Section 52.58. Exceptions and additional requirements for short-term programs.

 

(1)   Applicability.

(a) A residential care center for children and youth may operate a short-term treatment program with approval of the department. This section applies to the operation of short-term treatment programs. A short-term treatment program shall comply with all provisions of this chapter except as provided in this section.

(b) The requirements of this section apply to short-term resident readmissions except that the assessment and treatment care plan for the resident under sub. (5) needs only be updated to reflect the resident's current treatment and care needs.

(2)   Definitions. In this section:

(a) "Short-term resident admission" means a short-term resident whose stay at the center is expected to be 90 days or less or whose return to the center for another short-term stay readmission occurs 90 days or more from the resident's discharge from that center or who is placed into a different center for short-term care readmission.

(b) "Short-term resident readmission" means a short-term resident whose readmission to the center for another short-term stay occurs less than 90 days from his or her discharge from that center and whose stay at the center may be of varying periodic episodes within a 90 day period.

(c) "Short-term treatment program" means a program of temporary residential care and treatment service delivery to a resident whose placement is transitional for purposes of assessment, treatment, and planning for placement back into the community. "Short-term treatment program" does not include a respite care service program under s. DCF 52.59 or a crisis stabilization program certified under ch. DHS 34 .

(3)   Program statement. In place of the requirements for a program statement and operating plan under s. DCF 52.41 (1) (intro.) , (a) and (b) , a center that operates a short-term treatment program shall have a treatment program statement that includes all of the following:

(a) A narrative covering treatment purpose, philosophy, approach and methods for short-term transitional placement into the community.

(b) Identification of short-term treatment program professional service providers and consultants involved in short-term transitional placement efforts that are center or community based.

(c) Identification of any coordinating service and placement agencies.

(d) A description of the extent to which the center's short-term program is compatible with or will operate separately, including in residential living arrangements, from the center's non-short-term residential program. If it will be operated separately, identification of the building or area in which the short-term program will be operated.

(e) A description of arrangements for continuing education of short-term residents.

(f) A description of health care arrangements for short-term residents, including the process for securing medical authorizations for general and emergency medical care including surgery.

(g) A description of recreational activities and programming available for short-term residents.

(4)   Admissions. A center operating a short-term treatment program shall meet the provisions of s. DCF 52.21 , except s. DCF 52.21 (5) (a) and (8) (a) , and all of the following:

(a) Obtaining authorizations. For a short-term resident, the center as part of written admissions procedures shall obtain authorization from the parent or guardian of a resident for the center to do all of the following:

1. Provide or arrange for routine medical services and procedures, including dental services and non-prescription and prescription medications.

2. Obtain from a health care authority the authority to delegate and supervise administration of medications by center-authorized staff and for staff to handle and provide the medication to the resident and observe self-administration of the medication by the resident.

3. Obtain other medical information as needed on the resident.

4. Obtain written authorization to provide or order, when necessary, emergency medical procedures including surgery, when there is a life-threatening situation and it is not possible to immediately reach the parent or guardian authorized to give signed written specific informed consent.

(b) Health screening. Upon admission of a short-term resident, center staff shall do both of the following:

1. Observe the resident for evidence of ill health. A staff person capable of recognizing common signs of communicable diseases or other evidence of ill health shall make this observation. The new resident's temperature shall also be taken and evaluated. If the new resident shows overt signs of communicable disease or other evidence of ill health, the center shall make arrangements for immediate examination by a health care practitioner.

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.

(c) Preliminary care and treatment plan.

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) .

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.

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:

a. Referral agency goals and objectives for the resident, if any, and center care and treatment objectives for the resident.

b. The primary or immediate presenting behavior issues of the resident.

c. Center services to be provided to the resident to address those primary or immediate presenting behavior issues.

d. Any special immediate medical or dietary needs.

(5)   Assessment, treatment planning and discharge planning.

(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.

(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:

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:

a. Presenting issues or problems. These may include behavioral functioning, emotional or psychological status, personal and social development and familial relationships.

b. Educational needs.

c. Recreational interests and abilities.

d. Perceived barriers or risks in making the transition to community placement.

e. Services necessary to address assessment areas.

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:

a. Identification of staff and services to be provided or arranged by the center to meet the resident's needs.

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.

c. Transitional planning arrangements with the placing agency which provide for continuity in programming when the resident is placed into the community.

d. Arrangements for continuing educational services and other programming during the resident's stay at the center.

3. `Treatment plan implementation and review.'

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.

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.

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.

(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:

1. The date and reason for discharge.

2. New location of the resident.

3. A brief statement identifying resident readiness for discharge and placement elsewhere and remaining needs.

4. Name and title of person and agency to which the resident was discharged.

5. For an unplanned discharge, a brief summary or other documentation of the circumstances surrounding the discharge.

(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.

(7)   Training and evaluation.

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

1. Wrap around principles and philosophy.

2. Arranging for transitional care and transitional placement planning principles and methods.

(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.

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.