Wisconsin Legislature: DHS 75.42(2)(c)

(1) A residential service that provides services to minors shall maintain physically separate and secure living areas for minors and adults, unless there is a documented clinical need for an exception to this age requirement for transitional age youth, and this exception is approved by the service director.

(2) A residential service that provides services to minors shall have a written policy and procedure for addressing the educational needs of each participating minor.

History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.

DHS 75.36 Residential services for parents with residing minors. A residential service that allows for minors to reside at the facility while their parent or guardian receives treatment services at the facility, shall ensure the following:

(1) The service shall have written policies and procedures that address the safety of residing minors, supervision of residing minors, family services and supports, and behavioral expectations and interventions for residing minors.

(2) A residing family shall not share a bedroom with other residents of the service.

(3) A service with residing minors shall have a written policy and procedure for addressing the educational needs of each residing minor.

History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.

DHS 75.37 Emergency medical care for residents.

(1) A residential service shall have written policies and procedures for training staff members in life-sustaining techniques, which may include cardiopulmonary resuscitation, use of an automated external defibrillator, and emergency first aid.

(2) A residential service shall have a written plan for the provision of emergency medical care for patients.

(3) A residential service shall have a written plan for the provision of emergency transportation for patients needing emergency medical services.

(4) Residential service staff shall be trained to implement the plan for emergency medical care and emergency transportation within 14 days of hire and annually thereafter.

History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.

DHS 75.38 Seclusion and restraints.

(1) A service under this chapter is prohibited from the use of seclusion or restraints, unless the service meets all requirements outlined in s. 51.61 (1) (i), Stats.

(2) A service under this chapter is prohibited from the use of seclusion or restraint as part of a treatment program, except in emergency situations as provided in s. 51.61 (1) (i), Stats.

History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.

DHS 75.39 Medications. A residential service shall meet the requirements for medications under s. DHS 75.24 (19) or 83.37, whichever standard is higher. The medication storage area shall be clean, and shall be separated by a wall from any restroom, cleaning products, or any food-preparation or storage area.

History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22; correction made under s. 35.17, Stats., Register October 2021 No. 790.

DHS 75.40 Infection control program. A residential service shall meet the requirements for an infection control program under s. DHS 83.39.

History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.

DHS 75.41 Food service. A residential service shall meet the requirements for food service under s. DHS 83.41.

History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.

DHS 75.42 Physical environment.

(1) A residential service shall meet the requirements for physical environment under ss. DHS 83.43 to 83.46.

(2) A residential service that provides physical examinations or medical services shall have a patient examination or medical room. The patient examination or medical room shall contain all of the following:

(a) A wall that physically separates the patient examination or medical room from other bedrooms, living areas, staff areas, or facility common areas.

(b) A curtain for privacy.

(d) A medical examination table.

(3) A residential service that has a patient examination or medical room shall have written policies and procedures in place to ensure the room is appropriate for physical examinations or medical services. These polices shall, at minimum, contain provisions for all of the following:

(a) Removal of soiled linens after each use.

(b) Cleaning of surfaces, equipment, and floors after each use.

History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.

DHS 75.43 Safety.

(1) A residential service shall meet the requirements for safety under ss. DHS 83.47 to 83.51.

(2) A residential service shall have written policies and procedures for ensuring that the facility and staffing arrangements are adequate for the needs of the population to be served. Policies and procedures shall include:

(a) Safety of facility entrances and exits.

(b) Facility design such as ligature risk prevention, tamper-resistant electrical outlets, control of sharps, impact resistant glass, and anchoring of furniture.

(d) Levels of staff observation required to address patient needs.

(e) Co-mingled populations.

(3) Policies and procedures shall be reviewed annually, and any required modifications shall be completed.

History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.

DHS 75.44 Guests and visitors. A residential service shall have written policies and procedures regarding guests and visitors. Policies and procedures shall include:

(1) Areas prohibited from guest and visitor access.

(2) Procedures to ensure confidentiality for service patients.

(3) Management of risks such as the delivery of drugs or alcohol by guests and visitors, the possession or delivery of weapons or other contraband by guests and visitors, or potential violent behavior of guests or visitors.

History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.

DHS 75.45 Building design. A residential service shall meet the requirements for building design under ss. DHS 83.52 to 83.61.

History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.

DHS 75.46 Requirements for new construction, remodeling, additions, or newly-certified existing structures. A residential service shall meet the requirements for building design under ss. DHS 83.62 to 83.64.

History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.

Subchapter VI — Additional Requirements for Treatment Service Levels of Care

DHS 75.47 Applicability of other requirements.

(1) Relationship to treatment service general requirements. The requirements for a treatment service provided in subch. IV apply to this subchapter as the minimum standards for any service in this subchapter. If a requirement in any section of this subchapter is inconsistent with, or poses a more restrictive standard than a similar provision in subch. IV, the requirement is this subchapter shall control.

(2) Relationship to residential service facility requirements. The requirements for a residential treatment service provided in subch. V apply to this subchapter as the minimum standards for residential services under this subchapter. If a requirement regarding any residential services in this subchapter is inconsistent with, or poses a more restrictive standard than a similar provision in subch. V, the requirement is this subchapter shall control.

History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.

DHS 75.48 Service requirements by level of care tables.

(1) Table 75.48 (1) establishes additional requirements for outpatient levels of care.

(2) Table 75.48 (2) establishes additional requirements for residential levels of care.

(3) Table 75.48 (3) establishes additional requirements for residential withdrawal management levels of care.

History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22; correction in (2) (d) made under s. 35.17, Stats., Register October No 790.

DHS 75.49 Outpatient substance use treatment service.

(1) Service description. In this section, “outpatient substance use treatment service” means a non-residential treatment service totaling less than 9 hours of treatment services per patient per week for adults and less than 6 hours of treatment services per patient per week for minors, in which substance use treatment personnel provide screening, assessment, and treatment for substance use disorders. Outpatient substance use treatment services may include intake, evaluation and diagnosis, medication management, nursing services, case management, drug testing, counseling, individual therapy, group therapy, family therapy, psychoeducation, vocational services, peer support services, recovery coaching, outreach activities, and recovery support services to ameliorate symptoms and restore effective functioning.

(2) Location of service delivery.

(a) An outpatient substance use treatment service may provide services at one or more offices. If a service provides outpatient substance use treatment services at more than one office, all of the following shall apply:

1. The service shall designate one office as its main office.

2. All notices under this chapter will be sent to the main office.

3. Each office providing the service shall comply with the applicable requirements of this chapter.

4. The service shall adopt written policies and procedures to ensure that the service director is able to carry out the oversight and other responsibilities specified under s. DHS 75.18 (1) with respect to all other offices.

(b) A service may provide outpatient substance use treatment services in the community or other locations, provided all requirements of this chapter are able to be met in the setting.

(c) A service that provides outpatient substance use treatment services in the community shall have written policies and procedures for community-based service delivery.

(d) A service that provides outpatient substance use treatment services in the community shall provide annual training for all staff that deliver services in the community regarding in-home and community safety, and avoiding sexual or other exploitative relationships with patients. A record of each training shall be available to the department upon request.

History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22; correction in (2) (b) made under s. 35.17, Stats., Register October 2021 No. 790.

DHS 75.50 Outpatient integrated behavioral health treatment service.

(1) Service description. In this section, “outpatient integrated behavioral health treatment service” means a non-residential treatment service totaling less than 9 hours of treatment services per patient per week for adults, and less than 6 hours of treatment services per patient per week for minors, in which substance use and mental health treatment personnel provide screening, assessment and treatment for substance use and mental health disorders. Patients in this setting may receive treatment services for a substance use disorder, a mental health disorder, or both. Outpatient integrated behavioral health treatment services may include intake, evaluation and diagnosis, medication management, nursing services, case management, drug testing, counseling, individual therapy, group therapy, family therapy, psychoeducation, vocational services, peer support services, recovery coaching, outreach activities, and recovery support services to ameliorate symptoms and restore effective functioning.

(2) Combined certification. Certification for this level of care shall not be located with s. DHS 75.49 outpatient substance use treatment service or with a ch. DHS 35 community mental health treatment service at the same service location.

(3) Location of service delivery.

(a) An outpatient integrated behavioral health treatment service may provide services at one or more offices. If a service provides outpatient substance use treatment services at more than one office, all of the following shall apply:

1. The service shall designate one office as its main office.

2. All notices under this chapter will be sent to the main office.

3. Each office providing the service shall comply with the applicable requirements of this chapter.

(b) A service may provide outpatient integrated behavioral health treatment services in the community or other locations, provided all requirements of this chapter are able to be met in the setting.

(c) A service that provides outpatient integrated behavioral health treatment services in the community shall have written policies and procedures for community-based service delivery.

(d) A service that provides outpatient integrated behavioral health treatment services in the community shall provide annual training for all staff that deliver services in the community regarding in-home and community safety, and avoiding sexual or other exploitative relationships with patients. A record of each training shall be available to the department upon request.