(10) Policy on how the YCSF will address safety concerns specific to the youth being served.
(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 where the intervention will occur and how it will be handled procedurally. DHS 50.07 Personnel.
(1) POLICIES.
(a) A YCSF shall have written personnel policies.
(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.
(2) GENERAL QUALIFICATIONS.
(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. (b) Peer specialists or parent peer specialists must be trained in accordance with s. DHS 34.21 (8) (a) to (d). (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:
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. 2. Programs shall comply with caregiver misconduct reporting and investigation requirements in ch. DHS 13. 3. Each staff responsible for transporting youth shall have a valid Wisconsin driver’s license and a driving record free of any one of the violations specified in ss. 346.62 or 346.63, Stats, in the past 12 months. (Note) 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.
(3) REQUIRED PERSONNEL.
(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.
(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. (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. (d) Staffing requirements.
1. The program administrator, clinical coordinator, or designee must be available for consultation 24/7 either on site, by phone, or by other means.
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 50.08 Orientation and Training.
(1) Initial and ongoing orientation and training requirements must comply with s. DHS 34.21 (8) (a) to (d).
(2) Training must include review of ch. DHS 50, including review and training on all policy and procedures, program statement, and other pertinent information.
(3) Training must include content specific to youth in crisis and their treatment needs.
(4) Training for standard precautions, fire safety, first aid and choking, and medication administration and management is required and must comply with ss. DHS 83.20 (1) and (2).
(5) Training must include emergency safety interventions per s. DHS 50.12 and include de-escalation techniques, redirection, and other preventative techniques.
(6) Staff must be trained on mandated reporting requirements. YCSF staff are considered mandated reporters under ss. 48.981 (2) (a) to (c), Stats.
(7) Training must include youth-specific anti-human trafficking training.
(8) A YCSF shall maintain as part of its central administrative records 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 50.09 Clinical Supervision.
(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.
(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:
(a) A system to determine the status of youth and achievement of outcomes to determine if treatment provided is effective, and a system to identify any necessary corrective measures.
(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 Psy 2, or for a recognized psychotherapy practitioner, whichever is applicable.
(3) Clinical supervision must be provided by staff meeting the qualifications under s. DHS 34.21 (3) (b) 1. to 8.
(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 face-to-face mental health services they provide. (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 face−to−face mental health services they provide. (7) Clinical supervision shall be provided by one or more of the following means:
(a) Individual sessions with the staff member to review cases and assess performance.
(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.
(c) Group meetings to review and assess staff performance and provide staff advice or direction regarding specific situations or strategies.
(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.
(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.
(1) CRITERIA FOR ADMISSION. Admission is voluntary, except that a minor may be admitted to a youth crisis stabilization facility 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. (2) ELIGIBILITY FOR SERVICES. 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.
(a) Admission may be preventative.
(b) A YCSF may accept an eligible youth from an inpatient setting.
(3) CONSENT FOR ADMISSION. Except as provided in s. 51.14, Stats., 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.
(4) AUTHORIZATION. Admissions must be authorized by a staff member qualified under s. DHS 34.21(3) (b) 1. to 8. within 24 hours of admission. DHS 50.11 Program Components. A YCSF shall offer or arrange for all of the following minimum required services:
(1) A structured therapeutic milieu supervised by a clinical coordinator.
(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.
(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: (a) Providing the youth or legal representative with an explanation of the nature and goals of the program, and the rights and responsibilities of the youth.
(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.
(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.
(4) Discharge planning shall meet all of the following requirements:
(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.
(b) Discharge planning shall begin at the time of admission, outlining goals to be achieved during the youths’ stay.
(c) Discharge planning shall include the youth, and the youth’s legal representative if available.
(d) At discharge, all of the youth’s belongings and medications shall accompany the youth.
(e) A discharge summary in writing shall be maintained in the youths’ record.
DHS 50.12 Emergency Safety Interventions.
(1) PROHIBITED INTERVENTIONS. Mechanical restraints and chemical restraints are prohibited.
(2) GENERAL REQUIRMENTS. 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.
(3) ADMINISTRATION REQUIREMENTS. All of the following requirements apply to the administration of seclusion and physical restraint:
(a) Seclusion and physical restraint may only be administered when all other less restrictive methods have been exhausted.
(b) Seclusion and physical restraint shall be administered for the shortest time possible and only until the youth is no longer a danger to self or others.
(c) Seclusion and physical restraint shall be administered in a manner that is attentive to, and respectful of, the trauma history, dignity, and civil rights of the youth.
(d) Seclusion and physical restraint shall be administered in a manner that avoids or causes the least possible physical or emotional discomfort, harm, and pain to the youth.
(e) Regular access to bathroom facilities, drinking water, and necessary medication shall be provided according to the youth’s needs during the administration of seclusion or physical restraint. Temperature and lights shall be maintained at levels which are comfortable to the youth.
(4) SPECIFIC REQUIREMENTS FOR SECLUSION. A YCSF that opts to use seclusion shall do all of the following:
(a) Program staff members shall provide uninterrupted supervision and monitoring of the youth and entire seclusion area during seclusion by being in the room with the youth or by observation through a window into the room.
(b) A YCSF shall maintain an incident log to document the use of seclusion. The log shall include the time when the seclusion began, the youth’s behaviors and staff member’s responses to those behaviors every 5 minutes, and the time seclusion ended.
(c) Seclusion rooms shall be free of objects or fixtures with which the youth could inflict bodily harm.
(d) Only one youth at a time may be placed in a seclusion room.
(e) A youth may only be kept in the seclusion area by means of one of the following:
1. A staff member is in a position, such as in a doorway, to prevent a youth from leaving the seclusion area.
2. A door to a seclusion room is latched by positive pressure applied by a staff member’s hand without which the latch would spring back allowing the door to open on its own accord, or a program may use a magnetic door lock or a lock which requires the turn of a knob to unlock a door. Other designs of door locks shall not be used, including pad lock, key lock, or other locks of similar design.
