Intoxicated Driver Program Directory. To: State, County, and Local Officials Involved with the Intoxicated Driver Program

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Intoxicated Driver Program Directory

1 To: State, County, and Local Officials Involved with the Intoxicated Driver Program

This directory has been updated in response to requests from county staff working with the Intoxicated Driver Program (IDP). Intoxicated drivers, boaters, snowmobile users, all-terrain vehicle users, and possessors of certain controlled substances (cocaine, heroin, lysergic acid diethylamide, phencyclidine, amphetamine, methamphetamine, psilocin, or psilocybin), may be referred to the correct IDP contact within a Wisconsin county with the use of this directory. Contact the Designated Coordinator regarding information about each county’s programs and policies for assessment and/or treatment services.

Contact the assessment facility contact regarding court ordered referrals and reports. Collateral information regarding the referral should be sent to the assessment facility contact. When speaking with an individual needing an assessment, please inform them that they should contact the assessment facility for an appointment FIRST BY PHONE. A non-resident should contact the facility the day of their court appearance. Most assessments take 1-2 hours.

Previously this directory was available as a printed document but due to the advantages of the internet the directory will be web-based. This will facilitate fluid updates as the information changes. This directory is available for viewing and printing

at:https://www.dhs.wisconsin.gov/idp/directory.htm. Please submit updated staff, contact, and fee information for this directory to the IDP Coordinator whose contact information is listed on the following page.

We welcome your comments and suggestions for improvements to this directory. Substance Abuse Services Section

STATE OF WISCONSIN

DEPARTMENT OF HEALTH SERVICES

Division of Mental Health and Substance Abuse Services Bureau of Prevention Treatment and Recovery

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3 GENERAL INFORMATION

Website: http://dhs.wisconsin.gov/idp/ index.htm Intoxicated Driver Program

LeeAnn Cooper, IDP Coordinator Department of Health Services

Division of Mental Health and Substance Abuse Services Bureau of Prevention Treatment and Recovery

1 West Wilson Street, Room 850 PO Box 7851

Madison WI 53707-7851 Telephone: (608) 266-2453 Fax: (608) 266-1533

E-Mail: [email protected] Intoxicated Driver Assessor Training:

Kristi Obmascher

University of Wisconsin-Madison

Department of Professional Development and Applied Studies 313 Lowell Center

610 Langdon Street Madison WI 53706

Telephone: (608) 262-8971

E-Mail: [email protected]

Submit updated staff, contact, and fee information for this directory to: LeeAnn Cooper

Bureau of Prevention Treatment and Recovery 1 West Wilson Street, Room 850

Madison WI 53703

Telephone: (608) 266-2453 Fax: (608) 266-1533

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FORMS

WISCONSIN DEPARTMENT OF TRANSPORTATION MOTOR VEHICLE (MV) FORMS

FORM N0. FORM TITLE PACKAGE SIZE

MV 3631 Driver Safety Plan Final Report 100 per package

MV 3632 Court Order for Intoxicated Driver

Assessment & Driver Safety Plan 100 per package

MV 3633 Driver Safety Plan Order 100 per package

MV 3634 Order for Assessment & Driver

Safety Plan Report 100 per package

Motor Vehicle (MV) form orders require the form number, form title, quantity needed and your “ship to” address in writing:

By Mail: Maps and Publication Sales

Wisconsin Department of Transportation 3617 Peirstorff Street

P.O. Box 7713

Madison, WI 53707-7713 By Fax: (608) 246-5632

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5 WISCONSIN DEPARTMENT OF HEALTH SERVICES

FORMS FOR INTOXICATED USE OF MOTORIZED RECREATIONAL VEHICLES

Forms for intoxicated use of motorized recreational vehicles, Including Boats, Snowmobiles, All-Terrain Vehicles, and Possession of Certain Controlled Substances are produced by the Wisconsin Department of Health Services (DHS) and are available from:

http://dhs.wisconsin.gov/forms/, for printing and down-load.

FORM NUMBER FORM TITLE LANGUAGE

F-01336 Wisconsin Assessment of the Impaired Driver (WAID) 50 per package Only designated assessment facilities may order copies of the WAID:

Complete a

F-82025A

and email the completed form as an attachment to

[email protected]

.

F-20933 Court Order for Assessment English

F-20933S Orden de la Corte Para Evaluacion Spanish

F-20934 Court Ordered Assessment and Plan Report English

F-20934A Plan Recommendation English

F-20934S Evaluacion Ordenada Por la Corte Y Reporte Del Plan Spanish

F-20934AS Plan de Recommendacion Spanish

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Intoxicated Driver Program

Contact information by County

ADAMS COUNTY

Designated Coordinator:

Kay Saarinen-Barr Adams County Health and Human Services Department 108 East North Street

Friendship WI 53934 Telephone: (608) 339-4505 Fax: (608) 339-4593

[email protected] Assessment Facility Contact:

Kay Saarinen-Barr Adams County Health and Human Services Department 108 East North Street

Friendship WI 53934 Telephone: (608) 339-4511 Fax: (608) [email protected] Assessment Charge: $245.00 Assessment Fee $50.00 Reinstatement Fee

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ASHLAND COUNTY Designated Coordinator:

Linda Bailey, Adult Services Supervisor

Ashland County Health and Human Services Department 630 Sanborn Avenue

Ashland WI 54806

Telephone: (715) 682-7004 Ext. 138 Fax: (715) 682-7924

Allison Allen, Director of Behavioral Health Services NorthLakes Community Clinic

502 West Main St., Suite 305 Ashland WI 54806 Telephone: (715) 682-5207 Fax: (715) 682-5209 [email protected] Assessment Charge: $200.00 Assessment Fee $50.00 Rescheduling Fee $25.00 Reinstatement Fee

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9 Bad River Band of Lake Superior Chippewa Tribe

This assessment agency is available only to tribal members and their families Designated Coordinator:

Laura Moore

Bad River AODA Program 53585 Nokomis Road Ashland, WI 54806

Telephone: (715) 682-7133 ext. 4338 Assessment Facility Contact:

Laura Moore

Bad River AODA Program 53585 Nokomis Road Ashland, WI 54806

Telephone: (715) 682-7133 ext. 4338 Assessment Charge:

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BARRON COUNTY Designated Coordinator: Dave Hensley

Barron County Department of Health and Human Services 335 E. Monroe Avenue

Barron WI 54812

Telephone: (715) 537-6330 Fax: (715) 537-6363

[email protected] Assessment Facility Contact: Arlene Eslinger

Community Counseling Services 16947 County Hwy X Chippewa Falls WI 54729 Telephone: (715) 723-1221 Fax: (715) 738-1214 [email protected] Assessment Charge: $225.00 Assessment Fee

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11 BAYFIELD COUNTY

Cheryl Hanson, AODA / MH Coordinator Bayfield County Department of Human Services P.O. Box 100

Washburn WI 54891-0100 Telephone: (715) 373-6144 x133 Fax: (715) 373-6130

Allison Allen, Director of Behavioral Health Services NorthLakes Community Clinic

502 West Main Street, Suite 305 Ashland WI 54806 Telephone: (715) 682-5207 Fax: (715) 682-5209 [email protected] Assessment Charge: $200.00 Assessment Fee $50.00 Rescheduling Fee $25.00 Reinstatement Fee

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BROWN COUNTY Designated Coordinator:

Julie Feld, AODA Clinical Supervisor

Brown County Community Treatment Center / AODA Dept. 3150 Gershwin Drive

Green Bay WI 54311 Telephone: (920) 391-6945 Fax: (920) 391-4822 [email protected] Assessment Facility Contact:

Julie Feld, AODA Clinical Supervisor

Brown County Community Treatment Center /AODA Dept. 3150 Gershwin Drive Green Bay WI 54311 Telephone: (920) 391-4720 Fax: (920) 391-4822 [email protected] Assessment Charge: $275.00 Assessment Fee $100.00 Failed Appointment

$100.00 Reschedule Fee if less than 24 hour notice $100.00 Amend Driver Safety Plan

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13 BUFFALO COUNTY

Designated Coordinator: Jennifer Nelson

Buffalo County Department of Health and Human Services Courthouse P.O. Box 517 Alma WI 54610 Telephone: (608) 685-6326 Fax: (608) 685-3342 [email protected] Assessment Facility Contact: Rob Pitsman Triniteam 202 Graham Avenue Eau Claire WI 54701 Telephone: (715) 836-8106 Fax: (715) 836-8104 [email protected] Assessment Charge:

$200.00 Assessment Fee (paid at any time)

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BURNETT COUNTY Designated Coordinator: Byron Hopke

Burnett County Department Health and Human Services 7410 County Road K, Suite 280

Siren WI 54872-9043 Telephone: (715) 349-7600 Fax: (715) 349-2140 [email protected] Assessment Facility Contact: Ana Winton

Aurora Community Counseling (ACC), Inc. 24248 State Road 35/70, Unit D

Siren WI 54872 Telephone: (715) 349-7233 Fax: (715) [email protected] Assessment Charge: $260.00 Assessment Fee $260.00 Fail Appointment

$133.25 Extension of Driver Safety Plan

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15 CALUMET COUNTY

Designated Coordinator: Kristi LeClair

Calumet County Department of Human Services Courthouse, 206 Court Street

Chilton WI 53014

Telephone: (920) 849-1400 Fax: (920) 849-1468

[email protected] Assessment Facility Contact: Kelly Schoen

Calumet County Department of Human Services Courthouse, 206 Court Street

Chilton WI 53014 Telephone: (920) 849-1400 ext. 387 Fax: (920) 849-1468 [email protected] Assessment Charge: $240.00 Assessment Fee $120.00 Failed Appointment $25.00 Payment Plan Set-up $50.00 DSP Amendment

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CHIPPEWA COUNTY Designated Coordinator: Tim Easker

Chippewa County Department of Human Services 711 North Bridge Street, Room 122

Chippewa Falls WI 54729-1876 Telephone: (715) 726-7788 Fax: (715) 726-4560

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17 CLARK COUNTY

Designated Coordinator: Russell Girard

Clark County Community Services 517 Court Street, Room 503 Neillsville WI 54456

Telephone: (715) 743-5204 Fax: (715) 743-5209

[email protected] Assessment Facility Contact: Jeanine Voigt

Clark County Community Services 517 Court Street, Room 503 Neillsville WI 54456 Telephone: (715) 743-5204 Fax: (715) 743-5209 [email protected] Assessment Charge: $280.00 Assessment Fee $70.00 Non-Compliance Fee $110.00 No-show/Reschedule fee $70.00 Amendment/Extension fee

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Intoxicated Driver Program Directory 18 COLUMBIA COUNTY Designated Coordinator: Dr. Thomas Hayes Pauquette Center 2901 Hunters Trail P.O. Box 301 Portage WI 53901 Telephone: (608) 742-5518 Fax: (608) 742-4087 [email protected] Assessment Facility Contact: Sheila Starr Pauquette Center 2901 Hunters Trail P.O. Box 301 Portage WI 53901 Telephone: (608) 742-5518 Fax: (608) 742-4087 [email protected] Assessment Charge: $250.00 Assessment Fee

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19 CRAWFORD COUNTY

Designated Coordinator: Dan McWilliams, Director

Crawford County Human Services Department 225 North Beaumont Road, Suite 326

Prairie du Chien WI 53821 Telephone: (608) 326-0248 Fax: (608) 326-4395 [email protected] Assessment Facility Contact: David Nelson

Franciscan Skemp Behavioral Health (Villa Succés)

121 South Prairie Street Prairie du Chien WI 53821 Telephone: (608) 326-8424 Fax: (608) 326-8638 Assessment Charge: $366.00 OWI Assessment

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DANE COUNTY Designated Coordinator: Todd Campbell

Alcohol and Other Drug Abuse Manager Dane County Department of Human Services 1202 Northport Drive

Madison, Wisconsin 53704 Office: (608) 242-6488 Fax: (608) 242-6293

[email protected] Assessment Facility Contact: Margie Duncan

Journey Mental Health Center Clinical Assessment Unit 710 John Nolen Drive Madison WI 53713-1422 Telephone: (608) 280-2630 Fax: (608) 280-2655 [email protected] Assessment Charge: $300.00 Assessment Fee

$50.00 Extension of Driver Safety Plan $75.00 Reinstatement Fee

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21 DODGE COUNTY

Designated Coordinator: Sara Gaska

Dodge County Human Services and Health Department 199 County Road DF

Juneau WI 53039

Telephone: (920) 386-4094 Fax: (920) 386-3812 [email protected] Assessment Facility Contact: Sandra Eichmann

Dodge County Human Services and Health Department 199 County Road DF Juneau WI 53039 Telephone: (920) 386-3513 Fax: (920) 386-3812 [email protected] Assessment Charge: $250.00 Assessment Fee

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DOOR COUNTY Designated Coordinator: Joe Krebsbach

Door County Department of Human Services 421 Nebraska Street

Sturgeon Bay WI 54235 Telephone: (920) 746-2345 Fax: (920) 746-2439 [email protected] Assessment Facility Contact: Peggy Kubiak

Door County Department of Human Services 421 Nebraska Street Sturgeon Bay WI 54235 Telephone: (920) 746-2345 Fax: (920) 746-2439 [email protected] Assessment Charge: $225.00 Assessment Fee

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23 DOUGLAS COUNTY

Designated Coordinator: Dave Longsdorf

Douglas County Department of Health and Human Services 1316 North 14th Street, Suite 400

Superior WI 54880

Telephone: (715) 395-1304 Fax: (715) 395-1265

Dave Longsdorf

Douglas County Department of Health and Human Services 1316 North 14th Street, Suite 400

Superior WI 54880 Telephone: (715) 395-1304 Fax: (715) 395-1265 [email protected] Assessment Charge: $275.00 Assessment Fee

$50.00 Failed or rescheduled Appointment fee $50.00 Amend or Extend Driver Safety Plan $50.00 Out-of-State Transfer Fee

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DUNN COUNTY Designated Coordinator: Kris Korpela

Dunn County Department of Human Services 808 Main Street P.O. Box 470 Menomonie WI 54751 Telephone: (715) 231-2704 Fax: (715) 232-5987 [email protected] Assessment Facility Contact: Jill Gamez Arbor Place 320 21st Street NE Menomonie WI 54751 Telephone: (715) 235-4537 Fax: (715) 235-4535 Assessment Charge:

$230.00 OWI Assessment Fee $230.00 Failed Appointment $115.00 Late Cancellation

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25 EAU CLAIRE COUNTY

Designated Coordinator: Craig Olson

Eau Claire County Department of Human Services 721 Oxford Avenue

Eau Claire WI 54703 Telephone: (715) 839-1245 Fax: (715) 831-5784

[email protected] Assessment Facility Contact: Ann Feller

Eau Claire Community Program 101 N. Farwell St. Ste 204 Eau Claire WI 54703 Telephone: (715) 514-4600 Fax: (715) 514-4008

[email protected]

Online application: www.eauclairecommunityprogram.com Assessment Charge:

$265.00 Assessment Fee (Walk-in) $250.00 Assessment Fee (Online) $65.00 Final Follow-Up Fee $65.00 No Show Fee

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FLORENCE COUNTY Designated Coordinator: Janet Nanninga

Florence County Human Services Department CourthouseP.O. Box 225

Florence WI 54121

Telephone: (715) 528-3477 Fax: (715) 528-3341

[email protected] Assessment Facility Contact: Kristina Williams

Florence County Human Services Department Courthouse P.O. Box 225 Florence WI 54121 Telephone: (715) 528-3477 Fax: (715) 528-3341 [email protected] Assessment Charge: $225.00 Assessment Fee

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27 FOND DU LAC COUNTY

Designated Coordinator: Lynn Klapperich

Fond du Lac County Department of Community Programs 459 East First Street

Fond du Lac WI 54935 Telephone: (920) 929-3500 Fax: (920) 929-3129

[email protected] Assessment Facility Contact: Barbara Higgins

Fond du Lac County Department of Community Programs 459 East First Street

Fond du Lac WI 54935 Telephone: (920) 929-3565 Fax: (920) 929-3129 [email protected] Assessment Charge: $260.00 Assessment Fee $125.00 Failed Appointment

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FOREST COUNTY Designated Coordinator:

Donna M. Shimeck, MA, LCSW The Human Service Center Forest / Oneida / Vilas County 705 East Timber Drive

P.O. Box 897

Rhinelander WI 54501-0897 Telephone: (715) 369-2215 x1256 Fax: (715) 369-2214

[email protected] Assessment Facility Contact: Jodi Baker, SAC, IDP-AT The Human Service Center Forest / Oneida / Vilas County 705 East Timber Drive

P.O. Box 897 Rhinelander WI 54501-0897 Telephone: (715) 369-2215 x1229 Fax: (715) 369-2214 [email protected] Assessment Charge: $250.00 Assessment Fee

$100.00 Failed Appointment/Late Cancelation $50.00 Amendment

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29 GRANT COUNTY

Diana Kroeber, AODA Supervisor Unified Community Services

200 West Alona Lane Lancaster WI 53813

Telephone: (608) 723-6357 Fax: (608) 723-4417

[email protected] Assessment Facility Contact: Diana Kroeber, AODA Supervisor Unified Community Services 200 West Alona Lane

Lancaster WI 53813 Telephone: (608) 723-6357 Fax: (608) 723-4417 [email protected] Assessment Charge: $282.00 Assessment Fee

$150.00 IDP Failed Appointment $25.00 Other Failed Appointment

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GREEN COUNTY Designated Coordinator: Bob Gibson

Green County Human Services N3152 State Hwy 81

Monroe WI 53566

Telephone: (608) 328-9352 (AODA Office) Fax: (608) 328-9480

[email protected]

Assessment Facility Contact: Marlene Bergemann

Green County Human Services N3152 State Hwy 81 Monroe WI 53566 Telephone: (608) 328-9352 Fax: (608) 328-9480 [email protected] Assessment Charge: $250.00-$300.00 IDP Fee $50.00 No show Fee

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31 GREEN LAKE COUNTY

Jana Tetzlaff, Clinical Services Manager

Green Lake County Department of Health and Human Services 571 County Road A P.O. Box 588 Green Lake WI 54941 Telephone: (920) 294-4070 Telephone: (800) 664-3588 Fax: (920) 294-4139 [email protected] Assessment Facility Contact:

Jana Tetzlaff, Clinical Services Manager

Green Lake County Department of Health and Human Services 571 County Road A P.O. Box 588 Green Lake WI 54941 Telephone: (920) 294-4070 Telephone: (800) 664-3588 Fax: (920) 294-4139 [email protected] Assessment Charge: $275.00 Assessment Fee

$65.00 Amend Driver Safety Plan No Show / Forfeit Fees

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IOWA COUNTY Designated Coordinator:

Diana Kroeber, AODA Supervisor Unified Community Services

1122 Professional Drive Dodgeville WI 53533 Telephone: (608) 935-2776 Fax: (608) 935-3174

[email protected] Assessment Facility Contact: Diana Kroeber, AODA Supervisor Unified Community Services 1122 Professional Drive Dodgeville WI 53533 Telephone: (608) 935-2776 Fax: (608) 935-3174 [email protected] Assessment Charge: $282.00 Assessment Fee

$150.00 IDP Failed Appointment $25.00 Other Failed Appointment

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33 IRON COUNTY

Designated Coordinator: Carolyn Kolson-Janov

Iron County Dept. of Human Services Courthouse 300 Taconite St., Suite 201 Hurley WI 54534 Telephone: (715) 561-3636 Fax: (715) 561-2128 [email protected] Assessment Facility Contact: Sally Langland

Iron County Dept. of Human Services Courthouse 300 Taconite St., Suite 201 Hurley WI 54534 Telephone: (715) 561-3636 Fax: (715) 561-2128 Assessment Charge: $200.00 Assessment Fee

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JACKSON COUNTY Designated Coordinator:

Heather Hainz, Behavioral Health Unit Manager

Jackson County Health and Human Services Department 420 Hwy 54 West

P.O. Box 457

Black River Falls WI 54615 Telephone: (715) 284-4301 Fax: (715) 284-7713

[email protected] Assessment Facility Contact: Karla Gearing

Jackson County Health and Human Services Department 420 Hwy 54 West

P.O. Box 457

Black River Falls WI 54615 Telephone: (715) 284-4301 Fax: (715) 284-7713 [email protected] Assessment Charge: $275.00 OWI Fee $50.00 Rescheduling fee $50.00 Amendment fee

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35 JEFFERSON COUNTY

Holly Pagel, Outpatient Clinic Supervisor Jefferson County Human Services Department 1541 Annex Road

Jefferson WI 53549

Telephone: (920) 674-3105 Fax: (920) 674-6113

[email protected] Assessment Facility Contact: Jude Christensen

Lead IDP Assessor

Jefferson County Human Services Department 1541 Annex Road Jefferson WI 53549 Telephone: (920) 674-3105 Fax: (920) 674-6113 [email protected] Assessment Charge:

$295.00 Assessment and Driver Safety Plan Fee $145.00 Missed Appointment Fee

$95.00 Amended Paperwork Fee $93.00 Extension of Driver Safety Plan

$110.00 Reinstatement of Driver Safety Plan from non-compliance to compliance $140.00 Transfer of paperwork to or from another county

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JUNEAU COUNTY Designated Coordinator: Charles Lipford

Juneau County Department of Human Services Courthouse Annex

220 East La Crosse Street Mauston WI 53948

Telephone: (608) 847-2400 Fax: (608) 847-9421 [email protected] Assessment Facility Contact: Charles Lipford

Juneau County Department of Human Services Courthouse Annex

220 East La Crosse Street Mauston WI 53948 Telephone: (608) 847-2400 Fax: (608) 847-9421 [email protected] Assessment Charge: $275.00 Assessment Fee

($50.00 non-refundable deposit at time of scheduling) $50.00 Transfer Fee

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Intoxicated Driver Program Directory 37 KENOSHA COUNTY Designated Coordinator: Guida Brown Hope Council 5942 6th Avenue Kenosha WI 53140 Telephone: (262) 658-8166 Fax: (262) 658-8210 [email protected] Assessment Facility Contact: Cheryl Pataska Hope Council 5942 6th Avenue Kenosha WI 53140 Telephone: (262) 658-8166 Fax: (262) 658-8210 [email protected] Assessment Charge $255.00 Assessment Fee

$100.00 Biomarker Fee for drivers with 3 or more offenses $50.00 No Show/Rescheduling without 24 hour notice (first time) $75.00 No Show/Rescheduling without 24 hour notice (second time)

$100.00 No Show/Rescheduling without 24 hour notice (third or more times) $50.00 Non-Compliance Fee after 14 days

$25.00 No Show for Victim Impact Panel

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KEWAUNEE COUNTY Designated Coordinator: Scott R. Gartzke

Kewaunee County Department of Human Services 810 Lincoln Street

Kewaunee WI 54216 Telephone: (920) 388-7033 Fax: (920) 388-7044 [email protected] Assessment Facility Contact: Scott R. Gartzke

Kewaunee County Department of Human Services 810 Lincoln Street Kewaunee WI 54216 Telephone: (920) 388-7033 Fax: (920) 388-7044 [email protected] Assessment Charge: $275.00 Assessment Fee

$125.00 Amended Driver Safety Plan Fee $75.00 Driver Safety Plan Extension Fee $150.00 Updated Assessment Fee

$100.00 Reinstatement Fee $150.00 Missed Appointment Fee $50.00 Paperwork Transfer Fee

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39 Lac du Flambeau Lake Superior Chippewa Indians

This assessment agency is available only to tribal members and their family Designated Coordinator:

Lisa Mohawk

Family Resource Center 533 Peace Pipe Road Lac du Flambeau WI 54538 Telephone: (715) 588-1511 [email protected] Assessment Facility Contact: Lisa Mohawk

Family Resource Center 533 Peace Pipe Road Lac du Flambeau WI 54538 Telephone: (715) 588-1511 [email protected] Assessment Charge: $250.00 Assessment Fee $100.00 No Show Fee $100.00 Late/cancellation Fee $50.00 Amended/extended DSP Fee

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LA CROSSE COUNTY Designated Coordinator:

Becky Spanjers, Chemical Health Supervisor La Crosse County Human Services

Chemical Health and Justice Sanctions 333 Vine Street, Room 740

La Crosse WI 54601 Telephone: (608)789-4895 Fax: (608) 793-6562

Becky Spanjers, Chemical Health Supervisor La Crosse County Human Services

Chemical Health and Justice Sanctions 333 Vine Street, Room 740

La Crosse WI 54601 Telephone: (608) 784-4357 Fax: (608) 793-6562 [email protected] Assessment Charge $350.00 Assessment Fee $20.00 Failed Appointment $25.00 Transfer Fee

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41 LAFAYETTE COUNTY

Shane Schuhmacher, Director

Lafayette County Human Services Department 627 Main Street

Darlington WI 53530 Telephone: (608) 776-4800 Fax: (608) 776-4914 [email protected] Assessment Facility Contact: Sheena Abbitt

Lafayette County Human Services Department 627 Main Street Darlington WI 53530 Telephone: (608) 776-4800 Fax: (608) 776-4914 [email protected] Assessment Charge:

$300.00 OWI Assessment Fee

$300.00 IDP Failed Appointment Fee

$50.00 Amended/Non-compliance/Extension Fee $25.00 Other Failed Appointment Fee

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LANGLADE COUNTY Designated Coordinator: Tanya Zaloudek

North Central Health Care Center 1225 Langlade Road

Antigo WI 54409

Telephone: (715) 627-6694 Fax: (715) 627-6645 [email protected] Assessment Facility Contact: Karen Slattery

North Central Health Care Center 1225 Langlade Road Antigo WI 54409 Telephone: (715) 627-6694 Fax: (715) 627-6645 [email protected] Assessment Charge: $215.00 Assessment Fee $57.00 Failed Appointment

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43 LINCOLN COUNTY

Designated Coordinator: Tanya Zaloudek

North Central Health Care – Merrill Center 607 North Sales St.

Merrill WI 54452

Telephone: (715) 536-9482 Fax: (715) 539-2972 [email protected] Assessment Facility Contact: Karen Slattery

North Central Health Care – Merrill Center 607 North Sales St. Merrill WI 54452 Telephone: (715) 536-9482 Fax: (715) 539-2972 [email protected] Assessment Charge: $215.00 Assessment Fee $57.00 Failed Appointment

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MANITOWOC COUNTY Designated Coordinator: Gary Daehn

Manitowoc County Human Services Department 926 South 8th Street P.O. Box 1177 Manitowoc WI 54221-1177 Telephone: (920) 683-4230 Fax: (920) 683-4243 [email protected] Assessment Facility Contact: Gary Daehn

Manitowoc County Human Services Department 926 South 8th Street P.O. Box 1177 Manitowoc WI 54221-1177 Telephone: (920) 683-4230 Fax: (920) 683-4243 [email protected] Assessment Charge: $220.00 Assessment Fee $100.00 Failed Appointment $40.00 Extension Fee $40.00 Amendment Fee

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45 MARATHON COUNTY

Designated Coordinator: Lynne Buechler

North Central Health Care Center 1100 Lakeview Drive

Wausau, WI 54403 Telephone: 715-848-4600 Fax: (715) 845-6050 [email protected] Assessment Facility Contact: Lynne Buechler

North Central Health Care Center 1100 Lake View Drive

Wausau WI 54403 Telephone: (715) 848-4600 Fax: (715) 845-6050 [email protected] Assessment Charge: $165.00 Assessment Fee $57.00 Failed Appointment

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MARINETTE COUNTY Designated Coordinator: Rob Valentine

Marinette County Human Services Department 2500 Hall Avenue

Marinette WI 54143

Telephone: (715) 732-7760 Fax: (715) 732-7711

[email protected] Assessment Facility Contact: Rob Valentine

Marinette County Human Services Department 2500 Hall Avenue Marinette Wisconsin 54143 Telephone: (715) 732-7760 Fax: (715) 732-7711 [email protected] Assessment Charge: $250.00 Assessment Fee

$250.00 Failed Appointment / Reschedule Fee $100.00 Amendment Fee

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47 MARQUETTE COUNTY

Designated Coordinator: Mandy Stanley

Marquette County Human Services 480 Underwood Avenue P.O. Box 405 Montello WI 53949 Telephone: (608) 297-3124 Fax: (608) 297-8718 [email protected] Assessment Facility Contact: Tiffany Schmit

Marquette County Human Services-Clinical Services 480 Underwood Avenue P.O. Box 405 Montello WI 53949 Telephone: (608) 297-3181 Fax: (608) 297-2148 [email protected] Assessment Charge: $200.00 Assessment Fee $100.00 Failed Appointment $100.00 Out-of-State Packet $65.00 Amend Driver Safety Plan

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MENOMINEE COUNTY Designated Coordinator:

Amy Zimmer, Program Manager

Menominee County Health and Human Services Department W3272 Wolf River Road

P.O. Box 280 Keshena WI 54135

Telephone: (715) 799-3861 Fax: (715) 799-3517

[email protected] Assessment Facility Contact: Amy Zimmer, Program Manager

Menominee County Health and Human Services Department W3272 Wolf River Road

P.O. Box 280 Keshena WI 54135 Telephone: (715) 799-3861 Fax: (715) 799-3517 [email protected] Assessment Charge:

$220.00 Assessment Fee State IDP $200.00 Assessment Fee Tribal IDP $220.00/200.00 Failed Appointment $50.00 Driver Safety Plan Amendment Fee $25.00 Cancellation Fee

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Intoxicated Driver Program Directory 49 MILWAUKEE COUNTY Designated Coordinator: Patricia Gutierrez Impact, Inc.

6737 West Washington Street, Suite 2225 West Allis WI 53214

Telephone: (414) 443-6000 (Appointments) Telephone: (414) 256-4808 (General Information) Fax: (414) 771-4808

[email protected] Assessment Facility Contact: Patricia Gutierrez

Impact, Inc.

6737 West Washington Street, Suite 2225 West Allis WI 53214 Telephone: 414-256-4808 Telephone: 414-443-6000 (Appointments) Fax: 414-771-4808 [email protected] Assessment Charge:

$280.00 Wisconsin Resident OWI Fee $140.00 Failed Appointment

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MONROE COUNTY Designated Coordinator: Lori Svendsen

Monroe County Department of Human Services 14301 County Hwy B, A-19

Sparta WI 54656-4509 Telephone: (608) 269-8600 Fax: (608) 269-8935

[email protected] Assessment Facility Contact: Lori Svendsen

Monroe County Department of Human Services 14301 County Hwy B, A-19

Sparta WI 54656-4509 Telephone: (608) 269-8600 Fax: (608) 269-8935

[email protected] Assessment Charge:

$300.00 Assessment Fee (Pay at scheduling) $300.00 Failed Appointment

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51 OCONTO COUNTY

Designated Coordinator: Julie Whitworth

Oconto County Department of Health and Human Services 501 Park Avenue

Oconto WI 54153

Telephone: (920) 834-7000 Fax: (920) 834-6889

[email protected] Assessment Facility Contact: Barb Rasmussen

Oconto County Department of Health and Human Services 501 Park Avenue Oconto WI 54153 Telephone: (920) 834-7000 Fax: (920) 834-6889 [email protected] Assessment Charge: $240.00 Assessment Fee

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52

ONEIDA COUNTY Designated Coordinator:

P.O. Box 897

$100.00 Failed Appointment/Late Cancellation $50.00 Amendment

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53 OUTAGAMIE COUNTY

Designated Coordinator: Brian Bezier, Psy.D

Outagamie County Health & Human Services 401 South Elm Street

Appleton WI 54911

Telephone: (920) 832-5270 Fax: (920) 832-5488

[email protected] Assessment Facility Contact: Carrie Burton

Theda Care Behavioral Health Services 1095 Midway Road

Menasha WI 54952

Telephone: (920) 720-2300 (Appt Desk) Telephone: (920) 738-5934 (IDP Info) Fax: (920) 720-3719

$230.00 Assessment Fee $115.00 Failed Appointment $115.00 Amend Driver Safety Plan

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OZAUKEE COUNTY Designated Coordinator: Lynn Gillian

Ozaukee County Department of Human Services 121 West Main Street

Port Washington WI 53074-0994 Telephone: (262) 284-8200 Fax: (262) 284-8104

[email protected] Assessment Facility Contact: Assessment Facility Contact: Vicki Kaas

Ozaukee County Department of Human Services 121 West Main Street

Port Washington WI 53074-0994 Telephone: (262) 284-8143 Fax: (262) 284-8104 [email protected] Assessment Charge:

$255.00 Paid by credit Card

$5.00 discount for payment by cash, cashier check or money order $125.00 No Show Fee

$125.00 Reassessment Fee $75.00 Amended Assessment Fee $75.00 Transfer or Reassessment Fee

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55 PEPIN COUNTY

Designated Coordinator: Carol Nedland

Pepin County Department of Human Services 740 7th Avenue West

Durand WI 54736

Telephone: (715) 672-8941 Fax: (715) 672-8593 [email protected] Assessment Facility Contact: Pam Haukeness, Director Arbor Place 320 21st Street NE Menomonie WI 54751 Telephone: (715) 235-4537 Fax: (715) 235-4535 [email protected] Assessment Charge:

$225.00 OWI Assessment Fee

$200.00 Failed Appointment / No Show $112.50 Late Canceled Fee

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PIERCE COUNTY Designated Coordinator: Ron Kiesler

Pierce County Department of Human Services 412 West Kinne Street

P.O. Box 670 Ellsworth WI 54011

Telephone: (715) 273-6770 Fax: (715) 273-6862

[email protected] Assessment Facility Contact: Reggie Christiansen

Pierce County Department of Human Services 412 West Kinne Street

P.O. Box 670 Ellsworth WI 54011 Telephone: (715) 273-6770 Fax: (715) 273-6862 [email protected] [email protected] Assessment Charge: $329.00 Assessment Fee $100.00 Failed Appointment $132.00 Transfer Fee $132.00 Amendment Fee

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57 POLK COUNTY

Designated Coordinator: Gary Ehrich

Polk County Human Services Department 100 Polk Plaza, Suite 50

Balsam Lake WI 54810 Telephone: (715) 485-8402 Fax: (715) 485-8450 [email protected]

Assessment Facility Contact: Gary Ehrich

Polk County Human Services Department 100 Polk Plaza, Suite 50

Balsam Lake WI 54810 Telephone: (715) 485-8402 Fax: (715) 485-8450 [email protected] Assessment Charge: $300.00 Assessment Fee

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PORTAGE COUNTY Designated Coordinator: Amy Marcott

Portage County Health and Human Services 817 Whiting Avenue

Stevens Point WI 54481 Telephone: (715) 345-5810 Fax: (715) 345-5966

[email protected] Assessment Facility Contact: Jessica Hake

Portage County Health and Human Services 817 Whiting Avenue Stevens Point WI 54481 Telephone: (715) 343-6319 Fax: (715) 345-5966 [email protected] Assessment Charge:

$250.00 Assessment Fee ($50.00 Deposit) $50.00 Failed Appointment (Loss of Deposit) $50.00 Amendment and/or Extension Fee

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59 PRICE COUNTY

Designated Coordinator: Kathy Billek

Price County Dept. of Human Services 104 South Eyder Avenue

Phillips WI 54555

Telephone: (715) 339-2158 Fax: (715) 339-4018

Community Counseling Services 16947 County Hwy X Chippewa Falls WI 54729 Telephone: (715) 723-1221 Fax: (715) 738-1214 [email protected] Assessment Charge:

$225.00 Assessment Fee ($100 Deposit at Scheduling) $100.00 Failed Appointment

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RACINE COUNTY Designated Coordinator:

Mary Jane Whitmore, LCSW, CSAC

Behavioral Health Services of Racine County Racine County Human Services Department 1717 Taylor Avenue

Racine WI 53403

Telephone: (262) 638-6548 Fax: (262) 638-7719

Mary Jane Whitmore, LCSW, CSAC

Behavioral Health Services of Racine County Racine County Human Services Department 1717 Taylor Avenue Racine WI 53403 Telephone: (262) 638-6548 Fax: (262) 638-7719 [email protected] Assessment Charge: $200.00 Assessment Fee

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61 RICHLAND COUNTY

Myranda Culver, Clinic Coordinator

Richland County Health and Human Services 221 W. Seminary Street

Richland Center, WI 53581 Telephone: (608) 649-5792 Fax: (608) 647-6611

[email protected] Assessment Facility Contact: Louvin Goodman, CSAS

Richland County Health and Human Services 221 W. Seminary Street Richland Center, WI 53581 Telephone: (608) 647-8821 Fax: (608) 647-6611 [email protected] Assessment Charge: $297.00 Assessment Fee $20.00 Failed Appointment $55.00 Amend Driver Safety Plan

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ROCK COUNTY Designated Coordinator:

Rebecca Rudolph, MS, LPC w/AODA Authorization Rock County Human Services Department

113 S. Franklin Street P.O. Box 1649 Janesville WI 53547-1649 Telephone: (608) 743-2402 Fax: (608) 743-2406 [email protected] Assessment Facility Contact:

Rebecca Rudolph, MS, LPC w/AODA Authorization Rock County Human Services Department

113 S. Franklin Street P.O. Box 1649 Janesville WI 53547-1649 Telephone: (608) 743-2402 Fax: (608) 743-2406 [email protected] Assessment Charge: $300.00 Assessment Fee $110.00 Failed Appointment $110.00 Amend Driver Safety Plan $110.00 Out of State Packet

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63 RUSK COUNTY

Designated Coordinator: Jeremy Jacobs

Rusk County Health and Human Services 311 East Miner Ave., Suite C240

Ladysmith WI 54848 Telephone: (715) 532-2299 Fax: (715) 532-2126 [email protected] Assessment Facility Contact: Arlene Eslinger

$50.00 Failed Appointment Fee $50.00 Non-Compliance Fee

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ST CROIX COUNTY Designated Coordinator: Kristin DePrey

St Croix County Health and Human Services 1752 Dorset Lane

New Richmond WI 540171063 Telephone: (715) 246-6991 Fax: (715) 246-8383

[email protected] Assessment Facility Contact: Mel Solsvig

St Croix County Health and Human Services 1752 Dorset Lane New Richmond WI 54017-1063 Telephone: (715) 246-6991 Fax: (715) 246-8383 Assessment Scheduling: (715) 246-8255 [email protected] Assessment Charge: $370.00 Assessment Fee $370.00 No Show/Late Cancellation $177.00 Amendment to Driver Safety Plan

$177.00 Plan extension to complete Driver Safety Plan $177.00 Final Report

$45.00 Plan Extension for payment of treatment fees $40.00 Out-of-State Referral

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65 SAUK COUNTY

Betty Kryka, BS, CSAC, IndCS Sauk County Human Services P.O. Box 29

Baraboo, WI 53913

Telephone: (608) 355-4200 Fax: (608) 355-4299 [email protected] Assessment Facility Contact: Diane Brey

Street Clare Center 1510 Jefferson St Baraboo, WI 53913 Telephone: (608) 356-8520 Fax: (608) 356-1365 Assessment Charge: $275.00 Assessment Fee ($75.00 Non-Refundable Deposit)

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SAWYER COUNTY Designated Coordinator:

Paul Grahovac, Program Director Sawyer County Human Services 10610 Main St., Suite 224 Hayward WI 54843

Telephone: (715) 634-4806 Ext 2334 Fax: (715) 634-3580

Joe Bodo, Program Coordinator Sawyer County Human Services 10610 Main St., Suite 224 Hayward WI 54843 Telephone: (715) 634-4806 Ext 2317 Fax: (715) 634-3580 [email protected] Assessment Charge: $200.00 Assessment Fee

($100.00 down to schedule, remaining $100.00 due at appointment) $50.00 No Show/Late cancel Fee

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67 SHAWANO COUNTY

Designated Coordinator: Judy Kressin-Reindl

Shawano County Department of Human Services Lakeland Center 504 Lakeland Road Shawano WI 54166 Telephone: (715) 526-4700 Fax: (715) 526-5542 [email protected] Assessment Facility Contact:

Judy Kressin-Reindl

Shawano County Department of Human Services Lakeland Center 504 Lakeland Road Shawano WI 54166 Telephone: (715) 526-4700 Fax: (715) 526-5542 [email protected] Assessment Charge: $225.00 Assessment Fee

$225.00 Cancellation Fee (without 48 hours notice) $225.00 Failed Appointment (15 minutes late) $100.00 Amended Driver Safety Plan

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SHEBOYGAN COUNTY Designated Coordinator: Linda Knebel, Coordinator Outpatient Services

Sheboygan County Human Services Department 1011 North 8th Street

Sheboygan WI 53081 Telephone: (920) 459-6414 Fax: (920) 459-4353

Deb Althen, IDP Assistant Outpatient Services

Sheboygan County Human Services Department 1011 North 8th Street Sheboygan WI 53081 Telephone: (920) 459-4323 Fax: (920) 459-4353 [email protected] Assessment Charge: $250.00 Assessment Fee (Forfeit fee if a no-show)

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69 TAYLOR COUNTY

Designated Coordinator: Jen Meyer

Taylor County Community Human Services Department 540 East College St.

Medford WI 54451

Telephone: (715) 748-3332 Fax: (715) 748-3342

[email protected] Assessment Facility Contact: Jen Meyer

Taylor County Community Human Services Dept. 540 East College St. Medford WI 54451 Telephone: (715) 748-3332 Fax: (715) 748-3342 [email protected] Assessment Charge: $290.00 Assessment Fee

$110.00 Amend Driver Safety Plan or Extension $135.00 Compliance Reinstatement

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TREMPEALEAU COUNTY Designated Coordinator:

DeeAnn Anderson, Services Coordinator

Trempealeau County Department of Human Services County Courthouse P.O. Box 67

Whitehall WI 54773

Telephone: (715) 538-2311 x266 Fax: (715) 538-1760

[email protected] Assessment Facility Contact: Nick Lee

West Central Behavioral Health 23062 Whitehall Road

Independence WI 54747 Telephone: (866) 805-0304

Telephone: (715) 985-3452 (Spanish) Fax: (715) 985-2692 (Attention: Jean) [email protected]

Assessment Charge: $220.00 Assessment Fee

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71 VERNON COUNTY

Designated Coordinator: Jean Klousia

Vernon County Human Services 318 Fairlane Drive, Suite 100 Viroqua WI 54665

Telephone: (608) 637-5210 Fax: (608) 637-5505

[email protected] Assessment Facility Contact: Melony Hansen

Family & Children’s Center 1321 North Main Street P.O. Box 149 Viroqua WI 54665 Telephone: (800) 944-7856 Telephone: (608) 637-7052 Fax: (608) 637-8500 [email protected] Assessment Charge:

$225.00 Assessment Fee (due prior to appointment) $50.00 Failed Appointment / No-Show

$50.00 Non-Compliance Fee $50.00 4 Month Extension Fee

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VILAS COUNTY Designated Coordinator:

P.O. Box 897

$100.00 Failed Appointment/Late Cancellation $50.00 Amendment

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73 WALWORTH COUNTY

Designated Coordinator: Carlo Nevicosi

Walworth County Health and Human Services W4051 County Road NN P.O. Box 1005 Elkhorn WI 53121-1005 Telephone: (262) 741-3200 Fax: (262) 741-3299 [email protected] Assessment Facility Contact: Cathy Griffin

Walworth County Health and Human Services W4051 County Road NN P.O. Box 1005 Elkhorn WI 53121-1005 Telephone: (800) 365-1587 Telephone: (262) 741-3200 Fax: (262) 741-3299 [email protected] Assessment Charge: $250.00 Assessment Fee $40.00 Failed Appointment

$100.00 Multiple assessment fee (for each additional assessment completed at one time) $75.00 Amend Driver Safety Plan

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WASHBURN COUNTY Designated Coordinator:

Al SimonWashburn County Health and Human Services Department P.O. Box 250

Shell Lake WI 54871 Telephone: (715) 468-4747 Fax: (715) 468-4753

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75 WASHINGTON COUNTY

Jackie Moglowsky, Behavioral Health Manager Washington County Human Services Department 333 East Washington Street W., Suite 2100 West Bend WI 53095-2585

Telephone: (262) 335-4825 Fax: (262) 335-6827

Mary Simon Elevate, Inc. W169N21005 Meadow Lane Jackson WI 53037 Telephone: (262) 677-2249 Fax: (262) 677-2124 [email protected] Assessment Charge: $250.00 Assessment Fee

$110.00 Amend Driver Safety Plan $110.00 Reinstatement Fee

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WAUKESHA COUNTY Designated Coordinator: John Kettler

Waukesha County Health and Human Services 514 Riverview Avenue

Waukesha WI 53188 Telephone: (262) 548-7666 Fax: (262) 548-7656

[email protected] Assessment Facility Contact: Joseph Muchka

Addiction Resource Council 741 N. Grand Avenue, Suite 300 Waukesha WI 53186 Telephone: (262) 524-7921 Fax: (262) 524-7932 [email protected] Assessment Charge: $250.00 Assessment Fee

$100.00 No show/Reschedule Fee$50 Noncompliance Fee $50.00 Extend Driver Safety Plan

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77 WAUPACA COUNTY

Designated Coordinator: Ronald Pehlke

Waupaca County Department of Health and Human Services 811 Harding Street

Waupaca WI 54981-2087 Telephone: (715) 258-6353 Fax: (715) 258-6409

[email protected] Assessment Facility Contact: Ronald Pehlke

Waupaca County Department of Health and Human Services 811 Harding Street

Waupaca WI 54981-2087 Telephone: (715) 258-6304

Telephone: (715) 258-4977 (OWI signup) Telephone: (715) 258-6287

Fax: (715) 258-6409

$242.00 Assessment Fee $412.00 Voluntary Client Fee $242.00 Failed Appointment $120.00 Late Fee

$120.00 Amend / Extend Driver Safety Plan

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WAUSHARA COUNTY Designated Coordinator: Sue Shemanski

Waushara County Department of Human Services 230 West Park Street

P.O. Box 1230 Wautoma WI 54982

Telephone: (920) 787-6550 Fax: (920) 787 0421

[email protected]

Assessment Facility Contact: Sue Shemanski

Waushara County Department of Human Services 230 West Park Street

P.O. Box 1230 Wautoma WI 54982 Telephone: (920) 787-6550 Fax: (920) 787 0421 [email protected] Assessment Charge: $200.00 Assessment Fee $100.00 Failed Appointment $50.00 Extend Driver Safety Plan

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79 WINNEBAGO COUNTY

Michael Daehn, Ph.D., Chief Psychologist/Clinical Supervisor Winnebago County Department of Human Services

220 Washington Avenue Oshkosh WI 54903-2187 Telephone: (920) 236-4722 Fax: (920) 236-1269

[email protected] Assessment Facility Contact: IDP Secretary

Winnebago County Department of Human Services 220 Washington Avenue Oshkosh WI 54903 Telephone: (920) 236-4734 Fax: (920) 236-1269 Assessment Charge: $250.00 Assessment Fee $125.00 Failed Appointment $125.00 Amend Driver Safety Plan

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WOOD COUNTY Designated Coordinator:

Randall Ambrosius, AODA/MH Manager Wood County Unified Services Dept. 2611 12th St. South

Wisconsin Rapids WI 54494 Telephone: (715) 421-8840 Fax: (715) 421-2266

[email protected] Assessment Facility Contact: Randall Ambrosius

Wood County Unified Services Dept. 2611 12th St. South Wisconsin Rapids WI 54494 Telephone: (715) 421-8840 Fax: (715) 421-2266 [email protected] Assessment Charge:

$225.00 OWI Assessment fee $80.00 Failed Appointment $85.00 Amend Driver Safety Plan