Chapter DHS 50

DHS 50.02(18) (18) “Physical restraint” means any manual method, such as a basket hold, or a mechanical device that the individual cannot remove easily and that is intended to limit independent functioning, restrict the freedom of movement or normal range of motion of one or more limbs or the entire body, but not including any of the following:

DHS 50.02(18)(a) (a) Mechanical supports used to enhance independent functioning or achieve proper body position, balance, or alignment, such as arm splints to reduce contractures or leg braces to support the legs while standing or walking.

DHS 50.02(18)(b) (b) Physical guidance and prompting techniques of brief duration.

DHS 50.02(19) (19) “Program” means a YCSF’s treatment and services component.

DHS 50.02(19g) (19g) “Signature” or “signed” means a signature that meets the requirements in s. 990.01 (38), Stats.

DHS 50.02(19r) (19r) 

DHS 50.02(19r)(a) (a) “Telehealth” means the use of telecommunications technology by a certified provider to deliver services allowable under this chapter, s. DHS 107.02 (5), and ss. 49.45 (61) and 49.46 (2) (b) 21. to 23., Stats., including assessment, diagnosis, consultation, treatment, or transfer of medically relevant data in a functionally equivalent manner as that of an in-person contact.

DHS 50.02(19r)(b) (b) “Telehealth” may include real-time interactive audio-only communication.

DHS 50.02(19r)(c) (c) “Telehealth” does not include communication between a certified provider and a recipient that consists solely of an electronic mail, text, or facsimile transmission.

DHS 50.02(20) (20) “Trauma-informed” means a service, or the provision of a service, in a manner that demonstrates an understanding of, and attentiveness to, a youth’s trauma history and background and how those impact the youth’s treatment needs. Trauma-informed services recognize the impact of trauma on a youth’s behavior. Trauma-informed care prioritizes addressing and minimizing the impact of trauma in a youth’s life.

DHS 50.02(21) (21) “Youth” means an individual under the age of 18 who is being treated at, or seeking treatment from, a YCSF.

DHS 50.02(22) (22) “Youth crisis stabilization facility” or “YCSF” has the meaning given in s. 51.042(1)(b), Stats.

DHS 50.02 History History: EmR1922: emerg. cr., eff. 11-2-19; CR 19-077: cr. Register July 2020 No. 775, eff. 8-1-20; correction in (2) (f), (9), (12), (13) (a), (b), (15) (b) 1., (18) (a) made under s. 35.17, Stats., Register July 2020 No. 775; CR 23-053: cr. (10m), (19g), (19r) Register September 2023 No. 813, eff. 10-1-23.

DHS 50.03 DHS 50.03 Certification.

DHS 50.03(1) (1) General. No person or entity may operate a YCSF without successfully completing a background check verified by the Office of Caregiver quality and obtaining a certification from the department. A YCSF that has a certification from the department under this section is not subject to facility regulation under ch. 48, Stats.

DHS 50.03 Note Note: Information about obtaining a background check is available at: https://www.dhs.wisconsin.gov/caregiver/cbcprocess.htm.

DHS 50.03(2) (2) Application. A YCSF may apply for a certification by submitting all of the following application materials to the department at the address given on the application:

DHS 50.03(2)(a) (a) A completed application form.

DHS 50.03 Note Note: Application forms are available at https://www.dhs.wisconsin.gov/regulations/mentalhealth/certification.htm.

DHS 50.03(2)(b) (b) Payment for the application fee required under s. 51.04, Stats.,

DHS 50.03 Note Note: Fee information is available at https://www.dhs.wisconsin.gov/regulations/mentalhealth/certification.htm.

DHS 50.03(2)(c) (c) A program statement as specified under s. DHS 50.05.

DHS 50.03(2)(e) (e) A copy of the youth crisis stabilization facility’s policies and procedures, as specified under s. DHS 50.06.

DHS 50.03(2)(f) (f) A floor plan of the YCSF, specifying dimensions, exits, and planned room usage.

DHS 50.03(2)(g) (g) All inspection reports completed during the last 12 months as defined in ss. DHS 50.15 to 50.18.

DHS 50.03(2)(h) (h) Proof of building insurance, risk, and liability insurance, and agency-owned vehicle insurance if transporting youth.

DHS 50.03(2)(i) (i) Payment of any forfeitures, fees, or assessments related to any licenses or certifications issued by the department to the applicant, or a written statement signed by an authorized representative stating that no fees, forfeitures, assessments are owed.

DHS 50.03(2)(j) (j) Any other applicable fees.

DHS 50.03(2)(k) (k) Any additional information requested by the department.

DHS 50.03(3) (3) Compliance review. Upon receipt of all completed application materials described in (2), the applicant shall permit the department to conduct an on-site inspection of the facility and a review of any documentation necessary to determine compliance with this chapter.

DHS 50.03(4) (4) Certification Determination.

DHS 50.03(4)(a) (a) The department shall make a certification determination within 60 days of receiving all completed application materials.

DHS 50.03(4)(b) (b) If the department does not approve the YCSF’s program statement or determines that an applicant does not comply with the requirements of this chapter, the department may deny the certification. A denial of certification shall be in writing and shall contain the reason for the denial and notice of opportunity for a hearing under s. 227.42, Stats.

DHS 50.03(4)(c) (c) The department may limit the number of certificates issued pursuant to s. 51.042 (2) (a), Stats.

DHS 50.03(5) (5) Notification of changes. A YCSF that has received certification from the department shall notify the department of any change of administration, ownership, program name, or any other change that may affect compliance with this chapter before the effective date of the change. A certification is non-transferable. A new application will be required if the department determines there is a substantial change in the YCSF.

DHS 50.03(6) (6) Duration of certification.

DHS 50.03(6)(a) (a) A certification is valid until suspended or terminated by the department.

DHS 50.03(6)(b) (b) A certification becomes invalid upon non-payment of biennial fees.

DHS 50.03(6)(c) (c) A certification becomes invalid upon suspension or termination by the department.

DHS 50.03(6)(d) (d) A certification may be suspended or terminated under sub. (10).

DHS 50.03(7) (7) Biennial report and fees.

DHS 50.03(7)(a) (a) Every 24 months, by the date of renewal, the program shall submit a biennial report on the form provided by the department, and shall submit payment of certification continuation fees for the purpose of renewing certification of the program for two years.

DHS 50.03(7)(b) (b) The department will send the re-certification materials to the provider, which the provider is expected to fill out and submit to the department according to instructions provided.

DHS 50.03(7)(c) (c) A certification will be suspended or terminated if biennial reports are not submitted prior to the end of the biennial cycle.

DHS 50.03(8) (8) YCSF inspections. The YCSF shall permit unannounced, on-site inspections of the site by the department to conduct program reviews, complaint investigations involving any aspect of the YCSF, death investigations, or to determine a YCSF’s progress in correcting a deficiency cited by the department. The department may use a random selection process for reviewing client records during program reviews. Complaint-driven program reviews shall include the records related to the complaint and may include additional records and interviews.

DHS 50.03(9) (9) Notice of deficiencies.

DHS 50.03(9)(a) (a) If the department determines that a YCSF has a deficiency, the department shall issue a notice of deficiency to the YCSF within 10 business days. The notice of deficiency may place restrictions on the YCSF or its activities, or suspend or terminate the YCSF’s certification, pursuant to sub. (10).

DHS 50.03(9)(b) (b) The YCSF shall submit a plan of correction to the department within 10 business days as indicated in the notice of deficiency. The plan of correction shall propose the specific steps the YCSF will take to correct the deficiency, the timelines within which the corrections will be made, and the licensed professional staff members who will implement the plan and monitor for future compliance.

DHS 50.03(9)(c) (c) If the department determines that the plan of correction submitted by the YCSF does not adequately address the deficiencies listed in the notice of deficiency, the department may request a new plan of correction from the YCSF or may impose a plan of correction.

DHS 50.03(10) (10) Termination and suspension of certification.

DHS 50.03(10)(a) (a) The department may terminate certification at any time for major deficiency by issuing a notice of termination to the YCSF. The notice shall specify the reason for the department action and the appeal information under sub. (11).

DHS 50.03(10)(b) (b) The department may suspend a YCSF’s certification if the department determines that immediate action is required to protect the health, safety, and welfare of youth. Written notice of suspension shall specify the reason for the department action and the date the action becomes effective. Within 10 business days after the order is issued, the department shall either lift or impose conditions on the suspension of the YCSF’s certification or proceed to terminate the YCSF’s certification.

DHS 50.03(11) (11) Appeals.

DHS 50.03(11)(a) (a) If the department denies, suspends, or terminates certification, or imposes conditions on a certification, the YCSF may request a hearing under ch. 227, Stats.

DHS 50.03(11)(b) (b) An applicant for YCSF certification does not have a right to appeal when all of the following apply:

DHS 50.03(11)(b)1. 1. The issue is the denial of the application for certification.

DHS 50.03(11)(b)2. 2. The department has determined to limit the number of YCSFs statewide.

DHS 50.03(11)(b)3. 3. The addition of the facility would exceed the limit determined by the department.

DHS 50.03 History History: EmR1922: emerg. cr., eff. 11-2-19; CR 19-077: cr. Register July 2020 No. 775, eff. 8-1-20; correction in (2) (g), (6) (d), (9) (a), (10) (a) made under s. 35.17, Stats., Register July 2020 No. 775.

DHS 50.04 DHS 50.04 Variance and waiver.

DHS 50.04(1) (1) In this section:

DHS 50.04(1)(a) (a) “Variance” means an alternate means of meeting a requirement in this chapter.

DHS 50.04(1)(b) (b) “Waiver” means an exemption from a requirement of this chapter.

DHS 50.04(2) (2) The department may grant a waiver or variance if the department determines that the proposed waiver or variance will not diminish the effectiveness of the services provided and will not jeopardize the health, safety, welfare, or rights of any youth. The department may specify a timeframe or time limit for the waiver. A request for a variance or waiver must be submitted on a form provided by the department.

DHS 50.04 Note Note: A variance and waiver request form is available by accessing https://www.dhs.wisconsin.gov/library/f-60289.htm.

DHS 50.04(3) (3) The department may rescind or limit a waiver or variance at any time by notifying the YCSF, if any of the following occurs:

DHS 50.04(3)(a) (a) The department determines the waiver or variance has adversely affected or is likely to adversely affect the health, safety or welfare of the youths.

DHS 50.04(3)(b) (b) The YCSF fails to comply with any of the conditions of the waiver or variance as granted.

DHS 50.04(4) (4) The department shall inform a YCSF in writing if it rescinds or limits a waiver or variance.

DHS 50.04 History History: EmR1922: emerg. cr., eff. 11-2-19; CR 19-077: cr. Register July 2020 No. 775, eff. 8-1-20.

DHS 50.05 DHS 50.05 Program Statement. A program statement shall contain all of the following:

DHS 50.05(1) (1) A description of how the YCSF fits into a continuum of care for youth crisis stabilization and treatment services.

DHS 50.05(2) (2) A description of services the program intends to provide, including all of the following:

DHS 50.05(2)(a) (a) Referral and screening procedures.

DHS 50.05(2)(b) (b) Intake procedures, including medication review.

DHS 50.05(2)(c) (c) Assessment and treatment planning, including assessment of risk factors and safety planning for youth.

DHS 50.05(2)(d) (d) Treatment services, including crisis prevention and emotional regulation, including, if applicable, a description of any services that will be delivered in a group setting.

DHS 50.05(2)(e) (e) Care coordination.

DHS 50.05(2)(f) (f) Discharge planning, including any linkages and follow-up.

DHS 50.05(3) (3) A description of the therapeutic environment the program proposes to create, its intended therapeutic benefits, and the rationale supporting its use for the youth served by the YCSF. This description shall include:

DHS 50.05(3)(a) (a) Any evidence-based practices and other services to be implemented at the YCSF. The description should include a rationale for how the services will help the youth population achieve and sustain positive outcomes.

DHS 50.05(3)(b) (b) A plan for coordination of any services that will be provided through outside providers, including with any of a youth’s current providers.

DHS 50.05(4) (4) A description of how the YCSF and its services are trauma-informed, strengths-based, and culturally responsive.

DHS 50.05(5) (5) A description of how the YCSF encourages involvement of families and caregivers in treatment planning and services, and involves individuals authorized to participate in the treatment planning and services.

DHS 50.05(6) (6) A description of the YCSF’s process for communicating with a youth’s school or educational setting and the measures it will take to facilitate a youth’s ability to stay up to date in educational expectations.

DHS 50.05(7) (7) The proposed schedule of the program, including any times allocated for treatment, recreation, study time, and meals.

DHS 50.05(8) (8) The YCSF’s proposal for meeting staffing level requirements in s. DHS 50.07, the qualifications and roles for each position, and an analysis showing that staffing is adequate to meet the needs of the youth that the program proposes to serve.

DHS 50.05(9) (9) A description of food service and how it will be provided, including at least three meals a day and snacks.

DHS 50.05(10) (10) A description of how the program will offer appropriate indoor and outdoor recreation activities.