DHS 50.06DHS 50.06 Required Policies. A YCSF must have written policies and procedures for the following: DHS 50.06(1)(1) Admission policy and criteria, including ages and gender of youth served, and how bedrooms will be allocated. DHS 50.06(2)(2) Utilization review policy addressing determination of need and length of stay, frequency of review, and other utilization policy as needed. The YCSF is meant to be a short-term crisis stabilization facility. If utilization reviews show that a youth requires stabilization longer than a 30-day period, approval from the department must be obtained. DHS 50.06(3)(3) Policy on prescriber consulting relationships and processes to access consultation with a physician, psychiatrist, physician’s assistant, or advanced practice nurse prescriber, to prescribe or consult on psychiatric medications of youths. This can include a youth’s own provider. DHS 50.06(4)(4) Policy on how medications will be stored, secured, managed, and administered, and which staff is responsible. A description of how medical conditions, if any, will be managed. DHS 50.06(7)(7) Policies for youths’ personal possessions, communication devices including phones, electronics usage, room searches, or other applicable policies. DHS 50.06(8)(8) Facility rules, provided to youth and staff. DHS 50.06(9)(9) Where client records will be maintained and how confidentiality requirements of those records will be safeguarded, as required under s. DHS 50.14. DHS 50.06(10)(10) Policy on how the YCSF will address safety concerns specific to the youth being served. DHS 50.06(11)(11) Policy on emergency safety interventions. This policy must comply with s. DHS 50.12. It must specify alternative interventions, best practices, and how the YCSF plans to implement emergency safety interventions. If seclusion or restraint will be used, it must provide a description of how it will be handled procedurally and for seclusion where the intervention will occur. DHS 50.06(11m)(11m) Policy on telehealth, including when telehealth can be used and by whom, patient privacy and information security considerations, and the right to decline services provided via telehealth. DHS 50.06 HistoryHistory: EmR1922: emerg. cr., eff. 11-2-19; CR 19-077: cr. Register July 2020 No. 775, eff. 8-1-20; CR 23-053: cr. (11m) Register September 2023 No. 813, eff. 10-1-23. DHS 50.07(1)(b)(b) A YCSF shall maintain written documentation of employee qualifications and shall make that information available upon request for review by youths and their representatives or parents, and by the department. DHS 50.07(2)(a)(a) Qualified staff shall comply with s. DHS 34.21 (3) (b) 1. to 19. and must follow current department of safety and professional services standards for licensure and scope of practice. DHS 50.07(2)(c)(c) Each staff member shall have the professional certification, training, experience, and ability to carry out his or her assigned duties as documented through the following steps: DHS 50.07(2)(c)1.1. Each applicant must pass a state background check as provided in s. 50.065, Stats. and ch. DHS 12, before being allowed to work for the YCSF. If the applicant lived in another state, a background check shall be obtained from that state as well. DHS 50.07(2)(c)2.2. Programs shall comply with caregiver misconduct reporting and investigation requirements in ch. DHS 13. DHS 50.07(2)(c)3.3. Each staff responsible for transporting youth shall have a valid Wisconsin driver’s license and a driving record free of any violations specified in ss. 346.62 or 346.63, Stats, in the past 12 months. DHS 50.07 NoteNote: For a state of Wisconsin background check, obtain the name, sex, race, and date of birth of the person about whom you are requesting the check. Information on the process and fees for a background check can be found online at https://www.dhs.wisconsin.gov/caregiver/cbcprocess.htm. DHS 50.07(3)(a)(a) Program administrator. Each YCSF shall have a program administrator who is responsible for the overall YCSF operations and ensuring that the YCSF is in compliance with this chapter and other applicable state and federal laws. DHS 50.07(3)(b)(b) Clinical coordinator. Each YCSF shall have a clinical coordinator who is responsible for the mental health services provided by the program and for ensuring that all staff members providing mental health services have the qualifications required for their roles in the program and comply with all requirements relating to assessment, treatment planning, service delivery, and service documentation. The clinical coordinator shall be qualified under s. DHS 34.21 (3) (b) 1. to 8. The program administrator may also serve as the clinical coordinator. DHS 50.07(3)(c)(c) Required designee. The program administrator shall identify one or more staff members to whom authority may be delegated in the absence of the clinical coordinator. The designee must be qualified under s. DHS 34.21 (3) (b) 1. to 8. DHS 50.07(3)(d)1.1. The program administrator, clinical coordinator, or designee must be available for consultation 24/7 either on site, by phone, or by other means. DHS 50.07(3)(d)2.2. At all times that youth are present at a YCSF, the program shall have a minimum of two staff members present that are qualified under s. DHS 50.07 (2). At least one of the two staff members present must meet one of the requirements from s. DHS 34.21 (3) (b) 1. to 14. DHS 50.07 HistoryHistory: EmR1922: emerg. cr., eff. 11-2-19; CR 19-077: cr. Register July 2020 No. 775, eff. 8-1-20. DHS 50.08(2)(2) Training must include review of this chapter, including review and training on all YCSF policy and procedures, program statement, and other pertinent information. DHS 50.08(3)(3) Training must include content specific to youth in crisis and their treatment needs. DHS 50.08(4)(4) Training for standard precautions, fire safety, first aid and choking, and medication administration and management is required and must comply with s. DHS 83.20 (1) and (2). DHS 50.08(5)(5) Training must include emergency safety interventions per s. DHS 50.12 and include de-escalation techniques, redirection, and other preventative techniques. DHS 50.08(6)(6) Staff must be trained on mandated reporting requirements. YCSF staff are considered mandated reporters under ss. 48.981 (2) (a) to (c), Stats. DHS 50.08(7)(7) As part of its central administrative records, a YCSF shall maintain updated, written copies of its orientation program, evidence of current licensure and certification of professional staff, and documentation of orientation and ongoing training received by program staff and volunteers. DHS 50.08 HistoryHistory: EmR1922: emerg. cr., eff. 11-2-19; CR 19-077: cr. Register July 2020 No. 775, eff. 8-1-20; correction in (2), (4) made under s. 35.17, Stats., Register July 2020 No. 775. DHS 50.09(1)(1) The clinical coordinator shall be responsible for oversight of the job performance and actions of each staff member who is providing clinical services and support services, and for ensuring staff compliance with all laws and regulations governing care and treatment as well as the standards of practice of their individual professions. DHS 50.09(2)(2) Each YCSF shall develop and implement a written policy for clinical supervision and clinical collaboration designed to provide sufficient guidance to assure the delivery of effective services. The policy shall address all of the following: DHS 50.09(2)(a)(a) A method of assessing and evaluating treatment needs and outcomes to determine if treatment provided is effective, and a system to identify any necessary corrective measures and make changes to improve progress. DHS 50.09(2)(b)(b) Identification of clinical issues, including incidents that pose a significant risk of an adverse outcome for youth that should warrant clinical collaboration, or clinical supervision that is in addition to the supervisions specified under ch. MPSW 4, 12, or 16, or ch. Psy 2, or for a recognized psychotherapy practitioner, whichever is applicable. DHS 50.09(4)(4) Program staff who have not completed 3000 hours of supervised clinical experience, or who are not qualified under s. DHS 34.21 (3) (b) 1. to 8., shall receive a minimum of one hour of clinical supervision per week or for every 30 clock hours of mental health services they provide. DHS 50.09(5)(5) Program staff who have completed 3000 hours of supervised clinical experience and who are qualified under s. DHS 34.21 (3) (b)1. to 8., shall participate in a minimum of one hour of peer clinical consultation per month or for every 120 clock hours of mental health services they provide. DHS 50.09(7)(7) Clinical supervision shall be provided by one or more of the following means: DHS 50.09(7)(a)(a) Individual sessions with the staff member to review cases and assess performance. DHS 50.09(7)(b)(b) Individual side-by-side sessions in which the supervisor is present while the staff person provides services and in which the supervisor assesses, teaches, and gives advice regarding the staff member’s performance during or after the session. DHS 50.09(7)(c)(c) Group meetings to review and assess staff performance and provide staff advice or direction regarding specific situations or strategies. DHS 50.09(7)(d)(d) Other professionally recognized methods of supervision, such as review using videotaped sessions or peer review, if the other methods are approved by the department and are specifically described in the written policies of the program. DHS 50.09(8)(8) Clinical supervision shall be documented in a supervision or collaboration record, containing entries that are signed and dated by the staff member providing supervision. DHS 50.09 HistoryHistory: EmR1922: emerg. cr., eff. 11-2-19; CR 19-077: cr. Register July 2020 No. 775, eff. 8-1-20; correction in (2) (b), (6), (9) made under s. 35.17, Stats., Register July 2020 No. 775; CR 23-053: am. (4), (5) Register September 2023 No. 813, eff. 10-1-23. DHS 50.10(1)(1) Criteria for admission. Admission is voluntary, except that a minor may be admitted to a YCSF under this section by a court order under s. 51.20 (13) (a) 3., Stats., or through the procedure under s. 51.13, Stats. No YCSF may accept a minor for detention under s. 51.15, Stats. DHS 50.10(2)(a)(a) A YCSF provides emergency mental health services. To receive emergency mental health services, a youth shall be in a crisis or be in a situation which is likely to develop into a crisis if supports are not provided. DHS 50.10(2)(c)(c) A YCSF may accept an eligible youth from an inpatient setting. DHS 50.10(3)(3) Consent for admission. A YCSF may admit a youth only after obtaining the written and informed consent of the youth or their legal representative, or if authorized by a county department under s. 51.42 or 51.437, Stats., to which the youth has been committed pursuant to s. 51.20 (13), Stats. DHS 50.10 HistoryHistory: EmR1922: emerg. cr., eff. 11-2-19; CR 19-077: cr. Register July 2020 No. 775, eff. 8-1-20; correction in numbering in (2) made under s. 13.92 (4) (b) 1., Stats., Register July 2020 No. 775. DHS 50.11DHS 50.11 Program Components. A YCSF shall offer or arrange for all of the following minimum required services: DHS 50.11(1)(1) A structured therapeutic milieu supervised by a clinical coordinator. DHS 50.11(2)(2) Therapeutic interventions and skills-building which will help youth manage their emotions and behavior in ways that will benefit them and will assist them in avoiding future crises. DHS 50.11(3)(3) A YCSF shall provide care coordination services to each youth. The care coordinator shall be staff in compliance with s. DHS 34.21 (3) (b) 1. to 14. Care coordination shall include all of the following: DHS 50.11(3)(a)(a) Providing the youth or legal representative, or both, with an explanation of the nature and goals of the program, and the rights and responsibilities of the youth. DHS 50.11(3)(b)(b) Facilitating the youth’s assessment, developing and implementing the treatment plan, conducting ongoing case reviews, and identifying services to support the youth at discharge, encouraging family-driven care whenever possible. DHS 50.11(3)(c)(c) Serving as an advocate for the youth with other agencies and programs to help the youth obtain necessary services and coordinating treatment to prevent further crises. DHS 50.11(4)(4) Discharge planning shall meet all of the following requirements: DHS 50.11(4)(a)(a) Discharge planning shall be designed to support the successful reintegration of youth into family, community, and school activities, and to prevent recurrence of a crisis. DHS 50.11(4)(b)(b) Discharge planning shall begin at the time of admission, outlining goals to be achieved during the youths’ stay. DHS 50.11(4)(c)(c) Discharge planning shall include the youth, and the youth’s legal representative if available. DHS 50.11(4)(d)(d) At discharge, all of the youth’s belongings and medications shall accompany the youth. DHS 50.11(4)(e)(e) A discharge summary in writing shall be maintained in the youths’ record. DHS 50.11 HistoryHistory: EmR1922: emerg. cr., eff. 11-2-19; CR 19-077: cr. Register July 2020 No. 775, eff. 8-1-20. DHS 50.12DHS 50.12 Emergency safety interventions. DHS 50.12(1)(1) Prohibited interventions. Mechanical restraints and chemical restraints are prohibited. DHS 50.12(2)(2) General requirements. Seclusion and physical restraint shall only be administered by YCSF staff who have completed orientation and training described in s. DHS 50.08 and shall comply with the requirements for emergency safety interventions under s. 51.61 (1) (i), Stats., s. DHS 94.10, and this chapter. DHS 50.12(3)(3) Administration requirements. All of the following requirements apply to the administration of seclusion and physical restraint: DHS 50.12(3)(a)(a) Seclusion and physical restraint may only be administered when all other less restrictive methods have been exhausted.
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