DHS 75.12 History History: Cr. Register, July, 2000, No. 535, eff. 8-1-00; 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 75.13 DHS 75.13 Outpatient treatment service.
DHS 75.13(1)(1)Service description. An outpatient treatment service is a non-residential treatment service totaling less than 12 hours of counseling per patient per week, which provides a variety of evaluation, diagnostic, crisis and treatment services relating to substance abuse to ameliorate negative symptoms and restore effective functioning. Services include individual counseling and intervention and may include group therapy and referral to non-substance abuse services that may occur over an extended period.
DHS 75.13(2) (2)Requirements. To receive certification from the department under this chapter, an outpatient treatment service shall comply with all requirements included in s. DHS 75.03 that apply to an outpatient treatment service, as shown in Table 75.03, and, in addition, an outpatient 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 75.13(2m) (2m)If an outpatient treatment service is designated by a board under s. DHS 62.04 (1) as an assessment facility, the outpatient treatment service shall also comply with the requirements under ch. DHS 62.
DHS 75.13(3) (3)Required personnel.
DHS 75.13(3)(a) (a) An outpatient treatment service shall have the following personnel:
DHS 75.13(3)(a)1. 1. A director responsible for the overall operation of the service, including the therapeutic design and delivery of services.
DHS 75.13(3)(a)2. 2. A physician available to provide medical supervision and clinical consultation as either an employee of the service or through a written agreement.
DHS 75.13(3)(a)3. 3. A substance abuse counselor available during hours of operation.
DHS 75.13(3)(a)4. 4. A mental health professional available either as an employee of the service or through a written agreement to provide joint and concurrent services for the treatment of dually diagnosed patients.
DHS 75.13(3)(a)5. 5. A clinical supervisor to provide ongoing clinical supervision of the counseling staff, or a person outside the agency who is a clinical supervisor and who by a written agreement will provide ongoing clinical supervision of the counseling staff.
DHS 75.13(3)(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 75.13(3)(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 75.13(4) (4)Clinical supervision.
DHS 75.13(4)(a) (a) An outpatient 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 75.13 Note Note: Section SPS 162.01 (1) states that a clinical supervisor shall provide a minimum of:
DHS 75.13 Note 1. Two hours of clinical supervision for every 40 hours of work performed by a substance abuse counselor-in-training.
DHS 75.13 Note 2. Two hours of clinical supervision for every 40 hours of counseling provided by a substance abuse counselor.
DHS 75.13 Note 3. One hour of clinical supervision for every 40 hours of counseling provided by a clinical substance abuse counselor.
DHS 75.13 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 75.13(4)(b) (b) A clinical supervisor shall provide supervision and performance evaluation of substance abuse counselors in the areas identified in s. SPS 162.01 (5).
DHS 75.13 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 75.13(5) (5)Service operations.
DHS 75.13(5)(a) (a) A service shall work with patients who need health care services but do not have access to them to help them gain access to those services.
DHS 75.13(5)(b) (b) A service shall complete a patient's treatment plan within two visits after admission.
DHS 75.13(5)(c) (c) A service shall arrange for additional psychological tests for a patient as needed.
DHS 75.13(5)(d) (d) Service staff shall review, evaluate and revise a patient's treatment plan, as needed, in consultation with the clinical supervisor, based on ongoing assessment of the patient. If a patient is dually diagnosed, service staff shall review, evaluate and revise the patient's treatment plan, as needed, in consultation also with a mental health professional.
DHS 75.13(5)(e) (e) The service medical director or licensed clinical psychologist shall establish the patient's diagnosis or review and concur with the diagnosis made by the patient's primary physician, and shall review the recommended level of care needed, the assessment report and the treatment plan. The medical director or licensed clinical psychologist shall sign and date a statement that these tasks have been carried out and shall insert the statement in the patient's case record.
DHS 75.13(6) (6)Admission. Admission to an outpatient treatment service is appropriate only if one of the following conditions is met:
DHS 75.13(6)(a) (a) The person to be admitted is determined appropriate for placement in this level of care by the application of approved placement criteria.
DHS 75.13(6)(b) (b) 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 75.13 History History: Cr. Register, July, 2000, No. 535, eff. 8-1-00; CR 06-035: cr. (2m), Register November 2006 No. 611, eff. 12-1-06; correction in (2m) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635; CR 09-109: am. (4) Register May 2010 No. 653, eff. 6-1-10; correction in (4) (a), (b) made under s. 13.92 (4) (b) 7., Stats., Register November 2011 No. 671.
DHS 75.14 DHS 75.14 Transitional residential treatment service.
DHS 75.14(1)(1)Service description. A transitional residential treatment service is a clinically supervised, peer-supported therapeutic environment with clinical involvement. The service provides substance abuse treatment in the form of counseling for 3 to 11 hours per patient weekly, immediate access to peer support through the environment and intensive case management which may include direct education and monitoring in the areas of personal health and hygiene, community socialization, job readiness, problem resolution counseling, housekeeping and financial planning.
DHS 75.14(2) (2)Requirements. To receive certification from the department under this chapter, a transitional residential treatment service shall comply with all requirements included in s. DHS 75.03 that apply to a transitional residential treatment service, as shown in Table 75.03, and, in addition, a transitional residential 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 75.14(3) (3)Organizational requirements. Before operating or expanding a transitional residential treatment service, a facility shall be approved under ch. DHS 124 as a hospital, licensed under ch. DHS 83 as a community-based residential facility, certified under ch. DHS 82 or licensed under ch. DHS 88 as an adult family home.
DHS 75.14(4) (4)Required personnel.
DHS 75.14(4)(a) (a) A transitional residential treatment service shall have the following personnel:
DHS 75.14(4)(a)1. 1. A director responsible for the overall operation of the service, including the therapeutic design and delivery of services.
DHS 75.14(4)(a)2. 2. A physician available to provide medical supervision and clinical consultation as either an employee of the service or under a written contract with the service.
DHS 75.14(4)(a)3. 3. At least one full-time substance abuse counselor for every 15 patients or fraction thereof.
DHS 75.14(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 a written agreement will provide ongoing clinical supervision of the counseling staff.
DHS 75.14(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 75.14(4)(b) (b) A certified 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 75.14(5) (5)Clinical supervision.
DHS 75.14(5)(a) (a) A transitional residential 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 75.14 Note Note: Section SPS 162.01 (1) states that a clinical supervisor shall provide a minimum of:
DHS 75.14 Note 1. Two hours of clinical supervision for every 40 hours of work performed by a substance abuse counselor-in-training.
DHS 75.14 Note 2. Two hours of clinical supervision for every 40 hours of counseling provided by a substance abuse counselor.
DHS 75.14 Note 3. One hour of clinical supervision for every 40 hours of counseling provided by a clinical substance abuse counselor.
DHS 75.14 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 75.14(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 75.14 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 75.14(6) (6)Service operations.
DHS 75.14(6)(a) (a) Medical screening.
DHS 75.14(6)(a)1.1. A physician, registered nurse or physician assistant shall conduct medical screening of a patient no later than 7 working days after the person's admission to identify health problems and to screen for communicable diseases unless there is documentation that screening was completed within 90 days prior to admission.
DHS 75.14(6)(a)2. 2. A patient continuing in treatment shall receive an annual follow-up medical screening unless the patient is being seen regularly by a personal physician.
DHS 75.14(6)(b) (b) Medical service needs. A service shall arrange for services for a patient with medical needs unless otherwise arranged for by the patient.
DHS 75.14(6)(c) (c) Intake. A service shall complete intake within 24 hours of a person's admission to the service except that the initial assessment and initial treatment plan shall be completed within 4 working days of admission.
DHS 75.14(6)(d) (d) Hours of operation. A service shall operate 24 hours per day and 7 days per week.
DHS 75.14(6)(e) (e) Policies and procedures manual. A service shall have a written policy and procedures manual that includes all of the following:
DHS 75.14(6)(e)1. 1. The service philosophy and objectives.
DHS 75.14(6)(e)2. 2. The service's patient capacity.
DHS 75.14(6)(e)3. 3. A statement concerning the type and physical condition of patients appropriate for the service.
DHS 75.14(6)(e)4. 4. Admission policy, including:
DHS 75.14(6)(e)4.a. a. Target group served, if any.
DHS 75.14(6)(e)4.b. b. Limitations on admission.
DHS 75.14(6)(e)5. 5. Procedures for screening for communicable disease.
DHS 75.14(6)(e)6. 6. Service goals and services defined and justified in terms of patient needs, including:
DHS 75.14(6)(e)6.a. a. Staff assignments to accomplish service goals.
DHS 75.14(6)(e)6.b. b. Description of community resources available to assist in meeting the service's treatment goals.
DHS 75.14(6)(f) (f) Documentation of review.
DHS 75.14(6)(f)1.1. A service shall maintain documentation that the governing body, director and representatives of the administrative and direct service staffs have annually revised, updated as necessary and approved the policy and procedures manual, including the service philosophy and objectives.
DHS 75.14(6)(f)2. 2. The service shall maintain documentation to verify that each staff member has reviewed a copy of the policy and procedures manual.
DHS 75.14(6)(g) (g) Emergency medical care. A service shall have a written agreement with a hospital or clinic for the hospital or clinic to provide emergency medical care to patients.
DHS 75.14(6)(h) (h) Emergency transportation. A service shall have arrangements for emergency transportation, when needed, of patients to emergency medical care services.
DHS 75.14(6)(i) (i) Treatment plan. The service's treatment staff shall prepare a written treatment plan for each patient referred from prior treatment service, which is designed to establish continuing contact for the support of the patient. A patient's treatment plan shall include information, unmet goals and objectives from the patient's prior treatment experience and treatment staff shall review and update the treatment plan every 30 days.
DHS 75.14(6)(j) (j) Support services. A service shall provide support services that promote self-care by the patient, which shall include all of the following:
DHS 75.14(6)(j)1. 1. Planned activities of daily living.
DHS 75.14(6)(j)2. 2. Planned development of social skills to promote personal adjustment to society upon discharge.
DHS 75.14(6)(k) (k) Employment related services. A service shall make job readiness counseling, problem-resolution counseling and prevocational and vocational training activities available to patients.
DHS 75.14(6)(L) (L) Recreational services. A service shall have planned recreational services for patients, which shall include all of the following:
DHS 75.14(6)(L)1. 1. Emphasis on recreation skills in independent living situations.
DHS 75.14(6)(L)2. 2. Use of both internal and community recreational resources.
DHS 75.14(7) (7)Admission. Admission to a transitional residential treatment service is appropriate only for one of the following reasons:
DHS 75.14(7)(a) (a) The person was admitted to and discharged from one or more services under s. DHS 75.10, 75.11, 75.12 or 75.13 within the past 12 months or is currently being served under either s. DHS 75.12 or 75.13.
DHS 75.14(7)(b) (b) The person has an extensive lifetime treatment history and has experienced at least two detoxification episodes during the past 12 months, and one of the following conditions is met:
DHS 75.14(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.
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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.