Wisconsin Legislature: DOC 347.23(8)

(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.

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

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

(6) Youth shall receive 3 nutritious meals and a snack daily, with no more than 12 hours between the evening meal and breakfast. Two of the meals shall be hot, including the entrée.

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

History: CR 20-030: cr. Register October 2021 No. 790, eff. 11-1-21.

Subchapter VI — Health and Mental Health Care

DOC 347.21 Health screening.

(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 health screening form shall be documented.

(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 347.26 applies if a youth screens positive for risk of suicide or self-harm.

(3) The health screening shall be conducted in a confidential setting upon the youth’s admission.

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

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

(6) Within 72 hours of admission, a qualified health care professional shall offer the youth sexually transmitted infection testing, and all female youth shall be offered pregnancy testing.

(7) Documentation of health screening results and subsequent review of the health screening form shall be maintained in the youth’s confidential medical record.

History: CR 20-030: cr. Register October 2021 No. 790, eff. 11-1-21.

DOC 347.22 Health care assessment.

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

(2) A health care assessment is not required for a youth readmitted to the facility when the last health care assessment was performed within 90 days and when the youth’s new admission health screening shows no change in health status.

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

History: CR 20-030: cr. Register October 2021 No. 790, eff. 11-1-21.

DOC 347.23 Medical care.

(1) The facility shall provide youth medical care under s. 938.505 (1), Stats.

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

(3) The facility shall provide access and arrange for transportation to emergency medical care services.

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

(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.

(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.

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

(8) When practicable, the facility shall be in contact with a youth’s personal physician.

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

(a) Pregnancy management.

(b) Acute and chronic medical conditions management.

(d) Detoxification and withdrawal care.

(e) Immunizations.

History: CR 20-030: cr. Register October 2021 No. 790, eff. 11-1-21.

DOC 347.24 Informed consent.

(1) At admission, the facility shall obtain the name and contact information of an adult family member or guardian who can provide information about a youth’s health and mental health history.

(2) The facility shall ensure all medical and mental health examinations and services conform to applicable state laws for informed consent and the right to refuse treatment.

(3) The facility shall obtain informed consent using a language that is understandable to the youth and the youth’s parent or guardian.

History: CR 20-030: cr. Register October 2021 No. 790, eff. 11-1-21.

DOC 347.25 Mental health care.

(1) The facility shall provide youth with mental health services from a qualified mental health professional.

(2) All qualified mental health professionals shall have training on and be knowledgeable about the assessment of mental health disorders, trauma, and suicide risk among adolescents and age-appropriate interventions.

(3) All qualified mental health professionals shall provide services in accordance with recognized standards of practice.

(4) 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.

(5) All youth shall receive a mental health assessment by a qualified mental health professional within 7 days of admission. The assessment shall be documented.

(6) The mental health assessment shall be conducted in a confidential setting.

(7) The facility shall have sufficient service hours from qualified mental health professionals to timely meet the needs of youth in the facility.

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

(9) Qualified mental health professionals shall develop individual mental health treatment plans for youth with identified mental health needs.

(10) Qualified mental health professionals shall work with facility staff to provide guidance, insight, and direction on managing and understanding the needs and behavior of youth.

(11) The facility shall provide access to emergency mental health care and transportation, if necessary.

History: CR 20-030: cr. Register October 2021 No. 790, eff. 11-1-21.

DOC 347.26 Suicide and self-harm prevention.

(1) Risk of serious harm. The facility shall do all of the following:

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

(b) Determine whether the youth has ever considered or engaged in self-harm or attempted suicide.

(c) 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.

(d) 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.

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

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

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

(c) Establish monitoring procedures for youth on suicide or self-harm watch, including frequency and documentation of wellness checks under s. DOC 347.48.

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

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

(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.

(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.

(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.

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

(f) Notify the youth’s parent or legal guardian any time a youth is placed on suicide or self-harm watch.

(g) Notify the youth’s case worker in the county or tribe of supervision any time a youth is placed on suicide or self-harm watch.

(h) Identify persons to be notified in case of attempted or completed suicides or self-harm.

(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:

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

(b) Date and time watch was initiated.

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

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

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

(g) Date and time of notification to youth’s parent or legal guardian under sub. (3) (f).

(h) Date and time of notification to youth’s case worker in the county or tribe of supervision under sub. (3) (g).

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

History: CR 20-030: cr. Register October 2021 No. 790, eff. 11-1-21.

DOC 347.27 Dental health care.

(1) A dental screening shall be performed by a licensed dentist or a qualified healthcare professional within 7 days of admission.

(2) An oral examination shall be performed by a licensed dentist within 60 days of admission and every 6 months thereafter, unless the facility obtains information that the youth received a dental examination within the previous 6 months.

(3) The facility shall provide access to emergency dental care and transportation to those services, as needed.