Wisconsin Legislature: DHS 50.05(4)

(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.

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

1. The issue is the denial of the application for certification.

2. The department has determined to limit the number of YCSFs statewide.

3. The addition of the facility would exceed the limit determined by the department.

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 Variance and waiver.

(1) In this section:

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

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

(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.

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

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

(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.

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

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

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

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

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

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

(a) Referral and screening procedures.

(b) Intake procedures, including medication review.

(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.

(e) Care coordination.

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

(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:

(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.

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

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

(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.

(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.

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

(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.

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

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

(11) A description of methods used to evaluate services.

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

Subchapter II - Program Requirements

DHS 50.06 Required Policies. A YCSF must have written policies and procedures for the following:

(1) Admission policy and criteria, including ages and gender of youth served, and how bedrooms will be allocated.

(2) Utilization review policy addressing determination of need and length of stay, frequency of review, and other utilization policy as needed. The YCSF is meant to be a short-term crisis stabilization facility. If utilization reviews show that a youth requires stabilization longer than a 30-day period, approval from the department must be obtained.

Note: Approval may be requested at: https://www.dhs.wisconsin.gov/mh/ycsf.htm.

(3) Policy on prescriber consulting relationships and processes to access consultation with a physician, psychiatrist, physician’s assistant, or advanced practice nurse prescriber, to prescribe or consult on psychiatric medications of youths. This can include a youth’s own provider.

(4) Policy on how medications will be stored, secured, managed, and administered, and which staff is responsible. A description of how medical conditions, if any, will be managed.

(5) Policy on medical emergencies.

(6) Policy on clinical supervision, per s. DHS 50.09.

(7) Policies for youths’ personal possessions, communication devices including phones, electronics usage, room searches, or other applicable policies.

(8) Facility rules, provided to youth and staff.

(9) Where client records will be maintained and how confidentiality requirements of those records will be safeguarded, as required under s. DHS 50.14.

(10) Policy on how the YCSF will address safety concerns specific to the youth being served.

(11) Policy on emergency safety interventions. This policy must comply with s. DHS 50.12. It must specify alternative interventions, best practices, and how the YCSF plans to implement emergency safety interventions. If seclusion or restraint will be used, it must provide a description of how it will be handled procedurally and for seclusion where the intervention will occur.

(11m) Policy on telehealth, including when telehealth can be used and by whom, patient privacy and information security considerations, and the right to decline services provided via telehealth.

History: EmR1922: emerg. cr., eff. 11-2-19; CR 19-077: cr. Register July 2020 No. 775, eff. 8-1-20; CR 23-053: cr. (11m) Register September 2023 No. 813, eff. 10-1-23.

DHS 50.07 Personnel.

(1) Policies.

(a) A YCSF shall have written personnel policies.

(b) A YCSF shall maintain written documentation of employee qualifications and shall make that information available upon request for review by youths and their representatives or parents, and by the department.

(2) General qualifications.

(a) Qualified staff shall comply with s. DHS 34.21 (3) (b) 1. to 19. and must follow current department of safety and professional services standards for licensure and scope of practice.

(b) Peer specialists or parent peer specialists must be trained in accordance with s. DHS 34.21 (8) (a) to (d).

(c) Each staff member shall have the professional certification, training, experience, and ability to carry out his or her assigned duties as documented through the following steps:

1. Each applicant must pass a state background check as provided in s. 50.065, Stats. and ch. DHS 12, before being allowed to work for the YCSF. If the applicant lived in another state, a background check shall be obtained from that state as well.

2. Programs shall comply with caregiver misconduct reporting and investigation requirements in ch. DHS 13.

3. Each staff responsible for transporting youth shall have a valid Wisconsin driver’s license and a driving record free of any violations specified in ss. 346.62 or 346.63, Stats, in the past 12 months.

Note: For a state of Wisconsin background check, obtain the name, sex, race, and date of birth of the person about whom you are requesting the check. Information on the process and fees for a background check can be found online at https://www.dhs.wisconsin.gov/caregiver/cbcprocess.htm.

(3) Required personnel.

(a) Program administrator. Each YCSF shall have a program administrator who is responsible for the overall YCSF operations and ensuring that the YCSF is in compliance with this chapter and other applicable state and federal laws.

(b) Clinical coordinator. Each YCSF shall have a clinical coordinator who is responsible for the mental health services provided by the program and for ensuring that all staff members providing mental health services have the qualifications required for their roles in the program and comply with all requirements relating to assessment, treatment planning, service delivery, and service documentation. The clinical coordinator shall be qualified under s. DHS 34.21 (3) (b) 1. to 8. The program administrator may also serve as the clinical coordinator.

(c) Required designee. The program administrator shall identify one or more staff members to whom authority may be delegated in the absence of the clinical coordinator. The designee must be qualified under s. DHS 34.21 (3) (b) 1. to 8.

(d) Staffing requirements.

1. The program administrator, clinical coordinator, or designee must be available for consultation 24/7 either on site, by phone, or by other means.

2. At all times that youth are present at a YCSF, the program shall have a minimum of two staff members present that are qualified under s. DHS 50.07 (2). At least one of the two staff members present must meet one of the requirements from s. DHS 34.21 (3) (b) 1. to 14.

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

DHS 50.08 Orientation and Training.

(1) Initial and ongoing orientation and training requirements must comply with s. DHS 34.21 (8) (a) to (d).

(2) Training must include review of this chapter, including review and training on all YCSF policy and procedures, program statement, and other pertinent information.

(3) Training must include content specific to youth in crisis and their treatment needs.

(4) Training for standard precautions, fire safety, first aid and choking, and medication administration and management is required and must comply with s. DHS 83.20 (1) and (2).

(5) Training must include emergency safety interventions per s. DHS 50.12 and include de-escalation techniques, redirection, and other preventative techniques.

(6) Staff must be trained on mandated reporting requirements. YCSF staff are considered mandated reporters under ss. 48.981 (2) (a) to (c), Stats.

(7) As part of its central administrative records, a YCSF shall maintain updated, written copies of its orientation program, evidence of current licensure and certification of professional staff, and documentation of orientation and ongoing training received by program staff and volunteers.

History: EmR1922: emerg. cr., eff. 11-2-19; CR 19-077: cr. Register July 2020 No. 775, eff. 8-1-20; correction in (2), (4) made under s. 35.17, Stats., Register July 2020 No. 775.

DHS 50.09 Clinical Supervision.

(1) The clinical coordinator shall be responsible for oversight of the job performance and actions of each staff member who is providing clinical services and support services, and for ensuring staff compliance with all laws and regulations governing care and treatment as well as the standards of practice of their individual professions.

(2) Each YCSF shall develop and implement a written policy for clinical supervision and clinical collaboration designed to provide sufficient guidance to assure the delivery of effective services. The policy shall address all of the following:

(a) A method of assessing and evaluating treatment needs and outcomes to determine if treatment provided is effective, and a system to identify any necessary corrective measures and make changes to improve progress.

(b) Identification of clinical issues, including incidents that pose a significant risk of an adverse outcome for youth that should warrant clinical collaboration, or clinical supervision that is in addition to the supervisions specified under ch. MPSW 4, 12, or 16, or ch. Psy 2, or for a recognized psychotherapy practitioner, whichever is applicable.

(3) Clinical supervision must be provided by staff meeting the qualifications under s. DHS 34.21 (3) (b) 1. to 8.