Chapter DCF 52

DCF 52.58(4)(b)2. 2. Arrange for or obtain the results of a complete physical examination comparable to a HealthCheck examination for each resident in accordance with the HealthCheck periodicity schedule.

DCF 52.58(4)(c) (c) Preliminary care and treatment plan.

DCF 52.58(4)(c)1. 1. Upon admission of a new short-term resident to a center for a short-term treatment program, the center shall develop a preliminary care and treatment plan for the new resident pending completion of the short-term program assessment and treatment plan under sub. (5) (b).

DCF 52.58(4)(c)2. 2. The preliminary care and treatment plan shall be based on the center’s review of information received from the referral agency and the center’s professional intake staff person’s initial evaluation of the new resident’s treatment and care needs.

DCF 52.58(4)(c)3. 3. The preliminary care and treatment plan shall be completed within 7 calendar days of a short-term resident’s admission and shall identify or describe all of the following:

DCF 52.58(4)(c)3.a. a. Referral agency goals and objectives for the resident, if any, and center care and treatment objectives for the resident.

DCF 52.58(4)(c)3.b. b. The primary or immediate presenting behavior issues of the resident.

DCF 52.58(4)(c)3.c. c. Center services to be provided to the resident to address those primary or immediate presenting behavior issues.

DCF 52.58(4)(c)3.d. d. Any special immediate medical or dietary needs.

DCF 52.58(5) (5) Assessment, treatment planning and discharge planning.

DCF 52.58(5)(a) (a) General. A center’s short-term treatment program shall meet the assessment and treatment planning requirements under par. (b), instead of those under s. DCF 52.22, for each resident. Center staff shall date and document meeting these requirements in each short-term resident’s record.

DCF 52.58(5)(b) (b) Assessment and treatment and care planning. A plan for a short-term care resident’s care and treatment shall be developed within 15 calendar days of admission. The plan shall include all of the following:

DCF 52.58(5)(b)1. 1. ‘Assessment.’ A documented assessment of the resident’s needs both immediate and for transition to community placement. The assessment shall be conducted where possible with resident care worker staff who will work with the resident, the placing person or agency, the resident if 12 years of age or older, a center social worker and, as necessary, professional consultants. The assessment shall cover all of the following:

DCF 52.58(5)(b)1.a. a. Presenting issues or problems. These may include behavioral functioning, emotional or psychological status, personal and social development and familial relationships.

DCF 52.58(5)(b)1.b. b. Educational needs.

DCF 52.58(5)(b)1.c. c. Recreational interests and abilities.

DCF 52.58(5)(b)1.d. d. Perceived barriers or risks in making the transition to community placement.

DCF 52.58(5)(b)1.e. e. Services necessary to address assessment areas.

DCF 52.58(5)(b)2. 2. ‘Treatment and care plan.’ A dated treatment and care plan developed where possible by the persons or agencies identified under subd. 1. that is time-limited, goal-oriented and individualized to meet specific resident needs identified in the assessment under subd.1. The plan shall include all of the following components:

DCF 52.58(5)(b)2.a. a. Identification of staff and services to be provided or arranged by the center to meet the resident’s needs.

DCF 52.58(5)(b)2.b. b. A statement of behavioral or functional objectives that specifies resident behaviors to be addressed with the objectives focused on preparing the resident for transition to community based placement services and other placement arrangements.

DCF 52.58(5)(b)2.c. c. Transitional planning arrangements with the placing agency which provide for continuity in programming when the resident is placed into the community.

DCF 52.58(5)(b)2.d. d. Arrangements for continuing educational services and other programming during the resident’s stay at the center.

DCF 52.58(5)(b)3. 3. ‘Treatment plan implementation and review.’

DCF 52.58(5)(b)3.a. a. A short-term resident’s services case manager shall coordinate, monitor and document in the resident’s treatment record a review and assessment of the treatment and care plan for the resident no later than 30 days after admission and at least every 30 days thereafter to determine the resident’s readiness for community placement by considering the resident’s strengths and suitability for community placement.

DCF 52.58(5)(b)3.b. b. The review and assessment under subd. 3. shall identify the reason for continued placement at the center, any planning efforts for community placement, barriers to placement in the community and plans to eliminate those barriers and recommendations if any, for changes in transitional placement planning or in efforts to prepare the resident for community placement.

DCF 52.58(5)(b)3.c. c. In documenting a review and assessment of the treatment and care plan for a resident, the resident’s services case manager shall enter the date of the review and list the participants in the review.

DCF 52.58(5)(c) (c) Discharge planning. A short-term treatment program need only comply with sub. (2) in s. DCF 52.23, and shall include documentation of all of the following in any discharge plan for a resident:

DCF 52.58(5)(c)1. 1. The date and reason for discharge.

DCF 52.58(5)(c)2. 2. New location of the resident.

DCF 52.58(5)(c)3. 3. A brief statement identifying resident readiness for discharge and placement elsewhere and remaining needs.

DCF 52.58(5)(c)4. 4. Name and title of person and agency to which the resident was discharged.

DCF 52.58(5)(c)5. 5. For an unplanned discharge, a brief summary or other documentation of the circumstances surrounding the discharge.

DCF 52.58(6) (6) Resident records. A short-term treatment program shall meet the resident record requirements in this section and in s. DCF 52.49 except under s. DCF 52.49 (2) (b) 1. a. to g. and 3.

DCF 52.58(7) (7) Training and evaluation.

DCF 52.58(7)(a) (a) Initial training for staff of short-term treatment programs shall include training in the following areas:

DCF 52.58(7)(a)1. 1. Wrap around principles and philosophy.

DCF 52.58(7)(a)2. 2. Arranging for transitional care and transitional placement planning principles and methods.

DCF 52.58(7)(b) (b) A center shall at least annually evaluate its short-term treatment care program through a center survey to be completed and returned to the center by referral sources. The center shall use the survey information to improve, as necessary, its short-term care program.

DCF 52.58 History History: Cr. Register, February, 2000, No. 530, eff. 9-1-00; corrections in (2) (c), (3) (intro.), (4) (intro.), (5) (a), (c) (intro.) and (6) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635; EmR1414: emerg. am. (2) (c), (4) (b) 1., 2., eff. 8-1-14; CR 14-054: am. (2) (c), (4) (b) 1, 2., (5) (b) 2. d. Register April 2015 No. 712, eff. 5-1-15; CR 21-107: am. (2) (b) Register June 2022 No. 798, eff. 7-1-22.

DCF 52.59 DCF 52.59 Respite care services programs.

DCF 52.59(1) (1) Applicability. A residential care center for children and youth may operate a respite care services program with approval of the department. A residential care center for children and youth that chooses to provide respite care services shall comply with the provisions of this chapter except as stated in this section.

DCF 52.59(2) (2) Definitions. In this section:

DCF 52.59(2)(a) (a) “Respite care” means temporary care for a child with a disability or special care need, usually on behalf of a parent or regular caregiver for the purpose of providing relief to the parent or regular caregiver from the extraordinary and intensive demands of providing ongoing care for the child, but also for when a parent or regular caregiver may be at risk of abusing a child due to stress and, therefore, requires relief from caregiver duties, or the parent or regular caregiver is in a crisis situation that can be alleviated by providing temporary relief from caregiver duties.

DCF 52.59(2)(b) (b) “Respite care services episode” or “episode” means a period of time during which respite care is provided to a parent or regular caregiver by placing a child, otherwise under the parent’s or regular caregiver’s care, at a residential care center.

DCF 52.59(2)(c) (c) “Respite care services program” means a center-provided program of respite care services for a child with a disability or special need on behalf of a parent or regular caregiver and includes, for the child, individualized personal care and services at the level necessary to meet the child’s immediate needs, along with room and board provided in comfortable surroundings.

DCF 52.59(3) (3) Exceptions for respite care programs. Respite care programs shall comply with all provisions of this chapter except the following:

DCF 52.59(3)(a) (a) Section DCF 52.21 (1), (2), (5) (a) and (8) (a).

DCF 52.59(3)(b) (b) Sections DCF 52.22 and 52.23.

DCF 52.59(3)(c) (c) Section DCF 52.41.

DCF 52.59(3)(d) (d) Section DCF 52.49 (2) (b) 1. a. to g. and 3.

DCF 52.59(4) (4) Program statement. A center accepting respite care clients shall have a program statement describing its respite care services program. The program statement shall cover at minimum all of the following:

DCF 52.59(4)(a) (a) The purposes for which respite care is provided and the type of population served.

DCF 52.59(4)(b) (b) Specific center assessment procedures and services available for care arrangements in assisting a child admitted for respite care.

DCF 52.59(4)(c) (c) Compatibility of the respite care services program component with other programs of the center.

DCF 52.59(4)(d) (d) Staffing arrangements for respite care services.

DCF 52.59(4)(e) (e) Health care arrangements for respite care placements, including the process for securing medical authorizations for general and emergency medical care including surgery.

DCF 52.59(4)(f) (f) Recreational activities and programming for respite care placements.

DCF 52.59(5) (5) Admissions. A center operating a respite care services program shall have all of the following written policies and procedures for admission of a prospective respite care resident:

DCF 52.59(5)(a) (a) A policy regarding the type of respite care children who can be served, such as those who are emotionally disturbed, physically disabled, medically needy, or developmentally disabled, including the specific types of developmental disabilities served.

DCF 52.59(5)(b) (b) Procedures for screening children referred for respite care to ensure that they are appropriate for the center’s respite care program.

DCF 52.59(5)(c) (c) Procedures for obtaining parent or guardian written consents for emergency medical care and authorization for administration of medications.

DCF 52.59(5)(d) (d)

DCF 52.59(5)(d)1. 1. Procedures for obtaining from the parent or other regular caregiver necessary and essential information for the temporary care of the child, which may include medical, behavioral, dietary, or emotional concerns and appropriate responses or instructions. Assessment shall cover at minimum the following areas: eating, toileting, mobility, communication, health problems, behavioral issues, socialization, supervision needs, and personal self-help.

DCF 52.59(5)(d)2. 2. Procedures for obtaining identifying information at the time of admission on the child and the child’s family and information about current special needs of the child, including usual day activities; transportation arrangements; any appointments; current health problems; special equipment used; communication issues; behavioral issues; eating habits, schedule and preferences; sleeping habits and any usual bedtime routine; toileting concerns; safety concerns; discipline or behavioral management recommendations; preferred leisure time activities; and any other comments from the parent or regular caregiver.

DCF 52.59(5)(e) (e) Procedures as described under s. DCF 52.21 (7) for orienting a child to the center’s respite care program, available care staff and room arrangements, and assisting the child in any adjustment issues to the child’s temporary stay.

DCF 52.59(5)(f) (f) Procedures for assigning specific care staff to a respite care child.

DCF 52.59(5)(g) (g) Procedures for contacting the parent or other regular caregiver regarding care questions or in emergency situations.

DCF 52.59(5)(h) (h) A policy on who may pick up the child or youth at the end of respite care and policies and procedures for establishing the date and time at which the child or youth is to be picked up.

DCF 52.59(5)(i) (i) Procedures for making a record of all of the child’s personal belongings and medications upon arrival at the center.

DCF 52.59(5)(j) (j) Procedures for maintaining a log with dates of all respite care episodes for each child.

DCF 52.59(6) (6) Staffing. A center shall assign a staff person to have primarily responsibility for the center’s respite care services program. This person shall have experience in serving the type of disability or population the center serves. Staff-to-child ratios shall at minimum meet the ratio as otherwise prescribed in s. DCF 52.12 or be as needed to meet the needs of the respite care persons in care. The responsible staff person shall have access to medical, psychiatric, dietary and social services consultation as needed.

DCF 52.59(7) (7) Written care plan.

DCF 52.59(7)(a) (a) Written care plan. A center shall develop a written plan of care for each child admitted to the center for respite care.

DCF 52.59(7)(b) (b) Planning for the child.

DCF 52.59(7)(b)1. 1. The written care plan shall be prepared in consultation with the child’s parent or other regular caregiver and prior to placement, except if the reason for placement is of a crisis emergency nature.

DCF 52.59(7)(b)2. 2. The written care plan shall provide for necessary service supports to meet social, emotional adjustment, medical, and dietary needs; physical environment accommodation; means for the respite care child to contact the child’s parent or other regular caregiver; accommodations to meet physical disabilities such as requiring, if needed by the child, a TTY device for the hearing impaired, handrails, or visual devices; and a planned variety of recreational activities. The educational needs of the child shall be attended to while in placement as prescribed by the parent or other regular caregiver.

DCF 52.59(7)(c) (c) Length of stay. A respite care placement shall not extend beyond 9 days per episode unless department approval is first obtained.

DCF 52.59(8) (8) Discharge. When a child is discharged from respite care, the residential care center shall document all of the following in the child’s respite care record:

DCF 52.59(8)(a) (a) The dates of the child’s stay, a summary of the child’s stay with any significant incidents noted, and the name of the person to whom the child was discharged.

DCF 52.59(8)(b) (b) A list of all personal belongings, medications, and medical equipment that went with the child upon discharge.

DCF 52.59(9) (9) Training and evaluation.

DCF 52.59(9)(a) (a) Training.

DCF 52.59(9)(a)1. 1. Training for staff of a respite care services program shall include training in the areas of arranging for transitional care and transitional placement planning principles and methods.

DCF 52.59(9)(a)2. 2. Staff shall have respite care training designed around the specific needs of individuals for which care is provided, such as autism, epilepsy, cerebral palsy and intellectual disabilities. As part of this training, staff who have not already had some experience working with the type of individual to be cared for shall have at least 8 hours of supervised experience by someone who is knowledgeable in working with the type of individual or more than 8 hours if necessary to ensure the provision of competent care.

DCF 52.59(9)(b) (b) Evaluation. After each respite care episode, a residential care center shall evaluate the care provided through a survey to be completed by the parent or other regular caregiver and, if possible, the child. The center shall use the survey information to improve, as necessary, its respite care services program and shall keep these surveys on file for one year from their completion.

DCF 52.59(10) (10) Client records. A center with a respite care services program shall meet the resident record requirements found under this section and under s. DCF 52.49, except requirements under s. DCF 52.49 (2) (b) 1. a. to g. and 3. A respite care resident’s record shall include all documentation required under this section.

DCF 52.59 History History: Cr. Register, February, 2000, No. 530, eff. 9-1-00; corrections in (3), (5) (e), (6) and (10) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635; CR 14-054: am. (2) (a) to (c), (4) (b), (5) (a), (b), (d) 1., 2., (e), (f), (i), (7) (a), (b), (8), (9) (b) Register April 2015 No. 712, eff. 5-1-15; correction in (7) (b) 2. made under s. 35.17, Stats., Register September 2017 No. 741; 2019 Wis. Act 1: am. (9) (a) 2. Register May 2019 No. 761, eff. 6-1-19; CR 20-003: am. (5) (a) Register July 2020 No. 775, eff. 8-1-20; CR 21-107: am. (5) (d) 2., (7) (b) 2. Register June 2022 No. 798, eff. 7-1-22.

subch. VIII of ch. DCF 52 Subchapter VIII — Need Determination and License Application