Chapter DOC 346

DOC 346.18(2) (2) The facility shall develop menus that satisfy generally accepted nutritional standards.

DOC 346.18(3) (3) An annual menu review by a qualified nutritionist or dietician shall be completed and maintained in the facility files. Any change or substitution to the menu shall be documented.

DOC 346.18(4) (4) A youth may abstain from any foods that violate the youth’s religion. Consistent with available resources, the facility shall provide a substitute with other available foods from the menu served at the meal. The substitutions shall be consistent with sub. (2).

DOC 346.18(5) (5) Special diets are provided as prescribed by a qualified health care professional.

DOC 346.18(6) (6) Youth shall receive 3 nutritious meals and a snack daily, with no more than 14 hours between the evening meal and breakfast. Two of the meals shall be hot, including the entrée.

DOC 346.18(7) (7) Youth shall eat meals in a cafeteria or common area unless approved by a supervisor or designee.

DOC 346.18 History History: CR 24-065: cr. Register July 2025 No. 835, eff. 8-1-25.

subch. VI of ch. DOC 346 Subchapter VI — Health and Mental Health Care

DOC 346.19 DOC 346.19 Health screening.

DOC 346.19(1) (1) The facility shall use a health screening form that is developed in conjunction with qualified health care professionals and is completed at the time of admission for each youth to record information about current and past medical, mental health, and dental conditions, physical and developmental disabilities, recent injuries or physical trauma, alcohol or other drug abuse problems, and suicide or self-harm risk. The completion of a health screening form upon admission of youth shall be documented.

DOC 346.19(2) (2) A youth whose screening under sub. (1) is not completed within one hour of admission shall be under constant staff supervision until the screening is completed. Section DOC 346.23 applies if a youth screens positive for risk of suicide or self-harm.

DOC 346.19(3) (3) The health screening shall be conducted in a confidential setting.

DOC 346.19(4) (4) If urgent concerns are identified during the health screening, referrals to medical, mental health, or supervisory staff shall be immediate.

DOC 346.19(5) (5) A qualified health care professional shall review the health screening within 72 hours. The review shall be documented.

DOC 346.19(6) (6) Documentation of health screening results and subsequent review of the health screening form shall be maintained in the youth’s confidential file.

DOC 346.19 History History: CR 24-065: cr. Register July 2025 No. 835, eff. 8-1-25.

DOC 346.20 DOC 346.20 Health care assessment.

DOC 346.20(1) (1) All youth shall receive a full health care assessment by a qualified health care professional within 7 days of admission.

DOC 346.20(2) (2) The assessment shall be documented.

DOC 346.20(3) (3) Documentation of health care assessment results shall be maintained in the youth’s confidential medical record.

DOC 346.20 History History: CR 24-065: cr. Register July 2025 No. 835, eff. 8-1-25.

DOC 346.21 DOC 346.21 Medical care.

DOC 346.21(1) (1) The facility shall provide youth with necessary medical care while the youth is in custody.

DOC 346.21(2) (2) The facility shall provide youth with a schedule of access to medical care to be provided under sub. (1).

DOC 346.21(3) (3) The facility shall provide access to emergency medical and dental services.

DOC 346.21(4) (4) All licensed or certified health care professionals shall provide services in accordance with the standards of practice established by the applicable regulatory body.

DOC 346.21(5) (5) Health care staff shall be in compliance with state and federal licensure certification and registration. Verification of compliance shall be maintained at the facility.

DOC 346.21(6) (6) A youth may refuse specific health evaluations and treatments in accordance with applicable federal and state law. All refusals shall be documented and maintained in the youth’s confidential medical record.

DOC 346.21(7) (7) The facility shall allow for submission and screening of medical requests on a daily basis.

DOC 346.21(8) (8) The facility’s provision of medical care shall ensure access to all of the following:

DOC 346.21(8)(a) (a) Pregnancy management.

DOC 346.21(8)(b) (b) Acute and chronic medical conditions management.

DOC 346.21(8)(c) (c) Communicable disease and infection control.

DOC 346.21(8)(d) (d) Detoxification and withdrawal care.

DOC 346.21 History History: CR 24-065: cr. Register July 2025 No. 835, eff. 8-1-25.

DOC 346.22 DOC 346.22 Mental health care.

DOC 346.22(1) (1) The facility shall provide youth with necessary mental health services from a qualified mental health professional while the youth is in custody.

DOC 346.22(2) (2) Licensed mental health professionals shall be in compliance with state and federal licensure certification and registration. Verification of compliance shall be maintained at the facility.

DOC 346.22(3) (3) The facility shall have a schedule of access to on-site mental health care services.

DOC 346.22(4) (4) The facility shall provide access to emergency mental health care.

DOC 346.22 History History: CR 24-065: cr. Register July 2025 No. 835, eff. 8-1-25.

DOC 346.23 DOC 346.23 Suicide and self-harm prevention.

DOC 346.23(1) (1) Risk of suicide or self-harm. The facility shall do all of the following:

DOC 346.23(1)(a) (a) Obtain documented information from a transporting agency’s observation pertaining to a youth’s mental health and potential for suicide or self-harm.

DOC 346.23(1)(b) (b) Require staff to immediately notify qualified medical and mental health professionals of all incidents of self-harm or attempted self-harm. The notification and incident shall be documented.

DOC 346.23(1)(c) (c) Require staff to immediately notify qualified medical and mental health professionals of youth who have communicated having ideation, plan, or intent to engage in self-harm or suicide. The notification and incident shall be documented.

DOC 346.23(2) (2) Suicide or self-harm watch. The facility shall do all of the following:

DOC 346.23(2)(a) (a) Identify designated supervisory staff to be notified if a youth is determined to be a suicide or self-harm risk.

DOC 346.23(2)(b) (b) Designate areas within the facility and provide security precautions for youth who are placed on suicide or self-harm watch.

DOC 346.23(2)(c) (c) Establish monitoring procedures for youth on suicide or self-harm watch, including frequency and documentation of wellness checks under s. DOC 346.39.

DOC 346.23(3) (3) Youth supervision. The facility shall do all of the following:

DOC 346.23(3)(a) (a) Identify staff who may initiate a suicide or self-harm watch.

DOC 346.23(3)(b) (b) Require notification to qualified mental health professionals when the youth is placed on suicide or self-harm watch. Assessment by a qualified mental health professional shall be completed as soon as practicable.

DOC 346.23(3)(c) (c) Identify qualified mental health professionals who are authorized to remove a youth from a suicide or self-harm watch status after an in-person assessment.

DOC 346.23(3)(d) (d) Establish requirements for the frequency of communication between health care and facility staff regarding the status of a youth who is on suicide or self-harm watch.

DOC 346.23(3)(e) (e) Establish an intervention protocol during an apparent suicide or self-harm attempt, including life-sustaining measures.

DOC 346.23(3)(f) (f) Identify persons to be notified in case of attempted or completed suicides or self-harm.

DOC 346.23(4) (4) Documentation. The facility shall document actions taken and decisions made regarding youth who are at risk of attempting suicide or self-harm, including all of the following:

DOC 346.23(4)(a) (a) Individual initiating the suicide or self-harm watch.

DOC 346.23(4)(b) (b) Date and time watch was initiated.

DOC 346.23(4)(c) (c) Reason watch was initiated.

DOC 346.23(4)(d) (d) Date, time, and name of supervisor contacted.

DOC 346.23(4)(e) (e) Date and time of referral to a qualified mental health professional.

DOC 346.23(4)(f) (f) Written documentation from the qualified mental health professional removing a youth from a suicide or self-harm watch including name, date, and time.

DOC 346.23(5) (5) Support services. The facility shall provide access to debriefing and support services for youth and staff following a suicide or self-harm incident.

DOC 346.23 History History: CR 24-065: cr. Register July 2025 No. 835, eff. 8-1-25.

DOC 346.24 DOC 346.24 Medications.

DOC 346.24(1) (1) The facility shall comply with state and federal law regarding procuring, prescribing, dispensing, delivering, administering, and disposing of prescription and nonprescription medications.

DOC 346.24(2) (2) All medications brought into the facility shall be verified, inventoried, and maintained in a designated secure storage area.

DOC 346.24(3) (3) Designated trained staff may administer or deliver prescribed doses of medication at prescribed times.

DOC 346.24(4) (4) Prescription and nonprescription medication administered or delivered to a youth shall be documented, including who prescribed the medication, who administered or delivered the medication, and the date and time of administration or delivery.

DOC 346.24(5) (5) All refusals of recommended or prescribed medications by a youth shall be documented.

DOC 346.24(6) (6) All medication errors shall be documented.

DOC 346.24(7) (7) The facility shall inventory and return or dispose of unused medications upon the youth’s release or transfer.

DOC 346.24 History History: CR 24-065: cr. Register July 2025 No. 835, eff. 8-1-25.

DOC 346.25 DOC 346.25 Medical records.

DOC 346.25(1) (1) Youth medical records shall be kept separate from other records, including custodial records, and shall be maintained in a confidential manner in accordance with ss. 146.81 to 146.83, Stats., and other applicable state or federal laws.

DOC 346.25(2) (2) Records shall be securely maintained and accessible only be designated staff.

DOC 346.25 History History: CR 24-065: cr. Register July 2025 No. 835, eff. 8-1-25.

subch. VII of ch. DOC 346 Subchapter VII — Resources for Youth

DOC 346.26 DOC 346.26 Clothing, towels, and bedding.

DOC 346.26(1) (1) Clothing.

DOC 346.26(1)(a) (a) If youth are not permitted to wear personal clothing, all of the following shall be provided upon admission:

DOC 346.26(1)(a)1. 1. A set of clean clothing.

DOC 346.26(1)(a)2. 2. Clean socks and undergarments.

DOC 346.26(1)(a)3. 3. Clean footwear.

DOC 346.26(1)(b) (b) Clothing shall be laundered at a minimum of 2 times per week, and on a more frequent basis as needed.

DOC 346.26(1)(c) (c) Undergarments and socks shall be laundered as necessary to provide clean undergarments and socks daily.

DOC 346.26(2) (2) Towels and bedding.