DHS 31.20 Building design.
DHS 31.21 Infection control program.
DHS 31.22 Food service.
DHS 31.23 Fire safety requirements.
DHS 31.24 Fire protection systems.
DHS 31.25 Oxygen storage.
DHS 31.26 Records retention and posting.
Subchapter IV – Grant Program Requirements
DHS 31.27 Grant program overview.
DHS 31.28 Application.
DHS 31.29 Awards.
DHS 31.30 Restrictions.
DHS 31.31 Records and reports.
Subchapter I – General Provisions and Requirements
DHS 31.01 Authority and purpose. This chapter is promulgated under the authority of ss. 51.036 (4), and 227.11 (2), Stats., for the purpose of certifying and regulating crisis urgent care and observation facilities.
DHS 31.02 Applicability.
(1) This subchapter establishes general program requirements that apply to crisis urgent care and observation facilities, including those facilities that are also licensed as a hospital under ch. 50, Stats. The requirements under this section shall not prohibit, limit, or otherwise interfere with services provided by a county, hospital, or other facility that are provided under the facility’s existing licensure or certification. This chapter shall apply to any of the following: (a) A publicly or privately operated facility providing crisis urgent care and observation facility services, in accordance with s. 51.036, Stats. (b) A publicly or privately operated hospital providing crisis urgent care and observation facility services, in accordance with s. 51.036, Stats. This applies to co-located and off-site facilities. (2) The certification requirements of this chapter do not apply to any facility meeting the criteria under s. 51.036 (2) (f), Stats.
DHS 31.03 Definitions. In this chapter:
_Hlk184040775(1) “Assessment” means the procedure by which staff of the program, operating within their scope of practice, gathers relevant information to assess risk, identifies client care needs, and determines intervention or treatment options. (2) “Bed” means a piece of furniture designed to accommodate a person sleeping in an outstretched position. For purposes of this chapter, a bed may include a reclining chair, convertible sofa, or recovery couch.
_Hlk184372125(3) “Behavioral health assessment” means the process of gathering relevant information regarding a client’s behavioral and mental health status. (4) “Care coordination” means the deliberate organization of a person’s care across multiple care providers and support networks.
(5) “CCF” means a crisis urgent care and observation facility.(6) “Certification" means the approval granted by the department that a CCF meets the requirements of this chapter.
_Hlk190154593(7) “Certified peer specialist” means a person who has all of the following: (a) Lived experience with mental illness or substance use disorders, or both.
(b) Completed a formal training and holds a department certification in the peer specialist model of mental health or substance use disorders support, or both.
(8) “Client” means a person receiving care at a CCF. Unless otherwise indicated in this chapter, a person screened for services but not admitted is not a client.
(9) “Clinical supervision” means a process of oversight of an employees’ professional development and practice to ensure that each client is receiving quality care.
(10) “Cognitive assessment” means the process of gathering relevant information regarding a client’s cognitive, developmental, or intellectual status.
(11) “County department" means a county department of human services under s. 46.23, Stats., or a county department of community programs under s. 51.42 (1) (b), Stats. (13) “Crisis counseling” means brief and crisis specific support provided to help ameliorate symptoms of an immediate crisis and promote safety. This may include active listening, validation, and identification of coping skills.
(14) “Crisis plan” means a plan prepared for an individual so that, if a crisis occurs, the individual and persons supporting them and responding to the situation will have the information and resources they need to meet the person’s individual needs.
(15) “Crisis urgent care and observation facility” or “crisis care facility” has the meaning provided in s. 51.036 (1) (b), Stats. (16) “Day” means calendar day, unless otherwise indicated.
(17) “De-escalation” means the use of interventions to stabilize, slow, or reduce the intensity of a crisis.
(18) “Department" means the Wisconsin department of health services.
(19) “Direct care” means care provided by staff directly related to clients. Direct care does not include training, orientation, or non-client related administrative tasks.
(20) “Elopement” means when a client leaves a CCF without authorization or supervision and may be a threat to their health or safety.
(21) “Follow-up” means the process of assessing the well-being of a client, including those who have been discharged.
(22) “Hub-and-spoke health home pilot program” means a network of treatment, resources, and support for persons with substance use and health care needs.
(23) “Ligature resistant” means an object designed to reduce the ability of securing a ligature to it.
(24) “Medication management” means services that include prescribing, transcribing, verifying, dispensing, delivering, administering, monitoring, and reporting over the counter and prescription medication.
(25) “Nursing assessment” means the process of gathering relevant information regarding a client’s physical and medical health status.
(26) “Observation unit” means a space for client care and observation for client stays less than 24 hours where multiple clients may occupy a single room.
(27) “Opioid reversal medication” means a medication approved by the federal drug administration that blocks the effects of opioids.
(28) “Peer clinical consultation” means a process where staff review cases and seek advice and feedback from professional peers for the purpose of improved clinical practice and client outcomes.
(29) “Prescriber” means a physician, physician assistant, or nurse prescriber, who is operating within the scope of their license to deliver services under this chapter.
(30) “Psychiatric Bed Locator” means a tool to assist in identifying potentially available psychiatric beds.
(31) “Psychosocial assessment” means an assessment of a client’s psychological and social functioning.
(32) “Psychotherapy” means licensed clinicians applying therapeutic services to assist a client, family, or group to achieve behavioral health stability.
(33) “Re-assessment” means the procedure by which staff of the program, operating within their scope of practice, gather relevant information to update a client’s initial assessment based on a change in symptoms, status, needs, or risk.
(34) “Peer recovery coach” means an individual who practices in the recovery field and who provides support and assistance to individuals who are in treatment or recovery from mental illness and/or a substance use disorder.
(35) “Risk assessment” means the process of gathering relevant information regarding a client’s risk of harm to self or others.
(36) “Safety plan” means a personalized set of written guidelines to be used as a tool to assist someone prior to or during a crisis to identify coping skills and access supports.
(37) “Secure” or “secured” means a locked area within a CCF.
(38) “Sight and sound separation” means the maintenance of physical separation between minors and adults so that both sustained visual contact and direct and sustained oral communication between them is not possible.
(39) “Screening” means a process of identification of needs and risk including urgent medical, mental health, psychiatric, or substance use crisis needs.
(40) “Stabilization” means a service aimed at reducing or eliminating a client’s symptoms to reduce the need for inpatient hospitalization.
(41) “Staffing plan” means a document to strategically identify and anticipate the workforce required to effectively deliver client care.
(42) “Substance use disorder assessment” means the process of gathering relevant information regarding a client’s substance use status. Substance use disorder assessment does not include rendering treatment as defined in s. 51.45(2)(g), Stats. (43)
(a) “Telehealth” means the use of telecommunications technology by a certified provider to deliver services allowable under ss. 49.45 (61) and 49.46 (2) (b) 21. to 23., Stats., this chapter, and s. DHS 107.02 (5), including assessment, diagnosis, consultation, treatment, or transfer of medically relevant data in a functionally equivalent manner as that of an in-person contact. (b) “Telehealth” may include real-time interactive audio-only communication.
(c) “Telehealth does not include communication between a certified provider and a recipient that consists solely of an electronic mail, text, or facsimile transmission.
(44) “Transfer” means the movement of a client or individual in need of services between approved treatment facilities, or from an approved treatment facility to the community, or from the community to an approved treatment facility.
(45) “Variance” means an alternate means of meeting a requirement in this chapter.
(46) “Waiver” means an exemption from a requirement of this chapter.
(47) “Wisconsin Prescription Drug Monitoring Program database” or “PDMP database” means an online tool used to provide information about monitored prescription drugs that are dispensed in the state.
(48) “Withdrawal abatement” means providing care and interventions to address an individual's physical or psychosocial needs related to acute intoxication or withdrawal until the crisis is resolved.
DHS 31.04 Certification.
(1) General.
(a) No person, agency, or facility may operate a CCF without a certification from the department.
(b) Any facility licensed as a hospital under ch. 50 that provides services consistent with those described in this chapter can apply for CCF certification under this section. (c) This chapter shall not prevent co-location of a CCF with other facilities, including hospitals, or shared staffing arrangements.
(2) Application. All of the following materials shall be submitted to the department when applying for CCF certification:
(a) A completed application specifying the population to be served, and which demonstrates the program’s ability to do all the following:
1. Accept referrals for crisis services for adults and, if specifically identified in the application, for minors, including all the following:
a. Involuntary clients brought under s. 51.15, Stats.
