Chapter DOC 347

DOC 347.23(4) (4) All licensed or certified health care professionals shall provide services in accordance with the standards of practice established by the applicable regulatory body.

DOC 347.23(5) (5) Health care staff shall be in compliance with state and federal licensure certification and registration. Verification of compliance shall be maintained at the facility.

DOC 347.23(6) (6) A youth may refuse specific health evaluations and treatments in accordance with applicable federal and state law. All refusals shall be documented and maintained in the youth’s confidential medical record.

DOC 347.23(7) (7) The facility shall allow for submission and screening of medical requests on a daily basis.

DOC 347.23(8) (8) When practicable, the facility shall be in contact with a youth’s personal physician.

DOC 347.23(9) (9) The facility’s provision of medical care shall ensure access to all of the following:

DOC 347.23(9)(a) (a) Pregnancy management.

DOC 347.23(9)(b) (b) Acute and chronic medical conditions management.

DOC 347.23(9)(c) (c) Communicable disease and infection control.

DOC 347.23(9)(d) (d) Detoxification and withdrawal care.

DOC 347.23(9)(e) (e) Immunizations.

DOC 347.23 History History: CR 20-030: cr. Register October 2021 No. 790, eff. 11-1-21.

DOC 347.24 DOC 347.24 Informed consent.

DOC 347.24(1) (1) At admission, the facility shall obtain the name and contact information of an adult family member or guardian who can provide information about a youth’s health and mental health history.

DOC 347.24(2) (2) The facility shall ensure all medical and mental health examinations and services conform to applicable state laws for informed consent and the right to refuse treatment.

DOC 347.24(3) (3) The facility shall obtain informed consent using a language that is understandable to the youth and the youth’s parent or guardian.

DOC 347.24 History History: CR 20-030: cr. Register October 2021 No. 790, eff. 11-1-21.

DOC 347.25 DOC 347.25 Mental health care.

DOC 347.25(1) (1) The facility shall provide youth with mental health services from a qualified mental health professional.

DOC 347.25(2) (2) All qualified mental health professionals shall have training on and be knowledgeable about the assessment of mental health disorders, trauma, and suicide risk among adolescents and age-appropriate interventions.

DOC 347.25(3) (3) All qualified mental health professionals shall provide services in accordance with recognized standards of practice.

DOC 347.25(4) (4) Licensed mental health professionals shall be in compliance with state and federal licensure certification and registration. Verification of compliance shall be maintained at the facility.

DOC 347.25(5) (5) All youth shall receive a mental health assessment by a qualified mental health professional within 7 days of admission. The assessment shall be documented.

DOC 347.25(6) (6) The mental health assessment shall be conducted in a confidential setting.

DOC 347.25(7) (7) The facility shall have sufficient service hours from qualified mental health professionals to timely meet the needs of youth in the facility.

DOC 347.25(8) (8) The facility shall have a schedule of access to on-site mental health care services.

DOC 347.25(9) (9) Qualified mental health professionals shall develop individual mental health treatment plans for youth with identified mental health needs.

DOC 347.25(10) (10) Qualified mental health professionals shall work with facility staff to provide guidance, insight, and direction on managing and understanding the needs and behavior of youth.

DOC 347.25(11) (11) The facility shall provide access to emergency mental health care and transportation, if necessary.

DOC 347.25 History History: CR 20-030: cr. Register October 2021 No. 790, eff. 11-1-21.

DOC 347.26 DOC 347.26 Suicide and self-harm prevention.

DOC 347.26(1) (1) Risk of serious harm. The facility shall do all of the following:

DOC 347.26(1)(a) (a) Obtain documented information from a transporting agency’s observation pertaining to a youth’s mental health and potential for suicide or self-harm.

DOC 347.26(1)(b) (b) Determine whether the youth has ever considered or engaged in self-harm or attempted suicide.

DOC 347.26(1)(c) (c) Require staff to immediately notify qualified medical and mental health professionals of all incidents of self-harm or attempted self-harm. The notification and incident shall be documented.

DOC 347.26(1)(d) (d) Require staff to immediately notify qualified medical and mental health professionals of youth who have communicated having ideation, plan, or intent to engage in self-harm or suicide. The notification and incident shall be documented.

DOC 347.26(2) (2) Suicide or self-harm watch. The facility shall do all of the following:

DOC 347.26(2)(a) (a) Identify designated supervisory staff to be notified if a youth is determined to be a suicide or self-harm risk.

DOC 347.26(2)(b) (b) Designate areas within the facility and provide security precautions for youth who are placed on suicide or self-harm watch.

DOC 347.26(2)(c) (c) Establish monitoring procedures for youth on suicide or self-harm watch, including frequency and documentation of wellness checks under s. DOC 347.48.

DOC 347.26(3) (3) Youth supervision. The facility shall do all of the following:

DOC 347.26(3)(a) (a) Identify staff who may initiate a suicide or self-harm watch.

DOC 347.26(3)(b) (b) Require notification to qualified mental health professionals when the youth is placed on suicide or self-harm watch. Assessment by a qualified mental health professional shall be completed as soon as practicable.

DOC 347.26(3)(c) (c) Identify qualified mental health professionals who are authorized to remove a youth from a suicide or self-harm watch status after an in-person assessment.

DOC 347.26(3)(d) (d) Establish requirements for the frequency of communication between health care and facility staff regarding the status of a youth who is on suicide or self-harm watch.

DOC 347.26(3)(e) (e) Establish an intervention protocol during an apparent suicide or self-harm attempt, including life-sustaining measures.

DOC 347.26(3)(f) (f) Notify the youth’s parent or legal guardian any time a youth is placed on suicide or self-harm watch.

DOC 347.26(3)(g) (g) Notify the youth’s case worker in the county or tribe of supervision any time a youth is placed on suicide or self-harm watch.

DOC 347.26(3)(h) (h) Identify persons to be notified in case of attempted or completed suicides or self-harm.

DOC 347.26(4) (4) Documentation. The facility shall document actions taken and decisions made regarding youth who are at risk of attempting suicide or self-harm, including all of the following:

DOC 347.26(4)(a) (a) Individual initiating the suicide or self-harm watch.

DOC 347.26(4)(b) (b) Date and time watch was initiated.

DOC 347.26(4)(c) (c) Reason watch was initiated.

DOC 347.26(4)(d) (d) Date, time, and name of supervisor contacted.

DOC 347.26(4)(e) (e) Date and time of referral to a qualified mental health professional.

DOC 347.26(4)(f) (f) Written documentation from the qualified mental health professional removing a youth from a suicide or self-harm watch including name, date, and time.

DOC 347.26(4)(g) (g) Date and time of notification to youth’s parent or legal guardian under sub. (3) (f).

DOC 347.26(4)(h) (h) Date and time of notification to youth’s case worker in the county or tribe of supervision under sub. (3) (g).

DOC 347.26(5) (5) Support services. The facility shall provide access to debriefing and support services for youth and staff following a suicide or self-harm incident.

DOC 347.26 History History: CR 20-030: cr. Register October 2021 No. 790, eff. 11-1-21.

DOC 347.27 DOC 347.27 Dental health care.

DOC 347.27(1) (1) A dental screening shall be performed by a licensed dentist or a qualified healthcare professional within 7 days of admission.

DOC 347.27(2) (2) An oral examination shall be performed by a licensed dentist within 60 days of admission and every 6 months thereafter, unless the facility obtains information that the youth received a dental examination within the previous 6 months.

DOC 347.27(3) (3) The facility shall provide access to emergency dental care and transportation to those services, as needed.

DOC 347.27 History History: CR 20-030: cr. Register October 2021 No. 790, eff. 11-1-21.

DOC 347.28 DOC 347.28 Medications.

DOC 347.28(1) (1) The facility shall comply with state and federal law regarding procuring, prescribing, dispensing, delivering, administering, and disposing of prescription and nonprescription medications.

DOC 347.28(2) (2) All medications brought into the facility shall be verified, inventoried, and maintained in a designated secure storage area.

DOC 347.28(3) (3) Designated trained staff may administer or deliver prescribed doses of medication at prescribed times. Annual documented training shall be provided to facility staff that deliver medications.

DOC 347.28(4) (4) Staff shall administer or deliver medications under circumstances that protect the youth’s confidentiality.

DOC 347.28(5) (5) Prescription and nonprescription medication administered or delivered to a youth shall be documented, including who prescribed the medication, who administered or delivered the medication, and the date and time of administration or delivery.

DOC 347.28(6) (6) All refusals of recommended or prescribed medications by a youth shall be documented.

DOC 347.28(7) (7) The facility shall inventory and return or dispose of unused medications upon the youth’s release or transfer.

DOC 347.28(8) (8) All medication errors shall be documented.

DOC 347.28 History History: CR 20-030: cr. Register October 2021 No. 790, eff. 11-1-21.

DOC 347.29 DOC 347.29 Medical records.

DOC 347.29(1) (1) Youth medical records shall be kept separate from other records, including custodial records, and shall be maintained in a confidential manner in accordance with ss. 146.81 to 146.83, Stats., and all other applicable state and federal laws.

DOC 347.29(2) (2) Records shall be securely maintained and accessible only by designated staff.

DOC 347.29(3) (3) No person except those authorized under s. 51.30 or 146.82, Stats., or other applicable state and federal laws, may have access to information in the records or be permitted to inspect the records.

DOC 347.29 History History: CR 20-030: cr. Register October 2021 No. 790, eff. 11-1-21.

subch. VII of ch. DOC 347 Subchapter VII — Resources for Youth

DOC 347.30 DOC 347.30 Clothing, towels, and bedding.

DOC 347.30(1) (1) Clothing.

DOC 347.30(1)(a) (a) If youth are not permitted to wear personal clothing, all of the following shall be provided upon admission:

DOC 347.30(1)(a)1. 1. A set of clean clothing.

DOC 347.30(1)(a)2. 2. Clean socks and undergarments.

DOC 347.30(1)(a)3. 3. Clean footwear.

DOC 347.30(1)(b) (b) All clothing provided shall be of appropriate size for the youth.

DOC 347.30(1)(c) (c) All clothing provided shall be appropriate to the season.