Wisconsin Administrative Code › Department of Health Services › DHS 30-100 - Community Services › Chapter DHS 61 - Community Mental Health And Developmental Disabilities › Subchapter IV - Community Mental Health Programs › Section DHS 61.79 - Children and adolescent inpatient program

Current through June 24, 2024
The following personnel requirements are minimum. There is
					 no intention to restrict new programs to these minimal staffing patterns.
					 Existing treatment programs which exceed these requirements may not be reduced
					 without extensive and thorough review and a clear realization of what services
					 would be lost by reduction.
(1)
				  REQUIRED PERSONNEL.
(a)
Psychiatry.
Each child and adolescent mental health inpatient
				  service shall provide a minimum of 1.4 hours a week psychiatric treatment time
				  per patient under care. Additional psychiatrists, as needed, shall be available
				  for inpatient visits in order to carry out an adequate treatment program. For
				  emergency purposes a psychiatrist will be on call 24 hours a day each day the
				  facility is in operation. A psychiatrist shall be readily accessible by
				  telephone and ideally, be able to reach the facility within one hour of being
				  called.
(b)
Nursing
				  service.
1. The following schedule of
				  licensed nursing coverage is minimal.
Day Shift
Evening Shift
Night Shift* (see below)
.64 hrs/pat/day
.64
.32
or
4.48 hrs/pat/wk
4.48
2.24
2.
				  Aides, child care workers and other paraprofessionals. Child care workers are
				  primarily responsible for day-to-day living experiences of the children. They
				  also carry out assigned aspects of the treatment program under the direction
				  and supervision of designated treatment staff. Each service shall employ a
				  sufficient number of aides, child care workers and paraprofessionals to provide
				  the following minimal care:
Day Shift Children (0-12)
Evening Shift
Night Shift
.98 hrs/pat/day
1.28
.64
or
6.86 hrs/pat/wk
8.96
4.48
Day Shift Adolescent (over
								  12)
Evening Shift
Night Shift
.80 hrs/pat/day
1.10
.40
or
5.60 hrs/pat/wk
7.70
2.80
(c)
Activity therapy.
The
				  inpatient service shall maintain a ratio of 1.6 hours of activity therapy staff
				  time per patient per week. Additional therapists may be employed as needed. In
				  addition sufficient free time for unstructured but supervised play or activity
				  will be provided.
(d)
Social service.
Each service shall employ at least one full
				  time social worker and provide for a minimum of 1.6 hours per week per patient
				  under care.
(e)
Psychological service.
Each service must provide a minimum of
				  one hour per week of psychology time for each patient under care.
(f)
Educational service.
Each mental health inpatient service for children and adolescents is
				  responsible for providing or arranging for special educational programs to meet
				  the needs of all patients being served in the facility. If the service provides
				  its own school program, 4.8 hours per patient per week of teacher time is
				  considered minimal care.
(g)
Vocational service.
If indicated by patient need each
				  inpatient service shall make available a vocational program to each adolescent
				  14 years of age and older according to the individual patient's age,
				  developmental level and clinical status. This program will be under the
				  auspices of a vocational counselor and is to be carried out in conjunction
				  with, and not in place of the school program. Vocational counseling and
				  training shall be a minimum of 1.3 hours per patient per week, if the service
				  operates its own school program and .8 hour per patient per week, if the
				  facility uses public or other schools.
(h)
Speech and language
				  therapy.
Each mental health inpatient service shall provide one hour
				  per patient per week minimal care of speech and language therapist time for
				  children and adolescents diagnosed as requiring such therapy.
(i)
Add-on factor.
To
				  account for vacation time, sick leave or other absences to which employees may
				  be entitled, the application of a "post shift" factor of 1.59 should be
				  calculated for treatment posts staffed 7 days a week and 1.13 for those staffed
				  5 days a week. In addition, a 20% factor should be used to account for patient
				  charting, planning and other non-face to face care which is required to
				  maintain the program.
See
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