Wisconsin Legislature: DCF 52.59(4)(e)

(c) Discharge planning. A short-term treatment program need only comply with sub. (2) in s. DCF 52.23, and shall include documentation of all of the following in any discharge plan for a resident:

1. The date and reason for discharge.

2. New location of the resident.

3. A brief statement identifying resident readiness for discharge and placement elsewhere and remaining needs.

4. Name and title of person and agency to which the resident was discharged.

5. For an unplanned discharge, a brief summary or other documentation of the circumstances surrounding the discharge.

(6) Resident records. A short-term treatment program shall meet the resident record requirements in this section and in s. DCF 52.49 except under s. DCF 52.49 (2) (b) 1. a. to g. and 3.

(7) Training and evaluation.

(a) Initial training for staff of short-term treatment programs shall include training in the following areas:

1. Wrap around principles and philosophy.

2. Arranging for transitional care and transitional placement planning principles and methods.

(b) A center shall at least annually evaluate its short-term treatment care program through a center survey to be completed and returned to the center by referral sources. The center shall use the survey information to improve, as necessary, its short-term care program.

History: Cr. Register, February, 2000, No. 530, eff. 9-1-00; corrections in (2) (c), (3) (intro.), (4) (intro.), (5) (a), (c) (intro.) and (6) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635; EmR1414: emerg. am. (2) (c), (4) (b) 1., 2., eff. 8-1-14; CR 14-054: am. (2) (c), (4) (b) 1, 2., (5) (b) 2. d. Register April 2015 No. 712, eff. 5-1-15; CR 21-107: am. (2) (b) Register June 2022 No. 798, eff. 7-1-22.

DCF 52.59 Respite care services programs.

(1) Applicability. A residential care center for children and youth may operate a respite care services program with approval of the department. A residential care center for children and youth that chooses to provide respite care services shall comply with the provisions of this chapter except as stated in this section.

(2) Definitions. In this section:

(a) “Respite care” means temporary care for a child with a disability or special care need, usually on behalf of a parent or regular caregiver for the purpose of providing relief to the parent or regular caregiver from the extraordinary and intensive demands of providing ongoing care for the child, but also for when a parent or regular caregiver may be at risk of abusing a child due to stress and, therefore, requires relief from caregiver duties, or the parent or regular caregiver is in a crisis situation that can be alleviated by providing temporary relief from caregiver duties.

(b) “Respite care services episode” or “episode” means a period of time during which respite care is provided to a parent or regular caregiver by placing a child, otherwise under the parent’s or regular caregiver’s care, at a residential care center.

(c) “Respite care services program” means a center-provided program of respite care services for a child with a disability or special need on behalf of a parent or regular caregiver and includes, for the child, individualized personal care and services at the level necessary to meet the child’s immediate needs, along with room and board provided in comfortable surroundings.

(3) Exceptions for respite care programs. Respite care programs shall comply with all provisions of this chapter except the following:

(a) Section DCF 52.21 (1), (2), (5) (a) and (8) (a).

(b) Sections DCF 52.22 and 52.23.

(d) Section DCF 52.49 (2) (b) 1. a. to g. and 3.

(4) Program statement. A center accepting respite care clients shall have a program statement describing its respite care services program. The program statement shall cover at minimum all of the following:

(a) The purposes for which respite care is provided and the type of population served.

(b) Specific center assessment procedures and services available for care arrangements in assisting a child admitted for respite care.

(d) Staffing arrangements for respite care services.

(e) Health care arrangements for respite care placements, including the process for securing medical authorizations for general and emergency medical care including surgery.

(f) Recreational activities and programming for respite care placements.

(5) Admissions. A center operating a respite care services program shall have all of the following written policies and procedures for admission of a prospective respite care resident:

(a) A policy regarding the type of respite care children who can be served, such as those who are emotionally disturbed, physically disabled, medically needy, or developmentally disabled, including the specific types of developmental disabilities served.

(b) Procedures for screening children referred for respite care to ensure that they are appropriate for the center’s respite care program.

(c) Procedures for obtaining parent or guardian written consents for emergency medical care and authorization for administration of medications.

(d)

1. Procedures for obtaining from the parent or other regular caregiver necessary and essential information for the temporary care of the child, which may include medical, behavioral, dietary, or emotional concerns and appropriate responses or instructions. Assessment shall cover at minimum the following areas: eating, toileting, mobility, communication, health problems, behavioral issues, socialization, supervision needs, and personal self-help.

2. Procedures for obtaining identifying information at the time of admission on the child and the child’s family and information about current special needs of the child, including usual day activities; transportation arrangements; any appointments; current health problems; special equipment used; communication issues; behavioral issues; eating habits, schedule and preferences; sleeping habits and any usual bedtime routine; toileting concerns; safety concerns; discipline or behavioral management recommendations; preferred leisure time activities; and any other comments from the parent or regular caregiver.

(e) Procedures as described under s. DCF 52.21 (7) for orienting a child to the center’s respite care program, available care staff and room arrangements, and assisting the child in any adjustment issues to the child’s temporary stay.

(f) Procedures for assigning specific care staff to a respite care child.

(g) Procedures for contacting the parent or other regular caregiver regarding care questions or in emergency situations.

(h) A policy on who may pick up the child or youth at the end of respite care and policies and procedures for establishing the date and time at which the child or youth is to be picked up.

(i) Procedures for making a record of all of the child’s personal belongings and medications upon arrival at the center.

(j) Procedures for maintaining a log with dates of all respite care episodes for each child.

(6) Staffing. A center shall assign a staff person to have primarily responsibility for the center’s respite care services program. This person shall have experience in serving the type of disability or population the center serves. Staff-to-child ratios shall at minimum meet the ratio as otherwise prescribed in s. DCF 52.12 or be as needed to meet the needs of the respite care persons in care. The responsible staff person shall have access to medical, psychiatric, dietary and social services consultation as needed.

(7) Written care plan.

(a) Written care plan. A center shall develop a written plan of care for each child admitted to the center for respite care.

(b) Planning for the child.

1. The written care plan shall be prepared in consultation with the child’s parent or other regular caregiver and prior to placement, except if the reason for placement is of a crisis emergency nature.

2. The written care plan shall provide for necessary service supports to meet social, emotional adjustment, medical, and dietary needs; physical environment accommodation; means for the respite care child to contact the child’s parent or other regular caregiver; accommodations to meet physical disabilities such as requiring, if needed by the child, a TTY device for the hearing impaired, handrails, or visual devices; and a planned variety of recreational activities. The educational needs of the child shall be attended to while in placement as prescribed by the parent or other regular caregiver.

(c) Length of stay. A respite care placement shall not extend beyond 9 days per episode unless department approval is first obtained.

(8) Discharge. When a child is discharged from respite care, the residential care center shall document all of the following in the child’s respite care record:

(a) The dates of the child’s stay, a summary of the child’s stay with any significant incidents noted, and the name of the person to whom the child was discharged.

(b) A list of all personal belongings, medications, and medical equipment that went with the child upon discharge.

(9) Training and evaluation.

(a) Training.

1. Training for staff of a respite care services program shall include training in the areas of arranging for transitional care and transitional placement planning principles and methods.

2. Staff shall have respite care training designed around the specific needs of individuals for which care is provided, such as autism, epilepsy, cerebral palsy and intellectual disabilities. As part of this training, staff who have not already had some experience working with the type of individual to be cared for shall have at least 8 hours of supervised experience by someone who is knowledgeable in working with the type of individual or more than 8 hours if necessary to ensure the provision of competent care.

(b) Evaluation. After each respite care episode, a residential care center shall evaluate the care provided through a survey to be completed by the parent or other regular caregiver and, if possible, the child. The center shall use the survey information to improve, as necessary, its respite care services program and shall keep these surveys on file for one year from their completion.

(10) Client records. A center with a respite care services program shall meet the resident record requirements found under this section and under s. DCF 52.49, except requirements under s. DCF 52.49 (2) (b) 1. a. to g. and 3. A respite care resident’s record shall include all documentation required under this section.

History: Cr. Register, February, 2000, No. 530, eff. 9-1-00; corrections in (3), (5) (e), (6) and (10) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635; CR 14-054: am. (2) (a) to (c), (4) (b), (5) (a), (b), (d) 1., 2., (e), (f), (i), (7) (a), (b), (8), (9) (b) Register April 2015 No. 712, eff. 5-1-15; correction in (7) (b) 2. made under s. 35.17, Stats., Register September 2017 No. 741; 2019 Wis. Act 1: am. (9) (a) 2. Register May 2019 No. 761, eff. 6-1-19; CR 20-003: am. (5) (a) Register July 2020 No. 775, eff. 8-1-20; CR 21-107: am. (5) (d) 2., (7) (b) 2. Register June 2022 No. 798, eff. 7-1-22.

Subchapter VIII — Need Determination and License Application

DCF 52.61 Determination of need for additional beds.

(1) Authority and purpose. This section is promulgated pursuant to s. 48.60 (3), Stats., to regulate the establishment of new residential care centers for children and youth and to control the expansion of existing residential care centers in order to ensure an adequate number and variety of facilities to meet the needs of Wisconsin children who require out-of-home residential care and to prevent unnecessary expansion of residential care centers and the resulting increase in costs to Wisconsin citizens.

(2) To whom the rules apply. This section applies to any new applicant for a license to operate a residential care center for children and youth and to existing residential care centers for children and youth wishing to expand the capacity of their facilities.

(3) Definition. In this section, “applicant” means any person wishing to apply for a license to begin operation of a new residential care center for children and youth or any person wishing to expand the capacity of an existing residential care facility for children and youth. “Applicant” does not include a person who by reason of consolidation or other acquisition acquires control or ownership of beds when the consolidation or other acquisition results in no increase in or a reduction of the existing state-wide residential care center bed capacity.

(4) Certification of need requirement. No person may apply for a license under s. DCF 52.62 (1) to operate a new residential care center for children and youth or for a license amendment under s. DCF 52.62 (3) to expand the bed capacity of an existing residential care center until the department has reviewed the need for the additional placement resources which would be created and has certified to the applicant in writing that a need exists for the proposed new placement resources.

(5) Demonstration of need. To enable the department to make a determination of need for a new residential care center for children and youth or for additional beds at an existing residential care center for children and youth, the applicant shall submit all of the following documents and information to the department:

(a) A detailed plan for the operation of the proposed residential care center which includes all of the following:

1. The number, sex, and age range of the children to be served.

2. The type or types of needs or disabilities of children to be served.

3. The center staffing, including a list of full-time and part-time positions by job titles and numbers.

4. A description of the proposed program and treatment goals.

5. A proposed budget, including the current or projected per diem rate.

6. The location of the center and a drawing of the layout of the physical plant.

(b) A detailed written description of the methodology and findings which document the reasons why the unserved children under par. (a) cannot be served satisfactorily in less restrictive settings such as is in their own homes with treatment services provided to the children and their families, in specialized treatment foster homes or in group homes.

(c) Documentation meeting the criteria in sub. (7) (a) 2. that existing Wisconsin residential care center placement resources are not adequate to meet the needs of Wisconsin children who require the type or types of care and treatment services the applicant proposes to provide. No beds occupied or to be occupied by children who are placed primarily for educational purposes may be considered in determining need under this section. Of the remaining beds, for purposes of determining need and establishing waiting lists, not more than 40% shall be considered available for out-of-state children.

(d) Information that supports the probability that a new or expanded center will be used by Wisconsin placement resources, and that an expanded center will attain and maintain an average monthly occupancy rate of 80% or more over the first 2 years of operation and that a new center will have an average monthly occupancy rate of not less than 80% at the end of the second year.

Note: The documents and information required by the Department to make a determination of need should be sent to the Bureau of Permanence and Out-of-Home Care, P.O. Box 8916, Madison, WI 53708.

(6) Publication of notice — party status.

(a) Upon receipt of the documents and information listed in sub. (5), the department shall publish a class 2 notice under ch. 985, Stats., in the official state newspaper designated under s. 985.04, Stats., and in a newspaper likely to give notice in the area of the proposed center. The notice shall include a statement that the department has received an application for a certificate of need to operate a new residential care center or to expand the bed capacity of an existing residential care center. The notice shall also include the number of additional beds, the geographic area to be served, the types of young people to be accepted for care, the services to be provided and program objectives.

(b) The notice shall invite the submission of written comments, factual data and reasons why the application should be granted or denied from any person within 30 days after the publication of the notice. The notice shall advise persons submitting written comments to indicate their interest in the application and whether the individual commentator wants to be considered for party status in any later proceedings.

(7) Need determination.

(a) Evaluation procedures.

1. The department shall review the applicant’s documents and information for completeness and may ask the applicant for additional materials or information that the department considers necessary for evaluation purposes.

2. Except as provided under subd. 3., the administrator of the department’s division of safety and permanence or a designee shall make the need determination decision based on the following criteria:

a. The compatibility of the applicant’s proposed plan of operation or expansion with the stated treatment goals for the program.

b. The validity of the research methodology used to document need for the proposed program.

c. The congruence of the conclusions reached in the applicant’s needs research with department data on current county placement needs and available beds in existing residential care centers for children and youth providing similar services.