Consultation with Ellie Jarvie at Department of Health Services (2017).
Consultation with Hugh Davis at Wisconsin Ties (March, 2016).
Consultation with Joann Stephens and Kim Eithun-Harsher at the Wisconsin Office of Children’s Mental Health (March, 2016).
Davis, H. (2017). Wisconsin Family Ties’ Parent Peer Specialist Services: Innovative Approaches to Children’s Mental Health. Wisconsin Family Ties.
DHS seclusion and restraint survey database which contains seclusion and restraint data in Wisconsin day treatment facilities. Annual data comparison reviewed for 2010-2015 to assess levels of seclusion and restraint to determine appropriateness of inclusion of emergency measures in the updated rule. Analysis and supporting documents used to determine effect on small business
Wisconsin has 41 certified child and adolescent mental health day treatment facilities that may be affected by this rule. All facilities are community-based, operating at non-profit organizations or affiliated with hospitals. The Department conducted a provider survey with all day treatment providers in April 2016 to assess components of programming, treatment, and staffing. The Department formed an Advisory Committee consisting of diverse stakeholders that met nine times. The Advisory Committee included members from five separate day treatment facilities, two parents of children who have utilized day treatment services, executive director of the Wisconsin Association of Family & Children’s Agencies which includes members who provide day treatment services, and advocates from three agencies who represent children’s mental health issues. The public was notified of all Advisory Committee meetings pursuant to Wisconsin’s Open Meetings law. Committee members reviewed the initial draft and their comments guided the development of the proposed rule. In addition, the Department requested comments on the economic impact of the proposed rule by publishing a solicitation in the Administrative Register and on the Department’s administrative rules website (hhtps://www.dhs.wisconsin.gov/rules/permanent.htm). Comments were solicited between October 8, 2018 and October 22, 2018. Effect on small business
$33,364. See Fiscal Estimate and Economic Impact Analysis (DOA Form 2049) for further information on the effect on small business.
Agency contact person
Sarah Coyle
(608) 266-2715
Statement on quality of agency data
The data sources used to draft the rules and analyses are accurate, reliable, and objective and are listed in the Summary of Factual Data and Analytical Methodologies section of this rule order.
Place where comments are to be submitted and deadline for submission
Comments may be submitted to the agency contact person that is listed above until the deadline given in the upcoming notice of public hearing. The deadline for submitting comments and the notice of public hearing will be posted on the Wisconsin Administrative Rules Website at http://adminrules.wisconsin.gov after the hearing is scheduled.
RULE TEXT
SECTION 1. Chapter DHS 40 is repealed and recreated to read:
MENTAL HEALTH DAY TREATMENT FOR YOUTH
DHS 40.01 Authority and purpose.
This chapter is promulgated under the authority of s. 51.42 (7) (b), Stats., and is intended to regulate programs providing mental health day treatment services for youth.
DHS 40.02 Applicability. This chapter applies to all programs providing mental health day treatment services for youth in the state of Wisconsin. This chapter does not regulate other providers of day treatment services for youth, such as alcohol and other substance use disorder treatment programs regulated by ch. DHS 75. If a comprehensive program offers services to youth in addition to mental health day treatment, this chapter applies only to those program components that offer mental health day treatment. DHS 40.03 Definitions. In this chapter:
(1)
“Advanced practice nurse” has the meaning given in s. N 8.02 (1).(2)
“Advanced practice nurse prescriber” has the meaning given in s. N 8.02 (2).(3) “Assessment” means the process required under s. DHS 40.13. (4) “Biopsychosocial information” means the combination of physical, psychological, social, environmental, and cultural factors that influence a youth’s development and functioning including underlying driving forces or unmet needs that are expressed through challenging behavior that a youth is exhibiting.
(5) “Care coordination” means efforts by day treatment programs to work jointly with other service systems and agencies including: schools, corrections, child welfare, substance use disorder treatment, and mental and physical health providers, in order to enhance services and supports and reduce barriers to service delivery.
(6) “Chemical restraint” means any medication or substance that may decrease a youth’s independent functioning and that is not administered pursuant to a current treatment plan.
(7) “Client” means a youth receiving mental health day treatment services from a program.
(8) “Clinical collaboration” means a joint intellectual and clinical effort by mental health professionals, intended to produce therapeutic benefits and favorable outcomes.
(9) “Clinical supervision” means the process described in s. DHS 40.10 (5). (10) “Community-based program” means a program providing mental health day treatment services for youth in a facility that is not affiliated with a hospital.
(11) “Co-occurring disorder” means any combination of both a mental health disorder and a substance use disorder.
(12) “Crisis response services” means written policies and procedures for identifying risk of suicidal ideation, attempted suicide, or risk of harm to self or others.
(13) “Cultural responsiveness” means the process by which staff engage respectfully and effectively with a youth or legal representative of all cultures, languages, classes, races, ethnic backgrounds, disabilities, religions, genders, sexual orientations, and other diversity factors in a manner that does all of the following:
(a) Recognizes, affirms, and values the worth of youth, families and communities.
(b) Protects and preserves the dignity of youth, families and communities.
(c) Provides choices for action that are aligned with the context and preferences that derive from their culture and worldview.
(14) “Deficiency” means a failure to meet a requirement of this chapter.
(15) “Department” means the Wisconsin department of health services.
(16) “Educational service” means a program provided by a local education agency that has a unique identification code assigned by the Wisconsin department of public instruction and that provides or directly supervises PK-12 services.
(17) “Evidence-based practice” means a practice, such as a systemic decision-making process or a service that has been shown, through available scientific evidence, to consistently improve measurable client outcomes.
(18) “Family-driven care” means care that facilitates involvement by family and legal representatives in a youth’s care, in order to improve outcomes.
(19) “Gender-sensitive service” means a service that comprehensively addresses gender-related needs and fosters positive gender identity development.
(20) “Intensive Hospital-based program” means a program providing mental health day treatment services for youth with an acute level of need. This setting is meant to support youth with severe symptomology who need closer supervision.
(21) “Legal representative” means any of the following:
(a) A guardian of the person, as defined under s. 54.01 (12), Stats. (b) An adult client’s health care agent, as defined in s. 155.01 (4), Stats. (c) A parent of a minor as defined in s. 48.02 (13), Stats., a guardian as defined in s. 48.02 (8), Stats., or a legal custodian, as defined in s. 48.02 (11), Stats. (d) Any other individual or entity with legal authority to represent the client.
(22) “Licensed treatment professional” means any of the following, whose license is in good standing at the time of practice:
(a) A physician licensed under s. 448.03 (1) (a), Stats., who has completed a residency in psychiatry. (b) A psychologist or a private practice school psychologist licensed under ch. 455, Stats. (c) A marriage and family therapist licensed under s. 457.10 or 457.11, Stats. (d) A professional counselor licensed under s. 457.12 or 457.13, Stats. (e) A clinical social worker licensed under s. 457.08 (4), Stats. (23) “Local educational agency” means a school district, as provided in s. 115.01 (3), Stats., a cooperative educational services agency (CESA) established under ch. 116, Stats. or a board established under s. 115.817, Stats. (24) “Major deficiency” means a determination by the department that any of the following occurred:
(a)
The program or a staff member created a risk of harm to a client or violated a client right created by this chapter. (b) A staff member had sexual contact, as defined in s. 940.225 (5)(b), Stats., with a client. (d) A staff member was included on the Caregiver Misconduct Registry under ch. DHS 13 and did not receive a rehabilitation determination from the department for all instances of substantiated misconduct.
