DOC 347.21(1)(1)The facility shall use a health screening form that is developed in conjunction with qualified health care professionals and is completed at the time of admission for each youth to record information about current and past medical, mental health, and dental conditions, physical and developmental disabilities, recent injuries or physical trauma, alcohol or other drug abuse problems, and suicide or self-harm risk. The health screening form shall be documented.
DOC 347.21(2) (2) A youth whose screening under sub. (1) is not completed within one hour of admission shall be under constant staff supervision until the screening is completed. Section DOC 347.26 applies if a youth screens positive for risk of suicide or self-harm.
DOC 347.21(3) (3) The health screening shall be conducted in a confidential setting upon the youth's admission.
DOC 347.21(4) (4) If urgent concerns are identified during the health screening, referrals to medical, mental health, or supervisory staff shall be immediate.
DOC 347.21(5) (5) A qualified health care professional shall review the health screening within 72 hours. The review shall be documented.
DOC 347.21(6) (6) Within 72 hours of admission, a qualified health care professional shall offer the youth sexually transmitted infection testing, and all female youth shall be offered pregnancy testing.
DOC 347.21(7) (7) Documentation of health screening results and subsequent review of the health screening form shall be maintained in the youth's confidential medical record.
DOC 347.21 History History: CR 20-030: cr. Register October 2021 No. 790, eff. 11-1-21.
DOC 347.22 DOC 347.22Health care assessment.
DOC 347.22(1)(1)All youth shall receive a full health care assessment by a qualified health care professional within 7 days of admission. The assessment shall be documented.
DOC 347.22(2) (2) A health care assessment is not required for a youth readmitted to the facility when the last health care assessment was performed within 90 days and when the youth's new admission health screening shows no change in health status.
DOC 347.22(3) (3) Documentation of health care assessment results shall be maintained in the youth's confidential medical record.
DOC 347.22 History History: CR 20-030: cr. Register October 2021 No. 790, eff. 11-1-21.
DOC 347.23 DOC 347.23Medical care.
DOC 347.23(1)(1)The facility shall provide youth medical care under s. 938.505 (1), Stats.
DOC 347.23(2) (2) The facility shall provide youth with a schedule of access to medical care to be provided under sub. (1).
DOC 347.23(3) (3) The facility shall provide access and arrange for transportation to emergency medical care services.
DOC 347.23(4) (4) All licensed or certified health care professionals shall provide services in accordance with the standards of practice established by the applicable regulatory body.
DOC 347.23(5) (5) Health care staff shall be in compliance with state and federal licensure certification and registration. Verification of compliance shall be maintained at the facility.
DOC 347.23(6) (6) A youth may refuse specific health evaluations and treatments in accordance with applicable federal and state law. All refusals shall be documented and maintained in the youth's confidential medical record.
DOC 347.23(7) (7) The facility shall allow for submission and screening of medical requests on a daily basis.
DOC 347.23(8) (8) When practicable, the facility shall be in contact with a youth's personal physician.
DOC 347.23(9) (9) The facility's provision of medical care shall ensure access to all of the following:
DOC 347.23(9)(a) (a) Pregnancy management.
DOC 347.23(9)(b) (b) Acute and chronic medical conditions management.
DOC 347.23(9)(c) (c) Communicable disease and infection control.
DOC 347.23(9)(d) (d) Detoxification and withdrawal care.
DOC 347.23(9)(e) (e) Immunizations.
DOC 347.23 History History: CR 20-030: cr. Register October 2021 No. 790, eff. 11-1-21.
DOC 347.24 DOC 347.24Informed consent.
DOC 347.24(1)(1)At admission, the facility shall obtain the name and contact information of an adult family member or guardian who can provide information about a youth's health and mental health history.
DOC 347.24(2) (2) The facility shall ensure all medical and mental health examinations and services conform to applicable state laws for informed consent and the right to refuse treatment.
DOC 347.24(3) (3) The facility shall obtain informed consent using a language that is understandable to the youth and the youth's parent or guardian.
DOC 347.24 History History: CR 20-030: cr. Register October 2021 No. 790, eff. 11-1-21.
DOC 347.25 DOC 347.25Mental health care.
DOC 347.25(1)(1)The facility shall provide youth with mental health services from a qualified mental health professional.
DOC 347.25(2) (2) All qualified mental health professionals shall have training on and be knowledgeable about the assessment of mental health disorders, trauma, and suicide risk among adolescents and age-appropriate interventions.
DOC 347.25(3) (3) All qualified mental health professionals shall provide services in accordance with recognized standards of practice.
DOC 347.25(4) (4) Licensed mental health professionals shall be in compliance with state and federal licensure certification and registration. Verification of compliance shall be maintained at the facility.
DOC 347.25(5) (5) All youth shall receive a mental health assessment by a qualified mental health professional within 7 days of admission. The assessment shall be documented.
DOC 347.25(6) (6) The mental health assessment shall be conducted in a confidential setting.
DOC 347.25(7) (7) The facility shall have sufficient service hours from qualified mental health professionals to timely meet the needs of youth in the facility.
DOC 347.25(8) (8) The facility shall have a schedule of access to on-site mental health care services.
DOC 347.25(9) (9) Qualified mental health professionals shall develop individual mental health treatment plans for youth with identified mental health needs.
DOC 347.25(10) (10) Qualified mental health professionals shall work with facility staff to provide guidance, insight, and direction on managing and understanding the needs and behavior of youth.
DOC 347.25(11) (11) The facility shall provide access to emergency mental health care and transportation, if necessary.
DOC 347.25 History History: CR 20-030: cr. Register October 2021 No. 790, eff. 11-1-21.
DOC 347.26 DOC 347.26Suicide and self-harm prevention.
DOC 347.26(1)(1)Risk of serious harm. The facility shall do all of the following:
DOC 347.26(1)(a) (a) Obtain documented information from a transporting agency's observation pertaining to a youth's mental health and potential for suicide or self-harm.
DOC 347.26(1)(b) (b) Determine whether the youth has ever considered or engaged in self-harm or attempted suicide.
DOC 347.26(1)(c) (c) Require staff to immediately notify qualified medical and mental health professionals of all incidents of self-harm or attempted self-harm. The notification and incident shall be documented.
DOC 347.26(1)(d) (d) Require staff to immediately notify qualified medical and mental health professionals of youth who have communicated having ideation, plan, or intent to engage in self-harm or suicide. The notification and incident shall be documented.
DOC 347.26(2) (2)Suicide or self-harm watch. The facility shall do all of the following:
DOC 347.26(2)(a) (a) Identify designated supervisory staff to be notified if a youth is determined to be a suicide or self-harm risk.
DOC 347.26(2)(b) (b) Designate areas within the facility and provide security precautions for youth who are placed on suicide or self-harm watch.
DOC 347.26(2)(c) (c) Establish monitoring procedures for youth on suicide or self-harm watch, including frequency and documentation of wellness checks under s. DOC 347.48.
DOC 347.26(3) (3)Youth supervision. The facility shall do all of the following:
DOC 347.26(3)(a) (a) Identify staff who may initiate a suicide or self-harm watch.
DOC 347.26(3)(b) (b) Require notification to qualified mental health professionals when the youth is placed on suicide or self-harm watch. Assessment by a qualified mental health professional shall be completed as soon as practicable.
DOC 347.26(3)(c) (c) Identify qualified mental health professionals who are authorized to remove a youth from a suicide or self-harm watch status after an in-person assessment.
DOC 347.26(3)(d) (d) Establish requirements for the frequency of communication between health care and facility staff regarding the status of a youth who is on suicide or self-harm watch.
DOC 347.26(3)(e) (e) Establish an intervention protocol during an apparent suicide or self-harm attempt, including life-sustaining measures.
DOC 347.26(3)(f) (f) Notify the youth's parent or legal guardian any time a youth is placed on suicide or self-harm watch.
DOC 347.26(3)(g) (g) Notify the youth's case worker in the county or tribe of supervision any time a youth is placed on suicide or self-harm watch.
DOC 347.26(3)(h) (h) Identify persons to be notified in case of attempted or completed suicides or self-harm.
DOC 347.26(4) (4)Documentation. The facility shall document actions taken and decisions made regarding youth who are at risk of attempting suicide or self-harm, including all of the following:
DOC 347.26(4)(a) (a) Individual initiating the suicide or self-harm watch.
DOC 347.26(4)(b) (b) Date and time watch was initiated.
DOC 347.26(4)(c) (c) Reason watch was initiated.
DOC 347.26(4)(d) (d) Date, time, and name of supervisor contacted.
DOC 347.26(4)(e) (e) Date and time of referral to a qualified mental health professional.
DOC 347.26(4)(f) (f) Written documentation from the qualified mental health professional removing a youth from a suicide or self-harm watch including name, date, and time.
DOC 347.26(4)(g) (g) Date and time of notification to youth's parent or legal guardian under sub. (3) (f).
DOC 347.26(4)(h) (h) Date and time of notification to youth's case worker in the county or tribe of supervision under sub. (3) (g).
DOC 347.26(5) (5)Support services. The facility shall provide access to debriefing and support services for youth and staff following a suicide or self-harm incident.
DOC 347.26 History History: CR 20-030: cr. Register October 2021 No. 790, eff. 11-1-21.
DOC 347.27 DOC 347.27Dental health care.
DOC 347.27(1)(1)A dental screening shall be performed by a licensed dentist or a qualified healthcare professional within 7 days of admission.
DOC 347.27(2) (2) An oral examination shall be performed by a licensed dentist within 60 days of admission and every 6 months thereafter, unless the facility obtains information that the youth received a dental examination within the previous 6 months.
DOC 347.27(3) (3) The facility shall provide access to emergency dental care and transportation to those services, as needed.
DOC 347.27 History History: CR 20-030: cr. Register October 2021 No. 790, eff. 11-1-21.
DOC 347.28 DOC 347.28Medications.
DOC 347.28(1)(1)The facility shall comply with state and federal law regarding procuring, prescribing, dispensing, delivering, administering, and disposing of prescription and nonprescription medications.
DOC 347.28(2) (2) All medications brought into the facility shall be verified, inventoried, and maintained in a designated secure storage area.
DOC 347.28(3) (3) Designated trained staff may administer or deliver prescribed doses of medication at prescribed times. Annual documented training shall be provided to facility staff that deliver medications.
DOC 347.28(4) (4) Staff shall administer or deliver medications under circumstances that protect the youth's confidentiality.
DOC 347.28(5) (5) Prescription and nonprescription medication administered or delivered to a youth shall be documented, including who prescribed the medication, who administered or delivered the medication, and the date and time of administration or delivery.
DOC 347.28(6) (6) All refusals of recommended or prescribed medications by a youth shall be documented.
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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.