Wis. Admin. Code Department of Health Services DHS 34.21 - Personnel
(1) POLICIES.
(a) An emergency mental health services
program shall have written personnel policies.
(b) A program shall maintain written
documentation of employee qualifications and shall make that information
available upon request for review by clients and their guardians or parents,
where guardian or parent consent is required for treatment, and by the
department.
(2) GENERAL
QUALIFICATIONS.
(a) Each employee shall have
the ability and emotional stability to carry out his or her assigned
duties.
(b)
1. An applicant for employment shall provide
references regarding professional abilities from at least 2 people and, if
requested by the program, references or transcripts from any post secondary
educational institution attended and employment history reports or
recommendations from prior employers.
2. References and recommendations shall be
documented either by letter or in a signed and dated record of a verbal
contact.
(c) A program
shall review and investigate application information carefully to determine
whether employment of the individual is in the best interests of the program's
clients. This shall include a check of relevant and available conviction
records. Subject to ss.
111.322 and
111.335, Stats., an individual
may not have a conviction record.
Note: See s.165.82, Stats., relating to the fee charged by the Wisconsin department of justice for a criminal records check.
(d) A program shall confirm an applicant's
current professional licensure or certification if that licensure or
certification is a condition of employment.
(3) QUALIFICATIONS OF CLINICAL STAFF.
(a) In this subsection, "supervised clinical
experience" means a minimum of one hour per week of supervision by a mental
health professional qualified under par. (b) 1. to 9., gained after the person
being supervised has received a master's degree.
(b) Program staff retained to provide mental
health crisis services shall meet the following minimum qualifications:
1. Psychiatrists shall be physicians licensed
under ch. 448, Stats., to practice medicine and surgery and shall have
completed 3 years of residency training in psychiatry or child psychiatry in a
program approved by the accreditation council for graduate medical education
and be either board-certified or eligible for certification by the American
board of psychiatry and neurology.
2. Psychologists shall be licensed under ch.
455, Stats., and shall be listed or meet the requirements for listing with the
national register of health service providers in psychology or have a minimum
of one year of supervised post-doctoral clinical experience related directly to
the assessment and treatment of persons with mental disorders.
3. Psychology residents shall hold a doctoral
degree in psychology meeting the requirements of s.
455.04 (1) (c),
Stats., and shall have successfully completed 1500 hours of supervised clinical
experience as documented by the Wisconsin psychology examining board.
4. Psychiatric residents shall hold a
doctoral degree in medicine as a medical doctor or doctor of osteopathy and
shall have successfully completed 1500 hours of supervised clinical experience
as documented by the program director of a psychiatric residency program
accredited by the accreditation council for graduate medical
education.
5. Certified independent
clinical social workers shall meet the qualifications established in ch. 457,
Stats., and be certified by the examining board of social workers, marriage and
family therapists and professional counselors.
6. Psychiatric nurses shall be licensed under
ch. 441, Stats., as a registered nurse, have completed 3000 hours of supervised
clinical experience and hold a master's degree in psychiatric mental health
nursing from a graduate school of nursing accredited by the national league for
nursing.
7. Professional counselors
and marriage and family therapists shall meet the qualifications required
established in ch. 457, Stats., and be certified by the examining board of
social workers, marriage and family therapists and professional
counselors.
8. Master's level
clinicians shall be persons with a master's degree and coursework in areas
directly related to providing mental health services, including clinical
psychology, psychology, school or educational psychology, rehabilitation
psychology, counseling and guidance or counseling psychology. Master's level
clinicians shall have 3000 hours of supervised clinical experience or be listed
in the national registry of health care providers in clinical social work, the
national association of social workers register of clinical social workers, the
national academy of certified mental health counselors or the national register
of health service providers in psychology.
9. Post-master's level clinician interns
shall have obtained a master's degree as provided in subd. 8. and have
completed 1500 hours of supervised clinical experience, documented as provided
in subd. 4.
10. Physician
assistants shall be certified and registered pursuant to ss.
448.05 and
448.07, Stats., and chs. Med 8
and 14 and shall have had at least one year of experience working in a clinical
mental health facility, or there shall be a specific plan for the person to
acquire equivalent training and skills within 3 months after beginning
employment.
11. Registered nurses
shall be licensed under ch. 441, Stats., as a registered nurse, and shall have
had training in psychiatric nursing and at least one year of experience working
in a clinical mental health facility, or there shall be a specific plan for the
person to acquire equivalent training and skills within 3 months after
beginning employment.
12.
Occupational therapists shall have obtained a bachelors degree and have
completed a minimum of one year of experience working in a mental health
clinical setting, and shall meet the requirements of s.
DHS 105.28
(1).
13. Certified social workers, certified
advance practice social workers and certified independent social workers shall
meet the qualifications established in ch. 457, Stats., and related
administrative rules, and have received certification by the examining board of
social workers, marriage and family therapists and professional
counselors.
14. Other qualified
mental health professionals shall have at least a bachelor's degree in a
relevant area of education or human services and a minimum of one year of
combined experience providing mental health services, or work experience and
training equivalent to a bachelor's degree including a minimum of 4 years of
work experience providing mental health services.
15. Specialists in specific areas of
therapeutic assistance, such as recreational and music therapists, shall have
complied with the appropriate certification or registration procedures for
their profession as required by state statute or administrative rule or the
governing body regulating their profession, and shall have at least one year of
experience in a mental health clinical setting.
16. Certified occupational therapy assistants
shall have at least one year of experience in a mental health clinical setting
and shall meet the requirements of s.
DHS 105.28
(2).
17. Licensed practical nurses shall be
licensed under ch. 441, Stats., as a licensed practical nurse and have had
either training in psychiatric nursing or one year of experience working in a
clinical mental health setting.
18.
Mental health technicians shall be paraprofessionals who are employed on the
basis of personal aptitude and life experience which demonstrates their ability
to provide effective emergency mental health services.
19. Clinical students shall be students
currently enrolled in an academic institution and working toward a degree in a
professional area identified in this subsection who are providing services to
the program under the supervision of a staff member meeting the qualifications
under this subsection for that professional area.
(4) REQUIRED STAFF.
(a)
Program administrator. A
program shall designate a program administrator, or equivalently titled person,
who shall have overall responsibility for the operation of the program and for
compliance of the program with this chapter.
(b)
Clinical director.
1. The program shall have on staff a clinical
director or similarly titled person qualified under sub. (3) (b) 1. or 2. who
shall have responsibility for the mental health services provided by the
program.
2. Either the clinical
director or another person qualified under sub. (3) (b) 1. to 8. who has been
given authority to act on the director's behalf shall be available for
consultation in person or by phone at all times the program is in
operation.
(5)
ADDITIONAL STAFF. A program shall have staff available who are qualified under
sub. (3) (b) 1. to 19. to meet the specific needs of the community as
identified in the emergency mental health services plan under s.
DHS 34.22
(1).
(6) VOLUNTEERS. A program may use volunteers
to support the activities of the program staff. Volunteers who work directly
with clients of the program or their families shall be supervised at all times
by a program staff member qualified under sub. (3) (b) 1. to 8.
(7) CLINICAL SUPERVISION.
(a) Each program shall develop and implement
a written policy for clinical supervision to ensure that:
1. The emergency mental health services being
provided by the program are appropriate and being delivered in a manner most
likely to result in positive outcomes for the program's clients.
2. The effectiveness and quality of service
delivery and program operations are improved over time by applying what is
learned from the supervision of staff under this section, the results of client
satisfaction surveys under s.
DHS
34.26, the review of the coordinated community
services plan under s.
DHS 34.22 (1)
(b), comments and suggestions offered by
staff, clients, family members, other providers, members of the public and
similar sources of information.
3.
Professional staff have the training and experience needed to carry out the
roles for which they have been retained, and receive the ongoing support,
supervision and consultation they need in order to provide effective services
for clients.
4. Any supervision
necessary to enable professional staff to meet requirements for credentialing
or ongoing certification under ch. 455, Stats. and related administrative rules
and under other requirements promulgated by the state or federal government or
professional associations is provided in compliance with those
requirements.
(b) The
clinical director is accountable for the quality of the services provided to
participants and for maintaining appropriate supervision of staff and making
appropriate consultation available for staff.
(c) Clinical supervision of individual
program staff members includes direct review, assessment and feedback regarding
each program staff member's delivery of emergency mental health
services.
(d) Program staff
providing emergency mental health services who have not had 3000 hours of
supervised clinical experience, or who are not qualified under sub. (3) (b) 1.
to 8., receive a minimum of one hour of clinical supervision per week or for
every 30 clock hours of direct crisis mental health services they
provide.
(e) Program staff who have
completed 3000 hours of supervised clinical experience and who are qualified
under sub. (3) (b) 1. to 8., participate in a minimum of one hour of peer
clinical consultation per month or for every 120 clock hours of direct crisis
mental health services they provide.
(f) Day to day clinical supervision and
consultation for individual program staff is provided by mental health
professionals qualified under sub. (3) (b) 1. to 8.
(g) Clinical supervision is accomplished by
one or more of the following means:
1.
Individual sessions with the staff member to review cases, assess performance
and let the staff member know how he or she is doing.
2. Individual side-by-side sessions in which
the supervisor is present while the staff person provides emergency mental
health services and in which the supervisor assesses, teaches and gives advice
regarding the staff member's performance.
3. Group meetings to review and assess staff
performance and provide staff advice or direction regarding specific situations
or strategies.
4. Other
professionally recognized methods of supervision, such as review using
videotaped sessions and peer review, if the other methods are approved by the
department and are specifically described in the written policies of the
program.
(h) Clinical
supervision provided for individual program staff is documented in
writing.
(i) Peer clinical
consultation is documented in either a regularly maintained program record or a
personal diary of the mental health professional receiving the
consultation.
(j) The clinical
director is permitted to direct a staff person to participate in additional
hours of supervision or consultation beyond the minimum identified in this
section in order to ensure that clients of the program receive appropriate
emergency mental health services.
(k) A mental health professional providing
clinical supervision is permitted to deliver no more than 60 hours per week of
direct crisis mental health services and supervision in any combination of
clinical settings.
(8)
ORIENTATION AND ONGOING TRAINING.
(a)
Orientation program. Each program shall develop and implement
an orientation program for all new staff and regularly scheduled volunteers.
The orientation shall be designed to ensure that staff and volunteers know and
understand all of the following:
1. Pertinent
parts of this chapter.
2. The
program's policies and procedures.
3. Job responsibilities for staff and
volunteers in the program.
4.
Applicable parts of chs. 48, 51 and 55, Stats., and any related administrative
rules.
5. The provisions of s.
51.30, Stats., and ch. DHS 92
regarding confidentiality of treatment records.
6. The provisions of s.
51.61, Stats., and ch. DHS 94
regarding patient rights.
7. Basic
mental health and psychopharmacology concepts applicable to crisis
situations.
8. Techniques and
procedures for assessing and responding to the emergency mental health service
needs of persons who are suicidal, including suicide assessment, suicide
management and prevention.
9.
Techniques for assessing and responding to the emergency mental health service
needs of persons who appear to have problems related to the abuse of alcohol or
other drugs.
10. Techniques and
procedures for providing non-violent crisis management for clients, including
verbal de-escalation, methods for obtaining backup, and acceptable methods for
self-protection and protection of the client and others in emergency
situations.
11. Policy on
telehealth, including when telehealth can be used and by whom, patient privacy
and information security considerations, and the right to decline services
provided via telehealth.
(b)
Orientation training
requirement.
1. Each newly hired
staff person who has had less than 6 months of experience in providing
emergency mental health services shall complete a minimum of 40 hours of
documented orientation training within 3 months after beginning work with the
program.
2. Each newly hired staff
person who has had 6 months or more of prior experience in providing emergency
mental health service shall complete a minimum of 20 hours of documented
orientation training within 3 months after beginning work with the
program.
3. Each volunteer shall
receive at least 40 hours of orientation training before working directly with
clients or their families.
(c)
Ongoing training
program. Each program shall develop and implement an ongoing training
program for all staff, which may include but is not limited to:
1. Time set aside for in-service
training.
2. Presentations by
community resource staff from other agencies.
3. Attendance at conferences and
workshops.
4. Discussion and
presentation of current principles and methods of providing emergency mental
health services.
(d)
Ongoing training requirement.
1. Each professional staff person shall
participate in at least the required number of hours of annual documented
training necessary to retain certification or licensure.
2. Staff shall receive at least 8 hours per
year of inservice training on emergency mental health services, rules and
procedures relevant to the operation of the program, compliance with state and
federal regulations, cultural competency in mental health services and current
issues in client's rights and services. Staff who are shared with other
community mental health programs may apply inservice hours received in those
programs toward this requirement.
(e)
Training records. A
program shall maintain as part of its central administrative records updated,
written copies of its orientation program, evidence of current licensure and
certification of professional staff, and documentation of orientation and
ongoing training received by program staff and volunteers.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.