Section 52.41. Center program.

 

(1)   Program statement and operating plan. Each center shall have a written program statement describing center treatment purpose, philosophy, approach and methods used and services available, and a written operating plan describing available treatment and services as specified under pars. (a) to (c) . A center shall give a copy of the current center program statement and, upon request, the center operating plan, and all updates, to each resident's placing person or agency and, if not the same, the resident's parents or guardian and legal custodian, if any. A center's operating plan shall describe all of the following:

(a) Treatment. Treatment program policies and procedures covering all of the following:

1. Treatment purpose, philosophy and services.

2. Qualifications of staff responsible for planning and carrying out treatment procedures.

3. The population served by age and sex and by type, such as developmentally disabled, emotionally disturbed, alcohol or drug abusing, transitioning to independence, juvenile delinquent or correctional aftercare, and the range or types of behaviors or conditions for which the center's treatment procedures and techniques are appropriate.

4. Pre-screening procedures used for determining appropriateness of admission.

5. Procedures used to involve the resident and the resident's parents or guardian and legal custodian, if any, in resident assessment and treatment planning including identification of the means used to foster positive relationships between the resident and the resident's family or guardian that are supportive of the resident in reaching treatment plan and permanency plan goals.

6. How the center will implement and review specific provisions of the resident's treatment plan, court order and permanency plan developed under s. 48.38 , Stats., including how the center will coordinate efforts with the placing person or agency and other involved persons or agencies.

7. Methods used by the center for determining when treatment goals are achieved, or that treatment is ineffective or detrimental for a particular resident.

8. Resident conduct as governed by center behavior management and control procedures or measures including house rules covering policies on resident overnight visits outside the center and off-grounds privileges and any resident rights limitations under s. DCF 52.31 prohibiting such things as gang-related clothing or therapeutically contraindicated items.

9. A list of daily activities available to residents including educational and recreational activities.

10. Procedures which ensure clear communication between resident care workers on one shift and the resident care workers on the next shift regarding any significant incident involving a resident they supervise in common such as running away, an incident of abuse or neglect pursuant to s. 48.981 , Stats., a behavior that injures the resident or others, an accident requiring medical attention, intentional property damage, any emergency safety intervention physical hold restraint or physically enforced separation as defined under s. DCF 52.42 (1) or any other incident of a serious nature. The procedures shall include documenting any incident involving a resident and the date and time it occurred in the resident's case record and, if pertinent to resident treatment, in the resident's treatment record progress notes.

11. Methods used by the center to evaluate its treatment program.

(b) Educational program services. Educational program services that coordinate a resident's educational programming with the school from which the resident came upon admission and the school which will receive the resident after center discharge and that cover all of the following:

1. Procedures for referring residents to public schools when not part of an on-grounds program.

2. Procedures for relating each resident's treatment plan goals under s. DCF 52.22 (2) (b) to educational goals and services based on the resident's needs.

3. Identification of all center staff, schools and agencies responsible for resident education.

4. Provision for either the center case work supervisor or a resident's services case manager to coordinate efforts with persons responsible for the resident's education. This shall include arranging, where possible, for educational personnel to participate in assessment of a new resident's needs and development of the resident's treatment plan under s. DCF 52.22 (2) and treatment plan implementation and review conferences under s. DCF 52.22 (3) (b) . Center staff identified under subd. 3. , shall ensure that a report of the resident's educational assessment and progress is given to the school or persons responsible for the individual's education following discharge from the center.

5. Procedures and timelines for assessing the educational progress of each resident. The procedures shall identify center staff involved in educational assessment, and how assessment information will be used in the review, implementation and revision of a particular resident's treatment plan and educational services.

6. Arrangements for provision of vocational training opportunities under s. 118.15 (1) (b) , Stats.

7. Compliance with applicable parts of ss. 115.77 , 115.81 and 118.165 , Stats., and cooperation with the Wisconsin department of public instruction in providing regular or exceptional educational services to residents.

(c) Health care services. Health care services provided to residents that include needed preventive, routine and emergency medical and dental care through all of the following:

1. Assessment on a regular basis of the general health and dental needs of each resident.

2. Education of residents by someone medically knowledgeable about the hazards of tobacco use, drugs and alcohol abuse and, where appropriate, about human sexuality, family planning materials and services, sexually transmitted diseases and how the human immunodeficiency virus (HIV) is transmitted.

3. Immunization of residents, unless otherwise directed in writing by a physician, according to ch. DHS 144 .

4. Arrangement with a physician or a clinic employing a physician to serve as consultant for health care arranged by the center for residents.

5. Provision for psychological testing, psychiatric examination and treatment as necessary to meet a resident's needs by having consultation and services available from a psychiatrist licensed as a physician under ch. 448 , Stats. , or a psychologist licensed under ch. 455 , Stats.

6. Provision for at least 2 dental examinations and cleanings for each resident each year and for other dental examinations and services for residents, as needed, from a dentist licensed under ch. 447 , Stats. , or a clinic employing dentists licensed under ch. 447 , Stats.

7. Availability of emergency medical services 24 hours a day, 7 days a week.

8. Explanation given to a resident in language suitable to the resident's age and understanding about any medical treatment he or she will receive.

9. Policies and procedures for hospitalizing a resident, for providing first aid to a resident and for administration of medications in accordance with s. DCF 52.46 (2) .

10. Identification of the circumstances that constitute a medical emergency, and instructions to staff on action to take when suspecting the existence of a medical emergency.

11. Compliance with ch. DHS 145 for the control and reporting of communicable diseases.

12. Arrangements for the center's health care consultant under subd. 4. to annually document and date a review of the adequacy of center health care service delivery including center procedures for administration, storage and disposal of medications as provided under s. DCF 52.46 (3) .

(2)   Program planning and scheduling.

(a) A center shall have a written daily program of general activities which meet the developmental needs of the residents.

(b) The program of activities shall provide each resident with experiences which encourage self-esteem and a positive self-image through:

1. Leisure-time activities.

2. Social interaction within the center and, if appropriate, the community.

3. Self-expression and communication.

4. Gross and fine motor development.

5. Daily living activities, including but not limited to, grooming and hygiene, toileting and common household chores such as making beds, cooking and washing clothes.

6. Interpersonal relations with peers, family, friends, staff and where possible and as appropriate, members of the opposite sex.

7. Opportunity for paid work within the constraints of child labor laws, resident rights and the resident's treatment plan.

(c) A center shall make maximum use of small groups to aid individual residents in preserving or attaining a sense of personal identity in daily living. The center shall:

1. Group residents according to age, developmental levels and social needs, with the ages of residents being primarily within a 4 year age range but not to exceed a 6 year age range.

2. Group residents under supervision of their own resident care worker and give a group opportunities to form and attain group self-identity in daily living and social activities.

(d) A center shall ensure that nonambulatory residents:

1. Spend a major portion of the daytime hours out of bed.

2. Spend a portion of the daytime hours out of their bedroom area.

3. Have planned daily activity and exercise periods.

4. Are able to move around by various methods and devices whenever possible.

(3)   Staff-to-resident ratio.

(a) In this subsection, "supervision" means guidance of the behavior and activities of a resident by a staff member to ensure the safety and well-being of the resident.

(b) The staff-to-resident ratios for staff providing supervision of residents shall be as follows:

1. `1:8 during waking hours.' A residential care center shall have at least one staff member awake and providing supervision for every 8 or fewer residents present in a program unit during waking hours.

2. `1:15 during sleeping hours.' A residential care center shall have at least one staff member awake and providing supervision for every 15 or fewer residents present in the program unit during sleeping hours. Each staff member shall be within hearing or call of residents being supervised without reliance on the use of electronic monitoring devices.

3. `Congregate living area.' A licensee shall ensure that a staff member provides sight and sound supervision at all times in each congregate living area of the center when residents are present. In this subdivision, "congregate living area" means any area in a center used for living or recreation except a bedroom, bathroom, or hallway.

(c) The staff-to-resident ratios in par. (b) are the minimal staffing requirements for resident care staff. The number of resident care staff providing supervision shall be increased as necessary to meet the needs of residents and to ensure their safety and welfare.

(d) No resident may be in a residential care center without supervision by a staff member.

(e) A licensee shall ensure that supervision is provided for each resident appropriate to the resident's age, maturity, behavior, and developmental level and sufficient to ensure the safety of all residents in the residential care center.

(f) Supervision of residents shall be by a staff member who meets or exceeds the qualifications of a resident care worker under s. DCF 52.12 (2) (e) .

(g) An inexperienced resident care worker who is required to take the traineeship program s. DCF 52.12 (5) (g) may only be counted in the ratios in par. (b) if the trainee is working with an experienced resident care worker who meets the qualifications in s. DCF 52.12 (2) (e) .

(h) A residential care center shall have at least one full-time equivalent resident services case manager under s. DCF 52.12 (1) (a) 3. for every 16 or fewer residents. A residential services case manager who is working less than full-time may have a maximum caseload that is the equivalent of 2.5 hours per week for each resident.

(4)   Recreation.

(a) A center shall provide leisure and recreational programming suitable for the ages, abilities and interests of the center's residents. This programming shall be consistent with the center's overall program goals and shall offer residents a variety of indoor and outdoor recreational activities.

(b) A center shall have well drained outdoor recreation areas that are free of hazards.

(5)   Religious practices. A center shall provide residents with opportunities for voluntary religious expression and participation. The center shall:

(a) Have written policies on religious training.

(b) Obtain the written consent of the resident's parent or guardian for church attendance and religious instruction when agency practice varies from that of the resident or the resident's family.

(c) Arrange for residents to participate in religious exercises in the community whenever possible.

(6)   Center applied policies and procedures. Center policies and procedures affecting residents and their interests shall be applied in a consistent and fair manner.

(7)   Other services.

(a) A center may operate on the center grounds other services or enterprises not governed by the center's license only if the center obtains the written consent of the department. Examples of other center nonresident services that may be allowed by the department to operate on center grounds are shelter care services, outpatient counseling services, day treatment services and day student educational services.

(b) A center which provides temporary shelter care services need not obtain a separate shelter care license under ch. DCF 59 if the personnel requirements in s. DCF 52.12 or 59.04 , the child care requirements found in s. DCF 59.05 , the requirements for records and reports found in s. DCF 59.07 and the physical plant standards in subch. VI of this chapter or in s. DCF 59.06 are met.

(8)   Resident accounts and restitution plan.

(a) The center shall have procedures for maintaining and managing a separate account for each resident's money and as applicable, shall comply with the provisions under s. 51.61 (1) (v) , Stats.

(b) The center shall, as applicable, have in place a restitution plan for a resident and as applicable, that is coordinated with any other restitution ordered by a court or as part of an agreement under ch. 938 , Stats. , that describes procedures for deducting sums from a resident's account or earnings as restitution for damages done by the resident. Deductions made for restitution shall be in accordance with a restitution plan as follows:

1. Before a center may withhold a part of a resident's earnings or account balance, a restitution plan shall be made a part of the resident's treatment record.

2. The restitution plan shall take into consideration the resident's ability to pay or be as prescribed under court order.

History: Cr. Register, February, 2000, No. 530 , eff. 9-1-00; correction in (1) (b) 7. made under s. 13.93 (2m) (b) 7., Stats., Register, June, 2001, No. 546 ; corrections in (1) (a) 8., 10., (b) 2., 4., (c) 3., 9., 11., 12., (3) (a), (c) and (7) (b) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635 ; EmR1106 : emerg. r. and recr. (3), eff. 9-16-11; CR 11-026 : am. (1) (a) 10., r. and recr. (3) Register December 2011 No. 672 , eff. 1-1-12; EmR1414 : emerg. am. (1) (a) 3., eff. 8-1-14; CR 14-054 : am. (1) (a) 3. Register April 2015 No. 712 , eff. 5-1-15.

Note

Section DCF 52.55 (1) (b) 1. requires that staff can safely evacuate all residents from the center in one trip for fire safety. Microsoft Windows NT 6.1.7601 Service Pack 1