Chapter DHS 75

DHS 75.36 History History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.

DHS 75.37 DHS 75.37 Emergency medical care for residents.

DHS 75.37(1) (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.

DHS 75.37(2) (2) A residential service shall have a written plan for the provision of emergency medical care for patients.

DHS 75.37(3) (3) A residential service shall have a written plan for the provision of emergency transportation for patients needing emergency medical services.

DHS 75.37(4) (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.

DHS 75.37 History History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.

DHS 75.38 DHS 75.38 Seclusion and restraints.

DHS 75.38(1) (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.

DHS 75.38(2) (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.

DHS 75.38 History History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.

DHS 75.39 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.

DHS 75.39 History 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 DHS 75.40 Infection control program. A residential service shall meet the requirements for an infection control program under s. DHS 83.39.

DHS 75.40 History History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.

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

DHS 75.41 History History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.

DHS 75.42 DHS 75.42 Physical environment.

DHS 75.42(1) (1) A residential service shall meet the requirements for physical environment under ss. DHS 83.43 to 83.46.

DHS 75.42(2) (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:

DHS 75.42(2)(a) (a) A wall that physically separates the patient examination or medical room from other bedrooms, living areas, staff areas, or facility common areas.

DHS 75.42(2)(b) (b) A curtain for privacy.

DHS 75.42(2)(c) (c) A functioning sink that is equipped with appropriate equipment and supplies for infection prevention.

DHS 75.42(2)(d) (d) A medical examination table.

DHS 75.42(3) (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:

DHS 75.42(3)(a) (a) Removal of soiled linens after each use.

DHS 75.42(3)(b) (b) Cleaning of surfaces, equipment, and floors after each use.

DHS 75.42(3)(c) (c) Designating the room as an examination or medical room and prohibiting non-medical uses of the room.

DHS 75.42 History History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.

DHS 75.43 DHS 75.43 Safety.

DHS 75.43(1) (1) A residential service shall meet the requirements for safety under ss. DHS 83.47 to 83.51.

DHS 75.43(2) (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:

DHS 75.43(2)(a) (a) Safety of facility entrances and exits.

DHS 75.43(2)(b) (b) Facility design such as ligature risk prevention, tamper-resistant electrical outlets, control of sharps, impact resistant glass, and anchoring of furniture.

DHS 75.43(2)(c) (c) Search of patients and property.

DHS 75.43(2)(d) (d) Levels of staff observation required to address patient needs.

DHS 75.43(2)(e) (e) Co-mingled populations.

DHS 75.43(3) (3) Policies and procedures shall be reviewed annually, and any required modifications shall be completed.

DHS 75.43 History History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.

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

DHS 75.44(1) (1) Areas prohibited from guest and visitor access.

DHS 75.44(2) (2) Procedures to ensure confidentiality for service patients.

DHS 75.44(3) (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.

DHS 75.44 History History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.

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

DHS 75.45 History History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.

DHS 75.46 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.

DHS 75.46 History History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.

subch. VI of ch. DHS 75 Subchapter VI — Additional Requirements for Treatment Service Levels of Care

DHS 75.47 DHS 75.47 Applicability of other requirements.

DHS 75.47(1) (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.

DHS 75.47(2) (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.

DHS 75.47 History History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.

DHS 75.48 DHS 75.48 Service requirements by level of care tables.

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

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

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

DHS 75.48 History 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 DHS 75.49 Outpatient substance use treatment service.

DHS 75.49(1) (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.

DHS 75.49(2) (2) Location of service delivery.

DHS 75.49(2)(a) (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:

DHS 75.49(2)(a)1. 1. The service shall designate one office as its main office.

DHS 75.49(2)(a)2. 2. All notices under this chapter will be sent to the main office.

DHS 75.49(2)(a)3. 3. Each office providing the service shall comply with the applicable requirements of this chapter.

DHS 75.49(2)(a)4. 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.

DHS 75.49(2)(b) (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.

DHS 75.49(2)(c) (c) A service that provides outpatient substance use treatment services in the community shall have written policies and procedures for community-based service delivery.

DHS 75.49(2)(d) (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.

DHS 75.49 History 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 DHS 75.50 Outpatient integrated behavioral health treatment service.

DHS 75.50(1) (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.

DHS 75.50(2) (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.

DHS 75.50(3) (3) Location of service delivery.

DHS 75.50(3)(a) (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:

DHS 75.50(3)(a)1. 1. The service shall designate one office as its main office.

DHS 75.50(3)(a)2. 2. All notices under this chapter will be sent to the main office.

DHS 75.50(3)(a)3. 3. Each office providing the service shall comply with the applicable requirements of this chapter.

DHS 75.50(3)(a)4. 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.

DHS 75.50(3)(b) (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.

DHS 75.50(3)(c) (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.

DHS 75.50(3)(d) (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.

DHS 75.50 History History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.

DHS 75.51 DHS 75.51 Intensive outpatient treatment service.

DHS 75.51(1) (1) Service description. In this section, “intensive outpatient treatment service” means a non-residential treatment service totaling at least 9 hours of treatment services per patient per week for adults and at least 6 hours of treatment services per patient per week for minors, in which substance use treatment personnel provide assessment and treatment for substance use disorders under the oversight of a medical director. Intensive outpatient treatment services may include screening, 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. Intensive outpatient treatment services address patient needs for mental health, psychiatric, or medical services through integrated co-occurring treatment or through coordinated services, consultation, and referrals.

DHS 75.51(2) (2) Location of service delivery.

DHS 75.51(2)(a) (a) An intensive outpatient treatment service may provide case management and outreach services in the community or other locations, provided all requirements of this chapter are able to be met in that setting.

DHS 75.51(2)(b) (b) A service that provides intensive outpatient case management and outreach services in the community shall have written policies and procedures for community-based service delivery.

DHS 75.51(2)(c) (c) A service that provides intensive outpatient case management and outreach 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.