(g) A service shall maintain medication records that allow for ongoing monitoring of any medication prescribed or administered by the service, and documentation of any adverse drug reactions or medication errors. Medication orders shall specify the name of the medication, dose, route of administration, frequency of administration, name of the prescriber who prescribed the medication, prescriber signature, and staff administering the medication, if applicable.
(h) A service that receives, stores, or dispenses medications shall have written policies and procedures regarding storage, dispensing, and disposal of medications, including:
1. Patient name, medication name, amount of medication, dosage, date of receipt, and date of dispensing or disposal.
2. Safeguards to prevent the diversion of medication.
(i) A non-residential service that receives, stores, or dispenses medications shall comply with 21 CFR 1301.72. The medication storage area shall be clean, and shall be separated by a wall from any restroom, cleaning products, or any food-preparation or storage area.
(j) A residential service under ss. DHS 75.53 to 75.58, shall follow the requirements for medication storage provided in s. DHS 75.39.
(20)Drug testing services.
(a) A service shall have written policies and procedures for drug testing, breath analysis, and toxicology services. Patients of a service shall be informed of these policies and procedures upon admission.
(b) A service may utilize drug testing information in conjunction with patient self-report, behavioral observations, collateral information, and clinical assessment to make determinations regarding patient care.
(c) A service shall have a method for obtaining confirmation of drug testing results.
(d) A service shall inform patients of the costs for drug testing services.
(e) A service shall obtain informed consent before releasing patient drug testing results. The service is responsible for ensuring that the patient understands possible consequences of disclosure of drug testing information.
(21)Transfer. If the service transfers a patient to another provider or if a change is made in the patient’s level of care, the transfer or change in the level of care shall be documented in the patient’s case record. A transfer summary shall be entered into the patient’s case record, including the following:
(a) The date of the transfer.
(b) A completed copy of the standardized placement criteria and level of care recommended.
(c) Documentation of communication and follow-up that ensures continuity of care from one provider or level of care to another.
(22)Discharge.
(a) A patient may be discharged from a service for any of the following reasons:
1. Successful completion of recommended services and treatment plan goals.
2. No longer meeting placement criteria for any level of care in the substance use treatment system.
3. Patient discontinuation of services.
4. Administrative discharge.
5. Death of the patient.
(b) A service shall have written policies and procedures for the service director’s review of administrative discharge or discharges due to patient dissatisfaction or attrition.
(c) A service shall have written policies and procedures for the service director’s review of discharges due to patient death from overdose.
(d) A discharge summary shall be entered into the patient’s case record, including the following:
1. A completed copy of the standardized placement criteria and level of care indicated.
2. Recommendations regarding care after discharge.
3. A description of the reasons for discharge.
4. The patient’s treatment status and condition at discharge.
5. A final evaluation of the patient’s progress toward the goals identified in the treatment plan.
(e) The discharge summary shall include a notation indicating the reason that any items from par. (d) were not able to be provided at discharge, if applicable.
(23)Continuing care services.
(a) An outpatient substance use treatment service under s. DHS 75.49 or an outpatient integrated behavioral health treatment service under s. DHS 75.50 may provide ongoing recovery monitoring, continuing care, aftercare, or behavioral health check-ups at the outpatient level of care.
(b) A patient who has completed services and been discharged may continue contact with the provider at agreed upon intervals without completing a new clinical assessment, intake, or treatment plan.
(c) Each contact with a patient in continuing care service shall be documented in a progress note.
(d) If, during the provision of continuing care services, there is indication that a higher level of care or additional services may be needed due to substance use relapse or other behavioral, mental, or physical health indicators, the service shall complete an updated level of care placement criteria screening or updated mental health assessment and make appropriate referrals and transfers of care.
(e) The continuing care service shall obtain valid and updated releases of information for any referrals or collateral communications regarding patients in continuing care.
(f) Continuing care services may not provide medical services.
(g) The death of a patient in continuing care services shall be subject to reporting as specified in s. DHS 75.10 (1).
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22; correction in (11) (b), (13) (m), (14) (e) 2., (g) made under s. 35.17, Stats., and correction in numbering in (21) made under s. 13.92 (4) (b) 1., Stats., Register October 2021 No. 790; CR 23-053: am. (12) (a) Register September 2023 No. 813, eff. 10-1-23.
DHS 75.25Outcome monitoring and quality improvement plan.
(1)A service shall have a written plan for monitoring outcomes and improving service quality, which includes all of the following:
(a) Measurable goals relating to service quality, participant satisfaction, and outcomes.
(b) Related initiatives for service improvement and key indicators of identified goals and outcomes.
(c) An annual report that summarizes the service’s quality improvement activities and program outcomes. The report shall be available to patients and their families, the public, and the department upon request.
(2)A service shall have a process for collecting, analyzing, and reporting a patient’s demographic and outcome data. At minimum, the following data shall be recorded at admission and discharge:
(a) The patient’s living situation.
(b) The patient’s substance use.
(c) The patient’s employment status and education.
(d) The patient’s arrests within the past 30 days.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22; correction in numbering in sub. (2) made under s. 13.92 (4) (b ) 1., Stats., Register October 2021 No. 790.
Subchapter V — Residential Service Facility Requirements
DHS 75.26Applicability.
(1)This subchapter applies to residential services certified under ss. DHS 75.53 to 75.58.
(2)A residential service that is approved as a hospital under ch. DHS 124 is not required to meet the requirements in this subchapter.
(3)A residential service that is approved under ch. DHS 83 as a community-based residential facility meets the facility requirements outlined in ss. DHS 75.29, 75.30, 75.33, 75.34, 75.40, 75.41, 75.45, and 75.46.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.27Organizational requirements. Before operating or expanding a residential service, a facility shall meet all residential facility requirements included in this subchapter.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.28Definitions. In this subchapter:
(1)“Ambulatory” means the ability to walk without difficulty or help.
(2)“Non-ambulatory” means a person who is unable to walk, but who may be mobile with the help of a wheelchair or other mobility devices.
(3)“Semi-ambulatory” means a person who is able to walk with difficulty or only with the assistance of an aid such as crutches, cane, or walker.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.29Application for initial certification.
(1)In order to meet the requirements in ss. DHS 75.30 to 75.46, an application for initial licensure as a residential service shall be on a form provided by the department, and shall be accompanied by all of the following:
(a) A floor plan specifying dimensions of the facility, exits, and planned room usage.
(b) An explanation of the 24-hour staffing pattern for the service.
(c) A statement indicating whether the service will provide treatment services for patients that are non-ambulatory or semi-ambulatory. If a service provides treatment services for patients that are non-ambulatory or semi-ambulatory, the floor plan shall include ramped exits to grade.
(d) Municipal zoning approval or occupancy permit.
(e) The results of an approved fire inspection completed within the last 12 months.
(f) Fireplace and chimney inspections completed within the last 12 months, if applicable.
(g) The results of furnace inspection completed within the last 12 months.
(h) The results of smoke and heat detector inspection completed within the last 12 months.
(i) The results of sprinkler inspection completed within the last 12 months.
(j) Well water test results completed within the last 12 months, if applicable.
(k) Building emergency evacuation plan.
(L) A disaster recovery plan in the case of flood, gas leak, electrical outage, or other emergency.
(m) Service policies and procedures.
(n) All required fees.
(o) Evidence that the applicant has 60 days of projected operating funds in reserve.
(p) Any additional information requested by the department.
(2)A residential service shall not make changes to service specifications under sub. (1) (a) to (c) without prior notification to the department.
(3)A residential service shall provide updated documents from sub. (1) upon department request.
History: CR 20-047: cr. Register October 2021 No. 790, eff. 10-1-22.
DHS 75.30Fit and qualified standards.
(1)Eligibility. An applicant may not be certified unless the department determines the applicant is fit and qualified to operate a service.
(2)Standards. In determining whether an applicant is fit and qualified, the department shall consider all of the following:
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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.