49.791 Substance abuse screening, testing, and treatment for employment and training programs.

(1) Definitions. In this section:

(a) “Able-bodied adult” has the meaning given in s. 49.79 (1) (am).

(b) “Administering agency” means an administrative agency within the executive branch under ch. 15 or an entity that contracts with the state such as a single county consortia under s. 49.78 (1r), a multicounty consortia under s. 49.78 (1) (br), or a tribal governing body under s. 49.78 (1) (cr).

(c) “Confirmation test” means an analytical procedure used to quantify a specific controlled substance or its metabolite in a specimen through a test that is different in scientific principle from that of the initial test procedure and capable of providing the requisite specificity, sensitivity, and quantitative accuracy to positively confirm use of a controlled substance.

(d) “Controlled substance” has the meaning given in s. 49.79 (1) (b).

(e) “Employment and training program” means the food stamp employment and training program under s. 49.79 (9).

(f) “Food stamp program” has the meaning given in s. 49.79 (1) (c).

(g) “Medical review officer” means a licensed medical provider who is employed by or providing services under a contract to a qualified drug testing vendor, has knowledge of substance abuse disorders and laboratory testing procedures, and has the necessary training and experience to interpret and evaluate an individual's positive test result in relation to the individual's medical history and valid prescriptions.

(h) “Metabolite” means a chemical present in the body when a controlled substance is being broken down through natural metabolic processes that can be detected or measured as a positive indicator that a controlled substance associated with the metabolite has been used.

(i) “Prescription” means a current order for a controlled substance that indicates the specific regimen and duration of the order and that is transmitted electronically or in writing by an individual authorized in this state to order the controlled substance.

(j) “Qualified drug testing vendor” means a laboratory certified by the federal centers for medical and medicaid services under the federal Clinical Laboratory Improvement Amendments of 1988 to collect a specimen, carry out laboratory analysis of the specimen, store the specimen for a confirmation test if required, complete a confirmation test, and provide review by a medical review officer.

(k) “Screening” means completing a questionnaire specified by the department regarding an individual's current and prior use of any controlled substance.

(L) “Specimen” means tissue, fluid, or any other product of the human body required to be submitted by an individual for testing under this section.

(m) “Trauma-informed” means operating under the understanding of the science of adverse childhood experiences, toxic stress, trauma, and resilience, incorporating that understanding into organizational culture, policies, programs, and practices, and adhering to trauma-informed principles such as safety, trustworthiness and transparency, peer support, collaboration and mutuality, empowerment, and cultural, historical, and gender issue recognition.

(n) “Treatment” means any service that is conducted under clinical supervision to assist an individual through the process of recovery from controlled substance abuse, including screening, application of approved placement criteria, intake, orientation, assessment, individualized treatment planning, intervention, individual or group and family counseling, referral, discharge planning, after care or continuing care, record keeping, consultation with other professionals regarding treatment services, recovery and case management, crisis intervention, education, employment, and problem resolution in life skills functioning.

(o) “Treatment program” means a program certified by the department to provide treatment for controlled substance abuse as a medically managed inpatient service, a medically monitored treatment service, a day treatment service, an outpatient treatment service, a transitional residential treatment service, or a narcotic treatment service for opiate addiction or, as approved by the department, psychosocial rehabilitation services.

(p) “Treatment provider” means a provider of treatment for controlled substance abuse certified by the department, a provider certified under s. 440.88, or a licensed professional who meets criteria established by the department of safety and professional services.

(2) Notice of requirement. An administering agency shall provide information in a format approved by the department to any individual who expresses interest in or is referred to participate in an employment and training program to explain the requirement for participants in certain employment and training programs to undergo screening, testing, and treatment for abuse of controlled substances.

(3) Administering and evaluating a controlled substance abuse screening questionnaire.

(a) At the time of application and at annual redetermination for eligibility in the food stamp program, an administering agency shall administer to any able-bodied adult who is subject to the work requirement under s. 49.79 (10) (a) and intends on meeting the work requirement through participation in the employment and training program a controlled substance abuse screening questionnaire approved by the department, which may include questions related to controlled substance abuse-related criminal background and controlled substance abuse. The administering agency shall determine whether answers to the controlled substance abuse screening questionnaire indicate possible use of a controlled substance without a valid prescription by the able-bodied adult.

(b)

1. An able-bodied adult who is administered a controlled substance abuse screening questionnaire under par. (a) shall answer all questions on the screening questionnaire, sign and date the questionnaire, and submit the questionnaire to the administering agency.

2. If the able-bodied adult indicates on the screening questionnaire submitted under subd. 1. the prescribed use of a controlled substance, the able-bodied adult shall provide evidence of the valid prescription to the administering agency.

(c) An able-bodied adult who is administered a controlled substance abuse screening questionnaire under par. (a) and who fails to comply with the requirements under par. (b) is not eligible to participate in the employment and training program, and the administering agency may not refer the individual to participate in the employment and training program. An able-bodied adult who is denied eligibility for participation in the employment and training program for failure to complete the requirements under par. (b) may complete the requirements under par. (b) at any time while eligible for the food stamp program.

(d) An able-bodied adult who completes a controlled substance abuse screening questionnaire under this subsection and whose answers to the screening questionnaire do not indicate possible abuse of a controlled substance has satisfied the requirements of this section and may participate in an employment and training program subject to this section.

(4) Testing for use of a controlled substance required.

(a) Individuals required to undergo testing; exception.

1. Except as provided in subd. 2., an administering agency shall require an able-bodied adult whose answers on the controlled substance abuse screening questionnaire submitted under sub. (3) indicate possible use of a controlled substance without a prescription to undergo a test for the use of a controlled substance.

2. An administering agency may not require an able-bodied adult whose answers on the controlled substance abuse screening questionnaire submitted under sub. (3) indicate possible use of a controlled substance and who also indicates readiness to enter treatment for controlled substance abuse to undergo a test for the use of a controlled substance.

(b) Nature of testing required. A test for use of a controlled substance under this subsection consists of laboratory analysis of a specimen collected from an able-bodied adult described in par. (a) in a manner specified by the department that is consistent with guidelines from the federal department of health and human services by a qualified drug testing vendor or a provider approved by the department. The qualified drug testing vendor or other provider shall analyze the specimen for the presence of controlled substances specified by the department.

(c) Contracts for testing services.

1. The administering agency, subject to the department's approval, may contract with a trauma-informed qualified drug testing vendor to collect a specimen, carry out laboratory analysis of the specimen, store the specimen for confirmatory testing if required, complete confirmatory testing, provide review by a medical review officer, and document and report test results to the administering agency.

2. The department may require administering agencies to use a specific drug testing service procured through state contracting if the department determines that volume discounts or other preferential pricing terms may be achieved through a statewide contract.

(d) Effects of refusal to submit to drug test.

1. An able-bodied adult who is required to undergo a test for the use of a controlled substance under par. (a) but who refuses to submit to a drug test by doing any of the following is ineligible to participate in the employment and training program until the individual agrees to be tested for use of a controlled substance and test results have been reported:

a. Failing or refusing to appear for a scheduled drug test without good cause.

b. Failing or refusing to complete a form or release of information required for testing, including any form or release required by the qualified drug testing vendor to permit the vendor to report test results to the administering agency or department.

c. Failing or refusing to provide a valid specimen for testing.

d. Failing or refusing to provide verification of identity to the testing vendor.

2. The administering agency may direct an able-bodied adult who initially refused to submit to a drug test under subd. 1. and subsequently agrees to submit to a test to undergo drug testing on a random basis at any time within 10 business days after the able-bodied adult agrees to submit to a test.

(e) Confirmation test required. If an able-bodied adult tests positive for the use of a controlled substance, the qualified drug testing vendor shall perform a confirmation test using the same specimen obtained for the initial drug test. The vendor's medical review officer who is responsible for determining the presence of a controlled substance under par. (b) shall interpret all drug test results that are not negative.

(f) Accepting test results from other programs. For purposes of this section, an administering agency may use results of a drug test performed by the administering agency for the purpose of eligibility for another state program, including a work experience program under s. 49.162, 49.36, or 108.133, performed at the request of the department of corrections, or performed by other drug testing providers as approved by the department to determine whether to refer an able-bodied adult to treatment if all of the following apply:

1. The test results are provided directly to the administering agency.

2. The test results include tests for all controlled substances required by the department to be tested under this section.

3. The test occurred within 90 days before the results are provided to the administering agency.

(g) Effect of a negative test. An able-bodied adult who undergoes a test for use of a controlled substance under this subsection and tests negative for use of a controlled substance or who tests positive for use of a controlled substance but provides to the administering agency a prescription for each controlled substance for which the adult tests positive is not prohibited from participating in an employment and training program.

(h) Effect of a positive test. An able-bodied adult who undergoes a test for use of a controlled substance under this subsection, whose test results are positive, and who does not provide evidence of a prescription for the controlled substance, as determined by the qualified drug testing vendor's medical review officer, is required to participate in treatment under sub. (5) to participate in an employment and training program.

(5) Participation in treatment required.

(a) Individuals required to participate in treatment. An able-bodied adult who is described under sub. (4) (a) or (h) is required to participate in trauma-informed treatment to be eligible to participate in an employment and training program.

(b) Referral for treatment; monitoring. The applicable administering agency shall provide to every able-bodied adult who is required to participate in treatment under par. (a) information about treatment programs and county-specific assessment and enrollment activities required for entry into treatment. The applicable administering agency shall monitor the able-bodied adult's progress in entering and completing treatment and the results of random testing for the use of a controlled substance carried out during and at the conclusion of treatment.

(c) Evaluation and assessment. A treatment provider shall conduct a trauma-informed substance abuse evaluation and assessment of each able-bodied adult and take any of the following actions, as appropriate, based on the evaluation and assessment:

1. If the treatment provider determines the able-bodied adult does not need treatment, notify the administering agency that the able-bodied adult does not need treatment.

2. If the treatment provider determines the able-bodied adult is in need of treatment, refer the individual to an appropriate treatment program to begin treatment and notify the administering agency of the referral and the expected start date and duration of treatment.

3. If a treatment provider determines the able-bodied adult is in need of treatment but is unable to refer the adult because there is a waiting list for enrollment, enter the able-bodied adult on the waiting list and notify the administering agency of the date the adult is expected to be enrolled.

(d) Eligibility when treatment not needed or on waiting list.

1. An able-bodied adult described in par. (c) 1. is determined to have satisfied the requirements of this section and is eligible under this section to participate in an employment and training program.

2. An able-bodied adult who is on a waiting list for enrollment in an appropriate treatment program under par. (c) 3. shall continue to take all necessary steps to continue seeking enrollment in the appropriate treatment program. The able-bodied adult is eligible under this section to participate in an employment and training program while on the waiting list if the adult is not eligible for immediate enrollment in another appropriate treatment program.

(e) Satisfying treatment requirement through another program. An administering agency shall accept as satisfying the requirements of this subsection participation in any treatment program. The able-bodied adult satisfying the requirements of this subsection by participating in another treatment program shall execute a release of information to allow the administering agency to obtain verification of successful participation in that treatment program.

(f) Effects of refusal to submit to treatment. An able-bodied adult who is required to participate in treatment under par. (a) but who refuses to participate in treatment by doing any of the following is ineligible to participate in the employment and training program until the individual agrees to participate in treatment while still eligible for the food stamp program:

1. Failing or refusing to complete a form or release required for treatment program administration, including a form or release required by the treatment provider in order to share information with the administering agency about the able-bodied adult's participation in treatment.

2. Failing or refusing to participate in a controlled substance test required by the treatment provider or the administering agency during the course of required treatment, including any random controlled substance testing directed by the treatment provider or administering agency.

3. Failing or refusing to meet attendance or participation requirements established by the treatment provider.

4. Failing or refusing to complete a substance abuse assessment.

(g) Completion of required treatment. An able-bodied adult required under par. (a) to participate in treatment is considered to have successfully completed treatment if all applicable components identified under par. (c) are satisfied.

(h) Work requirements while in treatment. An able-bodied adult who is participating in an employment and training program is exempt from complying with requirements to work a specified number of hours under s. 49.79 (9) or (10) while participating in treatment under this subsection.

(6) Effect of completion, withdrawal, or termination from employment and training program. An able-bodied adult who satisfies any of the following is no longer subject to s. 49.79 (9) (d) or this section:

(a) The able-bodied adult has completed or voluntarily withdrawn from participation in an employment and training program.

(b) The able-bodied adult is terminated from an employment and training program for reasons unrelated to this section.

(c) The able-bodied adult is no longer subject to the requirements of s. 49.79 (10).

(7) Confidentiality of records. Completed screening questionnaires, prescriptions, testing results, and treatment records relating to this section may not be disclosed except for purposes connected with the administration of an employment and training program or except when disclosure is otherwise authorized by law or by written consent from the individual who is the subject of the record. The department may establish administrative, physical, and technical safeguard procedures administering agencies must follow to assure compliance with state and federal laws related to public assistance program records, drug testing and treatment records, and medical records.

(8) Appeals. An adverse decision under this section may be appealed under 7 CFR 273.15 and procedures established in rules promulgated by the division of hearings and appeals.

(9) Payment of costs for screening, testing, and treatment.

(a) The department shall pay for all costs related to screening able-bodied adults under sub. (3), including the costs of producing, administering, and reviewing screening questionnaires.

(b) The department shall pay for all costs related to testing able-bodied adults under sub. (4), including any costs related to contracting with qualified drug testing vendors under sub. (4) (c).

(c) The department shall pay costs for treatment under sub. (5) that are not covered by the Medical Assistance program under subch. IV of ch. 49 or other private insurance. Payments by the department under this paragraph shall be at rates no higher than the rates paid for comparable services under the Medical Assistance program.

History: 2017 a. 370.