Chapter DCF 52

DCF 52.59(4)(d) (d) Staffing arrangements for respite care services.

DCF 52.59(4)(e) (e) Health care arrangements for respite care placements, including the process for securing medical authorizations for general and emergency medical care including surgery.

DCF 52.59(4)(f) (f) Recreational activities and programming for respite care placements.

DCF 52.59(5) (5) Admissions. A center operating a respite care services program shall have all of the following written policies and procedures for admission of a prospective respite care resident:

DCF 52.59(5)(a) (a) A policy regarding the type of respite care children who can be served, such as those who are emotionally disturbed, physically disabled, medically needy, or developmentally disabled, including the specific types of developmental disabilities served.

DCF 52.59(5)(b) (b) Procedures for screening children referred for respite care to ensure that they are appropriate for the center’s respite care program.

DCF 52.59(5)(c) (c) Procedures for obtaining parent or guardian written consents for emergency medical care and authorization for administration of medications.

DCF 52.59(5)(d) (d)

DCF 52.59(5)(d)1. 1. Procedures for obtaining from the parent or other regular caregiver necessary and essential information for the temporary care of the child, which may include medical, behavioral, dietary, or emotional concerns and appropriate responses or instructions. Assessment shall cover at minimum the following areas: eating, toileting, mobility, communication, health problems, behavioral issues, socialization, supervision needs, and personal self-help.

DCF 52.59(5)(d)2. 2. Procedures for obtaining identifying information at the time of admission on the child and the child’s family and information about current special needs of the child, including usual day activities; transportation arrangements; any appointments; current health problems; special equipment used; communication issues; behavioral issues; eating habits, schedule and preferences; sleeping habits and any usual bedtime routine; toileting concerns; safety concerns; discipline or behavioral management recommendations; preferred leisure time activities; and any other comments from the parent or regular caregiver.

DCF 52.59(5)(e) (e) Procedures as described under s. DCF 52.21 (7) for orienting a child to the center’s respite care program, available care staff and room arrangements, and assisting the child in any adjustment issues to the child’s temporary stay.

DCF 52.59(5)(f) (f) Procedures for assigning specific care staff to a respite care child.

DCF 52.59(5)(g) (g) Procedures for contacting the parent or other regular caregiver regarding care questions or in emergency situations.

DCF 52.59(5)(h) (h) A policy on who may pick up the child or youth at the end of respite care and policies and procedures for establishing the date and time at which the child or youth is to be picked up.

DCF 52.59(5)(i) (i) Procedures for making a record of all of the child’s personal belongings and medications upon arrival at the center.

DCF 52.59(5)(j) (j) Procedures for maintaining a log with dates of all respite care episodes for each child.

DCF 52.59(6) (6) Staffing. A center shall assign a staff person to have primarily responsibility for the center’s respite care services program. This person shall have experience in serving the type of disability or population the center serves. Staff-to-child ratios shall at minimum meet the ratio as otherwise prescribed in s. DCF 52.12 or be as needed to meet the needs of the respite care persons in care. The responsible staff person shall have access to medical, psychiatric, dietary and social services consultation as needed.

DCF 52.59(7) (7) Written care plan.

DCF 52.59(7)(a) (a) Written care plan. A center shall develop a written plan of care for each child admitted to the center for respite care.

DCF 52.59(7)(b) (b) Planning for the child.

DCF 52.59(7)(b)1. 1. The written care plan shall be prepared in consultation with the child’s parent or other regular caregiver and prior to placement, except if the reason for placement is of a crisis emergency nature.

DCF 52.59(7)(b)2. 2. The written care plan shall provide for necessary service supports to meet social, emotional adjustment, medical, and dietary needs; physical environment accommodation; means for the respite care child to contact the child’s parent or other regular caregiver; accommodations to meet physical disabilities such as requiring, if needed by the child, a TTY device for the hearing impaired, handrails, or visual devices; and a planned variety of recreational activities. The educational needs of the child shall be attended to while in placement as prescribed by the parent or other regular caregiver.

DCF 52.59(7)(c) (c) Length of stay. A respite care placement shall not extend beyond 9 days per episode unless department approval is first obtained.

DCF 52.59(8) (8) Discharge. When a child is discharged from respite care, the residential care center shall document all of the following in the child’s respite care record:

DCF 52.59(8)(a) (a) The dates of the child’s stay, a summary of the child’s stay with any significant incidents noted, and the name of the person to whom the child was discharged.

DCF 52.59(8)(b) (b) A list of all personal belongings, medications, and medical equipment that went with the child upon discharge.

DCF 52.59(9) (9) Training and evaluation.

DCF 52.59(9)(a) (a) Training.

DCF 52.59(9)(a)1. 1. Training for staff of a respite care services program shall include training in the areas of arranging for transitional care and transitional placement planning principles and methods.

DCF 52.59(9)(a)2. 2. Staff shall have respite care training designed around the specific needs of individuals for which care is provided, such as autism, epilepsy, cerebral palsy and intellectual disabilities. As part of this training, staff who have not already had some experience working with the type of individual to be cared for shall have at least 8 hours of supervised experience by someone who is knowledgeable in working with the type of individual or more than 8 hours if necessary to ensure the provision of competent care.

DCF 52.59(9)(b) (b) Evaluation. After each respite care episode, a residential care center shall evaluate the care provided through a survey to be completed by the parent or other regular caregiver and, if possible, the child. The center shall use the survey information to improve, as necessary, its respite care services program and shall keep these surveys on file for one year from their completion.

DCF 52.59(10) (10) Client records. A center with a respite care services program shall meet the resident record requirements found under this section and under s. DCF 52.49, except requirements under s. DCF 52.49 (2) (b) 1. a. to g. and 3. A respite care resident’s record shall include all documentation required under this section.

DCF 52.59 History History: Cr. Register, February, 2000, No. 530, eff. 9-1-00; corrections in (3), (5) (e), (6) and (10) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635; CR 14-054: am. (2) (a) to (c), (4) (b), (5) (a), (b), (d) 1., 2., (e), (f), (i), (7) (a), (b), (8), (9) (b) Register April 2015 No. 712, eff. 5-1-15; correction in (7) (b) 2. made under s. 35.17, Stats., Register September 2017 No. 741; 2019 Wis. Act 1: am. (9) (a) 2. Register May 2019 No. 761, eff. 6-1-19; CR 20-003: am. (5) (a) Register July 2020 No. 775, eff. 8-1-20; CR 21-107: am. (5) (d) 2., (7) (b) 2. Register June 2022 No. 798, eff. 7-1-22.

subch. VIII of ch. DCF 52 Subchapter VIII — Need Determination and License Application

DCF 52.61 DCF 52.61 Determination of need for additional beds.

DCF 52.61(1) (1) Authority and purpose. This section is promulgated pursuant to s. 48.60 (3), Stats., to regulate the establishment of new residential care centers for children and youth and to control the expansion of existing residential care centers in order to ensure an adequate number and variety of facilities to meet the needs of Wisconsin children who require out-of-home residential care and to prevent unnecessary expansion of residential care centers and the resulting increase in costs to Wisconsin citizens.

DCF 52.61(2) (2) To whom the rules apply. This section applies to any new applicant for a license to operate a residential care center for children and youth and to existing residential care centers for children and youth wishing to expand the capacity of their facilities.

DCF 52.61(3) (3) Definition. In this section, “applicant” means any person wishing to apply for a license to begin operation of a new residential care center for children and youth or any person wishing to expand the capacity of an existing residential care facility for children and youth. “Applicant” does not include a person who by reason of consolidation or other acquisition acquires control or ownership of beds when the consolidation or other acquisition results in no increase in or a reduction of the existing state-wide residential care center bed capacity.

DCF 52.61(4) (4) Certification of need requirement. No person may apply for a license under s. DCF 52.62 (1) to operate a new residential care center for children and youth or for a license amendment under s. DCF 52.62 (3) to expand the bed capacity of an existing residential care center until the department has reviewed the need for the additional placement resources which would be created and has certified to the applicant in writing that a need exists for the proposed new placement resources.

DCF 52.61(5) (5) Demonstration of need. To enable the department to make a determination of need for a new residential care center for children and youth or for additional beds at an existing residential care center for children and youth, the applicant shall submit all of the following documents and information to the department:

DCF 52.61(5)(a) (a) A detailed plan for the operation of the proposed residential care center which includes all of the following:

DCF 52.61(5)(a)1. 1. The number, sex, and age range of the children to be served.

DCF 52.61(5)(a)2. 2. The type or types of needs or disabilities of children to be served.

DCF 52.61(5)(a)3. 3. The center staffing, including a list of full-time and part-time positions by job titles and numbers.

DCF 52.61(5)(a)4. 4. A description of the proposed program and treatment goals.

DCF 52.61(5)(a)5. 5. A proposed budget, including the current or projected per diem rate.

DCF 52.61(5)(a)6. 6. The location of the center and a drawing of the layout of the physical plant.

DCF 52.61(5)(b) (b) A detailed written description of the methodology and findings which document the reasons why the unserved children under par. (a) cannot be served satisfactorily in less restrictive settings such as is in their own homes with treatment services provided to the children and their families, in specialized treatment foster homes or in group homes.

DCF 52.61(5)(c) (c) Documentation meeting the criteria in sub. (7) (a) 2. that existing Wisconsin residential care center placement resources are not adequate to meet the needs of Wisconsin children who require the type or types of care and treatment services the applicant proposes to provide. No beds occupied or to be occupied by children who are placed primarily for educational purposes may be considered in determining need under this section. Of the remaining beds, for purposes of determining need and establishing waiting lists, not more than 40% shall be considered available for out-of-state children.

DCF 52.61(5)(d) (d) Information that supports the probability that a new or expanded center will be used by Wisconsin placement resources, and that an expanded center will attain and maintain an average monthly occupancy rate of 80% or more over the first 2 years of operation and that a new center will have an average monthly occupancy rate of not less than 80% at the end of the second year.

DCF 52.61 Note Note: The documents and information required by the Department to make a determination of need should be sent to the Bureau of Permanence and Out-of-Home Care, P.O. Box 8916, Madison, WI 53708.

DCF 52.61(6) (6) Publication of notice — party status.

DCF 52.61(6)(a) (a) Upon receipt of the documents and information listed in sub. (5), the department shall publish a class 2 notice under ch. 985, Stats., in the official state newspaper designated under s. 985.04, Stats., and in a newspaper likely to give notice in the area of the proposed center. The notice shall include a statement that the department has received an application for a certificate of need to operate a new residential care center or to expand the bed capacity of an existing residential care center. The notice shall also include the number of additional beds, the geographic area to be served, the types of young people to be accepted for care, the services to be provided and program objectives.

DCF 52.61(6)(b) (b) The notice shall invite the submission of written comments, factual data and reasons why the application should be granted or denied from any person within 30 days after the publication of the notice. The notice shall advise persons submitting written comments to indicate their interest in the application and whether the individual commentator wants to be considered for party status in any later proceedings.

DCF 52.61(7) (7) Need determination.

DCF 52.61(7)(a) (a) Evaluation procedures.

DCF 52.61(7)(a)1. 1. The department shall review the applicant’s documents and information for completeness and may ask the applicant for additional materials or information that the department considers necessary for evaluation purposes.

DCF 52.61(7)(a)2. 2. Except as provided under subd. 3., the administrator of the department’s division of safety and permanence or a designee shall make the need determination decision based on the following criteria:

DCF 52.61(7)(a)2.a. a. The compatibility of the applicant’s proposed plan of operation or expansion with the stated treatment goals for the program.

DCF 52.61(7)(a)2.b. b. The validity of the research methodology used to document need for the proposed program.

DCF 52.61(7)(a)2.c. c. The congruence of the conclusions reached in the applicant’s needs research with department data on current county placement needs and available beds in existing residential care centers for children and youth providing similar services.

DCF 52.61(7)(a)2.d. d. The correctness of the applicant’s contention that the proposed center is more appropriate than less restrictive care arrangements for children.

DCF 52.61(7)(a)2.e. e. The applicant’s documentation supporting the argument that existing Wisconsin residential care centers for children and youth are not adequate to meet the needs of Wisconsin children who require the type or types of care and treatment services the applicant proposes to provide.

DCF 52.61(7)(a)2.f. f. The applicant’s documentation of the probability that the center, if expanded, will attain and maintain an average monthly occupancy rate of at least 80% for the first 2 years of operation or, if new, will attain an average monthly occupancy rate of at least 80% at the end of the second year of operation.

DCF 52.61(7)(a)3. 3. An application for expansion of an existing residential care center for children and youth by 3 or fewer additional beds shall be presumed to meet the criterion under subd. 2. d. unless at least one of the following is true:

DCF 52.61(7)(a)3.a. a. The center submitted another application for expansion of bed capacity in the previous 2 years and that application was approved.

DCF 52.61(7)(a)3.b. b. There is clear and convincing evidence that the criteria under subd. 2. have not been met.

DCF 52.61(7)(b) (b) Notice of determination.

DCF 52.61(7)(b)1. 1. Within 90 calendar days after the date on which all required documents and information were received from an applicant, the department shall send written notice of its determination of need to the applicant and to anyone who commented under sub. (6) (b) on the application. The notice shall state the specific reason for the determination.

DCF 52.61(7)(b)2. 2. If the department determines that there is need for additional beds, the notice shall be accompanied by the department’s certification that a need exists for the proposed new placement resources which entitles the person to apply for a license to operate a new center or to apply for an amended license that will permit the addition of beds at an existing center.

DCF 52.61(7)(b)3. 3. The duration of the approval under subd. 2. shall be limited to 18 months from the date that it is issued, except that the department may grant one 6-month extension if the approved applicant has a good reason for the delay in becoming operational and documents to the satisfaction of the department that it will be operational within that 6-month period. Any request for extension shall be filed before expiration of the initial 18-month period. If the proposed center is not operational during that 18-month time period, or the extended period, the need determination shall be considered invalid and the approval shall be cancelled. In this subdivision, “operational” means in regard to a new center that the center has been licensed under s. DCF 52.62 and that all approved beds meet requirements for operation, and in regard to expansion of an existing center that all additional beds meet requirements for operation and the center is licensed under s. DCF 52.62 to operate with the additional beds. An acceptable reason for an extension under this subdivision shall include unforeseen delay in obtaining adequate financing approval, in staffing or in construction.

DCF 52.61(7)(c) (c) Appeal.

DCF 52.61(7)(c)1. 1. An applicant or a party adversely affected by a determination issued under par. (b) 1. may request an administrative hearing under s. 227.42, Stats., from the department of administration’s division of hearings and appeals by submitting a written request for hearing to that office so that it arrives there within 30 days after the date of the notice under par. (b).

DCF 52.61(7)(c)2. 2. The standard of review for the hearing shall be whether the record contains the quantity and quality of evidence that a reasonable person could accept as adequate to support the decision.

DCF 52.61 Note Note: A request for a hearing may be mailed to Division of Hearings and Appeals, P.O. Box 7875, Madison, WI 53707-7875 or faxed to [phone]. A copy of the request should be sent to Department of Children and Families, Division of Safety and Permanence, P.O. Box 8916, Madison, WI 53703-8916.

DCF 52.61 History History: Cr. Register, February, 2000, No. 530, eff. 9-1-00; corrections in (4) and (7) (b) 3. made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635; EmR1414: emerg. am. (7) (a) 2. c. to e., eff. 8-1-14; CR 14-054: am. (1), (7) (a) 2. c. to e. Register April 2015 No. 712, eff. 5-1-15; CR 21-107: am. (7) (a) 2. (intro.) Register June 2022 No. 798, eff. 7-1-22.

DCF 52.62 DCF 52.62 Licensing administration.

DCF 52.62(1) (1) General conditions for approval of license. An applicant for a license under this chapter shall complete all application forms truthfully and accurately and pay all fees and forfeitures due and owing prior to receiving a license. The department shall issue a residential care center license to an applicant within 60 days based upon receipt and department approval of a properly completed application and a department investigation and determination that the applicant is fit and qualified. Continued licensure requires a licensee to remain fit and qualified. In determining whether an applicant is fit and qualified, the department shall consider any history of civil or criminal violation of statutes or regulations of the United States, this state, or any other state or other offenses substantially related to the care of children or adults by the applicant, owner, manager, representative, employee, center resident, or other individual directly or indirectly participating in the operation of the residential care center. This includes substantiated findings by a county social services or human services department of child abuse or neglect under s. 48.981, Stats., or substantiated reports of abuse of residents or patients under ch. 50, Stats., whether or not it results in criminal charges or convictions.

DCF 52.62(2) (2) Initial license application.

DCF 52.62(2)(a) (a) A person wanting a license to operate a residential care center for children and youth shall apply on a form provided by the department and shall include all information requested on the form and all related materials and information required under par. (c), along with the license fee required under s. 48.615, Stats. A complete application includes completion of all information requested on the application form and all related materials and information required under par. (c) and the license fee.

DCF 52.62 Note Note: An application form may be obtained by writing or telephoning any field office listed in Appendix D. The completed form and required related materials and information and the license fee should be returned to the field office responsible for the county where the center is located.

DCF 52.62(2)(b) (b) A complete application for a license shall be submitted to the department at least 60 days before the date proposed for the center to begin operating.

DCF 52.62(2)(c) (c) An applicant for a license shall submit all of the following information and materials along with the completed application form:

DCF 52.62(2)(c)1. 1. A copy of the certificate of need under s. DCF 52.61 (7) (b).

DCF 52.62(2)(c)2. 2. A statement signed by the applicant agreeing to comply with this chapter.

DCF 52.62(2)(c)3. 3. A completed and signed background information disclosure on a form prescribed by the department.

DCF 52.62 Note Note: DCF-F-2978-E, Background Information Disclosure is available in the forms section of the department’s website at https://dcf.wisconsin.gov/ or by writing or telephoning any field office listed in Appendix D. The background information disclosure form does not need to be notarized.

DCF 52.62(2)(c)4. 4. Diagrammatic floor plans of all center buildings showing all of the following:

DCF 52.62(2)(c)4.a. a. The location of all exits.