Chapter DHS 94

DHS 94.24(2)(d)1.b. b. Before a patient is placed in seclusion;

DHS 94.24(2)(d)1.c. c. When there is documented reason to believe the patient has, on his or her person, objects or materials which threaten the safety or security of patients or other persons; or

DHS 94.24(2)(d)1.d. d. If, for security reasons, the facility routinely conducts personal searches of patients committed under ch. 971 or 975, Stats., patients residing in the maximum security facility at the Mendota mental health institute or a secure mental health unit or facility under s. 980.065, Stats., and persons transferred under s. 51.35 (3) or 51.37, Stats.;

DHS 94.24(2)(d)2. 2. A strip search of an inpatient may be conducted:

DHS 94.24(2)(d)2.a. a. Only in a clean and private place;

DHS 94.24(2)(d)2.b. b. Except in an emergency, only by a person of the same sex;

DHS 94.24(2)(d)2.c. c. Only when all less intrusive search procedures are deemed inadequate; and

DHS 94.24(2)(d)2.d. d. Only under circumstances specified under subd. 1. a. to c.;

DHS 94.24(2)(d)3. 3. A body cavity search of an inpatient may be conducted:

DHS 94.24(2)(d)3.a. a. Only in a clean and private place;

DHS 94.24(2)(d)3.b. b. Only by a physician and, whenever possible, by a physician of the same sex;

DHS 94.24(2)(d)3.c. c. Only when all less intrusive search procedures are deemed inadequate; and

DHS 94.24(2)(d)3.d. d. Only under circumstances specified under subd. 1. a. to c.

DHS 94.24(2)(e) (e) The room and personal belongings of an inpatient may be searched only when there is documented reason to believe that security rules have been violated, except that searches may be conducted in forensic units, the maximum security facility at the Mendota mental health institute or a secure mental health unit or facility under s. 980.065, Stats., in accordance with written facility policies.

DHS 94.24(2)(f) (f) Each inpatient shall be assisted to achieve maximum capability in personal hygiene and self-grooming and shall have reasonable access to:

DHS 94.24(2)(f)1. 1. Toilet articles;

DHS 94.24(2)(f)2. 2. Toothbrush and dentifrice;

DHS 94.24(2)(f)3. 3. A shower or tub bath at least once every 2 days, unless medically contraindicated;

DHS 94.24(2)(f)4. 4. Services of a barber or beautician on a regular basis; and

DHS 94.24(2)(f)5. 5. Shaving equipment and facilities.

DHS 94.24(2)(g) (g) Each patient shall be given an opportunity to refute any accusations prior to initiation of disciplinary action.

DHS 94.24(2)(h) (h) No patient may be disciplined for a violation of a treatment facility rule unless the patient has had prior notice of the rule.

DHS 94.24(2)(i) (i)

DHS 94.24(2)(i)1. 1. Each inpatient shall have unscheduled access to a working flush toilet and sink, except when the patient is in seclusion or for security reasons or when medically contraindicated.

DHS 94.24(2)(i)2. 2. Upon request of the patient, the legal guardian of an incompetent patient or the parent of a minor, staff of the same sex shall be available to assist the patient in toileting or bathing.

DHS 94.24(2)(i)3. 3. Every patient in isolation or seclusion shall be provided an opportunity for access to a toilet at least every 30 minutes.

DHS 94.24(2)(j) (j) Inpatients shall be allowed to provide their own room decorations except that a facility may restrict this right for documented security or safety reasons. Facilities may adopt policies restricting the areas where patients may display sexually explicit or patently offensive room decorations and may prohibit gang-related room decorations.

DHS 94.24(3) (3) Social, recreational and leisure time activities.

DHS 94.24(3)(a) (a) Inpatients shall be provided access to current newspapers and magazines, and shall have reasonable access to radio and television upon request, except for documented security or safety reasons.

DHS 94.24(3)(b) (b) An inpatient shall be allowed individual expression through music, art, reading materials and media except for any limitation that may be necessary for documented security or safety reasons.

DHS 94.24(3)(c) (c) Inpatients may not be prevented from acquiring, at their own expense, printed material, a television, a radio, recordings or movies, except for documented security or safety reasons.

DHS 94.24(3)(d) (d) Each inpatient shall have reasonable access to his or her own musical instruments and to art and writing supplies, along with reasonable access to appropriate space and supervision for the use of the instruments and supplies, except for documented security or safety reasons.

DHS 94.24 Note Note: Any denial or restriction of a patient’s right to use his or her personal articles is governed by s. DHS 94.05 and s. 51.61 (2), Stats.

DHS 94.24(3)(e) (e) Each inpatient shall be provided suitable opportunities for social interaction with members of both sexes, except for documented treatment, security or safety reasons.

DHS 94.24(3)(f) (f) Each inpatient shall have an opportunity for reasonable and regular access to facilities for physical exercise and shall have an opportunity for access to a variety of appropriate recreational facilities away from the living unit to the extent possible, except for any limitation that may be necessary for documented individual security or safety reasons.

DHS 94.24(3)(g) (g) Each inpatient shall be provided an opportunity to be out of doors at regular and frequent intervals, with supervision as necessary, except when health reasons or documented individual security reasons indicate otherwise.

DHS 94.24(3)(h) (h) Patients have a right to be free from having arbitrary decisions made about them. To be non-arbitrary, a decision about a client shall be rationally based upon a legitimate treatment, management or security interest.

DHS 94.24(3)(i) (i) Inpatients shall be permitted to conduct personal and business affairs in any lawful manner not otherwise limited by statute so long as these do not interfere with the patient’s treatment plan, the orderly operation of the facility, security or the rights of other patients.

DHS 94.24(4) (4) Food service.

DHS 94.24(4)(a) (a) Each inpatient shall be provided a nutritional diet which permits a reasonable choice of appealing food served in a pleasant manner.

DHS 94.24(4)(b) (b) Snacks between meals shall be accessible to inpatients on all living units, except when contraindicated for individual patients.

DHS 94.24(4)(c) (c) All inpatients shall be allowed a minimum of 30 minutes per meal and additional time as feasible.

DHS 94.24(4)(d) (d) Menu preparation shall take into account customary religious, cultural or strongly-held personal convictions of inpatients.

DHS 94.24 History History: Cr. Register, January, 1987, No. 373, eff. 2-1-87; am. (2) (b), (j), (3) (b), (f), (g), cr. (3) (h), renum. (3) (i) from HSS 94.07 (5), Register, June, 1996, No. 486, eff. 7-1-96; emerg. am. (2) (e), eff. 8-15-98; am. (2) (d) 1. d. and (e), Register, April, 1999, No. 520, eff. 5-1-99.

DHS 94.25 DHS 94.25 Patient funds. Except as otherwise provided under s. 51.61 (1) (v), Stats., a patient shall be permitted to use the patient’s own money as the patient wishes. A service provider holding funds for a patient shall give the patient an accounting of those funds in accordance with s. 51.61 (1) (v), Stats.

DHS 94.25 History History: Cr. Register, June, 1996, No. 486, eff. 7-1-96.

DHS 94.26 DHS 94.26 Clothing and laundry.

DHS 94.26(1) (1) Inpatients shall be permitted to wear their own clothing as authorized under s. 51.61 (1) (q), Stats., and this section.

DHS 94.26(2) (2) If inpatients do not have enough of their own clothing, they shall be furnished with appropriate noninstitutional clothing of proper size as follows:

DHS 94.26(2)(a) (a) There shall be sufficient clothing to allow each patient at least one change of underwear a day and 3 changes of clothing a week; and

DHS 94.26(2)(b) (b) There shall be clothing which is appropriate for patients to wear out of doors and on trips or visits in all weather conditions.

DHS 94.26(3) (3) All inpatients shall be provided with laundry service or, if the patient can use a washer and dryer, with access to washers and dryers. Facilities shall take reasonable measures to prevent the loss of inpatients’ clothing during use of laundry services.

DHS 94.26 History History: Cr. Register, January, 1987, No. 373, eff. 2-1-87; renum. from HSS 94.25, Register, June, 1996, No. 486, eff. 7-1-96.

DHS 94.27 DHS 94.27 Storage space.

DHS 94.27(1) (1) Each inpatient shall be provided sufficient and convenient space for clothing, toilet articles and other personal belongings, as required under s. 51.61 (1) (r), Stats., and this section.

DHS 94.27(2) (2) Individual storage space shall be conveniently accessible to the patient, shall accommodate hanging of clothes and shall be lockable or otherwise made secure if requested by the patient.

DHS 94.27(3) (3) Personal storage space may be searched only if there is documented reason to believe a violation of the facility’s security regulations has occurred and the patient is given the opportunity to be present during the search, except in forensic units where routine searches may be conducted in accordance with written facility policies.

DHS 94.27 History History: Cr. Register, January, 1987, No. 373, eff. 2-1-87; renum. from HSS 94.26, Register, June, 1996, No. 486, eff. 7-1-96.

DHS 94.28 DHS 94.28 Right to file grievances.

DHS 94.28(1) (1) A patient or a person acting on behalf of a patient may file a grievance under s. DHS 94.29 procedures with the administrator of a facility or other service provider or with a staff member of the facility or other service provider without fear of reprisal and may communicate, subject to s. 51.61 (1) (p), Stats., with any public official or any other person without fear of reprisal.

DHS 94.28(2) (2) No person may intentionally retaliate or discriminate against any patient, person acting on behalf of a patient or employee for contacting or providing information to any official or to an employee of any state protection and advocacy agency, or for initiating, participating in or testifying in a grievance procedure or in any action for any remedy authorized by law.

DHS 94.28(3) (3) No person may deprive a patient of the ability to seek redress for alleged violations of his or her rights by unreasonably precluding the patient from using the grievance procedure established under s. DHS 94.29 or from communicating, subject to any valid telephone or visitor restriction under s. DHS 94.05, with a court, government official, grievance investigator or staff member of a protection and advocacy agency or with legal counsel.

DHS 94.28 History History: Cr. Register, June, 1996, No. 486, eff. 7-1-96.

DHS 94.29 DHS 94.29 Grievance resolution procedures. Failure of a treatment facility to comply with any provision of rights under s. 51.61, Stats., or this chapter may be processed as a grievance under s. 51.61 (5), Stats., and subch. III of this chapter.

DHS 94.29 History History: Renum. from HSS 94.27 (1) and am., Register, June, 1996, No. 486, eff. 7-1-96.

DHS 94.30 DHS 94.30 Compliance assurance.

DHS 94.30(1) (1) Each treatment facility director and program director shall ensure that all of his or her employees who have any patient contact are aware of the requirements of this chapter and of the criminal and civil liabilities for violation of ss. 51.30 (10), 51.61, 146.84, 813.123, 940.22 (2), 940.225, 940.285, 940.295 and 943.20 (3) (d) 6., Stats., and of the protection for reporting violations of rights to licensing agencies under s. 51.61 (10), Stats.

DHS 94.30(2) (2) In the event that a contracted treatment facility does not comply with an applicable requirement of this chapter, the county department shall notify the department of the specific non-compliance within 7 calendar days of its discovery.

DHS 94.30 History History: Cr. Register, January, 1987, No. 373, eff. 2-1-87; renum. from HSS 94.28, Register, June, 1996, No. 486, eff. 7-1-96.

DHS 94.31 DHS 94.31 Application of other rules and regulations. In applying the requirements of this chapter, when a different state rule or federal regulation also applies to the protection of a particular right of patients, the different state rule or federal regulation shall be controlling if it does more to promote patient rights than the counterpart requirement in this chapter.

DHS 94.31 History History: Cr. Register, January, 1987, No. 373, eff. 2-1-87; renum. from HSS 94.29, Register, June, 1996, No. 486, eff. 7-1-96.

subch. III of ch. DHS 94 Subchapter III — Standards for Grievance Resolution Procedures

DHS 94.40 DHS 94.40 System requirements.

DHS 94.40(1) (1) Grievance resolution system required. All programs providing services or residential care to persons who need the services or residential care because of mental illness, a developmental disability, alcoholism or drug dependency, as those terms are defined in s. 51.01, Stats., shall have a grievance resolution system which complies with the requirements of this subchapter.

DHS 94.40(2) (2) Written policies. A program shall have written policies which provide that:

DHS 94.40(2)(a) (a) Staff of the program know and understand the rights of the clients they serve;

DHS 94.40(2)(b) (b) Fair, responsive and respectful procedures are available which permit clients to obtain resolution of their grievances within the time frames provided in this subchapter;

DHS 94.40(2)(c) (c) Staff and clients are instructed in both the formal procedures by which clients may seek resolution of grievances, and informal methods for resolving client concerns; and

DHS 94.40(2)(d) (d) Staff who act as client rights specialists, or private individuals with whom the program contracts for this service, are trained in the procedures required by this subchapter, techniques for resolution of concerns and grievances and the applicable provisions of ch. 51, Stats., ch. DHS 92 and this chapter.

DHS 94.40(3) (3) Client rights specialist.

DHS 94.40(3)(a) (a) Each program or coalition of programs shall designate one or more persons to act as client rights specialists.

DHS 94.40(3)(b) (b) The client rights specialist may be an employee of the program or of one of the programs in a coalition or may be a person under contract to a program or to a coalition of programs.

DHS 94.40(3)(c) (c) The client rights specialist assigned to conduct a program level review under s. DHS 94.41 shall not have any involvement in the conditions or activities forming the basis of the client’s grievance, or have any other substantial interest in those matters arising from his or her relationship to the program or the client, other than employment.

DHS 94.40(3)(d) (d) If at any time during the formal resolution process a grievant wishes to switch to the informal resolution process, and the other parties agree to the switch, the client rights specialist may suspend the formal resolution process and attempt to facilitate a resolution of the matter between the parties without prejudice to positions of the grievant or the program.

DHS 94.40(3)(e) (e) If the client chooses to use the informal resolution process and the matter is resolved, the client rights specialist shall prepare a brief report indicating the nature of the resolution and file it with the program manager, with copies to the client, any person acting on behalf of the client pursuant to s. DHS 94.49, and the parent or guardian of a client if that person’s consent is required for treatment.

DHS 94.40(4) (4) Informal resolution process.

DHS 94.40(4)(a) (a) Each program shall have available a process which offers clients and persons acting on behalf of clients the option of seeking informal resolution of their concerns.

DHS 94.40(4)(b) (b) Use of the informal resolution process shall not be a prerequisite for seeking formal relief.

DHS 94.40(4)(c) (c) The informal resolution process may be used pending initiation of the formal resolution process or as an adjunct during the formal resolution process.