DHS 75.09(5)(b)3. 3. He or she is incapacitated by alcohol and is placed in or is determined to be in need of protective custody by a law enforcement officer as required under s. 51.45 (11) (b), Stats.
DHS 75.09(5)(b)4. 4. He or she is under the influence of any substance other than alcohol or a sedative.
DHS 75.09(5)(b)5. 5. He or she requires restraints.
DHS 75.09(5)(b)6. 6. He or she requires medication normally used for the detoxification process.
DHS 75.09(5)(c) (c) Observation. Trained staff shall observe a patient and record the patient's condition at intervals no greater than every 30 minutes during the first 12 hours following admission.
DHS 75.09(5)(d) (d) Emergency medical treatment. A service shall have a written agreement with a general hospital for the hospital to provide emergency medical treatment of patients. Escort and transportation shall be provided as necessary to a patient who requires emergency medical treatment.
DHS 75.09(5)(e) (e) Medications.
DHS 75.09(5)(e)1.1. A service shall not administer or dispense medications.
DHS 75.09(5)(e)2. 2. When a patient has been admitted with prescribed medication, staff shall consult with the patient's physician or other person licensed to prescribe and administer medications to determine the appropriateness of the patient's continued use of the medication while under the influence of alcohol or sedatives.
DHS 75.09(5)(e)3. 3. If approval for continued use of prescribed medication is received from a physician, the patient may self-administer the medication under the observation of service staff.
DHS 75.09(5)(f) (f) Discharge plan. A service shall develop with each patient a discharge plan for the patient which shall address the patient's follow-up service needs determined by application of approved patient placement criteria administered by the service, and the provision for referral, escort and transportation to other treatment services, as necessary, to ensure that continuity of care is provided.
DHS 75.09 History History: Cr. Register, July, 2000, No. 535, eff. 8-1-00; correction in (3) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635.
DHS 75.10 DHS 75.10 Medically managed inpatient treatment service.
DHS 75.10(1)(1)Service description. A medically managed inpatient treatment service is operated by a general or specialty hospital, and includes 24-hour nursing care, physician management and the availability of all other resources of the hospital.
DHS 75.10(2) (2)Requirements. To receive certification from the department under this chapter, a medically managed inpatient treatment service shall comply with all requirements included in s. DHS 75.03 that apply to a medically managed inpatient treatment service, as shown in Table 75.03, and, in addition, a medically managed inpatient treatment service shall comply with the requirements of this section. If a requirement in this section conflicts with an applicable requirement in s. DHS 75.03, the requirement in this section shall be followed.
DHS 75.10(3) (3)Organizational requirements. Before operating or expanding an inpatient treatment service, a facility shall do all of the following:
DHS 75.10(3)(a) (a) Submit for approval to the department, a written justification for the service, documenting if the service has been operating, the service's effectiveness and the need for additional inpatient treatment resources in the geographic area in which the service will operate or is operating.
DHS 75.10(3)(b) (b) Notify the county department of community programs under s. 51.42, Stats., in the area in which the service will operate or is operating of the intention to begin to operate or expand the service.
DHS 75.10(3)(c) (c) Be approved as a hospital under ch. DHS 124.
DHS 75.10(4) (4)Required personnel.
DHS 75.10(4)(a) (a) An inpatient treatment service shall have all of the following personnel:
DHS 75.10(4)(a)1. 1. A director who is responsible for the overall operation of the service, including the therapeutic design and delivery of services.
DHS 75.10(4)(a)2. 2. A medical director.
DHS 75.10(4)(a)3. 3. A consulting psychiatrist who is licensed under ch. 448, Stats., and board-certified or eligible for certification by the American board of psychiatry and neurology or a consulting clinical psychologist licensed under ch. 455, Stats., who will be available as needed, with a written agreement to that effect. Each consultant shall be sufficiently knowledgeable about substance abuse and dependence treatment to carry out his or her assigned duties.
DHS 75.10(4)(a)4. 4. A mental health professional who is available either as an employee of the service or through written agreement to provide joint and concurrent services for the treatment of dually diagnosed patients.
DHS 75.10(4)(a)5. 5. At least one full-time certified substance abuse counselor for every 10 patients or fraction thereof.
DHS 75.10(4)(a)6. 6. At least one clinical supervisor on staff to provide ongoing clinical supervision of the counseling staff, or a person outside the agency who is a clinical supervisor and who by written agreement will provide ongoing clinical supervision of the counseling staff.
DHS 75.10(4)(b) (b) A clinical supervisor who meets the requirements of a substance abuse counselor may provide direct counseling services in addition to his or her supervisory responsibilities.
DHS 75.10(4)(c) (c) A trained staff member designated to be responsible for the operation of the service shall be on the premises at all times. That person may provide direct counseling or other duties in addition to being in charge of the service.
DHS 75.10(4)(d) (d) Other persons, such as volunteers and students, may work in an inpatient treatment facility if all of the following conditions are met:
DHS 75.10(4)(d)1. 1. Volunteers and students do not replace direct care staff required under par. (a) or carry out the duties of direct care staff, and there are written descriptions of their responsibilities and duties.
DHS 75.10(4)(d)2. 2. Volunteers and students are supervised by professional staff.
DHS 75.10(4)(d)3. 3. The inpatient treatment service has written procedures for selecting, orienting and providing in-service training to volunteers.
DHS 75.10(4)(d)4. 4. Volunteers and students meet the sensitivity and training expectations under s. DHS 75.03 (3) (h).
DHS 75.10(5) (5)Clinical supervision.
DHS 75.10(5)(a) (a) A medically managed inpatient treatment service shall provide for ongoing clinical supervision of the counseling staff. Ongoing clinical supervision shall be provided as required in s. SPS 162.01.
DHS 75.10 Note Note: Section SPS 162.01 (1) states that a clinical supervisor shall provide a minimum of:
DHS 75.10 Note 1. Two hours of clinical supervision for every 40 hours of work performed by a substance abuse counselor-in-training.
DHS 75.10 Note 2. Two hours of clinical supervision for every 40 hours of counseling provided by a substance abuse counselor.
DHS 75.10 Note 3. One hour of clinical supervision for every 40 hours of counseling provided by a clinical substance abuse counselor.
DHS 75.10 Note 4. One in person meeting each calendar month with a substance abuse counselor-in-training, substance abuse counselor, or clinical substance abuse counselor. This meeting may fulfill a part of the requirements above.
DHS 75.10(5)(b) (b) A clinical supervisor shall provide supervision to substance abuse counselors in the areas identified in s. SPS 162.01 (5).
DHS 75.10 Note Note: Section SPS 162.01 (5) states that the goals of clinical supervision are to provide the opportunity to develop competency in the transdisciplinary foundations, practice dimensions and care functions, provide a context for professional growth and development and ensure a continuance of quality patient care.
DHS 75.10(6) (6)Service operations.
DHS 75.10(6)(a) (a) A physician, registered nurse or physician assistant shall conduct medical screening of a patient no later than 24 hours after the person's admission to a service to identify health problems and to screen for communicable diseases.
DHS 75.10(6)(b) (b) A service shall arrange for services for a patient with medical needs unless otherwise arranged for by the patient.
DHS 75.10(6)(c) (c) A service shall complete intake within 24 hours of a person's admission to the service except that the initial assessment and treatment plan shall be completed within 4 days of admission.
DHS 75.10(6)(d) (d) A service shall arrange for additional psychological tests for a patient as needed.
DHS 75.10(6)(e) (e) A service shall have a written statement describing its treatment philosophy and objectives in providing care and treatment for substance abuse problems.
DHS 75.10(6)(f) (f) A substance abuse counselor or other qualified staff member of a service shall provide a minimum of 12 hours of counseling per week for each patient, including individual and group counseling. Family and couples counseling shall be provided or made available, when appropriate. The service shall ensure that:
DHS 75.10(6)(f)1. 1. Each patient receives at least one hour of individual counseling per week.
DHS 75.10(6)(f)2. 2. The service's treatment schedule is communicated to patients in writing and by any other means necessary for patients with communication difficulties.
DHS 75.10(6)(g) (g) Services required by a patient but not provided by a service shall be provided by other appropriate hospital services or outside agencies.
DHS 75.10(6)(h) (h) A service staff member shall be trained in life-sustaining techniques and emergency first aid.
DHS 75.10(6)(i) (i) A service shall have a written policy on urinalysis that shall include both the following:
DHS 75.10(6)(i)1. 1. Procedures for collection and analysis of samples.
DHS 75.10(6)(i)2. 2. A description of how urinalysis reports are used in the treatment of a patient.
DHS 75.10(7) (7)Admission.
DHS 75.10(7)(a) (a) Admission to an inpatient treatment service shall be by order of a physician. The physician's referral shall be in writing or indicated by the physician's signature on the placement criteria summary.
DHS 75.10(7)(b) (b) Admission to an inpatient treatment service is appropriate only if one of the following conditions is met:
DHS 75.10(7)(b)1. 1. The person to be admitted is determined appropriate for placement in this level of care by the application of approved placement criteria.
DHS 75.10(7)(b)2. 2. The person to be admitted is determined appropriate for this level of care through the alternative placement recommendations of WI-UPC or other approved placement criteria.
DHS 75.10 History History: Cr. Register, July, 2000, No. 535, eff. 8-1-00; correction in (3) (c) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635; CR 09-109: am. (5) Register May 2010 No. 653, eff. 6-1-10; correction in (5) (a), (b) made under s. 13.92 (4) (b) 7., Stats., Register November 2011 No. 671.
DHS 75.11 DHS 75.11 Medically monitored treatment service.
DHS 75.11(1)(1)Service description. A medically monitored treatment service operates as a 24-hour, community-based service providing observation, monitoring and treatment by a multidisciplinary team under supervision of a physician, with a minimum of 12 hours of counseling provided per week for each patient.
DHS 75.11(2) (2)Requirements. To receive certification from the department under this chapter, a medically monitored treatment service shall comply with all requirements included in s. DHS 75.03 that apply to a medically monitored treatment service as shown in Table 75.03 and, in addition, shall comply with the requirements of this section. If a requirement in this section conflicts with an applicable requirement in s. DHS 75.03, the requirement in this section shall be followed.
DHS 75.11(3) (3)Organizational requirements. Before operating or expanding a medically monitored treatment service, a facility shall be approved under ch. DHS 124 as a hospital or shall be licensed under ch. DHS 83 as a community-based residential facility.
DHS 75.11(4) (4)Required personnel.
DHS 75.11(4)(a) (a) A medically monitored treatment service shall have the following personnel:
DHS 75.11(4)(a)1. 1. A director responsible for the overall operation of the service, including the therapeutic design and delivery of services.
DHS 75.11(4)(a)2. 2. At least one full-time substance abuse counselor for every 15 patients or fraction thereof enrolled in the service.
DHS 75.11(4)(a)3. 3. A physician available to provide medical supervision and clinical consultation as either an employee of the service or through a written agreement.
DHS 75.11(4)(a)4. 4. At least one clinical supervisor on staff to provide ongoing clinical supervision of the counseling staff or a person outside the agency who is a clinical supervisor and who by written agreement will provide ongoing clinical supervision of the counseling staff.
DHS 75.11(4)(a)5. 5. A mental health professional available either as an employee of the service or through written agreement to provide joint and concurrent services for the treatment of dually diagnosed patients.
DHS 75.11(4)(b) (b) A clinical supervisor who meets the requirements of a substance abuse counselor may provide direct counseling services in addition to his or her supervisory responsibilities.
DHS 75.11(4)(c) (c) A trained staff member designated by the director to be responsible for the operation of the service shall be on the premises at all times the service is in operation. That person may provide direct counseling or other duties in addition to being in charge of the service.
DHS 75.11(5) (5)Clinical supervision.
DHS 75.11(5)(a) (a) A medically monitored treatment service shall provide for ongoing clinical supervision of the counseling staff. Ongoing clinical supervision shall be provided as required in s. SPS 162.01.
DHS 75.11 Note Note: Section SPS 162.01 (1) states that a clinical supervisor shall provide a minimum of:
DHS 75.11 Note 1. Two hours of clinical supervision for every 40 hours of work performed by a substance abuse counselor-in-training.
DHS 75.11 Note 2. Two hours of clinical supervision for every 40 hours of counseling provided by a substance abuse counselor.
DHS 75.11 Note 3. One hour of clinical supervision for every 40 hours of counseling provided by a clinical substance abuse counselor.
DHS 75.11 Note 4. One in person meeting each calendar month with a substance abuse counselor-in-training, substance abuse counselor, or clinical substance abuse counselor. This meeting may fulfill a part of the requirements above.
DHS 75.11(5)(b) (b) The clinical supervisor shall provide supervision and performance evaluation of substance abuse counselors in the areas identified in s. SPS 162.01 (5).
DHS 75.11 Note Note: Section SPS 162.01 (5) states that the goals of clinical supervision are to provide the opportunity to develop competency in the transdisciplinary foundations, practice dimensions and care functions, provide a context for professional growth and development and ensure a continuance of quality patient care.
DHS 75.11(6) (6)Service operations.
DHS 75.11(6)(a)1.1. A physician, registered nurse or physician assistant shall conduct a medical screening of a patient no later than 7 working days after the person's admission to a service to identify health problems and screen for communicable diseases unless there is documentation that screening was completed within 90 days prior to admission.
DHS 75.11(6)(a)2. 2. A service shall arrange for services for a patient with medical needs unless otherwise arranged by the patient.
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Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date the chapter was last published.