DHS 50.04(2) (2) The department may grant a waiver or variance if the department determines that the proposed waiver or variance will not diminish the effectiveness of the services provided and will not jeopardize the health, safety, welfare, or rights of any youth. The department may specify a timeframe or time limit for the waiver. A request for a variance or waiver must be submitted on a form provided by the department.
DHS 50.04 Note Note: A variance and waiver request form is available by accessing https://www.dhs.wisconsin.gov/library/f-60289.htm.
DHS 50.04(3) (3) The department may rescind or limit a waiver or variance at any time by notifying the YCSF, if any of the following occurs:
DHS 50.04(3)(a) (a) The department determines the waiver or variance has adversely affected or is likely to adversely affect the health, safety or welfare of the youths.
DHS 50.04(3)(b) (b) The YCSF fails to comply with any of the conditions of the waiver or variance as granted.
DHS 50.04(4) (4)The department shall inform a YCSF in writing if it rescinds or limits a waiver or variance.
DHS 50.04 History History: EmR1922: emerg. cr., eff. 11-2-19; CR 19-077: cr. Register July 2020 No. 775, eff. 8-1-20.
DHS 50.05 DHS 50.05 Program Statement. A program statement shall contain all of the following:
DHS 50.05(1) (1)A description of how the YCSF fits into a continuum of care for youth crisis stabilization and treatment services.
DHS 50.05(2) (2) A description of services the program intends to provide, including all of the following:
DHS 50.05(2)(a) (a) Referral and screening procedures.
DHS 50.05(2)(b) (b) Intake procedures, including medication review.
DHS 50.05(2)(c) (c) Assessment and treatment planning, including assessment of risk factors and safety planning for youth.
DHS 50.05(2)(d) (d) Treatment services, including crisis prevention and emotional regulation, including, if applicable, a description of any services that will be delivered in a group setting.
DHS 50.05(2)(e) (e) Care coordination.
DHS 50.05(2)(f) (f) Discharge planning, including any linkages and follow-up.
DHS 50.05(3) (3) A description of the therapeutic environment the program proposes to create, its intended therapeutic benefits, and the rationale supporting its use for the youth served by the YCSF. This description shall include:
DHS 50.05(3)(a) (a) Any evidence-based practices and other services to be implemented at the YCSF. The description should include a rationale for how the services will help the youth population achieve and sustain positive outcomes.
DHS 50.05(3)(b) (b) A plan for coordination of any services that will be provided through outside providers, including with any of a youth's current providers.
DHS 50.05(4) (4) A description of how the YCSF and its services are trauma-informed, strengths-based, and culturally responsive.
DHS 50.05(5) (5) A description of how the YCSF encourages involvement of families and caregivers in treatment planning and services, and involves individuals authorized to participate in the treatment planning and services.
DHS 50.05(6) (6) A description of the YCSF's process for communicating with a youth's school or educational setting and the measures it will take to facilitate a youth's ability to stay up to date in educational expectations.
DHS 50.05(7) (7) The proposed schedule of the program, including any times allocated for treatment, recreation, study time, and meals.
DHS 50.05(8) (8) The YCSF's proposal for meeting staffing level requirements in s. DHS 50.07, the qualifications and roles for each position, and an analysis showing that staffing is adequate to meet the needs of the youth that the program proposes to serve.
DHS 50.05(9) (9) A description of food service and how it will be provided, including at least three meals a day and snacks.
DHS 50.05(10) (10) A description of how the program will offer appropriate indoor and outdoor recreation activities.
DHS 50.05(11) (11) A description of methods used to evaluate services.
DHS 50.05 History History: EmR1922: emerg. cr., eff. 11-2-19; CR 19-077: cr. Register July 2020 No. 775, eff. 8-1-20.
subch. II of ch. DHS 50 Subchapter II - Program Requirements
DHS 50.06 DHS 50.06 Required Policies. A YCSF must have written policies and procedures for the following:
DHS 50.06(1) (1) Admission policy and criteria, including ages and gender of youth served, and how bedrooms will be allocated.
DHS 50.06(2) (2) Utilization review policy addressing determination of need and length of stay, frequency of review, and other utilization policy as needed. The YCSF is meant to be a short-term crisis stabilization facility. If utilization reviews show that a youth requires stabilization longer than a 30-day period, approval from the department must be obtained.
DHS 50.06 Note Note: Approval may be requested at: https://www.dhs.wisconsin.gov/mh/ycsf.htm.
DHS 50.06(3) (3) Policy on prescriber consulting relationships and processes to access consultation with a physician, psychiatrist, physician's assistant, or advanced practice nurse prescriber, to prescribe or consult on psychiatric medications of youths. This can include a youth's own provider.
DHS 50.06(4) (4) Policy on how medications will be stored, secured, managed, and administered, and which staff is responsible. A description of how medical conditions, if any, will be managed.
DHS 50.06(5) (5) Policy on medical emergencies.
DHS 50.06(6) (6) Policy on clinical supervision, per s. DHS 50.09.
DHS 50.06(7) (7) Policies for youths' personal possessions, communication devices including phones, electronics usage, room searches, or other applicable policies.
DHS 50.06(8) (8) Facility rules, provided to youth and staff.
DHS 50.06(9) (9) Where client records will be maintained and how confidentiality requirements of those records will be safeguarded, as required under s. DHS 50.14.
DHS 50.06(10) (10) Policy on how the YCSF will address safety concerns specific to the youth being served.
DHS 50.06(11) (11) Policy on emergency safety interventions. This policy must comply with s. DHS 50.12. It must specify alternative interventions, best practices, and how the YCSF plans to implement emergency safety interventions. If seclusion or restraint will be used, it must provide a description of how it will be handled procedurally and for seclusion where the intervention will occur.
DHS 50.06(11m) (11m) 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.
DHS 50.06 History History: EmR1922: emerg. cr., eff. 11-2-19; CR 19-077: cr. Register July 2020 No. 775, eff. 8-1-20; CR 23-053: cr. (11m) Register September 2023 No. 813, eff. 10-1-23.
DHS 50.07 DHS 50.07 Personnel.
DHS 50.07(1)(1)Policies.
DHS 50.07(1)(a)(a) A YCSF shall have written personnel policies.
DHS 50.07(1)(b) (b) A YCSF shall maintain written documentation of employee qualifications and shall make that information available upon request for review by youths and their representatives or parents, and by the department.
DHS 50.07(2) (2)General qualifications.
DHS 50.07(2)(a) (a) Qualified staff shall comply with s. DHS 34.21 (3) (b) 1. to 19. and must follow current department of safety and professional services standards for licensure and scope of practice.
DHS 50.07(2)(b) (b) Peer specialists or parent peer specialists must be trained in accordance with s. DHS 34.21 (8) (a) to (d).
DHS 50.07(2)(c) (c) Each staff member shall have the professional certification, training, experience, and ability to carry out his or her assigned duties as documented through the following steps:
DHS 50.07(2)(c)1. 1. Each applicant must pass a state background check as provided in s. 50.065, Stats. and ch. DHS 12, before being allowed to work for the YCSF. If the applicant lived in another state, a background check shall be obtained from that state as well.
DHS 50.07(2)(c)2. 2. Programs shall comply with caregiver misconduct reporting and investigation requirements in ch. DHS 13.
DHS 50.07(2)(c)3. 3. Each staff responsible for transporting youth shall have a valid Wisconsin driver's license and a driving record free of any violations specified in ss. 346.62 or 346.63, Stats, in the past 12 months.
DHS 50.07 Note Note: For a state of Wisconsin background check, obtain the name, sex, race, and date of birth of the person about whom you are requesting the check. Information on the process and fees for a background check can be found online at https://www.dhs.wisconsin.gov/caregiver/cbcprocess.htm.
DHS 50.07(3) (3)Required personnel.
DHS 50.07(3)(a)(a) Program administrator. Each YCSF shall have a program administrator who is responsible for the overall YCSF operations and ensuring that the YCSF is in compliance with this chapter and other applicable state and federal laws.
DHS 50.07(3)(b) (b) Clinical coordinator. Each YCSF shall have a clinical coordinator who is responsible for the mental health services provided by the program and for ensuring that all staff members providing mental health services have the qualifications required for their roles in the program and comply with all requirements relating to assessment, treatment planning, service delivery, and service documentation. The clinical coordinator shall be qualified under s. DHS 34.21 (3) (b) 1. to 8. The program administrator may also serve as the clinical coordinator.
DHS 50.07(3)(c) (c) Required designee. The program administrator shall identify one or more staff members to whom authority may be delegated in the absence of the clinical coordinator. The designee must be qualified under s. DHS 34.21 (3) (b) 1. to 8.
DHS 50.07(3)(d) (d) Staffing requirements.
DHS 50.07(3)(d)1.1. The program administrator, clinical coordinator, or designee must be available for consultation 24/7 either on site, by phone, or by other means.
DHS 50.07(3)(d)2. 2. At all times that youth are present at a YCSF, the program shall have a minimum of two staff members present that are qualified under s. DHS 50.07 (2). At least one of the two staff members present must meet one of the requirements from s. DHS 34.21 (3) (b) 1. to 14.
DHS 50.07 History History: EmR1922: emerg. cr., eff. 11-2-19; CR 19-077: cr. Register July 2020 No. 775, eff. 8-1-20.
DHS 50.08 DHS 50.08 Orientation and Training.
DHS 50.08(1)(1)Initial and ongoing orientation and training requirements must comply with s. DHS 34.21 (8) (a) to (d).
DHS 50.08(2) (2) Training must include review of this chapter, including review and training on all YCSF policy and procedures, program statement, and other pertinent information.
DHS 50.08(3) (3) Training must include content specific to youth in crisis and their treatment needs.
DHS 50.08(4) (4) Training for standard precautions, fire safety, first aid and choking, and medication administration and management is required and must comply with s. DHS 83.20 (1) and (2).
DHS 50.08(5) (5) Training must include emergency safety interventions per s. DHS 50.12 and include de-escalation techniques, redirection, and other preventative techniques.
DHS 50.08(6) (6) Staff must be trained on mandated reporting requirements. YCSF staff are considered mandated reporters under ss. 48.981 (2) (a) to (c), Stats.
DHS 50.08(7) (7) As part of its central administrative records, a YCSF shall maintain updated, written copies of its orientation program, evidence of current licensure and certification of professional staff, and documentation of orientation and ongoing training received by program staff and volunteers.
DHS 50.08 History History: EmR1922: emerg. cr., eff. 11-2-19; CR 19-077: cr. Register July 2020 No. 775, eff. 8-1-20; correction in (2), (4) made under s. 35.17, Stats., Register July 2020 No. 775.
DHS 50.09 DHS 50.09 Clinical Supervision.
DHS 50.09(1)(1)The clinical coordinator shall be responsible for oversight of the job performance and actions of each staff member who is providing clinical services and support services, and for ensuring staff compliance with all laws and regulations governing care and treatment as well as the standards of practice of their individual professions.
DHS 50.09(2) (2) Each YCSF shall develop and implement a written policy for clinical supervision and clinical collaboration designed to provide sufficient guidance to assure the delivery of effective services. The policy shall address all of the following:
DHS 50.09(2)(a) (a) A method of assessing and evaluating treatment needs and outcomes to determine if treatment provided is effective, and a system to identify any necessary corrective measures and make changes to improve progress.
DHS 50.09(2)(b) (b) Identification of clinical issues, including incidents that pose a significant risk of an adverse outcome for youth that should warrant clinical collaboration, or clinical supervision that is in addition to the supervisions specified under ch. MPSW 4, 12, or 16, or ch. Psy 2, or for a recognized psychotherapy practitioner, whichever is applicable.
DHS 50.09(3) (3) Clinical supervision must be provided by staff meeting the qualifications under s. DHS 34.21 (3) (b) 1. to 8.
DHS 50.09(4) (4) Program staff who have not completed 3000 hours of supervised clinical experience, or who are not qualified under s. DHS 34.21 (3) (b) 1. to 8., shall receive a minimum of one hour of clinical supervision per week or for every 30 clock hours of mental health services they provide.
DHS 50.09(5) (5) Program staff who have completed 3000 hours of supervised clinical experience and who are qualified under s. DHS 34.21 (3) (b)1. to 8., shall participate in a minimum of one hour of peer clinical consultation per month or for every 120 clock hours of mental health services they provide.
DHS 50.09(6) (6) Clinical supervision shall comply with chs. MPSW 4, 12, and 16 or ch. Psy 2.
DHS 50.09(7) (7) Clinical supervision shall be provided by one or more of the following means:
DHS 50.09(7)(a) (a) Individual sessions with the staff member to review cases and assess performance.
DHS 50.09(7)(b) (b) Individual side-by-side sessions in which the supervisor is present while the staff person provides services and in which the supervisor assesses, teaches, and gives advice regarding the staff member's performance during or after the session.
DHS 50.09(7)(c) (c) Group meetings to review and assess staff performance and provide staff advice or direction regarding specific situations or strategies.
DHS 50.09(7)(d) (d) Other professionally recognized methods of supervision, such as review using videotaped sessions or peer review, if the other methods are approved by the department and are specifically described in the written policies of the program.
DHS 50.09(8) (8) Clinical supervision shall be documented in a supervision or collaboration record, containing entries that are signed and dated by the staff member providing supervision.
DHS 50.09(9) (9) Clinical supervision shall comply with s. DHS 34.21 (7) (a) to (k).
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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.