, psychoeducation, peer 
support services, recovery coaching, and recovery support ser-
vices, to ameliorate acute behavioral health symptoms and stabi-
lize functioning. Medically managed inpatient treatment services 
address patient needs for mental health, psychiatric, or medical 
services through integrated co-occurring treatment.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.56 Adult residential integrated behavioral 
health stabilization service. (1) SERVICE DESCRIPTION. In 
this section, “adult residential integrated behavioral health stabi-
lization service” means a residential behavioral health treatment 
service, delivered under the oversight of a medical director, that 
provides withdrawal management and intoxication monitoring, as 
well as integrated behavioral health stabilization services, and in-
cludes nursing care on-site for medical monitoring available on a 
24-hour basis. Patients in this setting may receive treatment ser-
vices for a substance use disorder, a mental health disorder, or 
both. Adult residential integrated behavioral health stabilization 
services are appropriate for adult patients whose acute with-
drawal signs and symptoms or behavioral health needs are suffi-
ciently severe to require 24-hour care; however, the full resources 
of a hospital are not required. Services delivered in this setting 
may include screening, assessment, intake, evaluation and diag-
nosis, medical care, observation and monitoring, physical exami-
nation, determination of medical stability, medication manage-
ment, nursing services, case management, drug testing, counsel-
ing, individual therapy, group therapy, family therapy, psychoed-
ucation, peer support services, recovery coaching, recovery sup-
port services, and crisis intervention services, to ameliorate acute 
behavioral health symptoms and stabilize functioning.
(2) STAFF ORIENTATION AND TRAINING. (a) An adult resi-
dential integrated behavioral health stabilization service shall de-
velop and implement an orientation program for all staff and vol-
unteers. The orientation shall be designed to ensure that staff and 
volunteers know and understand all of the following:
1. The program’s general policies and procedures.
2. Applicable parts of chs. 48, 51 and 55, Stats., and any ad-
ministrative rules related to behavioral health emergency 
services.
3. Applicable parts of chapter DHS 34 rules concerning 
emergency mental health service programs.
4. Behavioral health and psychopharmacology concepts ap-
plicable to crisis situations.
5. Techniques and procedures for providing non-violent cri-
sis management for patients, including verbal de-escalation, 
methods for obtaining backup, and acceptable methods for self-
protection and protection of the patient and others in emergency 
situations.
(b) Unlicensed staff working in the clinical setting shall com-
plete a minimum of 40 hours of documented orientation training 
within 3 months after beginning work with the program.
(c) Staff of an adult residential integrated behavioral health 
stabilization service shall receive at least 8 hours per year of 
training on emergency behavioral health services, rules and pro-
cedures relevant to the operation of the program, compliance 
with state and federal regulations, cultural competency in behav-
ioral health services, and current issues in client’s rights and 
services.
(3) ADDITIONAL INTAKE AND ADMISSION REQUIREMENTS. 
(a) An adult residential integrated behavioral health stabilization 
service shall have written policies and procedures for the assess-
ment of safety and consideration of safety risks to the patient and 
others prior to admitting a patient.
(b) An individual with any of the following symptoms, behav-
iors, or concerns shall be excluded from admission to an adult 
residential integrated behavioral health stabilization service:
1. Assaultive ideation or assaultive behaviors combined with 
likelihood to act on those behaviors.
2. Exhibiting active self-injurious behavior. 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 75.56 WISCONSIN ADMINISTRATIVE CODE 32
3. A recent suicide attempt or ongoing suicidal ideation com-
bined with a continued threat or plan to act on suicidal ideation.
(c) The intake screening shall include documentation of the 
determination and plan for the level of observation needed to ad-
dress the patient’s needs and any safety concerns.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.57 Residential withdrawal management 
service. (1) SERVICE DESCRIPTION FOR RESIDENTIAL WITH-
DRAWAL MANAGEMENT SERVICE. In this section, “residential 
withdrawal management service” means a residential substance 
use treatment service that provides withdrawal management and 
intoxication monitoring, and includes medically managed 24-
hour on-site nursing care, under the supervision of a physician. 
Residential withdrawal management is appropriate for patients 
whose acute withdrawal signs and symptoms are sufficiently se-
vere to require 24-hour care; however, the full resources of a hos-
pital are not required. Services delivered in this setting may in-
clude screening, assessment, intake, evaluation and diagnosis, 
medical care, observation and monitoring, physical examination, 
medication management, nursing services, case management, 
drug testing, counseling, individual therapy, group therapy, fam-
ily therapy, psychoeducation, peer support services, recovery 
coaching, and recovery support services, to ameliorate symptoms 
of acute intoxication and withdrawal and to stabilize functioning. 
Services provided in this setting may include community-based 
withdrawal management and intoxication monitoring services, 
subject to the requirements listed in this section. 
(2) SERVICE DESCRIPTION FOR COMMUNITY-BASED WITH-
DRAWAL MANAGEMENT. Community-based withdrawal manage-
ment is a medically-managed withdrawal management service 
delivered on an outpatient basis by a physician, or other service 
personnel acting under the supervision of a physician.
(3) ADDITIONAL REQUIREMENTS FOR COMMUNITY-BASED 
WITHDRAWAL MANAGEMENT. (a) A service that provides com-
munity-based withdrawal management shall meet the require-
ments in this section, however, services may be provided on an 
outpatient basis, in the community, or in the patient’s home.
(b) Community-based withdrawal management services are 
delivered by medical and nursing professionals under the supervi-
sion of physician.
(c) A service that provides community-based withdrawal 
management services shall have written policies and procedures 
for the delivery of community-based withdrawal management 
services.
(d) Residential living areas under this section shall be physi-
cally separated from service areas for community-based with-
drawal management patients.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22; correction 
in (2) made under s. 35.17, Stats., Register October 2021 No. 790.
DHS 75.58 Residential intoxication monitoring ser-
vice. (1) SERVICE DESCRIPTION. In this section, “residential in-
toxication monitoring service” means a residential service that 
provides 24-hour observation to monitor the safe resolution of al-
cohol or sedative intoxication and to monitor for the development 
of alcohol withdrawal for intoxicated patients who are not in need 
of emergency medical or behavioral healthcare. Residential in-
toxication monitoring services may include screening, assess-
ment, intake, evaluation and diagnosis, observation and monitor-
ing, case management, drug testing, counseling, individual ther-
apy, group therapy, family therapy, psychoeducation, peer sup-
port services, recovery coaching, and recovery support services.
(2) OBSERVATION AND MEDICATION REQUIREMENTS. (a) 
Observation. Trained staff shall observe a patient and record the 
patient’s condition at intervals no greater than every 30 minutes 
during the first 12 hours following admission.
(b) Medications. 1. A residential intoxication monitoring 
service shall not administer or dispense medications.
2. When a patient has been admitted with prescribed medi-
cation, staff shall consult with the patient’s physician or other 
person licensed to prescribe and administer medications to deter-
mine the appropriateness of the patient’s continued use of the 
medication while under the influence of alcohol or sedatives.
3. If approval for continued use of prescribed medication is 
received from a prescriber, the patient may self-administer the 
medication under the observation of service staff.
(3) PROHIBITED ADMISSIONS. No person may be admitted if 
any of the following apply:
(a) The person’s behavior is determined by the service to be 
dangerous to self or others.
(b) The person requires professional nursing or medical care. 
(c) The person is incapacitated by alcohol and is placed in or 
is determined to be in need of protective custody by a law en-
forcement officer as required under s. 51.45 (11) (b), Stats.
(d) The person is under the influence of any substance other 
than alcohol or a sedative.
(e) The person requires restraints.
(f) The person requires medication normally used for the 
detoxification process.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22; (2) (a) (ti-
tle) created under s. 13.92 (4) (b) 2., Stats., and correction in (2) (b) 3. made under 
s. 35.17, Stats., Register October 2021 No. 790.
Subchapter VII — Opioid Treatment Programs and 
Office-Based Opioid Treatment 
DHS 75.59 Opioid treatment program. (1) SERVICE 
DESCRIPTION. In this section, “opioid treatment program,” or 
“OTP,” means a service that provides for the management and 
rehabilitation of persons with an opioid use disorder through the 
use of methadone and other FDA-approved medications for the 
treatment of persons with an opioid use disorder, and also pro-
vides a broad range of medical and psychological services, sub-
stance use counseling and social services. OTPs shall provide 
adequate medical, counseling, vocational, educational, and other 
assessment and treatment services. These services must be avail-
able at the primary facility, except where the program sponsor 
has entered into a formal, documented agreement with a private 
or public agency, organization, practitioner, or institution to pro-
vide these services to patients enrolled in the OTP. The program 
sponsor, in any event, must be able to document that these ser-
vices are fully and reasonably available to patients. An OTP is 
subject to the oversight of the SOTA.
(2) REQUIREMENTS. To receive certification from the depart-
ment under this chapter, an OTP shall comply with all require-
ments included in subch. IV, as applicable, be certified under and 
follow all requirements included in s. DHS 75.50 , and the re-
quirements of this section. If a requirement in this section con-
flicts with an applicable requirement in subch. IV or s. DHS 
75.50, the requirement in this section shall be followed.
(3) DEFINITIONS. In this section:
(a) “Biochemical monitoring” means the collection and anal-
ysis of specimens of body fluids such as blood or urine to deter-
mine use of licit or illicit drugs.
(b) “Central registry” means an organization that obtains pa-
tient identifying information from 2 or more OTPs about individ-
uals applying for maintenance treatment or detoxification treat-
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
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33 DEPARTMENT OF HEALTH SERVICES DHS 75.59
ment for the purpose of preventing an individual’s concurrent en-
rollment in more than one program.
(c) “Clinical probation” means the period of time determined 
by the treatment team that a patient is required to increase fre-
quency of service attendance due to rule violations.
(d) “Guest dose” means administration of a medication used 
for the treatment of opioid addiction to a person who is not a 
client of the program that is administering or dispensing the 
medication.
(e) “Initial dosing” means the first administration of 
methadone or other FDA-approved medication for the treatment 
of opioid use disorder to relieve a degree of withdrawal and drug 
craving of the patient.
(f) “Maintenance treatment” means the dispensing of a nar-
cotic drug in the treatment of an individual for opioid 
dependence.
(g) “Mandatory schedule” means the required dosing sched-
ule for a patient and the established frequency that the patient 
must attend the service.
(h) “Medically-supervised withdrawal” means dispensing, ad-
ministering, or prescribing of an FDA-approved medication for 
the treatment of opioid use disorder in gradually decreasing doses 
to alleviate adverse physical or psychological effects incident to 
withdrawal from the continuous or sustained use of opioid drugs. 
The purpose of medically supervised withdrawal is to bring a pa-
tient maintained on maintenance medication to a medication-free 
state within a target period.
(i) “Medication unit” means a facility established as part of a 
service but geographically separate from the service, from which 
licensed private practitioners and community pharmacists are:
1. Permitted to administer and dispense a narcotic drug.
2. Authorized to conduct biochemical monitoring for nar-
cotic drugs.
(j) “Objectively intoxicated person” means a person who is 
determined through a breathalyzer test to be under the influence 
of alcohol.
(k) “Opioid addiction” means psychological and physiologi-
cal dependence on an opiate substance, either natural or syn-
thetic, that is beyond voluntary control.
(L) “Patient identifying information” means the name, ad-
dress, social security number, photograph or similar information 
by which the identity of a patient can be determined with reason-
able accuracy and speed, either directly or by reference to other 
publicly available information.
(m) “Phase” means a patient’s level of dosing frequency.
(n) “Potentiation” means the increasing of potency and, in 
particular, the synergistic action of two or more drugs which pro-
duces an effect that is greater than the effect of each drug used 
alone.
(o) “SAMHSA” means the Substance Abuse and Mental 
Health Services Administration.
(p) “Service physician” means a physician licensed to practice 
medicine in the jurisdiction in which the service is located, and 
knowledgeable in addiction treatment, who assumes responsibil-
ity for the administration of all medical services performed by the 
OTP including ensuring that the service is in compliance with all 
federal, state and local laws relating to medical treatment of an 
opioid use disorder with an FDA approved medication for the 
treatment of an opioid use disorder.
(q) “Program sponsor” means the person named in the appli-
cation for certification described in 42 CFR 8.11 (b) who is re-
sponsible for the operation of the OTP and who assumes respon-
sibility for all its employees, including any practitioners, agents, 
or other persons providing medical, rehabilitative, or counseling 
services at the program or any of its medication units. The pro-
gram sponsor need not be a licensed physician but shall employ a 
licensed physician for the position of medical director. The pro-
gram sponsor is responsible for ensuring the service is in continu-
ous compliance with all federal, state, and local laws and 
regulations.
(r) “State opioid treatment authority” (SOTA) means the sub-
unit of the department designated by the governor to exercise the 
responsibility and authority in this state for governing the treat-
ment of a narcotic addiction with a narcotic drug.
(s) “Take-homes” means medications such as methadone that 
reduce the frequency of a patient’s service visits and with the ap-
proval of the service physician, are dispensed in an oral form and 
are in a container that at a minimum discloses the treatment ser-
vice name, address and telephone number and the patient’s name, 
the dosage amount and the date on which the medication is to be 
ingested.
(t) “Treatment contracting” means an agreement developed 
between the primary counselor or the clinic director and the pa-
tient in an effort to allow the patient to remain in treatment on 
condition that the patient adheres to service rules.
(u) “Treatment team” means a team established to evaluate 
the progress of a patient and consisting of at least the primary 
counselor, the service staff nurse who administers doses and the 
clinic director.
(4) STATE OPIOID TREATMENT AUTHORITY. The powers and 
duties of the SOTA include:
(a) Facilitating the development and implementation of rules, 
regulations, standards, and evidence-based practices, emerging 
best practices, or promising practices, to ensure the quality of ser-
vices delivered by OTPs.
(b) Monitoring and evaluation of program outcomes for ser-
vice recipients and the community. The SOTA may establish or 
follow already established performance indicators by accrediting 
bodies or SAMHSA including improvement in medical condi-
tion, recidivism rates, and such other measures as appropriate.
(c) Acting as a liaison between relevant state and federal 
agencies.
(d) Reviewing opioid treatment guidelines and regulations de-
veloped by the federal government.
(e) Delivering technical assistance and informational materi-
als to OTPs as needed.
(f) Performing both scheduled and unscheduled site visits to 
OTPs in cooperation with department certification office or other 
oversight agencies, or as designated by the SOTA, when neces-
sary and appropriate, and preparing reports as appropriate to as-
sist the department’s certification office or to meet the require-
ments set forth in s. 51.4223, Stats.
(g) Consulting with the federal government regarding ap-
proval or disapproval of requests for exceptions to federal regula-
tions, where appropriate.
(h) Reviewing and approving exceptions to federal and state 
dosage and take home policies and procedures.
(i) Receiving and addressing service recipient appeals and 
grievances in partnership with the department’s client rights 
office.
(j) Working cooperatively with other relevant state and local 
agencies to determine the service need in the location of a pro-
posed program by reviewing data to include overdose deaths, am-
bulance runs, hospitalizations, etc.
(k) Issuing a list of required evidence-based practices, emerg-
ing best practices, and promising practices to be delivered by 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 75.59 WISCONSIN ADMINISTRATIVE CODE 34
OTPs, so long as the required practices are recognized by 
SAMHSA, Centers for Disease Control, or National Institute of 
Health. The SOTA may also provide a list of recommended evi-
dence-based practices, emerging best practices, and promising 
practices. The SOTA may update the required practices list and 
the recommended practices list as needed to reflect advances in 
outcomes research and medical services for persons living with 
opioid use disorders. The SOTA shall take into consideration the 
adequacy of evidence to support the efficacy of the practice, the 
quality of workforce available, and the current availability of the 
practice in the state when updating the lists. At least 120 days be-
fore issuing the initial required practices list and any revisions to 
the required practices list, the SOTA shall provide stakeholders 
with an opportunity to comment and shall take those comments 
into consideration when updating the required practices list.
(L) Monitoring the central registry to prevent dual enroll-
ments in OTP’s and ensure that all required information is 
entered.
(5) REQUIRED PERSONNEL. (a) Clinic director. The service 
shall designate in writing a clinic director who is responsible for 
the day to day operation of the service and overall compliance 
with federal, state and local laws and regulations regarding the 
operation of OTPs, and for all employees including practitioners, 
agents, or other persons providing services at the facility. The 
service shall notify the SOTA in writing within 5 calendar days 
whenever there is a change in clinic director. If the clinic director 
is also licensed to provide counseling services they shall carry a 
caseload of patients that is reasonable to ensure prompt and ade-
quate access to care of those patients while balancing their other 
business responsibilities to the clinic.
(b) Medical director. The service shall designate a physician 
licensed under ch. 448, Stats., as its medical director. The medi-
cal director shall have at least one year of experience in addiction 
medicine or addiction psychiatry, be licensed to practice 
medicine or osteopathy, and meet all other requirements listed in 
s. DHS 75.03 (52). If a service is not able to secure a medical di-
rector who meets the one year of experience requirement, as doc-
umented through recruitment efforts, there shall be a specific 
plan for the person to acquire equivalent training and skills within 
4 months after beginning employment. The medical director, ser-
vice physician, or mid-level practitioner that has a federal excep-
tion approved by SAMHSA and the SOTA to 42 CFR 8.12 (b) , 
(e), (h), and (i) shall be physically present at the OTP at least 40 
percent of the time that the program administers or dispenses 
medication in order to comply with s. DHS 94.08, assure regula-
tory compliance, and carry out duties specifically assigned by 
regulation as required by SAMHSA under 42 CFR 8.12. OTPs in 
the first 60 days of operation may reduce the time requirement 
medical directors must be present on site to at least 20 percent of 
the time that the program administers or dispenses medication. 
On the 61st day of operation the service shall be subject to the re-
quirements of this rule.
(c) Nurses. The service shall have a registered nurse on staff 
to supervise the dosing process and perform other functions dele-
gated by the physician. A registered nurse shall be physically on 
the premises any time dosing is occurring.
(d) Nursing assistants. The service may employ nursing as-
sistants and related medical ancillary personnel to perform func-
tions permitted under state medical and nursing practice statutes 
and administrative rules.
(e) Licensed counselors. The service shall employ at least 
one of the following: substance abuse counselors, substance 
abuse counselors-in training, licensed marriage and family thera-
pists, licensed professional counselors, licensed clinical social 
workers, certified advanced practice social workers, certified in-
dependent social workers, or clinical substance abuse counselors 
who are under the supervision of a clinical supervisor. An OTP 
shall employ one of these identified clinicians for a minimum of 
one full-time equivalent of 40 hours per week for every 55 en-
rolled patients in the service. All counselors rostered to the ser-
vice are subject to this ratio.
(f) Supervision of counseling staff. The service shall provide 
for ongoing clinical supervision of the counseling staff in accor-
dance with s. SPS 162.01. The service shall employ one full-
time clinical supervisor at an equivalent of 40 hours per week for 
every 10 counselors employed. The clinical supervisor shall not 
carry a caseload greater than 30 patients to ensure access to 
prompt and adequate care of those patients while balancing their 
clinical supervision responsibilities.
(g) Physician assistants. The service may employ physician 
assistants to practice in accordance with ch. Med 8 and carry out 
duties specifically allowed by regulation as required by 
SAMHSA under 42 CFR 8.11 (h).
(6) ADMISSION. (a) Admission criteria. For admission to the 
service, a person shall meet all of the following criteria as deter-
mined by the service physician:
1. ‘Maintenance treatment for an adult.’ The service shall 
maintain current procedures determined by the service physician 
to ensure that patients are admitted to maintenance treatment by 
qualified personnel who have determined, using accepted medi-
cal criteria, such as those listed in the DSM, that the person is 
currently addicted to an opioid drug, and that the person became 
addicted at least one year before admission for treatment. In addi-
tion, a service physician shall ensure that each patient voluntarily 
chooses maintenance treatment and that all relevant facts con-
cerning the use of the opioid drug are clearly and adequately ex-
plained to the patient, and that each patient provides informed 
written consent to treatment.
2. ‘Maintenance treatment for a minor.’ A minor shall be el-
igible for maintenance treatment only if the minor has had at least 
2 documented unsuccessful attempts at short-term detoxification 
or drug-free treatment within a 12-month period. No minor may 
be admitted to maintenance treatment unless a parent, legal 
guardian, or responsible adult designated by the relevant state au-
thority consents in writing to such treatment.
3. ‘Maintenance treatment admission exceptions.’ If clini-
cally appropriate, the program physician may waive the require-
ment of a one-year history of addiction of subd. 1. for any of the 
following:
a. A patient released from penal institutions within 6 months 
of release.
b. A pregnant patient certified as pregnant by a service 
physician.
c. A previously treated patient who was discharged from the 
service less than 2 years prior.
4. ‘Detoxification treatment.’ An OTP shall maintain cur-
rent procedures that are designed to ensure that patients are ad-
mitted to short- or long-term detoxification treatment by quali-
fied personnel, such as a service physician, who determines that 
such treatment is appropriate for the specific patient by applying 
established diagnostic criteria. Patients with two or more unsuc-
cessful detoxification episodes within a 12-month period must be 
assessed by the service physician for other forms of treatment. A 
service shall not admit a patient for more than 2 detoxification 
treatment episodes in one year. 
5. ‘Health care release of information.’ When the patient re-
ceives health care services from outside the service, the patient 
shall provide names, addresses and written consents for release of 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
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35 DEPARTMENT OF HEALTH SERVICES DHS 75.59
information from each health care provider to allow the service to 
contact the providers, and shall update releases if changes occur.
6. ‘Prohibition on reward for referral.’ No service shall pro-
vide a bounty, free services, medication or other reward for refer-
ral of potential service recipients to the clinic.
(b) Voluntary treatment. Participation in an OTP shall be 
voluntary.
(c) Explanation. Clinical staff shall clearly and adequately 
explain to the patient being admitted all relevant facts concerning 
the use of medications used by the service, service rules, and 
expectations.
(d) Consent. The service shall require a patient to complete 
an informed medication consent form which clearly indicates 
which FDA-approved medication for opioid use disorder they 
will be receiving, the reason for the use of the medication, the ex-
pected benefits of the use of the medication, and the potential 
side effects of the medication.
(e) Examination. 1. For each patient eligible for admission, 
the service shall arrange for a comprehensive physical examina-
tion and clinically indicated laboratory work-up. The compre-
hensive physical examination shall be ordered by the service 
physician on the day of admission and shall include a complete 
blood count and liver function testing. The service shall test for 
Hepatitis A, B, C and HIV if the patient gives informed consent 
in writing. If the patient declines permission to test shall be doc-
umented in the patient’s record. An updated comprehensive 
physical examination including lab work shall be completed 
annually.
2. The service shall complete a psychosocial assessment and 
initial treatment plan within 3 days of admission.
(f) Initial dose. If a person meets the admission criteria under 
par. (a), an initial dose of an FDA-approved medication may be 
administered to the patient on the day of admission. For each 
new patient enrolled in a service, the initial dose of methadone 
shall not exceed 30 milligrams and the total dose for the first day 
shall not exceed 40 milligrams, unless the service physician doc-
uments in the patient’s record that 40 milligrams did not suppress 
opioid abstinence symptoms.
(g) Central registry. All facilities shall participate in the de-
partment’s central registry, subject to all of the following 
requirements:
1. A patient shall be informed of the service’s participation 
in the central registry, and prior to initiating a central registry in-
quiry the service shall obtain the patient’s written consent.
2. To prevent simultaneous enrollment of a patient in more 
than one OTP, at the time of admission and prior to the dosing of 
a patient, the service shall initiate a clearance inquiry by submit-
ting to the approved central registry the patient’s name, date of 
birth, and relevant information as required for the clearance pro-
cedure. No patient who is reported by the central registry to be 
participating in another such service shall be admitted to an OTP. 
When a dual enrollment is found, the patient shall be discharged 
from one OTP in order to continue enrollment at another OTP. 
The SOTA shall be notified within 24 hours of any dual enroll-
ment discovered.
3. A disclosure shall be made with the patient’s written con-
sent that meets the requirements of 42 CFR part 2, relating to al-
cohol and drug abuse patient records, except that the consent 
shall list the name and address of each central registry or accept-
able alternative and each known OTP to which a disclosure will 
be made.
4. Reports received by the central registry shall be treated as 
confidential and shall not be released except to a licensed service 
or its designated legal representative, as required by law or as part 
of continuity of operations in the case of an emergency. Informa-
tion made available by the central registry shall also be treated as 
confidential.
5. If a service operates not more than 200 miles away from 
an OTP in an adjoining state, the SOTA may direct the service to 
share service recipient information with the OTP in the other 
state to prevent simultaneous enrollment of persons in more than 
one OTP service.
6. A patient shall not be dosed prior to a central registry 
check being conducted.
7. Documentation of the central registry check shall be kept 
in the patient’s file.
(h) Information provided at admission. A patient admitted to 
the OTP shall receive written copies of the following information 
at the time of admission: 
1. The mission and goals of the OTP.
2. The hours during which services are provided.
3. The service must provide access to staff support 24 hours 
a day 7 days a week to ensure that the service provides a mecha-
nism to address patient emergencies (which includes medication 
verification by any other OTP, Emergency Department, correc-
tional institution, or jail) by establishing an emergency contact 
system. The purpose of the contact system is to obtain dosage 
levels and other pertinent patient information on a 24 hour, 7-day-
a-week-basis, as appropriate under confidentiality regulations. 
This subdivision does not require staff to be on site at all times, 
but at least one designated staff member is available “on call” as 
the emergency contact.
4. Treatment costs.
5. Patient rights and responsibilities.
6. Federal confidentiality requirements.
(i) Admissions protocol. The service shall have a written ad-
missions protocol that accomplishes all of the following:
1. Identifies the patient on the basis of appropriate substanti-
ated documents that contain the patient’s name and address, date 
of birth, sex and race or ethnic origin as evidenced by a valid 
driver’s license or other suitable documentation such as a 
passport.
2. Determines the patient’s current addiction, to the extent 
possible, the current degree of dependence on narcotics or opi-
ates, or both, including route of administration, length of time of 
the patient’s dependence, old and new needle marks, past treat-
ment history and arrest record.
3. Determines and verifies the patient’s age. If the patient is 
a minor, the policy shall require documentation as provided in 
par. (a) 2.
4. Identifies all substances being used. To the extent possi-
ble, service staff shall obtain information on all substances used, 
route of administration, length of time used and amount and fre-
quency of use.
5. Obtains information about past treatment. To the extent 
possible, service staff shall obtain information on a patient’s 
treatment history, use of secondary substances while in the treat-
ment, dates and length of time in treatment and reasons for 
discharge.
6. Obtains personal information about the patient. Personal 
information includes history and current status regarding employ-
ment, education, legal status (including arrests and conviction 
history), military service, family and psychiatric and medical 
information.
7. Identifies the patient’s reasons for seeking treatment. Rea-
sons shall include why the patient chose the service and whether 
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the chapter was last published. 
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DHS 75.59 WISCONSIN ADMINISTRATIVE CODE 36
they fully understand the treatment options and the nature and re-
quirements of medication assisted treatment are fully understood.
8. Completes an initial drug screening or analysis to detect 
the use of opiates, methadone, buprenorphine, synthetic opioids, 
amphetamines, methamphetamine, benzodiazepines, cocaine, al-
cohol, and THC. The analysis shall show positive for narcotics, 
or an adequate explanation for negative results shall be provided 
and noted in the prospective patient’s record.
9. Refers a patient who also has a physical health problem 
that cannot be treated within the service to an appropriate agency 
for appropriate treatment.
10. Obtains the patient’s written consent for the service to 
secure records from other agencies that may assist the service 
with treatment planning.
11. Refers prospective patients who are physiologically de-
pendent on alcohol, sedatives, or to anxiolytics to hospital detoxi-
fication before initiating treatment. If prospective patient refuses 
hospital detoxification, the medical director shall determine if the 
risk of treating a patient with a history of use of alcohol, seda-
tives, or anxiolytics outweighs the risk of non-admission to the 
service.
(j) First priority for services. A service shall offer priority 
admission either through immediate admission or priority place-
ment on a waiting list in the following order:
1. Pregnant women who inject drugs. Pregnant women are to 
be assessed for appropriateness for admission by a physician 
within 24 hours of contacting the service.
2. Pregnant women who are drug or alcohol dependent and 
need treatment.
3. Other individuals who inject drugs.
4. Others individuals who are drug or alcohol dependent and 
need treatment.
(k) Capacity management and wait list. 1. ‘Capacity man-
agement.’ An OTP must notify the SOTA within seven days of 
the program reaching both 90 and 100 percent of the program’s 
capacity to care for clients. Each week, the service must report its 
capacity, currently enrolled dosing clients, and any waiting list. 
A service reporting 90 percent of capacity must also notify the 
SOTA when the program’s census increases or decreases from 
the 90 percent level. 
2. ‘Waiting list.’ If the service is at capacity, it shall immedi-
ately advise a prospective patient of the service’s waiting list and 
provide that person with a referral to another treatment service 
that can serve the person’s treatment needs. The OTP shall pro-
vide the SOTA documentation of any waiting list and where 
prospective patients were referred for treatment upon request. An 
OTP must have a waiting list system. If the prospective patient 
seeking admission cannot be admitted within 14 days of the date 
of application, each person seeking admission must be placed on 
the waiting list, unless the person seeking admission is assessed 
by the service and found ineligible for admission according to 
this chapter, 42 CFR parts 2 to 11, or 45 CFR parts 160 to 164. 
The waiting list must assign a unique client identifier for each 
person seeking treatment while awaiting admission.
(L) Appropriate and un-coerced treatment. Service staff shall 
determine through a screening process that an OTP is the most 
appropriate treatment modality for the prospective patient and 
that treatment is not coerced.
(m) Non-admissions. The service shall maintain written logs 
that identify persons who were considered for admission or ini-
tially screened for admission but were not admitted. Such logs 
shall identify the reasons why the person was not admitted and 
what referrals were made for them by the service. These logs will 
be provided to the department upon request.
(7) ORIENTATION OF NEW PATIENTS. (a) Orientation infor-
mation. Within 3 days of admission, a patient shall receive an 
orientation to OTP services providing information on the 
following:
1. The mission and goals of the OTP.
2. The hours during which services are provided.
3. Treatment costs.
4. Patient rights and responsibilities.
5. Counseling services.
6. Federal confidentiality requirements.
7. Attendance expectations.
8. The OTP’s treatment philosophy and service structure.
9. How to attain self-administered dose privileges and re-
quirements to maintain those privileges.
10. Referral to services not provided by the OTP.
11. Rules governing patient conduct and infractions that can 
lead to disciplinary action or discharge from the OTP.
12. Information about initiating a discontinuation of 
medication.
(b) Written materials. Information provided in the orienta-
tion shall be accompanied by the provision of written materials 
on all covered topics.
(c) Proof of orientation. The OTP shall require a new patient 
to acknowledge in writing that the patient has received a full ori-
entation to all requirements and responsibilities associated with 
service enrollment.
(d) Additional orientation requirements for pregnant patients. 
For pregnant patients, the OTP shall explain the following:
1. The risks and benefits of opioid treatment medication dur-
ing pregnancy.
2. The program requirement for prenatal medical care.
(e) Documentation. Documentation of the provision of the 
above information shall be included in the patient’s record.
(8) HOURS OF OPERATION. (a) Accommodation of all pa-
tients. A service’s hours of operation shall accommodate pa-
tients involved in activities such as school, homemaking, child 
care and employment.
(b) Availability of dosing and counseling. Dosing and coun-
seling shall be available at a medically appropriate level to meet 
patient needs and shall offer non-traditional hours of operation 
that meet the majority of patient’s schedule needs. 
(c) Daily operations. All clinics must be open for dosing and 
counseling at least 6 days per week and shall be open 7 days a 
week if they have any patients that do not meet criteria for take 
home medication if those patients cannot be served via guest dos-
ing at other nearby clinics. Facilities shall notify the SOTA and 
patients of the date of any holiday when the service will be closed 
at least 7 days in advance of the holiday. Clinics may only close 
for a holiday if all patients are eligible for take-home medication. 
In the event that all patients are not eligible for take-home medi-
cation, the service may request to offer modified hours for the 
holiday.
(d) Training day. Any service may also be closed for one 
mandatory training day, if required by the SOTA.
(e) Comprehensive services. Facilities shall offer comprehen-
sive services, including individual and group counseling, and re-
ferral services, at least six days per week. Medical exams shall be 
provided on days when new admissions are scheduled and as 
needed for current patients.
(9) RESEARCH. (a) Human subjects. An OTP conducting or 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
37 DEPARTMENT OF HEALTH SERVICES DHS 75.59
permitting research involving human subjects shall establish a re-
search and human rights committee in accordance with s. 51.61 
(4), Stats., and 45 CFR part 46.
(b) Proposed research. All proposed research involving pa-
tients shall meet the requirements of s. 51.61 (1) (j) , Stats., 45 
CFR part 46 and this subsection.
(c) Written consent. No patient may be subjected to any ex-
perimental diagnostic or treatment technique or to any other ex-
perimental intervention unless the patient gives written informed 
consent and the research and human rights committee established 
under s. 51.61 (4), Stats., has determined that adequate provisions 
are made to do all of the following:
1. Protect the privacy of the patient.
2. Protect the confidentiality of treatment records in accor-
dance with s. 51.30, Stats., and ch. DHS 92.
3. Ensure that no patient may be approached to participate in 
the research unless the patient’s participation is approved by the 
person responsible for the patient’s treatment plan.
(10) MEDICAL SERVICES. (a) Primary medical services. An 
OTP may provide primary medical services for patients. The 
OTPs may use all FDA-approved medications and formulations 
for use in treating the patient with a substance use disorder.
(b) Coordination with medical providers. For medical needs 
of a patient that exceed the scope of the service under this chap-
ter, the service shall coordinate with appropriate medical 
providers. 
(c) Medical director responsibilities. The medical director of 
a service is responsible for all of the following:
1. Overseeing all medical services provided by the service.
2. Ensuring that the service complies with all federal, state, 
and local statutes, ordinances and regulations regarding medical 
treatment of an opioid use disorder.
3. Ensuring that evidence of current physiological or psycho-
logical dependence, length of history of addiction and exceptions 
as granted by the SOTA to criteria for admission are documented 
in the patient’s case record before the initial dose is administered.
4. Ensuring that a medical evaluation including a medical 
history and a physical examination have been completed for a pa-
tient before the initial dose is administered.
5. Making a clinical judgment that treatment is medically 
justified for a person who has resided in a penal or chronic care 
institution for one month or longer, under the following 
conditions:
a. The patient is admitted to treatment within 14 days before 
release or discharge or within 6 months after release without doc-
umented evidence to support findings of physiological 
dependence.
b. The patient would be eligible for admission if he or she 
were not incarcerated or institutionalized before eligibility was 
established.
c. The admitting service physician or service personnel su-
pervised by the service physician records in the patient’s case 
record evidence of the person’s prior residence in a penal or 
chronic care institution and evidence of all other findings of 
addiction.
d. The medical director signs and dates the recordings under 
subd. 5. c. before the initial dose is administered to the patient or 
within 48 hours after administration of the initial dose to the 
patient.
6. Ensuring that appropriate laboratory studies have been 
performed and reviewed.
7. Signing or countersigning all medical orders as required 
by federal or state law, including all of the following:
a. Initial medical orders and all subsequent medical order 
changes.
b. Approval of all take-home medications.
c. Approval of all changes in frequency of take-home 
medication.
d. Orders for additional take-home medication for an emer-
gency situation.
8. Reviewing and countersigning each treatment plan 4 times 
annually.
9. Ensuring that justification is recorded in the patient’s case 
record for reducing the frequency of service visits for observed 
drug ingesting and providing additional take-home medication 
under exceptional circumstances or when there is physical dis-
ability, as well as when any medication is prescribed for physical 
health or psychiatric problems.
10. Ensuring the correct amount of medication is adminis-
tered or dispensed, and for recording, signing and dating each 
change in the dosage schedule in a patient’s case record.
11. Ensuring that all physician orders are executed by the 
date given in the order or, if no date is specified, within 24 hours 
of the order being written.
12. Having a valid DEA registration for prescribing, admin-
istering, or dispensing controlled substances, and having a DEA 
waiver if they or any other healthcare professional they supervise 
prescribes, administers, or dispenses partial opioid agonists.
(d) Service physician responsibilities. A service physician is 
responsible for all of the following:
1. Determining the amount of the medication to be adminis-
tered or dispensed and recording, signing and dating each change 
in a patient’s dosage schedule in the patient’s case record.
2. Approving, by signature and date, any request for an ex-
ception to the requirements under sub. (13) relating to take-home 
medications.
3. Detoxification of a patient from narcotic drugs and admin-
istering the narcotic drug or authorizing an agent to administer it 
under physician supervision and physician orders in a manner 
that prevents the onset of withdrawal symptoms.
4. A history and physical examination of the patient deter-
mining that the patient is a suitable candidate for admission to an 
OTP.
(11) DOSAGE. (a) Dose determination. The dose determina-
tion for a patient is a matter of clinical judgment by a physician in 
consultation with the patient and appropriate clinical staff.
(b) Verbal orders. The service physician shall determine, on 
the basis of clinical judgment, the appropriate medication dose 
for the patient and may also use verbal orders pursuant to state, 
accreditation, and federal rules. Upon receiving the service 
physician’s order, the receiver shall record the order in the pa-
tient’s record, and then shall read back the written order to the is-
suing professional to assure that the order is understood clearly. 
Orders made orally or telephonically must be documented as 
such and staff recording must sign their name and title. Oral or 
telephone orders must be countersigned by the service physician 
no later than 72 hours after being given.
(c) Patient sanctioning. Any dose adjustment to sanction the 
patient, to reinforce the patient’s behavior, or for purposes of 
treatment contracting, is prohibited.
(d) Patients under the influence. The service shall delay ad-
ministration of an FDA-approved medication for the treatment of 
an opioid use disorder to a patient under the influence of illicit 
drugs or alcohol until diminution of intoxication symptoms can 
be observed and documented, or the patient shall be readmitted 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 75.59 WISCONSIN ADMINISTRATIVE CODE 38
for observation for withdrawal symptoms while augmenting the 
patient’s daily dose in a controlled, observable fashion.
(e) Sufficient dosing. The FDA-approved medication dose 
that a service provides to a patient shall be sufficient to produce 
the desired response in the patient for the desired duration of 
time.
(f) Initial methadone dose. A patient’s initial dose shall be 
based on the service physician’s evaluation of the history and 
present condition of the patient. The initial dose of methadone 
may not exceed 30 milligrams except that the total dose for the 
first day may not exceed 40 milligrams.
(g) Withdrawal planning. A service shall incorporate with-
drawal planning as a goal in a patient’s initial treatment plan and 
all subsequent treatment plans. A service physician shall deter-
mine the rate of withdrawal to prevent relapse or withdrawal 
symptoms.
(12) INVOLUNTARY TERMINATION FROM AN OTP. (a) Emer-
gency termination. 1. The service may terminate a patient im-
mediately, prior to a fair hearing and without provision for medi-
cally supervised withdrawal, when either of the following occurs:
a. The clinic director reasonably determines and documents 
that the patient’s continuance in the service presents an immedi-
ate and substantial threat of physical harm to other clients, ser-
vice personnel or property.
b. The program’s medical director reasonably determines 
that continued treatment of a client presents a serious docu-
mented medical risk.
2. Upon termination under this paragraph, the service shall:
a. Immediately notify the patient of the decision and the rea-
sons for the decision.
b. Schedule a hearing, to be held on the next business day and 
in accordance with par. (d), on the decision to terminate and pro-
vide notice of the hearing to the patient.
c. After a hearing is held in accordance with par. (d), notify 
the patient of the hearing officer’s decision within one business 
day of the hearing.
d. Provide referrals to ensure a continuum of care for the 
client, including continued counseling, medication, withdrawal 
management, and other services, including risk reduction and 
outreach.
3. Facilities that are in the process of termination are not re-
quired to provide medically supervised withdrawal services to 
clients who are discharged involuntarily on an emergency basis, 
but referrals for assistance elsewhere must be provided in such 
circumstances.
(b) Non-emergency termination. In a non-emergency situa-
tion, the service must afford the client the following procedural 
rights in addition to the rights listed in s. 51.61, Stats., and ch. 
DHS 94:
1. Prior to initiating medically supervised withdrawal, the 
service shall provide the client with prompt written notice which 
shall contain:
a. A statement of the reasons for the proposed termination, 
such as violations of a specific rule or rules, non-compliance 
with treatment contract, and the particulars of the infraction in-
cluding the date, time, and place.
b. Notification that the client has the right, within 2 business 
days following receipt of written notice, to submit a written re-
quest for a fair hearing on the proposed termination; if a fair hear-
ing is requested the medically supervised withdrawal is stopped 
until the hearing occurs and a decision is rendered.
c. A copy of the service’s hearing procedures.
2. If a timely request for a hearing is made, arrange with the 
patient or patient’s advocate for a mutually convenient date and 
time for a hearing within 10 business days of receipt of the notice. 
Additional time to secure appropriate representation may be 
granted to the client under exceptional circumstances.
3. Afford the client the opportunity of medically supervised 
withdrawal. If the client chooses medically supervised with-
drawal, the service shall provide medically supervised with-
drawal, or make arrangements for appropriate medically super-
vised withdrawal in another OTP. The rate of dosage reduction 
shall be determined by the services medical director in accor-
dance with the patient’s medical condition and the dosage level at 
which the client was medicated before the decision was made to 
terminate or suspend. In determining an appropriate course of 
withdrawal, the medical director shall review the record, consider 
the patient’s physical and mental health status, and, upon request 
of the client, may take into account the opinions of the patients 
other physicians and medical providers. If a hearing is requested 
by the patient, the medically supervised withdrawal shall cease 
until the hearing occurs and a decision is rendered.
4. If a patient is terminated for non-payment of fees, medi-
cally supervised withdrawal may begin immediately upon provid-
ing written notice of termination, and continue concurrent with 
client’s appeal, if any.
(c) Documentation of receipt of notice. The service shall doc-
ument provision of notice to the patient by obtaining the signa-
ture of the staff person providing notice and by obtaining a 
signed, dated receipt from the patient. If the patient refuses to 
sign a receipt, the service shall document that refusal on its 
record of notice.
(d) Hearing procedures. The service shall ensure that hear-
ings are conducted in accordance with the following procedures: 
1. An impartial hearing officer shall preside over the hearing. 
The hearing officer may be any staff or other person not directly 
involved in the facts of the incident giving rise to the disciplinary 
proceedings or in the decision to commence the proceedings, pro-
vided that the persons involved in either the facts of the incident 
or in the decision to commence the proceedings shall not have au-
thority over the hearing officer.
2. The patient may be represented at the hearing by any re-
sponsible adult of the client’s choosing. If the patient chooses to 
be represented by legal counsel, the patient must give the service 
at least 72 hours’ notice in advance of the hearing, so that the ser-
vice may consult its own legal counsel prior to the hearing.
3. At a hearing, the service bears the burden of proving, by a 
preponderance of the evidence, that the alleged violation 
occurred.
4. The patient shall be entitled, upon request, to examine any 
documentary evidence in the possession of the service that per-
tains to the subject matter of the hearing.
5. The patient shall be entitled to call his or her own wit-
nesses and to question any adverse witnesses.
6. The service shall make an audio recording of the hearing. 
The patient may also make an audio recording of the hearing at 
the patient’s expense.
7. The hearing officer shall make a decision within 7 busi-
ness days after the hearing and will base the decision solely upon 
the information presented at the hearing. The decision shall be 
based upon the services policy and procedures in effect and 
posted at the time of the violation.
8. The hearing officer shall issue the decision in writing, and 
shall provide the patient or and patient’s representative, or both, 
with a copy of the decision. The decision shall include an expla-
nation of the reasons for the decision, and instructions explaining 
how to file an appeal of an adverse decision to the department. 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
39 DEPARTMENT OF HEALTH SERVICES DHS 75.59
The instructions shall inform the client that the client’s written 
request for an appeal constitutes the client’s consent to release in-
formation to the department.
(e) Department review of program decisions to terminate. 1. 
A patient has the right to appeal an adverse decision of a hearing 
officer to the department’s client rights office. The patient must 
request this appeal in writing to the department within 3 business 
days following the receipt of the adverse decision. This request 
must be postmarked within the 3 business day time frame. The 
patient’s written appeal shall contain the patient’s argument in 
support of the appeal. The department will either affirm or re-
verse the hearing officer’s decision, or remand the decision to a 
new hearing officer for a new hearing. The decision of the de-
partment shall be made as follows in writing:
a. In the case of an emergency termination, the department 
shall decide within one business day of receipt of the complete 
hearing record and written materials submitted by both parties.
b. In the case of a non-emergency termination, the depart-
ment shall decide within 10 business days of the department’s re-
ceipt of the complete hearing record and written materials sub-
mitted by both parties. A service’s failure to submit the complete 
hearing record will result in a finding for the patient. The depart-
ment shall deliver a written decision, outlining the reason(s) for 
the decision, to the patient, the patient’s advocate, and the ser-
vice. The decision of the department is final.
2. In the case of a non-emergency termination, if the patient 
timely appeals the hearing decision, the service may not termi-
nate the client or begin medically supervised withdrawal without 
first receiving, and ensuring that the client also receives, the de-
partment’s decision on appeal.
(f) Humane taper. The process of withdrawal from medica-
tion for administrative reasons shall be conducted in a humane 
manner as determined by the service physician, and referral shall 
be made to other treatment services.
(13) TAKE-HOME MEDICATION PRACTICES. (a) Granting 
take-home privileges. During treatment, a patient may benefit 
from less frequent required visits for dosing. This shall be based 
on an assessment by the treatment staff. Time in treatment is not 
the sole consideration for granting take-home privileges. After 
consideration of treatment progress, the service physician shall 
determine if take-home doses are appropriate or if approval to 
take-home doses should be rescinded. Federal and State require-
ments that shall be adhered to by the SOTA and the service are as 
follows:
1. Take-home doses are not allowed during the first 30 days 
of treatment. Patients are expected to attend the service daily. 
Exception requests may be submitted for review when extenuat-
ing circumstances (i.e. pandemic) arise and will be reviewed and 
a determination made by the SOTA.
2. Take-home doses shall not be granted if the patient contin-
ues to use illicit drugs and if the primary counselor and the treat-
ment team determine that the patient is not making progress in 
treatment and has continued drug use or legal problems.
3. Take-home doses shall only be provided when the patient 
is clearly adhering to the requirements of the service. The patient 
shall be expected to show responsibility for security and handling 
of take-home doses.
4. Service staff shall go over the requirements for take-home 
privileges with a patient before the take-home practice for self-
dosing is implemented. Clinical staff shall require the patient to 
provide written acknowledgment that all the rules for self-dosing 
have been provided and understood at the time the review occurs.
5. Service staff may not use the level of the daily dose to de-
termine whether a patient receives take-home medication.
(b) Treatment team recommendation. A treatment team of ap-
propriate staff in consultation with a patient shall collect and 
evaluate the necessary information regarding a decision about 
take-home medication for the patient and make the recommenda-
tion to grant take-home privileges to the service physician.
(c) Service physician review. The rationale for approving, 
denying or rescinding take-home privileges shall be recorded in 
the patient’s case record and the documentation shall be re-
viewed, signed and dated by the service physician. Physician or-
ders for take-home medication for substance use disorders shall 
expire every 90 days. The physician shall document how a pa-
tient meets all criteria in par. (d) 1. to 8. within the order for take-
home medication and what phase level the patient is at for which 
medication.
(d) Service physician determination. The service physician 
shall determine whether, in the service physician’s reasonable 
clinical judgment, the patient has made substantial progress in re-
habilitation and can responsibly handle narcotic drugs. In order 
to make this determination in the affirmative and grant take home 
privileges, the service physician must consider and attest to all of 
the following:
1. The patient is not abusing substances, including alcohol.
2. The patient keeps scheduled service appointments.
3. The patient exhibits no serious behavioral problems at the 
service.
4. The patient is not involved in criminal activity, such as 
drug dealing and selling take-home doses.
5. The patient has a stable home environment and social 
relationships.
6. The patient has met the applicable criteria for length of 
time in treatment provided in pars. (e) and (h).
7. The patient provides assurance that take-home medication 
will be safely stored in a locked metal box within the home.
8. The rehabilitative benefit to the patient in decreasing the 
frequency of service attendance outweighs the potential risks of 
diversion.
(e) Time in treatment criteria and exceptions. The time in 
treatment criteria under par. (h) shall be the minimum time be-
fore take-home medications will be considered unless there are 
exceptional circumstances and the service applies for and re-
ceives approval from the designated federal agency and the SOTA 
for a particular patient.
(f) Individual consideration of request. A request for take-
home privileges shall be considered on an individual basis. No 
request for take-home privileges may be granted automatically to 
any patient.
(g) Additional criteria for 6-day take-home privilege. When a 
patient is considered for 6-day take-homes, the patient shall meet 
the following additional criteria:
1. The patient is employed, attends school, is a homemaker, 
or is disabled.
2. The patient is not known to have used or abused sub-
stances, including alcohol, in the previous year.
3. The patient is not known to have engaged in criminal ac-
tivity in the previous year.
(h) Phases. 1. Methadone shall be provided on a take-home 
basis as follows:
a. For patient time in treatment starting day 31 through day 
90, the patient shall be allowed no more than one take-home dose 
of medication per week.
b. For patient time in treatment starting day 91 through 180, 
the patient shall be allowed no more than 2 take-home doses of 
medication per week.
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 75.59 WISCONSIN ADMINISTRATIVE CODE 40
c. For patient time in treatment starting day 181 through day 
270, the patient shall be allowed no more than 3 take-home doses 
of medication per week.
d. For patient time in treatment starting day 271 through day 
365, the patient shall be allowed no more than 4 take-home doses 
of medication per week.
e. For patient time in treatment starting day 366 through day 
730, the patient shall be allowed no more than 6 take-home doses 
of medication per week.
f. For patient time in treatment starting day 731 through 
completion of treatment, the patient shall be allowed no more 
than 13 take-home doses every 2 weeks.
2. Buprenorphine Oral Products shall be provided on a take-
home basis as follows:
a. For patient time in treatment starting day 31 through day 
60, the patient shall be allowed no more than 1 take-home dose of 
medication per week.
b. For patient time in treatment starting day 61 through day 
90, the patient shall be allowed no more than 2 take-home doses 
of medication per week.
c. For patient time in treatment starting day 91 through day 
120, the patient shall be allowed no more than 3 take-home doses 
of medication per week.
d. For patient time in treatment starting day 121 through day 
240, the patient shall be allowed no more than 4 take-home doses 
of medication per week.
e. For patient time in treatment starting day 241 through day 
365, the patient shall be allowed no more than 6 take-home doses 
of medication per week.
f. For patient time in treatment starting day 366 through 
completion of treatment, the patient shall be allowed no more 
than 13 take-home doses every 2 weeks.
(i) Denial or rescinding of approval. A service shall deny or 
rescind approval for take-home privileges for any of the following 
reasons:
1. Signs or symptoms of withdrawal.
2. Continued illicit substance use.
3. The absence of laboratory evidence of FDA-approved nar-
cotic treatment in test samples, including serum levels.
4. Potential complications from concurrent disorders.
5. Ongoing or renewed criminal behavior.
6. An unstable home environment.
(j) Review. 1. The service physician shall review the status of 
every patient provided with take-home medication at least every 
90 days and more frequently if clinically indicated.
2. The service treatment team shall review the merits and 
detriments of continuing a patient’s take-home privilege and shall 
make appropriate recommendations to the service physician as 
part of the service physician’s 90-day review.
3. Service staff shall use biochemical monitoring to ensure 
that a patient with take-home privileges is not using illicit sub-
stances and is consuming the FDA-approved narcotic provided.
4. Service staff may not recommend denial or rescinding of a 
patient’s take-home privilege to punish the patient for an action 
not related to meeting requirements for take-home privileges.
(k) Reduction of take-home privileges or requirement of more 
frequent visits to the service. 1. A service may reduce a patient’s 
take-home privileges or may require more frequent visits to the 
service if the patient inexcusably misses a scheduled appointment 
with the service, including an appointment for dosing, counsel-
ing, a medical review or a psychosocial review or for an annual 
physical or an evaluation.
2. A service shall reduce a patient’s take-home privileges or 
may require more frequent visits to the service if the patient 
shows positive results in drug test analysis for morphine-like sub-
stances or substances of abuse or if the patient tests negative for 
the narcotic drug administered or dispensed by the service.
(L) Reinstatement. A service shall not reinstate take-home 
privileges that have been revoked until:
1. The patient has had at least 3 consecutive tests or analyses 
that are neither positive for morphine-like substances or sub-
stances of abuse, or negative for the narcotic drug administered or 
dispensed by the service. The tests must be at least one week 
apart.
2. The service physician determines that the patient can re-
sponsibly handle narcotic drugs.
(m) Clinical probation. 1. A patient receiving a 6-day supply 
of take-home medication or more who has a test or analysis that 
is confirmed to be positive for a substance of abuse or negative 
for the narcotic drug dispensed by the service shall be placed on 
clinical probation for 3 months.
2. A patient on 3-month clinical probation who has a test or 
analysis that is confirmed to be positive for a substance of abuse 
or negative for the narcotic drug administered or dispensed by the 
service shall be required to attend the service at least twice 
weekly for observation of the ingestion of medication, and may 
receive no more than a 3-day take-home supply of medication.
(n) Employment-related exception to 6-day supply. A patient 
who is employed and working on Saturdays may apply for an ex-
ception to the dosing requirements if dosing schedules of the ser-
vice conflict with working hours of the patient. A service may 
give the patient an additional take-home dose after verification of 
work hours through pay slips or other reliable means, and follow-
ing approval for the exception from the SOTA and the designated 
federal agency.
(14) EXCEPTIONS TO TAKE-HOME REQUIREMENTS. (a) Ex-
ception requests. A service may submit a request to the desig-
nated federal authority and the SOTA for an exception to certain 
take-home requirements for a particular patient if, in the reason-
able clinical judgment of the service physician, any of the follow-
ing conditions is met:
1. The patient has a physical disability that interferes with 
his or her ability to conform to the applicable mandatory sched-
ule. The patient may be permitted a temporarily or permanently 
reduced schedule provided that she or he is found under par. (c) to 
be responsible in handling narcotic drugs.
2. The patient, because of an exceptional circumstance such 
as illness, personal or family crisis, travel or other hardship, is un-
able to conform to the applicable mandatory schedule. The pa-
tient may be permitted a temporarily reduced schedule, provided 
that she or he is found under par. (c) to be responsible in handling 
narcotic drugs.
(b) Rationale for exception. The program physician or pro-
gram personnel supervised by the program physician shall record 
the rationale for an exception to an applicable mandatory sched-
ule in the patient’s case record. A patient may not be given more 
than a 14-day supply of narcotic drugs at one time.
(c) Exception criteria. The service physician’s judgment that 
a patient is responsible in handling narcotic drugs shall be sup-
ported by information in the patient’s case file that the patient 
meets all of the following criteria:
1. Absence of recent abuse of narcotic or non-narcotic drugs 
including alcohol.
2. Regularity of service attendance.
3. Absence of serious behavior problems in the service.
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
41 DEPARTMENT OF HEALTH SERVICES DHS 75.59
4. Absence of known recent criminal activity such as drug 
dealing.
5. Stability of the patient’s home environment and social 
relationships.
6. Length of time in maintenance treatment.
7. Assurance that take-home medication can be safely stored 
within the patient’s home.
8. The rehabilitative benefit to the patient derived from de-
creasing the frequency attendance outweighs the potential risks 
of diversion.
(d) Exception outcome. 1. Any exception to the take-home 
requirements is subject to approval of the designated federal 
agency and the SOTA. Both the designated federal agency and 
the SOTA must approve the exception. If one does not approve 
then the exception is considered denied.
2. Service staff on receipt of notices of approval or denial of 
a request for an exception from the SOTA and the designated fed-
eral agency shall place the notices in the patient’s case record.
(e) Exception review. Service staff shall review an exception 
when the conditions of the request change or at the time of review 
of the treatment plan, whichever occurs first.
(f) Exception duration. An exception shall remain in effect 
only as long as the conditions establishing the exception remain 
in effect.
(15) TESTING AND ANALYSIS FOR DRUGS. (a) Use. 1. A ser-
vice shall use drug tests and analyses to determine the presence of 
opiates, methadone, fentanyl, buprenorphine, amphetamines, 
benzodiazepines, methamphetamine, cocaine, and THC. Alco-
hol testing will occur for individuals with a history of alcohol use 
disorders and when concerns exist. Alcohol testing may occur 
via breathalyzer, urinalysis or blood testing. If any other drug has 
been determined by a service or the SOTA to be abused in that 
service’s locality, a specimen shall also be analyzed for that drug. 
A service shall receive a 30-day notice and opportunity to pro-
vide input before it must begin analyzing for any additional sub-
stances other than those listed above. Any laboratory that per-
forms the testing shall comply with 42 CFR part 493. A patient’s 
specimen shall be tested for the medication they are receiving for 
their opioid use disorder as well as the appropriate metabolite for 
that medication.
2. A service shall use the results of a drug test or analysis on 
a patient as a guide to review and modify treatment approaches 
and not as the sole criterion to discharge the patient from treat-
ment. If a patient tests positive for any illicit substance or alco-
hol, that substance must be specifically addressed in the patient’s 
treatment plan.
3. A service’s policies and procedures shall integrate testing 
and analysis into treatment planning and clinical practice.
(b) Drawing blood for testing. A service shall determine a pa-
tient’s methadone levels in plasma or serum via a peak and trough 
when medically indicated but no less frequently than annually for 
patients who receive methadone or whenever split dosing is re-
quested. The trough blood level should be drawn immediately 
prior to that day’s dose and the peak blood level should be drawn 
3-4 hours after the dose is administered.
(c) Obtaining urine specimens. A service shall obtain urine 
specimens for testing from a patient, unless a patient is medically 
unable to provide a urine specimen, in which case an exception to 
use another testing device may be requested from the Division of 
Quality Assurance and the SOTA. Specimens shall be collected 
in a clinical atmosphere that respects the patient’s confidentiality, 
as follows:
1. A urine specimen shall be collected on a random basis. 
During the first 90 days of treatment urine drug screens shall oc-
cur weekly. After that time period, urine drug screens shall occur 
at least once a month. 
2. The patient shall be informed about how test specimens 
are collected and the responsibility of the patient to provide a 
specimen when asked.
3. The bathroom used for collection shall be clean and al-
ways supplied with soap, paper towels, and toilet articles.
4. Specimens shall be collected in a manner that minimizes 
the possibility of falsification.
5. When service staff must directly observe the collection of 
a urine sample, this task shall be done with respect for patient 
privacy.
(d) Response to positive test results. 1. Service staff shall dis-
cuss positive test results with the patient within one week of the 
sample being taken by the service and shall document them in the 
patient’s case record with the patient’s response noted.
2. The service shall provide counseling, casework, medical 
review and other interventions when continued use of substances 
is identified. 
3. When there is a positive test result, service staff shall al-
low sufficient time before re-testing to prevent a second positive 
test result from the same substance use.
4. Service staff confronted with a patient’s denial of sub-
stance use shall consider the possibility of a false positive test. 
Patients shall be given the opportunity to challenge a test result 
by having the sample given retested.
5. Service staff shall review a patient’s dosage and shall 
counsel the patient regarding their use when test reports are posi-
tive for morphine-like substances and negative for the FDA-ap-
proved treatment.
(e) Frequency of drug screens. 1. The frequency that a ser-
vice shall require drug screening shall be clinically appropriate 
for each patient, allow for a rapid response to the possibility of re-
lapse, and occur at least on a monthly basis.
2. A service shall arrange for drug screens with sufficient 
frequency so that they can be used to assist in making informed 
decisions about take-home privileges.
(16) TREATMENT DURATION AND RETENTION. (a) Patient re-
tention. Patient retention shall be a major objective of treatment. 
The service shall do all of the following to retain patients for the 
planned course of treatment:
1. Render treatment in a way that is least disruptive to the pa-
tient’s travel, work, educational activities, ability to use support-
ive services, and family life.
2. Determine hours based on patient needs.
3. Ensure that a patient has ready access to clinical staff, par-
ticularly to the patient’s primary counselor.
4. Ensure that clinical staff are adequately trained and are 
sensitive to gender- and culture-specific issues.
5. Provide services that incorporate evidence based practice 
standards for substance use treatment.
6. Ensure that patients receive adequate doses of medication 
based on their individual needs.
7. Ensure that all clinical staff are accepting of medication-
assisted treatment.
8. Ensure that patients understand that they are responsible 
for complying with all aspects of their treatment, including par-
ticipating in counseling sessions.
(b) Effort to retain patients. Since treatment duration and re-
tention are directly correlated to rehabilitation success, a service 
shall make a concerted effort to retain patients within the first 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 75.59 WISCONSIN ADMINISTRATIVE CODE 42
year following admission. Evidence of this concerted effort shall 
include written documentation of all of the following:
1. Whether the patient continues to benefit from the 
treatment.
2. Whether the risk of relapse is discontinued.
3. Whether the patient exhibits no side effects from the 
treatment.
4. Whether continued treatment is medically necessary in 
the professional judgement of the service physician.
(c) Referral for further treatment. A service shall refer a pa-
tient discharged from the service to a more suitable treatment 
modality when further treatment is required or is requested by the 
patient and cannot be provided by the service.
(17) MULTIPLE SUBSTANCE USE AND CO-OCCURRING TREAT-
MENT. (a) Assessment. A service shall assess a prospective pa-
tient for admission during the admission process to distinguish 
substance use, abuse and dependence, and determine patterns of 
other substance use and self-reported etiologies, including non-
prescription, non-therapeutic and prescribed therapeutic use and 
mental health problems.
(b) Multiple substance use patients. 1. A service shall pro-
vide a variety of services that support cessation by a patient of al-
cohol and prescription and non-prescription substance use as the 
desired goal.
2. Service objectives shall indicate that abstinence by a pa-
tient from alcohol and prescription and non-prescription sub-
stance use should extend for increasing periods, progress toward 
long-term abstinence and be associated with improved life func-
tioning and well-being.
3. Service staff shall instruct multiple substance use patients 
about their vulnerabilities to cross-tolerance, drug-to-drug inter-
action and potentiation and the risk of dependency substitution 
associated with self-medication.
(c) Patients with co-occurring disorders. 1. A service shall 
have the ability to provide concurrent treatment for a patient diag-
nosed with both a mental health disorder and a substance use dis-
order. The service shall arrange for coordination of treatment op-
tions and for provision of a continuum of care across the bound-
aries of physical sites, services and outside treatment referral 
sources.
2. When a co-occurring disorder exists, a service shall de-
velop with the patient a treatment plan that integrates measures 
for treating all alcohol, drug and mental health problems. For the 
treatment of a patient with co-occurring disorders, the service 
shall arrange for a mental health professional to help develop the 
treatment plan and provide ongoing treatment services. The 
mental health professional shall be available either as an em-
ployee of the service or through a written agreement. The mental 
health professional shall complete a mental health assessment 
within 3 business days of admission. 
(18) PREGNANCY. Each OTP shall have written procedures 
for pregnant patients including the following minimum standards:
(a) Risks. A requirement that each patient admitted to the 
OTP be informed of the possible risks to herself or to her unborn 
child from the use of medication-assisted treatment, and be in-
formed that abrupt withdrawal from these medications may ad-
versely affect the unborn child.
(b) Medication-assisted treatment. A requirement that a 
pregnant patient who has a documented past opioid dependency 
and who may be in direct jeopardy of returning to opioid depen-
dency with all of its attendant dangers during pregnancy, be in-
formed that they may be placed on a medication-assisted treat-
ment regimen. The service shall also provide a statement that for 
such pregnant women, evidence of current physiological depen-
dence on opioid drugs is not needed if the medical director or 
other authorized program physician certifies the pregnancy, de-
termines and documents that the woman may resort to the use of 
opioid drugs, and determines that medication-assisted treatment 
is justified in their clinical opinion.
(c) Approval of admission. A requirement that the admission 
of each pregnant patient to an OTP be approved by the medical 
director or other authorized program physician prior to admitting 
the patient to the program.
(d) Coordination of care. A requirement that OTPs develop a 
form for release of information between themselves and the 
healthcare provider in care of obstetrical care. This voluntary 
form should be offered to all pregnant patients for coordination of 
medical care.
(e) Education. A requirement that each pregnant patient be 
given education on recognizing the symptoms of neonatal absti-
nence syndrome near the time of delivery.
(f) Prenatal care. Procedures for prenatal care that include:
1. Providing prenatal care by the service or by referral to an 
appropriate health care provider. If appropriate prenatal care is 
neither available on-site or by referral, or if the pregnant patient 
cannot afford care or refuses prenatal care services on-site or by 
referral, an OTP, at a minimum, should offer basic prenatal in-
struction on maternal, physical, and dietary care as part of its 
counseling services. If a pregnant patient refuses the offered on-
site or referred prenatal services, the medical director or treating 
physician must use informed consent procedures to have the pa-
tient formally acknowledge, in writing, refusal of these services.
2. A requirement that if a patient is referred to prenatal care 
outside the agency, the name, address and telephone number of 
the health care provider shall be recorded in the patient’s clinical 
record.
3. A requirement that if prenatal care is provided by the OTP, 
the clinical record shall include documentation to reflect services 
provided.
4. A requirement that if a patient is referred outside of the 
agency for prenatal services, the provider to whom she has been 
referred shall be notified that she is on medication-assisted treat-
ment; however, such notice shall only be given after the patient 
has signed a release of information. 
5. A requirement that any changes in medication-assisted 
treatment be communicated to the appropriate healthcare 
provider if the woman has prenatal care outside the agency if the 
patient allows communication among providers. 
6. A requirement that the service monitor the medication 
dose carefully throughout the pregnancy, moving rapidly to sup-
ply increased or split dose if it becomes necessary. 
7. A recommendation that blood serum levels for methadone 
agonist be monitored once a trimester, and every three days for 
two weeks after delivery to ensure appropriate level of medica-
tion before and after delivery by the appropriate healthcare pro-
fessional. The medical director shall request and review serum 
levels to determine whether any changes to treatment need to be 
made.
8. A requirement that the service shall offer on-site parenting 
education and training to all patients who are parents or shall re-
fer interested patients to appropriate alternative services for the 
training; and, 
(g) Pregnant patients that refuse prenatal services. Proce-
dures for a patient who refuses prenatal service by the OTP or an 
outside provider, including that
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
43 DEPARTMENT OF HEALTH SERVICES DHS 75.59
1. The medical director or other authorized program physi-
cian shall note this in the clinical record.
2. Requiring that the patient be asked to sign a statement that 
says “I have been offered the opportunity for prenatal care by the 
opioid treatment program or by a referral to a prenatal clinic or by 
a referral to the physician of my choice. I refuse prenatal counsel-
ing by the opioid treatment program. I refuse to permit the opioid 
treatment program to refer me to a physician or prenatal clinic for 
prenatal services.” If the patient refuses to sign the statement, the 
medical director or other authorized program physician shall in-
dicate in the signature block that “patient refused to sign” and af-
fix their signature and the date on the statement. 
(19) COMMUNICABLE DISEASE. (a) Tuberculosis - patients. 
An OTP shall screen patients for tuberculosis in a manner and 
frequency consistent with current CDC standard of practice. Tu-
berculosis treatment may be provided by referral to an appropri-
ate public health agency or community medical service.
(b) Tuberculosis - staff. A service shall screen prospective 
new staff and ongoing staff for tuberculosis in a manner and fre-
quency consistent with current CDC standard of practice.
(c) Screening. A service shall screen all patients via a risk 
factor assessment at admission and annually thereafter for viral 
hepatitis and sexually transmitted diseases and shall ensure that 
any necessary medical follow-up occurs, either on site or through 
referral to community medical services. Positive screening re-
sults or disease risks must have a management plan that is seen 
through to completion regardless of whether this is accomplished 
via services provided directly on-site or by referral and care 
coordination.
(d) Hepatitis B. A service shall ensure that all clinical staff 
have been immunized against hepatitis B. Documentation of re-
fusal to be immunized shall be entered in the staff member’s per-
sonnel record.
(20) FACILITY. A service shall provide a setting that is con-
ducive to rehabilitation of the patients and that meets all of the 
following requirements:
(a) Cleanliness. The waiting area, restrooms, dosing areas, 
and counseling offices shall be clean.
(b) Ventilation and lighting. Waiting areas, dosing stations 
and all other areas for patients shall be provided with adequate 
ventilation and lighting.
(c) Confidentiality. Dosing stations and adjacent areas shall 
be kept sanitary and ensure privacy and confidentiality.
(d) Sound proofing. Patient counseling rooms, physical exam-
ination rooms and other rooms or areas in the facility that are 
used to meet with patients shall have adequate sound proofing so 
that normal conversations will be confidential.
(e) Security. Adequate security shall be provided inside and 
outside the facility for the safety of the patients and to prevent loi-
tering and illegal activities.
(f) Restrooms. Separate toilet facilities shall be provided for 
patient and staff use.
(g) Accessibility. The facility and areas within the facility 
shall be accessible to persons with physical disabilities.
(h) Physical environment. The physical environment within 
the facility shall be conducive to promoting improved functioning 
and a drug-free lifestyle.
(i) Facility regulations. Meet all local, state, and federal 
requirements.
(j) Annual inspection. Post an annual inspection report from 
appropriate officials.
(k) First aid kit. The facility shall maintain stocked first aid 
kits for emergency use including naloxone.
(L) Disaster plan. Have a disaster plan and facility evacuation 
plan that is updated annually and posted in an area accessible to 
staff and patients.
(m) Accreditation body. The facility shall meet physical facil-
ity standards established by the services accreditation body.
(21) DIVERSION CONTROL. (a) Staff member responsibility. 
Each staff member of the OTP is responsible for being alert to 
potential diversion of medication by patients and staff.
(b) Minimize diversion. Service staff shall take all of the fol-
lowing measures to minimize diversion:
1. Require that doses of Methadone shall be dispensed only 
in liquid form. Other FDA approved medications are allowable in 
their FDA-approved formats as determined by the medical staff.
2. Require that each take-home bottle or other form of medi-
cation packaging used for medication-assisted treatment dis-
pensed have a label that contains the following information:
a. The OTPs name, address and telephone number.
b. The name of the patient.
c. The name of service physician prescribing the medication.
d. The name of the medication.
e. The dosing instructions and schedule.
f. The date that the take-home dose was prepared.
g. A warning that reads “Caution: Federal law prohibits the 
transfer of this drug to any person other than the patient for whom 
it was prescribed.”
h. Any other requirements pursuant to rules adopted by the 
department.
3. Require a patient to return all empty take-home bottles on 
the patient’s next day of service attendance following take-home 
dosing. Clinical staff shall examine the bottles to ensure that the 
bottles are received from the appropriate patient and in an intact 
state.
4. The service may discontinue take-home medications for 
patients who fail to return empty take-home bottles in the pre-
scribed manner. If upon review of take home medication it is de-
termined that medication is missing and cannot reasonably be ac-
counted for the service shall discontinue take home medication.
(c) Counselor responsibility. If a service receives reliable in-
formation that a patient is diverting medication, the patient’s pri-
mary counselor shall immediately discuss the problem with the 
patient.
(d) Revocation of take homes. Based on information provided 
by the patient or continuing reports of diversion, a service may 
revoke take-home privileges of the patient.
(e) State revocation of take-homes. The SOTA may, based on 
reports of diversion, revoke take-home privileges, exceptions or 
exemptions granted to or by the service for all patients. If a ser-
vice agency disagrees with the SOTA ’s decision, it may provide 
additional relevant information to the SOTA, request that SOTA 
review the revocation decision, or file a request for review and re-
consideration of the revocation decision with the Department’s 
Division of Care and Treatment Services.
(f) State revocation of a services ability to grant take-homes. 
The SOTA may revoke the authority of an OTP to grant take-
home privileges when the service cannot demonstrate that all re-
quirements have been met in granting take-home privileges to pa-
tients. If a service agency disagrees with the SOTA ’s decision, it 
may provide additional relevant information to the SOTA, request 
that SOTA review the revocation decision, or file a request for re-
view and reconsideration of the revocation decision with the De-
partment’s Division of Care and Treatment Services.
(g) Loitering. An OTP shall have a written policy to discour-
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 75.59 WISCONSIN ADMINISTRATIVE CODE 44
age the congregation of patients at a location inside or outside the 
service facility for non-programmatic reasons, and shall post that 
policy in the facility.
(h) Callbacks. The diversion control plan shall contain, at a 
minimum, a random call-back program with mandatory compli-
ance that includes:
1. Call-backs shall be in addition to the regular schedule of 
clinic visits.
2. Each patient receiving two or more take-home medica-
tions shall be called back randomly but no less frequently than on 
a quarterly basis.
3. Upon call back a service recipient shall report to the clinic 
the next day within dosing hours, with all take-home medica-
tions. The quantity and integrity of packaging shall be verified 
for all doses. If a take-home dose shows evidence of tampering, 
the clinic shall impose uniform sanctions for violating take-home 
policies, including sanctions for a patient’s tampering with a take-
home dose.
4. Patients shall be informed of consequences for violating 
the take-home policy.
5. The service shall maintain individual call-back results in 
the patient record.
(22) SERVICE APPROVAL. (a) Approval of primary service. 
An applicant for approval to operate an OTP in Wisconsin with 
the intent of administering or dispensing medication for the treat-
ment of an opioid use disorder shall submit all of the following to 
the SOTA:
1. Copies of all completed designated federal agency 
applications.
2. A copy of the request for registration with the DEA for the 
use of narcotic medications in the treatment of opiate addiction.
3. A narrative description of the treatment services that will 
be provided in addition to medication.
4. Documentation of the need for the service.
5. Criteria for admitting a patient.
6. A copy of the policy and procedures manual for the ser-
vice, detailing the operation of the service as follows:
a. A description of the intake process.
b. A description of the treatment process.
c. A description of the expectations the service has for a 
patient.
d. A description of any service privileges or sanctions.
e. A description of the service’s use of testing or analysis to 
detect substances and the purposes for which the results of testing 
or analysis are used as well as the frequency of use.
7. Documentation that there are adequate physical facilities 
to provide all necessary services.
8. Documentation that the service will have ready access to a 
comprehensive range of medical and rehabilitative services that 
will be available if needed, including the name, address, and a de-
scription of each hospital, institution, clinical laboratory or other 
facility available to provide the necessary services.
9. A list of persons working in the service who are licensed 
to administer or dispense narcotic drugs even if they are not re-
sponsible for administering or dispensing narcotic drugs.
(b) Approval of service sites. Only service sites approved by 
SAMHSA, the DEA and the SOTA may be used for treating per-
sons with an opioid use disorder with a narcotic drug.
(c) Approval of medication units. 1. To operate a medication 
unit, a service shall apply to the department for approval to oper-
ate the medication unit. A separate approval is required for each 
medication unit to be operated by the service. A medication unit 
is established to facilitate the needs of patients who are stabilized 
on an optimal dosage level. The department shall approve a med-
ication unit before it may begin operation.
2. Approval of a medication unit shall take into consideration 
the distribution of patients and other medication units in a geo-
graphic area.
3. If a service has its approval revoked, the approval of each 
medication unit operated by the service is automatically revoked. 
Revocation of the approval of a medication unit does not auto-
matically affect the approval of the primary service.
(23) ASSENT TO REGULATION. (a) Service sponsor. A per-
son who sponsors an OTP and any personnel responsible for a 
particular service shall agree in writing to adhere to all applicable 
requirements of this chapter and 21 CFR part 291 and 42 CFR 
part 2.
(b) Responsibilities. The service sponsor is responsible for all 
service staff and for all other service providers who work in the 
service at the primary facility or at other facilities or medication 
units.
(c) Written agreement. The service sponsor shall agree in 
writing to inform all service staff and all contracted service 
providers of the provisions of all pertinent state rules and federal 
regulations and shall monitor their activities to ensure that they 
comply with those rules and regulations.
(d) Replacement. The service shall notify the designated fed-
eral agency and SOTA within 5 business days after replacement 
of the service sponsor or medical director.
(e) Required services. OTPs shall provide adequate medical, 
counseling, vocational, educational, and other assessment and 
treatment services. These services must be available at the pri-
mary facility, except where the program sponsor has entered into 
a formal, documented agreement with a private or public agency, 
organization, practitioner, or institution to provide these services 
to patients enrolled in the OTP. The program sponsor, in any 
event, must be able to document that these services are fully and 
reasonably available to patients. This documentation must be 
provided to the department upon request.
(24) DEATH REPORTING. An OTP shall report the death of a 
patient and deaths related to a patient’s medication to the SOTA 
within 5 business days after learning of the death.
(25) PRESCRIPTION DRUG MONITORING PROGRAM. (a) Pol-
icy and procedure. The service must develop and maintain a pol-
icy and procedure that requires the ongoing monitoring of the 
data from the prescription drug monitoring program (PDMP) for 
each patient. The policy and procedure must include how the ser-
vice meets the requirements in par. (b).
(b) Requirements. If a medication used for the treatment of 
substance use disorder is administered or dispensed to a patient, 
the OTP shall be subject to the following requirements:
1. Upon admission a patient must be notified in writing that 
the medical director must monitor the PDMP to review the pre-
scribed controlled drugs a client received.
2. The medical director or the medical director’s delegate 
must review the data from the PDMP before the patient is ordered 
any controlled substance including medications for maintenance 
therapy, and subsequent reviews of the PDMP data must occur at 
least every 90 days.
3. A copy of the PDMP data reviewed must be maintained in 
the client’s file.
4. When the PDMP data contains a recent history of multiple 
prescribers or multiple prescriptions for controlled substances, 
the physician’s review of the data and subsequent actions must be 
documented in the patient’s file within 72 hours and must contain 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
45 DEPARTMENT OF HEALTH SERVICES DHS 75.59
the medical director’s determination of whether the prescriptions 
place the patient at risk of harm and the actions to be taken in re-
sponse to the PDMP findings. The provider must conduct subse-
quent reviews of the PDMP in these circumstances on a monthly 
basis.
5. If at any time the medical director believes the use of the 
controlled substances places the patient at risk of harm, the ser-
vice must seek the patient’s consent to discuss the patient’s opioid 
treatment with other prescribers and for other prescribers to dis-
close to the OTP’s medical director of the client’s condition that 
formed the basis of the other prescriptions. If the information is 
not obtained within 7 days, the medical director must document 
whether or not changes to the client’s medication dose or number 
of unsupervised use doses are necessary until the information is 
obtained.
(25m) GUEST DOSING. (a) Approval. To receive a guest 
dose, the patient must be enrolled in an OTP elsewhere in the 
state or country and be receiving the medication on a temporary 
basis because the client is not able to receive the medication at the 
program in which the client is enrolled. A patient may guest dose 
at a different OTP if prior approval is obtained from the patient’s 
medical director or program physician to receive services on a 
temporary basis from another OTP certified under this rule or by 
SAMHSA. The approval shall be noted in the patient’s record 
and shall include the following documentation:
1. The patient’s signed and dated consent for disclosing iden-
tifying information to the program which will provide services on 
a temporary basis.
2. A medication change order by the referring medical direc-
tor or program physician permitting the patient to receive ser-
vices on a temporary basis from the other program for a length of 
time not to exceed 30 days.
3. Evidence that the medical director or program physician 
for the program contacted to provide services on a temporary ba-
sis has accepted responsibility to treat the visiting patient, con-
curs with his or her dosage schedule, and supervises the adminis-
tration of the medication.
(b) Maximum number of days. Guest dosing shall be pro-
vided for a maximum of 30 days.
(c) Patient requirement. Patients receiving guest dosing shall 
have been enrolled at the home clinic for a minimum of 30 days 
before being eligible for a guest dose. Patients enrolled less than 
30 days at the home clinic shall be eligible for guest dosing only if 
approved by the SOTA.
(d) Drug screen requirement. Patients shall have two consec-
utive urine drug screens free of illicit substances or substances of 
abuse before being eligible for a guest dose, unless the medical 
director determines that the benefits of guest dosing outweigh the 
risks and documents the justification for granting guest dosing 
privileges in the patient’s record.
(26) OVERDOSE PREVENTION. (a) Naloxone. An OTP shall 
provide a patient with a naloxone kit or a prescription for nalox-
one at admission. The OTP shall provide instruction on the kits 
use including recognizing the signs and symptoms of overdose 
and calling 911 in overdose situations.
(b) Use or expiration of Naloxone. The OTP shall provide a 
new naloxone kit or prescription upon expiration or use of the old 
kit. 
(c) Exemption. The OTP shall be exempt from this require-
ment for one year if the client refuses the naloxone kit or already 
has a naloxone kit.
(d) Orientation training. Documentation that the patient has 
completed the orientation training on recognizing an overdose 
and how to use naloxone and received written information shall 
be completed and signed by service staff and the patient and 
maintained in the patient’s record.
(27) INTERIM MAINTENANCE TREATMENT. (a) The provision 
of interim maintenance with medication assisted treatment is 
prohibited under this rule unless the opioid treatment program 
has a waiver from the department in addition to authorization 
from SAMHSA in accordance with 42 CFR 8.11 (g).
(b) All of the requirements for comprehensive maintenance 
treatment apply to interim maintenance treatment with the fol-
lowing exceptions for patients receiving methadone: no take-
home doses are permitted except on federal holidays if the pro-
gram is closed on those days; an initial and periodic treatment 
plan are not required; a primary counselor is not required; and the 
rehabilitative and other services described in 42 CFR. 8.12 (f) 
(4), (f) (5) (i), and (f) (5) (iii) are not required.
(c) Interim maintenance cannot be provided to an individual 
for more than 120 days in any 12-month period.
(d) To receive interim maintenance, a patient must be fully el-
igible for admission to comprehensive maintenance.
(e) Interim maintenance treatment is for those patients who 
cannot be enrolled in comprehensive maintenance treatment in a 
reasonable geographic area within fourteen days of application 
for admission.
(f) During interim maintenance, the initial toxicology and at 
least two additional toxicology screening tests should be 
obtained.
(g) Programs offering interim maintenance must develop 
clear policies and procedures governing the admission to interim 
maintenance and transfer of patients to comprehensive 
maintenance.
(28) DISASTER PLANNING. (a) Emergency situations. Each 
OTP shall maintain an up-to-date disaster plan that addresses 
emergency situations including fire emergencies, tornadoes, 
earth quakes, flooding, winter storms, pandemics, and involun-
tary temporary or permanent facility closure.
(b) Committee. OTPs shall establish a health and safety com-
mittee that initiates planning actions for disaster scenarios. This 
committee shall:
1. Identify internal resources and areas of need that shall in-
clude, at minimum, considerations of:
a. Personnel training.
b. Equipment needs.
c. Evacuation plans.
d. Backup systems for payroll, billing records, and patient 
records.
e. Communications with staff, patients and local, state, and 
federal partners.
2. Identify external resources and areas of need that shall in-
clude, at minimum:
a. Suppliers of medication used for treatment of substance 
use disorder.
b. Other OTPs; and
c. Alternative dosing locations.
3. Develop a communication plan for the disaster scenario to 
inform patients, the SOTA, SAMHSA, the DEA, and any other 
parties deemed necessary.
4. Develop disaster documentation procedures for guest pa-
tients that shall include at minimum:
a. A temporary chart and client identification number.
b. Identity verification.
c. Medication verification.
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 75.59 WISCONSIN ADMINISTRATIVE CODE 46
(c) Emergency contact. Each OTP shall provide the SOTA 
with the emergency contact information for at least one member 
of the service.
(d) Medication supply. Each OTP shall keep at least a 10-day 
supply based on average caseload of methadone and buprenor-
phine products on site to prepare to receive clients from other fa-
cilities in disaster scenarios.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22; correction 
in (5) (b), (g), (6) (a) 3. a., 4., (h), (k) 2., (7) (a) (intro.), (9) (a), (10) (c) 12., (12) (b) 
2., (d) 2., 7., (h) 1. d. to f., 2. a. to e., (15) (a) 1., (21) (e), (f), (23) (a) made under s. 
35.17, Stats., correction in numbering in (25m) made under s. 13.92 (4) (b) 1. , 
Stats., correction in (6) (i) 3. made under s. 13.92 (4) (b) 4., Stats., and (10) (b) (title) 
created under s. 13.92 (4) (b) 2., Stats., Register October 2021 No. 790; CR 23-067: 
am. (5) (e) Register April 2025 No. 832, eff. 5-1-25.
DHS 75.60 Office-based opioid treatment. (1) AP-
PLICABILITY. This section shall not apply to office-based opioid 
treatment occurring in any of the following settings:
(a) A treatment service in which all patients receiving medi-
cation for addiction are enrolled in a service otherwise certified 
under this chapter.
(b) A state or local correctional facility.
(c) A hospital as defined under s. 50.33 (2), Stats., and their 
affiliates.
(d) A primary care service.
(e) A service providing medication for addiction to less than 
30 patients.
(2) SERVICE DESCRIPTION. In this section, “office-based opi-
oid treatment,” or “OBOT” service means pharmacotherapy for 
opioid use disorder, delivered in a stand-alone office-based opi-
oid treatment clinic, a private office, or public sector clinic set-
ting, excluding certified settings exempted in s. DHS 75.60 (1) or 
otherwise certified under this chapter, by practitioners authorized 
to prescribe outpatient supplies of medications approved by the 
FDA for the treatment of opioid addiction or dependence, preven-
tion of relapse of opioid addiction or dependence, or both. An 
OBOT is subject to the oversight of the state opioid treatment au-
thority. OBOT includes treatment with all medications approved 
by the FDA for such treatment. 
(3) RELATIONSHIP TO TREATMENT SERVICE GENERAL RE-
QUIREMENTS. A service that provides OBOT under this section 
shall be exempt from the treatment service general requirements 
in subchapter IV, unless otherwise indicated in this section.
(4) DEFINITIONS. In this section:
(a) “Drug Addiction Treatment Act of 2000” (DATA 2000) 
means Title XXXV, Section 3502 of the Children’s Health Act, 
permits physicians who meet certain qualifications to treat opioid 
addiction with Schedule III, IV, and V narcotic medications that 
have been specifically approved by the FDA for that indication.
(b) “DATA 2000 waiver” means an authorization conveyed by 
SAMHSA and the DEA to a practitioner that permits them to pre-
scribe or administer buprenorphine products to an individual 
with an opioid use disorder.
(c) “Primary care service” means outpatient general health 
care services provided by a clinic for regular health care services, 
preventive care, or for a specific health concern, and includes all 
of the following:
1. Care that promotes and maintains mental and physical 
health and wellness.
2. Care that prevents disease.
3. Screening, diagnosing, and treating acute or chronic con-
ditions caused by disease, injury, or illness.
4. Patient counseling and education.
5. Provision of a broad spectrum of preventive and curative 
health care over a period of time.
6. Coordination of care. 
(5) STATE OPIOID TREATMENT AUTHORITY. The powers and 
duties of the SOTA include:
(a) Facilitating the development and implementation of rules, 
regulations, standards, and evidence-based practices, emerging 
best practices, or promising practices, to ensure the quality of ser-
vices delivered by OBOT services.
(b) Acting as a liaison between relevant state and federal 
agencies.
(c) Reviewing opioid treatment guidelines and regulations de-
veloped by the federal government.
(d) Delivering technical assistance and informational materi-
als to OBOT services as needed.
(e) Performing both scheduled and unscheduled site visits 
OBOTs in cooperation with department certification office or 
other oversight agencies, or as designated by the SOTA, when 
necessary and appropriate, and preparing reports as appropriate.
(f) Consulting with the federal government regarding approval 
or disapproval of requests for exceptions to federal regulations, 
where appropriate.
(g) Receiving and addressing service recipient appeals and 
grievances in partnership with the department’s client rights 
office.
(h) Issuing a list of required evidence-based practices, emerg-
ing best practices, and promising practices to be delivered by 
OBOT services, so long as the required practices are recognized 
by SAMHSA, Centers for Disease Control, or National Institute 
of Health. The SOTA may also provide a list of recommended 
evidence-based practices, emerging best practices, and promising 
practices. The SOTA may update the required practices list and 
the recommended practices list as needed to reflect advances in 
outcomes research and medical services for persons living with 
opioid use disorders. The SOTA shall take into consideration the 
adequacy of evidence to support the efficacy of the practice, the 
quality of workforce available, and the current availability of the 
practice in the state when updating the lists. At least 120 days be-
fore issuing the initial required practices list and any revisions to 
the required practices list, the SOTA shall provide stakeholders 
with an opportunity to comment and shall take those comments 
into consideration when updating the required practices list.
(6) GENERAL REQUIREMENTS. (a) Governing authority or 
entity owner. The governing authority or entity owner of an 
OBOT service shall do all of the following:
1. Designate a member or representative of the governing 
body that is legally responsible for the operation of a service that 
has the authority to conduct the policy, actions, and affairs of the 
service, to complete the entity owner background check and to be 
the entity owner responsible for a service.
2. Appoint a service director whose qualifications, authority, 
and duties are defined in writing.
3. Establish written policies and procedures for the operation 
of the service and exercise general direction over the service, to 
ensure the following:
a. Compliance with local, state and federal laws.
b. That no person will be denied service or discriminated 
against on the basis of sex, race, color, creed, sexual orientation, 
disability, or age, in accordance with 45 CFR part 92 and Title VI 
of the Civil Rights Act of 1964, as amended, 42 USC. 2000d, Ti-
tle XI of the Education Amendments of 1972, 20 USC 1681-
1686 and s. 504 of the Rehabilitation Act of 1973, as amended, 
29 USC 794, and the Americans with Disabilities Act of 1990, as 
amended, 42 USC 12101-12213.
(b) Caregiver background check. At the time of hire, employ-
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
47 DEPARTMENT OF HEALTH SERVICES DHS 75.60
ment, or contract, and every 4 years after, the service shall con-
duct and document a caregiver background check following the 
procedures in ch. DHS 12 and s. 50.065, Stats. A service shall 
not employ or contract with a person who has been convicted of a 
crime or offense, or has a governmental finding of misconduct, 
found in ch. DHS 12 and s. 50.065, Stats., unless the person has 
been approved under the department's rehabilitation process as 
defined in ch. DHS 12.
(c) Personnel records. Employee records shall be available 
upon request at the service for review by the department. A sepa-
rate record for each employee shall be maintained, kept current, 
and at a minimum, include:
1. A written job description including duties, responsibilities 
and qualifications required for the employee.
2. Beginning date of employment.
3. Qualifications based on education or experience. 
4. A completed caregiver background check following proce-
dures under s. 50.065, Stats., and ch. DHS 12.
5. A copy of a signed statement regarding confidentiality of 
client information.
6. Documentation of any required training.
7. A copy of any required licenses or certifications.
(d) Confidentiality. A service shall have written policies, pro-
cedures, and staff training to ensure compliance with confiden-
tiality provisions of 42 CFR part 2, 45 CFR parts 164 and 170, s. 
51.30, Stats., and ch. DHS 92. Each staff member shall sign a 
statement acknowledging responsibility to maintain confidential-
ity of personal information about persons served.
(7) ASSESSMENT. (a) An OBOT service shall perform and 
document an assessment of each patient. The assessment shall 
include all of the following:
1. A comprehensive medical and psychiatric history.
2. A brief mental status exam.
3. Substance abuse history.
4. Family history and psychosocial supports.
5. Clinically appropriate physical examination at the time of 
admission and annually thereafter.
6. Urine drug screen or oral fluid drug testing.
7. Pregnancy test for patients of childbearing age and ability.
8. Review of the patient’s prescription information in the 
PDMP.
9. Testing for human immunodeficiency virus.
10. Testing for hepatitis B.
11. Testing for hepatitis C.
12. Consideration of screening for tuberculosis and sexually 
transmitted diseases in patients with known risk factors.
(b) A prescriber may satisfy the assessment requirements, 
other than toxicology testing, by reviewing records from a physi-
cal examination and laboratory testing of the patient that was 
conducted within a reasonable period of time prior to the visit.
(c) If any part of the assessment cannot be completed prior to 
the initiation of medication for opioid use disorder, the prescriber 
shall document the reasons in the patient’s record.
(d) For medical needs of a patient that exceed the scope of the 
service under this chapter, the service shall coordinate with ap-
propriate medical providers.
(8) INTAKE. An OBOT service shall comply with all of the 
following requirements:
(a) Before initiating a medication for opioid use disorder, an 
approved DATA 2000-waived prescriber shall give the patient or 
the patient’s representative information about all drugs approved 
by the FDA for use in medication-assisted treatment. The infor-
mation must be provided both orally and in writing. The pre-
scriber or the prescriber’s delegate shall note in the patient’s med-
ical record when this information was provided and make the 
record available to employees of the department upon request.
(b) Comply with all federal and state laws and regulations 
governing the prescribing of the medication.
(9) TREATMENT PLAN. (a) An OBOT service shall establish 
and document a treatment plan that includes all of the following: 
1. The prescriber’s rationale for selection of the specific drug 
to be used in the medication-assisted treatment.
2. Patient education regarding the medication and the ser-
vices to be provided.
3. The patient’s written, informed consent to treatment and 
for the medication they will be receiving.
4. Random urine-drug screens or oral swabs.
5. A signed treatment agreement that outlines the responsi-
bilities of the patient and the prescriber.
6. A plan for psychosocial treatment, pursuant to par. (c).
(b) The prescriber shall only provide medication for opioid 
use disorder in accordance with an acceptable treatment protocol 
for assessment, induction, stabilization, maintenance, and taper-
ing. Acceptable protocols include any of the following:
1. SAMHSA treatment improvement protocol publications 
for medication assisted treatment.
Note: SAMSHA treatment improvement protocols are available at: 
https://store.samhsa.gov.
2. ASAM national practice guidelines for the use of medica-
tions in the treatment of addiction involving opioid use.
Note: ASAM national practice guidelines are available at https://www.asam.org/.
(c) Unless the prescriber providing OBOT services is a board-
certified addictionologist, board certified addiction psychiatrist, 
or psychiatrist, the prescriber shall refer and work jointly with a 
qualified behavioral healthcare provider, community mental 
health services provider, or community addiction services 
provider, to determine the optimal type and intensity of psy-
chosocial treatment for the patient and document the treatment 
plan in the patient record. The treatment provided shall, at mini-
mum, include:
1. A psychosocial needs assessment, substance abuse coun-
seling, links to existing family supports, and referral to commu-
nity services.
2. Substance use treatment services addressing the patient’s 
needs identified during the assessment.
3. Procedures for revising the treatment plan if the patient 
does not adhere to the original plan.
4. When clinically appropriate, and if the patient refuses 
treatment from a qualified behavioral healthcare provider, com-
munity mental health services provider, or community addiction 
services provider, the prescriber shall document the reason for 
the refusal in the patient’s medical record.
5. Additional requirements related to the provision of behav-
ioral health services, including:
a. If the prescriber who prescribes the medication for opioid 
use disorder is also a board-certified addictionologist, psychia-
trist, or board certified psychiatrist, the prescriber may personally 
provide behavioral health services for addiction. 
b. If the prescriber refers the patient to a qualified behavioral 
healthcare provider, community addiction services provider, or 
community mental health services provider, the prescriber shall 
document the referral and the maintenance of meaningful inter-
actions with the provider in the patient record.
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 75.60 WISCONSIN ADMINISTRATIVE CODE 48
(10) PRESCRIBING REQUIREMENTS. (a) The OBOT service 
shall ensure that all of its patients receive the following: 
1. A prescription for naloxone.
2. Instructions for naloxone including recognizing the signs 
and symptoms of overdose and calling 911 in an overdose 
situation.
3. An offer for a new prescription for naloxone upon expira-
tion or use of the old kit.
4. If the patient refuses the prescription for naloxone the pre-
scriber shall provide the patient with information on where to ob-
tain naloxone without a prescription.
(b) The OBOT service shall ensure that all prescriptions for 
buprenorphine products shall comply with all of the following 
requirements:
1. The provision shall be in compliance with the FDA-ap-
proved risk evaluation and mitigation strategy for buprenorphine 
products.
Note: The FDA-approved risk evaluation and mitigation strategy for buprenor-
phine products can be found at https://www.access-
data.fda.gov/scripts/cder/rems/index.cfm.
2. With the exception of those conditions listed in subd. 3. a. 
to e., a prescriber who treats opioid use disorder with a buprenor-
phine product shall only prescribe buprenorphine and naloxone 
combination products for use in the OBOT service.
3. The prescriber shall prescribe buprenorphine without 
naloxone (buprenorphine mono-product) at the OBOT service 
only in the following situations, and shall fully document the evi-
dence for the decision to use buprenorphine mono-product in the 
patient’s record when any of the following apply:
a. A patient is pregnant or breast-feeding.
b. Converting a patient from buprenorphine mono-product to 
buprenorphine and naloxone combination product.
c. Formulations other than tablet or film form approved by 
the FDA are administered.
d. A buprenorphine and naloxone combination product is 
contraindicated for withdrawal management and the contraindi-
cation documented in the patient record.
e. The patient, after an explanation by the service of the dif-
ference between an allergic reaction and symptoms of opioid 
withdrawal precipitated by buprenorphine or naloxone, has an al-
lergy to or intolerance of a buprenorphine and naloxone combi-
nation product. This information shall be included in the patient’s 
record.
4. Due to a higher risk of fatal overdose when buprenorphine 
is prescribed with other opioids, benzodiazepines, sedative hyp-
notics, carisoprodol, or tramadol, the prescriber shall only co-
prescribe these substances when it is medically necessary and the 
following requirements are met:
a. The prescriber shall verify the diagnosis for which the pa-
tient is receiving the other drug and coordinate care with the pre-
scriber for the other drug, including whether it is possible to taper 
the drug to discontinuation. If the prescriber prescribing 
buprenorphine is the prescriber of the other drug, the prescriber 
shall taper the other drug to discontinuation, if it is safe to do so. 
The prescriber shall educate the patient about the serious risks of 
the combined use.
b. The prescriber shall document progress with achieving the 
tapering plan.
5. During the induction phase the prescriber shall not pre-
scribe a dosage that exceeds the recommendation in the United 
States FDA-approved labeling, except for medically indicated cir-
cumstances as documented in the patient record. The prescriber 
shall see the patient at least once per week during this phase.
6. During the stabilization phase, when using any oral for-
mulation of buprenorphine, the prescriber shall increase the daily 
dosage of buprenorphine in safe and effective increments to 
achieve the lowest dose that avoids intoxication, withdrawal, or 
significant drug craving.
7. During the first 90 days of treatment, no more than a 2-
week supply of the buprenorphine and naloxone combination 
product may be prescribed.
8. Starting with the 91st day of treatment and until the com-
pletion of 12 months of treatment, no more than a 30-day supply 
of the buprenorphine and naloxone combination product may be 
prescribed.
8m. The prescriber shall take steps to reduce the chances of 
buprenorphine diversion by using the lowest effective dose, ap-
propriate frequency of office visits, pill or film counts, and 
checks of the PDMP. The prescriber shall require urine drug 
screens, serum medication levels, or oral fluid testing at least 
twice per quarter for the first year of treatment and at least once 
per quarter thereafter.
9. When using any oral formulation of buprenorphine, the 
prescriber shall document in the medical record the rationale for 
prescribed doses exceeding 16 milligrams of buprenorphine per 
day.
10. Relapse prevention strategies shall be incorporated into 
counseling or assure that they are addressed by a qualified behav-
ioral healthcare provider who has the education and experience to 
provide substance abuse counseling.
11. Extended-release, injectable, or implanted buprenor-
phine product may be used. In using these formulations, the pre-
scriber shall:
a. Strictly comply with any required risk evaluation and mit-
igation strategy program for the drug.
b. Prescribe an extended-release buprenorphine product 
strictly in accordance with the FDA ’s approved labeling for the 
drug’s use.
c. Document in the patient record the rationale for the use of 
the extended-release buprenorphine product.
d. Require the extended-release, injectable, or implanted 
buprenorphine product to be administered by a licensed health 
care professional acting in accordance with the scope of the pro-
fessional license.
(c) The OBOT service that utilizes naltrexone to treat opioid 
use disorder shall comply with all of the following requirements: 
1. Prior to treating a patient with naltrexone, the patient shall 
be informed about the risk of opioid overdose if the patient ceases 
naltrexone and then uses opioids.
2. The prescriber shall take measures to ensure that the pa-
tient is adequately detoxified from opioids prior to treatment with 
naltrexone.
3. The prescriber shall use oral naltrexone only for treatment 
of patients who can be closely supervised and who are highly mo-
tivated and:
a. The dosage regime shall strictly comply with FDA-ap-
proved labeling for naltrexone hydrochloride tablets.
b. The patient shall be encouraged to have a support person 
administer and supervise the medication. Examples of a support 
person are a family member, close friend, or employer.
c. The OBOT service shall require urine drug screens, serum 
medication levels, or oral fluid drug testing at least every 3 
months for the first year of treatment and at least every 6 months 
thereafter.
d. The OBOT service shall incorporate relapse prevention 
strategies into counseling or assure that they are addressed by a 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
49 DEPARTMENT OF HEALTH SERVICES DHS 75.60
qualified behavioral healthcare provider who has the education 
and experience to provide substance abuse counseling.
4. The OBOT service may treat a patient with extended-re-
lease naltrexone for opioid dependence or for co-occurring opioid 
and alcohol use disorders.
a. Treatment with extended-release naltrexone for patients 
who have issues with treatment adherence should be considered. 
b. The injections dosage shall strictly comply with FDA-ap-
proved labeling for extended-release naltrexone.
c. Relapse prevention strategies shall be incorporated into 
counseling or assure that they are addressed by a qualified behav-
ioral healthcare provider who has the education and experience to 
provide substance abuse counseling.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22; correction 
in (1) (c), (2), (6) (a) 3. b., (d) made under s. 35.17, Stats., correction in numbering 
of (4) (c) 1. to 6., (10) (b) 8m. made under s. 13.92 (4) (b) 1., Stats., and correction 
in (10) (b) 2. made under s. 13.92 (4) (b) 7., Stats., Register October 2021 No. 790; 
correction in (11) (b) made under s. 35.17, Stats., Register November 2021 No. 791; 
correction in (10) (b) 1. made under s. 35.17, Stats., Register April 2025 No. 832; 
CR 25-055: am. (6) (b) Register February 2026 No. 842, eff. 3-1-26; correction 
in (6) (b) made under s. 35.17, Stats., Register February 2026 No. 842.
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842