(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, as well as a written operating plan describing
available treatment and services as specified under pars. (a) to (d). 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. An explanation of any medical treatment
that a resident will receive that is provided to the resident in language that
is suitable to the resident's age and developmental level.
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).
(d)
Reasonable and prudent parent
standard. Policies and procedures on how the center complies with the
requirements of the reasonable and prudent parent standard, including all of
the following:
1. How the communication log
under sub. (1m) will be used to inform different shifts of resident care
workers and RPPS decision makers of reasonable and prudent parenting requests
and decisions made for a resident under s.
DCF
52.415 for activities that do not take place in the
residential care center and are not supervised by a staff person.
2. How the information on the forms required
under ch. DCF 37 will be incorporated into a new resident's treatment plan, as
required under s.
DCF 52.22 (2)
(ag).
3. How the center will ensure the presence
on-site of at least one RPPS decision maker at all times.
4. A process for annually reviewing the
parameters and requirements of the reasonable and prudent parent standard in
conjunction with the center's corresponding policies and procedures.
Note: DCF-F-5123-E, Reasonable and
Prudent Parent Standard Review, is an optional form that a center may
use to assist with the annual review. The form is available in the forms
section of the department website at http://dcf.wisconsin.gov or by writing the
Division of Safety and Permanence, P.O. Box 8916, Madison, WI 537088916.
(1m)
COMMUNICATION LOG.
(a) A residential care
center shall require each shift of resident care workers and RPPS decision
makers to use a communication log to document and communicate with other
resident care workers and RPPS decision makers about residents whom they
supervise in common. The communication log shall include all of the following
for each shift:
1. Each resident's location,
behavior, and program participation.
2. Significant incidents involving a resident
as provided in sub. (1) (a) 10. and the center's corresponding policy.
3. Reasonable and prudent
parenting requests and decisions made for residents under s.
DCF
52.415 for activities that do not take place in the
residential care center and are not supervised by a staff person.
4. Staff arrival and departure
times.
(b) A residential
care center may designate units within the center and require resident care
staff and RPPS decision makers to use a separate communication log in each
unit.
(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.
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.
(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.