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Details

Detailed Information for : Mental Health Adolescent Inpatient
Description:
Initial certification for a program that provides inpatient treatment only if the child or adolescent requires treatment of a comprehensive and intensive nature and is likely to benefit from the program the inpatient facility has to offer or outpatient alternatives for treatment are not available.  
License Type:
Original  
Duration:
One Year.  
Fees:
In combination with other CSAS or Mental Health programs, $350 for one program, $500 for two, $600 for three, $675 for four, $750 for five or more programs as one location; $200 additional fee per branch office.  
Prerequisites:
Contact the Division of Quality Assurance at (608) 261-0658 or e-mail

See the requirements for becoming an approved hospital.  
Additional Information:
Certification is required prior to an entity receiving reimbursement under Chapter 51, Wisconsin Statutes; 3rd party reimbursement; and/or reimbursement for participants in the Medicaid program.

See our website for more information.  
Application Form(s):
Contact the Division of Quality Assurance at (608) 261-0658 or e-mail  
Wisconsin Statutes:
51.45, State Alcohol, Drug Abuse, Develomental Disabilities, and Mental Health Act.  
Administrative Rules/Codes:
Wisconsin Administrative Codes:
HFS 61.79 Community Mental Health Programs and
HFS 12,Caregiver Background Checks including Appendix A, Offenses Affecting Caregiver Eligibility  
Other Agencies Involved:
Apply for Wisconsin Medicaid (Title 19) once you are certified to provide mental health adolescent inpatient services.  
Contact Information
Contact:
Division of Quality Assurance, Behavior Health Certification Section
Home Page:
E-mail :
Hours of Operation:
7:45 am - 4:30 pm, Monday through Friday  
Phone:
(608)261-0658  
Fax:
 
TTY/TDD:
 
Mail Address:
PO Box 2969, Madison, WI 53701-2969  
Street Address:
1 West Wilson Street, Madison, WI 53703  
Agency Web Site:
 
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For additional assistance with business-related license, permit and registration information, visit the Wisconsin Small Business Development Center at http://www.wisconsinsbdc.org or phone them at 608-263-7680.


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