Chapter DCF 52

DCF 52.415(2)(b) (b) An RPPS decision maker may be a licensee, authorized representative of the licensee, or any staff person specified in s. DCF 52.12 (1) (a) 1. to 5.

DCF 52.415(2)(c) (c) An RPPS decision maker shall have knowledge of a resident and access to the resident’s treatment plan and other resident case records under s. DCF 52.49 related to the decision-making factors in sub. (4).

DCF 52.415(2)(d) (d) An RPPS decision maker shall document in the communication log under s. DCF 52.41 (1m) decisions made under this section for activities that do not take place in the residential care center and are not supervised by a staff person.

DCF 52.415(2)(e) (e) An RPPS decision maker shall document on a form prescribed by the department any decision made under this section that requires written permission from the center in lieu of the resident’s parent or guardian. The completed form shall be placed in the resident’s case record under s. DCF 52.49 (2) (b).

DCF 52.415 Note Note: DCF-F-5124-E, Reasonable and Prudent Parent Decision Record, is available in the forms section of the department website at http://dcf.wisconsin.gov or by writing the Division of Safety and Permanence, P.O. Box 8916, Madison, WI 53708−8916.

DCF 52.415(3) (3) Reasonable and prudent parent standard. When an RPPS decision maker is making a decision regarding a resident’s participation in activities, the RPPS decision maker shall use a decision-making standard that is characterized by careful and sensible parental decisions that maintain the health, safety, best interests, and cultural, religious, and tribal values of the resident while at the same time encouraging the emotional and developmental growth of the resident, if the activities meet the conditions in pars. (a) and (b) as follows:

DCF 52.415(3)(a) (a) Areas covered by the standard. The resident is participating or wants to participate in extracurricular, enrichment, cultural, or social activities, including all of the following.

DCF 52.415(3)(a)1. 1. Activities related to transportation, such as obtaining a driver’s license, driving, or carpooling with peers and other adults.

DCF 52.415(3)(a)2. 2. Formal or informal employment and related activities, such as opening an account in a bank or credit union.

DCF 52.415(3)(a)3. 3. Activities related to peer relationships, such as visiting with friends, staying overnight at a friend’s house, or dating.

DCF 52.415(3)(a)4. 4. Activities related to personal expression, such as haircuts; hair dying; clothing choices; or sources of entertainment, including games and music.

DCF 52.415(3)(b) (b) Age or developmentally appropriate activities. The resident is participating or wants to participate in activities that are suitable based on any of the following criteria:

DCF 52.415(3)(b)1. 1. Activities that are generally accepted as suitable for children of the same chronological age or level of maturity or that are determined to be developmentally appropriate for a child based on the cognitive, emotional, physical, and behavioral capacities that are typical for children of the same age or age group.

DCF 52.415(3)(b)2. 2. Activities that are suitable based on this resident’s cognitive, emotional, physical, and behavioral capacities.

DCF 52.415 Note Note: The reasonable and prudent parent standard does not apply to a child receiving respite care services.

DCF 52.415(4) (4) Decision-making factors. When applying the reasonable and prudent parent standard to a decision regarding a resident’s participation in an extracurricular, enrichment, cultural, or social activity, an RPPS decision maker shall consider all of the following:

DCF 52.415(4)(a) (a) Child-specific factors, including all of the following:

DCF 52.415(4)(a)1. 1. The resident’s treatment plan.

DCF 52.415(4)(a)2. 2. The resident’s wishes, as gathered by engaging the resident in an age-appropriate discussion about participation in the activity.

DCF 52.415(4)(a)3. 3. The age, maturity, and development of the resident.

DCF 52.415(4)(a)4. 4. Whether participating in the activity is in the best interest of the resident.

DCF 52.415(4)(a)5. 5. The resident’s behavioral history.

DCF 52.415(4)(a)6. 6. Court orders and other legal considerations affecting the resident, including the prohibitions in sub. (5).

DCF 52.415(4)(a)7. 7. Cultural, religious, and tribal values of the resident and the resident’s family. If the resident and the resident’s family have different cultural, religious, or tribal values, then the placing agency, or the department if the department is the resident’s guardian, is ultimately responsible for decisions concerning the resident’s care.

DCF 52.415(4)(b) (b) Activity-specific factors, including all of the following:

DCF 52.415(4)(b)1. 1. Potential risk factors of the situation, including whether the resident has the necessary training and safety equipment to safely participate in the activity under consideration.

DCF 52.415(4)(b)2. 2. How the activity will help the resident grow.

DCF 52.415(4)(b)3. 3. Whether participating in the activity will provide experiences that are similar to the experiences of other residents of the same age, maturity, or development.

DCF 52.415(4)(b)4. 4. Other information regarding the parent’s or guardian’s wishes and values, as obtained during the development and review of the resident’s treatment plan under s. DCF 52.22 (1) and (3) and other discussions with the resident’s parent or guardian.

DCF 52.415(4)(c) (c) Any other concerns regarding the safety of the resident, other residents in the residential care center, or the community.

DCF 52.415(4)(d) (d) Information on the forms required under ch. DCF 37.

DCF 52.415 Note Note: The forms required under ch. DCF 37 are DCF-F-872A-E, Information for Out-of-Home Care Providers, Part A and DCF-F-872B-E, Information for Out-of-Home Care Providers, Part B. Both forms are available in the forms section of the department website at http://dcf.wisconsin.gov or by writing the Division of Safety and Permanence, P.O. Box 8916, Madison, WI 53708-8916.

DCF 52.415(5) (5) Prohibitions. An RPPS decision maker may not do any of the following:

DCF 52.415(5)(a) (a) Permit a resident to participate in an activity that would violate a court order or any federal or state statute, rule, or regulation.

DCF 52.415(5)(b) (b) Make a decision that conflicts with the resident’s permanency plan or family interaction plan.

DCF 52.415(5)(c) (c) Consent to the resident’s marriage.

DCF 52.415(5)(d) (d) Authorize the resident’s enlistment in the U.S. armed forces.

DCF 52.415(5)(e) (e) Authorize medical, psychiatric, or surgical treatment for the resident beyond the terms of the consent for medical services authorized by the resident’s parent or guardian.

DCF 52.415(5)(f) (f) Represent the resident in a legal action or make a decision of substantial legal significance.

DCF 52.415(5)(g) (g) Determine which school the resident attends or make a decision for the resident regarding an educational right or requirement that is provided in federal or state law.

DCF 52.415 Note Note: For example, only a parent or guardian can make decisions about a resident’s individualized educational program under s. 115.787, Stats.

DCF 52.415(5)(h) (h) Require or prohibit a resident’s participation in an age or developmentally appropriate activity solely for convenience or a personal reason not applicable to the decision-making factors in sub. (4).

DCF 52.415 History History: EmR1633: emerg. cr., eff. 11-18-16: CR 16-051: cr. Register July 2017 No. 739, eff. 8-1-17.

DCF 52.42 DCF 52.42 Behavior management and control.

DCF 52.42(1) (1) Definitions. In this section:

DCF 52.42(1)(a) (a) “Behavior management and control” means techniques, measures, interventions and procedures applied in a systematic fashion to prevent or interrupt a resident’s behavior which threatens harm to the resident or others or to property and which promote positive behavioral or functional change fostering resident self-control.

DCF 52.42(1)(b) (b) “Informed consent document” means a document signed by a resident’s parent or guardian and legal custodian or under a court order or under another lawful authority which gives written informed consent for use of a locked unit for a resident based on the following:

DCF 52.42(1)(b)1. 1. Stated reasons why the intervention is necessary and why less restrictive alternatives are ineffective or inappropriate.

DCF 52.42(1)(b)2. 2. The behaviors needing modification.

DCF 52.42(1)(b)3. 3. The behavior outcomes desired.

DCF 52.42(1)(b)4. 4. The amount of time in each day and length of time in days or months the resident is expected to remain in the locked unit.

DCF 52.42(1)(b)5. 5. The time period for which the informed consent is effective.

DCF 52.42(1)(b)6. 6. The right to withdraw informed consent at any time verbally or in writing and possible consequences for the center and resident if consent is withdrawn.

DCF 52.42(1)(c) (c) “Locked unit” means a ward or wing designated as a protective environment in which treatment and services are provided and which is secured by means of a key lock in a manner that prevents residents from leaving the unit at will. A facility locked for purposes of external security is not a locked unit provided that residents may exit at will.

DCF 52.42(1)(d) (d) “Emergency safety intervention” means that a staff member physically intervenes with a resident when the resident’s behavior presents an imminent danger of harm to self or others and physical restraint or physically enforced separation is necessary to contain the risk and keep the resident and others safe.

DCF 52.42(1)(e) (e) “Physically enforced separation” means that a resident is temporarily physically removed to a time-out room or area including, where applicable, a locked unit. “Physically enforced separation” does not include sending a resident on the resident’s own volition to the resident’s room or another area for a cooling off period as part of a de-escalation technique.

DCF 52.42(1)(f) (f) “Physical hold restraint” means that a resident is temporarily physically restrained by a staff member.

DCF 52.42(1)(g) (g) “Time-out room” means a designated room used for temporarily holding a resident who is in physically enforced separation from other residents.

DCF 52.42(2) (2) Monitor and review responsibility.

DCF 52.42(2)(a) (a) A center shall assign to a professional staff member the responsibility to monitor and review, on an ongoing basis, the use of all center behavior management measures identified under par. (b) for appropriateness and consistency.

DCF 52.42(2)(b) (b) Monitoring and review shall cover violation of house rules and their resulting consequences, the use of physical hold restraint and physically enforced separation in emergency safety intervention, the use of a locked unit when used to facilitate a resident’s treatment plan under sub. (7) (a) 3., and all related center policies and procedures.

DCF 52.42(3) (3) Conduct of residents. A center shall have written policies and procedures covering the conduct expected of residents. The policies and procedures shall do all of the following:

DCF 52.42(3)(a) (a) Promote the growth, development and independence of residents.

DCF 52.42(3)(b) (b) Address the extent to which a resident’s choice will be accommodated in daily decision making. There shall be an emphasis on self-determination and self-management.

DCF 52.42(3)(c) (c) Specify center behavior management techniques and approaches available to change, eliminate or modify the behaviors or conditions identified in the center’s program statement and operating plan required under s. DCF 52.41 (1).

DCF 52.42(3)(d) (d) Specify criteria for levels of supervision of activities, including off-grounds activities. These criteria shall be directed at protecting the safety and security of residents, center staff, visitors and the community.

DCF 52.42(3)(e) (e) Provide for making a record of a resident’s off-grounds activities. The record shall include where the resident will be, duration of the visit, the name, address and phone number of the person responsible for the resident and expected time of the resident’s return.

DCF 52.42(3)(f) (f) Specify house rules for the residents. The house rules shall include all of the following:

DCF 52.42(3)(f)1. 1. A general description of acceptable and unacceptable conduct.

DCF 52.42(3)(f)2. 2. Curfew requirements.

DCF 52.42(3)(f)3. 3. A resident’s individual freedoms when the resident is involved in recreational or school activities away from the center.

DCF 52.42(3)(f)4. 4. Consequences for a resident who violates a house rule.

DCF 52.42 Note Note: There is a difference between a patient right and a privilege. Deprivation of a privilege such as watching television, playing video games, going to the movies or involvement in some other recreational activity may be used as a disciplinary measure.

DCF 52.42(3)(g) (g) Provide for distribution of the house rules to all staff and to all residents and their parents or guardians.

DCF 52.42(4) (4) Prohibited measures. Center staff may not employ any cruel or humiliating measure such as any of the following:

DCF 52.42(4)(a) (a) Physically hitting or harming a resident.

DCF 52.42(4)(b) (b) Requiring physical exercise such as running laps or doing push-ups or other activities causing physical discomfort such as squatting or bending, or requiring a resident to repeat physical movements or assigning the resident unduly strenuous physical work.

DCF 52.42(4)(c) (c) Verbally abusing, ridiculing or humiliating a resident.

DCF 52.42(4)(d) (d) Denying shelter, clothing, bedding, a meal, or a menu item, center program services, emotional support, sleep or entry to the center.

DCF 52.42(4)(e) (e) Use of a chemical or physical restraint or physically enforced separation or a time-out room as punishment.

DCF 52.42(4)(f) (f) Authorizing or directing another resident to employ behavior management techniques on a resident.

DCF 52.42(4)(g) (g) Penalizing a group for an identified group member’s misbehavior.

DCF 52.42(5) (5) Emergency safety intervention.

DCF 52.42(5)(a) (a) A center staff member may not use any type of physical restraint or physically enforced separation on a resident unless the resident’s behavior presents an imminent danger of harm to self or others and physical restraint is necessary to contain the risk and keep the resident and others safe.

DCF 52.42(5)(ae) (ae) A center staff member shall attempt other feasible alternatives to de-escalate a child and situation before using physical restraint or physically enforced separation.

DCF 52.42(5)(am) (am) A center staff member may not use physical restraint or physically enforced separation as disciplinary action, for the convenience of center staff, or for therapeutic purposes.

DCF 52.42(5)(as) (as) If physical restraint is necessary under par. (a), a center staff member may only use the physical restraint in the following manner:

DCF 52.42(5)(as)1. 1. With the least amount of force necessary and in the least restrictive manner to manage the imminent danger of harm to self or others.

DCF 52.42(5)(as)2. 2. That lasts only for the duration of time that there is an imminent danger of harm to self or others.