Wis. Admin. Code DHS § DHS 40.07

Current through May 28, 2024

Section DHS 40.07 - Program components

(1) REQUIRED POLICIES AND PROCEDURES. A program shall develop and implement written policies and procedures for:

(a) Admission and orientation.

(b) Fee agreements.

(c) Assessments.

(d) Contents and implementation of individualized treatment plans.

(e) Implementation of person-centered care, including:

1. Cultural responsiveness.

2. Developmentally appropriate and age-appropriate service planning and delivery.

3. Legal representative involvement.

4. Strength-based approaches and planning.

5. Trauma-informed and responsive approaches and planning.

(f) Care coordination.

(fm) 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.

(g) Confidentiality and compliance with 42 CFR part 2, 45 CFR parts 160, 162, and 164, s. 51.30, Stats., and ch. DHS 92.

(h) Compliance with Title 2 of the Americans with Disabilities Act of 1990.

(i) Client rights and grievance processes under s. 51.61, Stats., and ch. DHS 94.

(j) Crisis prevention and response, including the program's use of support services, seclusion, and physical restraint and the process for obtaining a written authorization from a physician that allows seclusion and physical restraint for a youth prior to utilizing any emergency intervention with that youth.

(k) Services for minor youth transitioning to adulthood.

(L) Discharge, transfer, and continuity of care.

(m) Quality assurance and performance improvement.

(n) Written personnel policies.

(2) INVOLVEMENT IN TREATMENT PLANNING FOR YOUTH.

(a) A program shall provide all of the following to a youth or legal representative upon request:

1. Copies of the policies and procedures, required under sub. (1).

2. Written documentation of each staff member's qualifications per s. DHS 40.09 (2) to (4).

3. Admission paperwork that explains the program and forms required for enrollment prior to the admission meeting, and assistance with understanding the paperwork.

4. A copy of ch. DHS 40.

5. Information about fees, payment sources, and how to access any applicable financial resources, and other community resources that are potentially helpful and how to access them.

(b) A program shall include the youth or legal representative throughout all parts of the treatment process, including screening, assessment, treatment, and discharge. A program shall make reasonable efforts to include any persons or family members that the youth or legal representative has authorized to participate in treatment or treatment planning. All of the following apply to the program's engagement of the youth or legal representative:

1. The assessment process shall engage the youth or legal representative to recognize the strengths and needs of the youth, and ensure that the youth or legal representative's perspectives, opinions, and preferences are included as part the treatment plan.

2. A program shall inform the youth or legal representative of the proposed services and supports within the treatment plan and provide a written copy of the plan.

3. Transition services shall consider the needs and preferences of the youth or legal representative.

(c) To ensure that the proposed services reflect a partnership between the youth or legal representative and program staff, a program shall do all of the following, as available and needed:

1. Employ, contract, or coordinate for the services of parent peer specialists who can help a youth or legal representative understand the operations of the program and support effective input in the planning and implementation of services.

2. Establish flexible schedules for meetings and activities so that legal representatives can participate without taking time off from work.

3. Make arrangements for transportation to the program if possible when legal representatives lack the ability to travel to the program using their own resources.

4. Adjust program services and activities to accommodate cultural and linguistic preferences and needs.

5. Use technological resources to encourage participation when in-person meetings are not possible, consistent with requirements to ensure confidentiality of treatment information.

(3) GENERAL REQUIREMENTS. In addition to services that are necessary to achieve the treatment objectives identified in each youth's assessment and individual treatment plan, all of the following minimum requirements services shall be provided:

(a)Community-based program. A community-based program shall offer all of the following:

1. Individual, group and family psychotherapy provided by trained mental health professionals.

2. A structured therapeutic milieu supervised by a clinical coordinator.

3. Care coordination.

4. Support services.

5. Crisis response services.

6. Implementation of transition services designed to support the reintegration of a youth who is completing the program into family, community and school activities and to prevent recurrence of the problems which led to the original placement in the program.

(b)Intensive hospital-based programs. An intensive hospital-based program shall offer minimum required services under par. (a) and shall increase the hours of direct clinical services under s. DHS 40.10 (3) (b) and increase the hours of operation under s. DHS 40.10 (4) (b) to meet the needs of youth who have severe symptomology and need closer supervision.

(4) SUPPORT SERVICES. Each program shall provide support services that include all of the following:

(a) Methods for documenting, measuring, and tracking progress on measurable objectives contained in a youth's treatment plan.

(b) Strategies for all of the following:

1. Reducing or eliminating the use of emergency safety interventions.

2. Teaching and increasing positive replacement behaviors, based on baseline measures at intake.

3. Building relationships between youth and staff members that promote trust and safety.

4. Empowering youth to take responsibility for their behavior and regulating their emotions.

5. Sensory interventions within the treatment milieu to enhance functioning and assist with behavioral challenges.

(5) VOLUNTARY TIME OUT. Support services shall be provided to a youth prior to using a voluntary time out. Voluntary time out should be used as a least restrictive measure, prior to involuntary seclusion or physical restraint, unless there is imminent danger due to a youth's aggression to self or others. Voluntary time out shall be encouraged for the shortest time possible and only for the length of time necessary for the youth to de-escalate or regulate his or her emotions. Programs shall encourage voluntary time out for youth who show signs of agitation or anxiety.

Wis. Admin. Code Department of Health Services DHS 40.07

Cr. Register, August, 1996, No. 488, eff. 9-1-96.

Adopted by, CR 19-018: cr. Register June 2020 No. 774, eff. 7-1-20; correction in (1) (g) made under s. 35.17, Stats., Register June 2020 No. 774, eff. 7/1/2020

Amended by, CR 23-053: cr. (1) (fm) Register September 2023 No. 813, eff. 10/1/2023

Amended by, CR 23-046: am. (2) (a) 2. Register April 29 No. 820, eff. 5/1/2024