DHS 40

DHS 40 Mental Health Day Treatment Services For Children

This chapter establishes certification requirements and operating standards for mental health day treatment programs serving youth (persons under 21) in Wisconsin, covering both community-based and intensive hospital-based program types. Operators must obtain and maintain department certification, implement required policies and procedures, provide specified program components (including psychotherapy, therapeutic milieu, care coordination, crisis response, and transition services), and meet personnel qualification and staffing standards. The chapter also governs ongoing oversight, inspections, deficiency notices, and certification suspension or termination procedures.

Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
1 DEPARTMENT OF HEALTH SERVICES DHS 40.03
Chapter DHS 40
MENTAL HEALTH DAY TREATMENT FOR YOUTH
DHS 40.01 Authority and purpose.
DHS 40.02 Applicability.
DHS 40.03 Definitions.
DHS 40.04 Certification.
DHS 40.05 Waivers and variances.
DHS 40.06 Coordination with educational services.
DHS 40.07 Program components.
DHS 40.08 Emergency safety interventions.
DHS 40.09 Personnel qualifications.
DHS 40.10 Required personnel and services.
DHS 40.11 Referral and Screening.
DHS 40.12 Admission.
DHS 40.13 Assessment.
DHS 40.14 Treatment Plan.
DHS 40.15 Client records.
DHS 40.16 Client rights.
DHS 40.17 Program evaluation.
DHS 40.18 Death Reporting.
Note: Chapter HFS 40 was renumbered to chapter DHS 40 under s. 13.92 (4) (b) 
1., Stats., and corrections made under s. 13.92 (4) (b) 7., Stats., Register November 
2008 No. 635. Chapter DHS 40 as it existed on June 30, 2020, was repealed and a 
new chapter DHS 40 was created by CR 19-018, effective 7-1-20.
DHS 40.01 Authority and purpose. This chapter is 
promulgated under the authority of s. 51.42 (7) (b), Stats., and is 
intended to regulate programs providing mental health day treat-
ment services for youth.
History: CR 19-018: cr. Register June 2020 No. 774, eff. 7-1-20.
DHS 40.02 Applicability. This chapter applies to all pro-
grams providing mental health day treatment services for youth 
in the state of Wisconsin. This chapter does not regulate other 
providers of day treatment services for youth, such as alcohol and 
other substance use disorder treatment programs regulated by ch. 
DHS 75. If a comprehensive program offers services to youth in 
addition to mental health day treatment, this chapter applies only 
to those program components that offer mental health day 
treatment.
History: CR 19-018: cr. Register June 2020 No. 774, eff. 7-1-20.
DHS 40.03 Definitions. In this chapter:
(1) “Advanced practice nurse” has the meaning given in s. N 
8.02 (1).
(2) “Advanced practice nurse prescriber” has the meaning 
given in s. N 8.02 (2).
(3) Assessment” means the process required under s. DHS 
40.13.
(4) “Biopsychosocial information” means the combination of 
physical, psychological, social, environmental, and cultural fac-
tors that influence a youth’s development and functioning includ-
ing underlying driving forces or unmet needs that are expressed 
through challenging behavior that a youth is exhibiting.
(5) “Care coordination” means efforts by day treatment pro-
grams to work jointly with other service systems and agencies, 
including schools, corrections, child welfare, substance use disor-
der treatment, and mental and physical health providers, in order 
to enhance services and supports and reduce barriers to service 
delivery.
(6) “Chemical restraint” means any medication or substance 
that may decrease a youth’s independent functioning and that is 
not administered pursuant to a current treatment plan.
(7) “Client” means a youth receiving mental health day treat-
ment services from a program.
(8) “Clinical collaboration” means a joint intellectual and 
clinical effort by mental health professionals, intended to produce 
therapeutic benefits and favorable outcomes.
(9) “Clinical supervision” means the process described in s. 
DHS 40.10 (5).
(10) “Community-based program” means a program provid-
ing mental health day treatment services for youth in a facility 
that is not affiliated with a hospital.
(11) “Co-occurring disorder” means any combination of both 
a mental health disorder and a substance use disorder.
(12) “Crisis response services” means written policies and 
procedures for identifying risk of suicidal ideation, attempted 
suicide, or risk of harm to self or others.
(13) “Cultural responsiveness” means the process by which 
staff engage respectfully and effectively with a youth or legal rep-
resentative of all cultures, languages, classes, races, ethnic back-
grounds, disabilities, religions, genders, sexual orientations, and 
other diversity factors in a manner that does all of the following:
(a) Recognizes, affirms, and values the worth of youth, fami-
lies and communities.
(b) Protects and preserves the dignity of youth, families and 
communities.
(c) Provides choices for action that are aligned with the con-
text and preferences that derive from their culture and worldview.
(14) “Deficiency” means a failure to meet a requirement of 
this chapter.
(15) “Department” means the Wisconsin department of 
health services.
(16) “Educational service” means a program provided by a 
local education agency that has a unique identification code as-
signed by the Wisconsin department of public instruction and 
that provides or directly supervises PK-12 services.
(17) “Evidence-based practice” means a practice, such as a 
systemic decision-making process or a service that has been 
shown, through available scientific evidence, to consistently im-
prove measurable client outcomes.
(18) “Family-driven care” means care that facilitates involve-
ment by family and legal representatives in a youth’s care, in or-
der to improve outcomes.
(18m) “Functionally equivalent” means a service provided 
via telehealth where the transmission of information is of suffi-
cient quality as to be the same level of service as an in-person 
visit. Transmission of voices, images, data, or video must be 
clear and understandable.
(19) “Gender-sensitive service” means a service that compre-
hensively addresses gender-related needs and fosters positive gen-
der identity development.
(20) “Intensive hospital-based program” means a program 
providing mental health day treatment services for youth with an 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 40.03 WISCONSIN ADMINISTRATIVE CODE 2
acute level of need. This setting is meant to support youth with 
severe symptomology who need closer supervision.
(21) “Legal representative” means any of the following:
(a) A guardian of the person, as defined under s. 54.01 (12), 
Stats.
(b) An adult client’s health care agent, as defined in s. 155.01 
(4), Stats.
(c) A parent of a minor, as defined in s. 48.02 (13), Stats., a 
guardian, as defined in s. 48.02 (8), Stats., or a legal custodian, as 
defined in s. 48.02 (11), Stats.
(d) Any other individual or entity with legal authority to rep-
resent the client.
(22) “Licensed treatment professional” means any of the fol-
lowing, whose license is in good standing at the time of practice:
(a) A physician licensed under s. 448.03 (1) (a), Stats., who 
has completed a residency in psychiatry.
(b) A psychologist or a private practice school psychologist li-
censed under ch. 455, Stats.
(c) A marriage and family therapist licensed under s. 457.10 
or 457.11, Stats.
(d) A professional counselor licensed under s. 457.12 or 
457.13, Stats.
(e) A clinical social worker licensed under s. 457.08 (4), Stats.
(23) “Local educational agency” means a school district, as 
provided in s. 115.01 (3), Stats., a cooperative educational ser-
vices agency (CESA) established under ch. 116, Stats., or a board 
established under s. 115.817, Stats.
(24) “Major deficiency” means a determination by the de-
partment that any of the following occurred:
(a) The program or a staff member created a risk of harm to a 
client or violated a client right created by this chapter.
(b) A staff member had sexual contact, as defined in s. 
940.225 (5) (b), Stats., with a client.
(c) A staff member was convicted of abuse under s. 940.285, 
940.29, or 940.295, Stats.
(d) A staff member was included on the Caregiver Miscon-
duct Registry under ch. DHS 13 and did not receive a rehabilita-
tion determination from the department for all instances of sub-
stantiated misconduct.
(e) The program or a staff member submitted or caused to be 
submitted a false statement for purposes of obtaining certifica-
tion under this chapter.
(f) A license, certification, or required approval of the pro-
gram expired, was revoked, or was suspended by any local, state, 
or federal authority, or the program’s Medicaid or Medicare 
provider certification was suspended or terminated for any basis 
under s. DHS 106.06 or federal law, or by any local, state, or fed-
eral authority.
(25) “Measurable objective” means a clear statement of the 
behavioral changes that are to be made, the conditions under 
which the behaviors are to occur, and a criterion for success.
(26) “Mechanical restraint” means any physical device, used 
for the purpose of limiting or controlling a youth’s movement.
(27) “Mental health day treatment service” means non-resi-
dential care that is prescribed by a physician and that is provided 
in a clinically supervised therapeutic milieu that provides an inte-
grated system of individual, family, and group psychotherapy, 
care coordination, and support services pursuant to a treatment 
plan.
(28) “Mental health professional” means a licensed treatment 
professional, a qualified treatment trainee, or a recognized psy-
chotherapy practitioner that practices within the scope of their 
practice.
(29) “Mental health support worker” means an individual 
who has a bachelor’s or master’s degree and provides services to 
implement the treatment plan.
(30) “Mental health technician” means an individual who as-
sists mental health support workers and mental health profession-
als with implementation of support services.
(31) “Mental illness” means a mental health disorder that a 
mental health professional determines substantially diminishes a 
youth’s ability to carry out age-appropriate activities of daily liv-
ing, except that “mental illness” does not include dementia or a 
developmental disability.
(32) “Occupational therapist” has the meaning given in s. 
448.96 (4), Stats.
(33) “Occupational therapy assistant” has the meaning given 
in s. 448.96 (6), Stats.
(34) “Parent peer specialist” means a person with knowledge 
gained from parenting youth with social, emotional, behavioral, 
mental health or substance use challenges and who has training to 
increase their skills to guide and support other parents or those in 
a parenting role.
(35) “Physical restraint” means use of physical force for the 
purpose of interfering with the movement of a youth, which in-
cludes forcibly moving or transporting a youth from one location 
to a seclusion room or area. “Physical restraint” does not include 
briefly holding a youth, without force, to calm or comfort her or 
him, or holding a youth’s hand to safely escort him or her from 
one area to another and similar physical guidance and prompting 
techniques of brief duration.
(36) “Positive behavior support” means specific proactive 
strategies, documented in the treatment plan, intended to replace 
challenging behaviors with positive and functional alternatives.
(37) “Physician” has the meaning given in s. 448.01 (5) , 
Stats.
(38) “Physician assistant” has the meaning given in s. 
448.971 (2), Stats.
(39) “Prescriber” means a physician, a physician assistant 
acting within the conditions and limitations set forth in ch. Med 
8, or an advanced practice nurse prescriber acting within the con-
ditions and limitations set forth in s. N 8.06.
(40) “Program” means a community-based program or a hos-
pital-based program.
(41) “Psychotherapy” has the meaning given in s. 457.01 
(8m), Stats., for marriage and family therapy, professional coun-
seling, and social workers or s. 455.01 (6) , Stats., for 
psychologists.
(42) “Psychotropic medication” means a prescription drug, 
as defined in s. 450.01 (20), Stats., that is prescribed by a pre-
scriber to treat or manage mental illness.
(43) “Qualified treatment trainee” means either of the 
following:
(a) A graduate student who is enrolled in an accredited insti-
tution in psychology, counseling, marriage and family therapy, 
social work, nursing or a closely related field and is doing a super-
vised practicum for their graduate degree program.
(b) A person who has been awarded a graduate degree by an 
accredited institution and has completed coursework in psychol-
ogy, counseling, marriage and family therapy, social work, nurs-
ing or a closely related field who has not yet completed the appli-
cable supervised practice requirements described under s. 
MPSW 4.01, 12.01, or 16.04, or s. Psy 2.10.
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
3 DEPARTMENT OF HEALTH SERVICES DHS 40.04
(44) “Recognized psychotherapy practitioner” means an indi-
vidual who may lawfully practice psychotherapy within the scope 
of a license, permit, registration or certificate granted by this 
state, other than under ch. 455 or 457, Stats.
(45) “Registered nurse” means a person licensed under s. 
441.06, Stats. as a registered nurse.
(46) “Seclusion” means the involuntary confinement and iso-
lation in a room or area from which the youth is prevented from 
leaving.
(47) “Sensory interventions” means a treatment or therapy 
that makes use of, or aims to improve, sensitivity to one or more 
of the senses.
(48) “Service” means a crisis response service, a mental 
health day treatment service, a support service, transition service, 
trauma-informed service, or minimum required service under s. 
DHS 40.07 (4).
(49) “Severe emotional disturbance” means an emotional or 
behavioral problem for a youth that currently meets, or at any 
time during the past year met, criteria for a mental disorder spec-
ified within a recognized diagnostic classification, and that pro-
duces a functional impairment which substantially interferes with 
or limits functioning in family, school, employment, relation-
ships, or community activities.
(49m) “Signature” or “signed” means a signature that meets 
the requirements in s. 990.01 (38), Stats.
(50) “Staff member” means a person employed or contracted 
through the program who provides treatment services to a youth 
or legal representative.
(51) “Support service” means individualized advice, guid-
ance, or assistance with planning, designed to facilitate positive 
alternatives to challenging behaviors, and to assist a youth with 
developing adaptive and functional restoration. “Support ser-
vice” does not include psychotherapy or time spent in educational 
services, meals, or recreation.
(51m) (a) “Telehealth” means the use of telecommunica-
tions technology by a certified provider to deliver services allow-
able under this chapter, s. DHS 107.02 (5), and ss. 49.45 (61) and 
49.46 (2) (b) 21. to 23., Stats., including assessment, diagnosis, 
consultation, treatment, or transfer of medically relevant data in a 
functionally equivalent manner as that of an in-person contact. 
(b) “Telehealth” may include real-time interactive audio-only 
communication. 
(c) “Telehealth” does not include communication between a 
certified provider and a recipient that consists solely of an elec-
tronic mail, text, or facsimile transmission.
(52) “Therapeutic milieu” means the combination of physical 
and interpersonal environments established and maintained in 
the mental health day treatment program to provide safety, trust, 
and consistency of care, and to model, teach, and reinforce posi-
tive and supportive behaviors and interactions among youth and 
staff.
(53) “Therapeutic specialists” means experiential therapists, 
art therapists, and music therapists who have complied with the 
appropriate certification procedures for their profession as re-
quired by state statute or administrative rule or the governing 
body regulating their profession.
(54) “Transition services” means services provided to a 
youth to ensure continuity of care and management of the youth’s 
needs to ensure gradual reintegration back into school and the 
community as appropriate.
(55) “Treatment plan” means the document required under s. 
DHS 40.14.
(56) “Trauma” means significant distress or impairment in a 
person’s social, coping, or other important areas of functioning, 
resulting from experiences or events.
(57) “Trauma-informed service” means a service that is at-
tentive to the role that trauma plays in the lives of youth and fam-
ily members, including recognition of the traumatic effect of mis-
diagnosis, coercive treatment, and inadvertent re-traumatization.
(58) “Variance” means a modification to a requirement of 
this chapter.
(59) “Voluntary time out” means an intervention intended to 
accomplish any of the following:
(a) Encourage youth to voluntarily use a calming or safe place 
that does not physically confine the youth, and that permits pro-
gram staff members to visually monitor the youth when they are 
experiencing agitation or anxiety.
(b) Protect a client from another client who is posing a risk of 
harm or serious disruption.
(60) “Waiver” means an exemption from a specific require-
ment of this chapter.
(61) “Youth” means a person under 21 years of age.
History: CR 19-018: cr. Register June 2020 No. 774, eff. 7-1-20; correction in 
(5), (21) (c), (23), (27), (31), (35), (41), (42), (43) (b), (49), (51) made under s. 
35.17, Stats., and correction in (39) made under s. 13.92 (4) (b) 7., Stats., Register 
June 2020 No. 774; CR 23-053: cr. (18m), (49m), (51m) Register September 2023 
No. 813, eff. 10-1-23; CR 25-055: am. (38) Register February 2026 No. 842, eff. 
3-1-26; correction in (41) made under s. 35. 17, Stats., Register February 2026 
No. 842.
DHS 40.04 Certification. (1) INITIAL CERTIFICATION 
REQUIREMENTS. (a) General. A program that provides mental 
health day treatment services may not be established without cer-
tification from the department.
(b) Application. 1. Certification may be granted to establish 
any of the following:
a. A community-based program.
b. An intensive hospital-based program.
Note: Application materials may be obtained from the Behavioral Health Certi-
fication Section, Division of Quality Assurance, PO Box 2969, Madison, WI 
53701-2969 or online at DHSDQAMentalHealthAODA@wisconsin.gov. Com-
pleted application materials may be submitted by mail to the Behavioral Health Cer-
tification Section, Division of Quality Assurance, PO Box 2969, Madison, WI 
53701-2969.
2. A program may apply for certification by submitting the 
following application materials to the department:
a. A completed application form.
b. Payment for the certification fee required under s. 51.04, 
Stats.
Note: Fee amounts are found at https://www.dhs.wisconsin.gov/regulations/in-
dex.htm.
c. A program description, containing all of the following 
information:
1) The age range and characteristics of youth the program pro-
poses to admit and if the program proposes to offer services 
based on age, the age range and client characteristics for each 
service.
2) The maximum number of youth that the program proposes 
to serve at any given time.
3) The hours and days of the year when the program will oper-
ate, and the proposed times during the day and week when youth 
will receive services from the program.
4) The treatment, services and supports, including parent peer 
specialists when appropriate, that will be offered by the program, 
and a rationale for how they will help the youth population 
achieve and sustain positive outcomes. If the program proposes 
to incorporate specific evidence-based practices in its array of 
services, a description of those services, the training and certifi-
cation that its staff members have received or will receive that 
qualifies them to offer those services, and how those services will 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 40.04 WISCONSIN ADMINISTRATIVE CODE 4
be provided. A description of the therapeutic milieu the program 
proposes to create with the proposed treatment, services and sup-
ports, how it will be maintained, its intended therapeutic benefits, 
and the rationale supporting its use for the youth served by the 
program. If the program proposes to offer other services within 
the same facility or program, it shall indicate the process that the 
program will use in deciding when and how to offer these ser-
vices, how it will obtain any necessary authorization for these 
services, and how these services will be funded and regulated.
5) The program’s proposal for meeting staffing level require-
ments in s. DHS 40.10 (2), the qualifications and roles for each 
position, and an analysis showing that staffing is adequate to 
meet the needs of the youth that the program proposes to serve. 
A description is also required of any specialized training and cer-
tification that program staff members have received or will be re-
ceiving that will help them better identify and address the spe-
cific needs of the youth served by the program.
6) A description of the physical settings indicating where ser-
vices will be provided and whether these settings will be used for 
other purposes. Documentation of inspection or permit indicat-
ing the state building code requirements have been met, including 
chs. SPS 361 to 366, American with Disabilities Act, any appli-
cable local ordinance or municipal building codes, and any addi-
tional information requested by the department.
7) If a program is proposing to operate a community-based 
program in a school, an agreement that describes the school in 
which the program will be located, the area or areas in the school 
where program operations will occur, the interactions that the 
program will have with other school activities and classes, the re-
lationship that the program staff will have with school staff, how 
program staff and school staff will maintain separate duties, and 
the activities that youth will be participating in while also receiv-
ing services through the program.
8) How the program will participate in care coordination for 
youth within the community.
9) Where client records will be maintained and how confiden-
tiality requirements of those records will be safeguarded, as re-
quired under s. DHS 40.15.
10) How the program will arrange for food service to any 
youth who is in the program for four or more hours during a day.
(c) Initial on-site inspection. Upon receipt of all application 
materials described in sub. (2), the applicant shall do all of the 
following:
1. Permit the department to conduct an on-site inspection of 
the program’s physical settings to determine compliance with this 
chapter.
2. Make available for review by the department any docu-
mentation necessary to determine compliance with the standards 
in this chapter.
(d) Certification determination. 1. The department shall 
make a certification determination within 60 days of receiving all 
completed application materials.
2. The department may grant certification if all the require-
ments of this chapter are met.
3. If the department determines that a program applying for 
certification does not comply with the requirements of this chap-
ter, has a major deficiency, or the program description is not ap-
proved, the department may deny certification. A denial of certi-
fication shall be in writing and shall contain the reason for the de-
nial and notice of appeal rights.
(e) Scope of certification. Certification granted by the depart-
ment shall only be valid for the program described in the applica-
tion materials.
(2) ONGOING OVERSIGHT PROVISIONS. (a) Notification of 
changes. A program that has received certification from the de-
partment shall notify the department of any change of adminis-
tration, ownership, program name, required staff, or any other 
program change that may affect compliance with this chapter be-
fore the effective date of the change. A new application will be 
required if, upon notification, the department determines there is 
a substantial change in the program.
Note: Program notifications should be made to: Behavioral Health Certification 
Section, Division of Quality Assurance, PO Box 2969, Madison, WI 53701-2969 or 
by emailing DHSDQAMentalHealthAODA@wisconsin.gov.
(b) Duration of certification. 1g. Certification is valid until 
suspended or terminated by the department under sub. (2) (f).
1r. Certification may be suspended or terminated under sub. 
(2) (f).
2. Any program that intends to close shall notify the depart-
ment in writing at least 30 days before closing and comply with s. 
DHS 40.15 (9).
(c) Biennial report and fees. Every 24 months, by the date of 
renewal, the program shall submit a biennial report on the form 
provided by the department, and shall submit payment of certifi-
cation continuation fees for the purpose of renewing certification 
of the program for two years.
(d) Ongoing on-site inspections. The program shall permit 
unannounced, on-site inspections of the program by the depart-
ment to conduct program reviews, to conduct complaint or death 
investigations involving any aspect of the program, or to deter-
mine a program’s progress in correcting a deficiency or major de-
ficiency cited by the department. All of the following conditions 
apply to an on-site inspection:
1. The department shall use a random selection process for 
reviewing client records during program reviews.
2. The department shall conduct client interviews as part of 
the program review process.
(e) Notice of deficiencies. 1. If the department determines 
that a program has a deficiency, the department shall issue a no-
tice of deficiency to the program. The notice of deficiency may 
place restrictions on the activities of the program, or suspend or 
terminate the program’s certification.
2. The program shall submit a plan of correction to the de-
partment as indicated in the notice of deficiency. The plan of cor-
rection shall identify the specific steps the program will take to 
correct the deficiency, the timelines within which the corrections 
will be made, and the staff members who will implement the plan 
and monitor for future compliance.
3. If the department determines that the plan of correction 
submitted by the program does not adequately address deficien-
cies listed in the notice of deficiency, the department may impose 
a plan of correction.
(f) Termination and suspension of certification. 1. The de-
partment may terminate certification at any time for any major 
deficiency by issuing a notice of major deficiency to the program. 
The notice shall specify the reason for the department action and 
contain appeal information.
2. The department may summarily suspend a program’s cer-
tification if the department determines that immediate action is 
required to protect the health, safety, or welfare of youth. Notice 
of suspension may be written or verbal and shall specify the rea-
son for the department action and the date the action becomes ef-
fective. Within 10 working days after the order is issued, the de-
partment shall either lift the suspension on the program’s certifi-
cation or proceed to terminate the program’s certification.
(g) Appeals. If the department denies or terminates certifica-
tion, the program may request a hearing under ch. 227, Stats.
(h) Reapplication. If an application for certification is de-
nied, the program may not reapply for certification for one year 
following the date on which certification was denied.
(i) Dissemination of results. Upon completing action on an 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
5 DEPARTMENT OF HEALTH SERVICES DHS 40.07
application for certification, staff of the department shall provide 
a summary of the results of the process to the applicant, to the 
subunit within the department responsible for monitoring com-
munity mental health programs, and to the department of com-
munity programs under s. 51.42, Stats., in the county in which 
the program is located.
History: CR 19-018: cr. Register June 2020 No. 774, eff. 7-1-20; correction in 
numbering of (2) (b) 1g., 1r. made under s. 13.92 (4) (b) 1., Stats., and correction in 
(1) (c) (intro.), (2) (a), (b) 2., (c), (d) made under s. 35.17, Stats., Register June 2020 
No. 774; correction in (2) (b) 1g., 1r. made under s. 13.92 (4) (b) 7., Stats., Register 
December 2020 No. 780.
DHS 40.05 Waivers and variances. (1) REQUEST. A 
program may request a waiver or a variance from the department. 
A request shall be made in writing and include all of the 
following:
(a) The name of the program.
(b) The rule provision from which the waiver or variance is 
requested.
(c) The time period for which the waiver or variance is 
requested.
(d) If the request is for a variance, the specific alternative ac-
tion that the program proposes.
(e) The reasons for the request and a supporting justification.
(f) Any other information requested by the department.
Note: An application for a waiver or variance should be addressed to the Behav-
ioral Health Certification Section, Division of Quality Assurance, P.O. Box 2969, 
Madison, WI 53701-2969 or emailed to DHSDQAMentalHealthAODA@wiscon-
sin.gov.
(2) REQUIREMENTS. (a) The department may grant a waiver 
or variance requested by a program, or may impose additional 
conditions on the proposed waiver or variance, including limiting 
their duration, or providing that the waiver or variance may be 
withdrawn for any of the reasons specified in par. (b) if the de-
partment determines all of the following:
1. The waiver or variance is not likely to adversely affect the 
health, safety, or welfare of any youth.
2. The waiver or variance is likely to improve services, or 
management and operation of the program, or permit piloting of 
new services.
(b) The department may revoke a waiver or variance granted 
under par. (a) if any of the following occurs:
1. The program fails to comply with the variance as granted.
2. The program notifies the department that it wishes to re-
linquish the waiver or variance.
3. There is a change in applicable state or federal law.
4. The department determines the revocation is necessary to 
protect the health, safety, or welfare of a youth.
(3) NOTIFICATION. (am) Within 60 days of the receipt of a 
request for a waiver or variance, the department shall notify the 
program in writing of its decision to do any of the following:
1. Extend the department’s review period for the request.
2. Grant or deny the waiver or variance as requested.
3. Grant the waiver or variance with additional conditions 
imposed by the department.
(bm) If the department denies a request for a waiver or vari-
ance, or revokes a waiver or variance, the department shall notify 
the program in writing of the reason for the denial or revocation.
History: CR 19-018: cr. Register June 2020 No. 774, eff. 7-1-20; correction in 
numbering in (3) made under s. 13.92 (4) (b) 1., Stats., Register June 2020 No. 774.
DHS 40.06 Coordination with educational services. 
(1) Programs shall make reasonable efforts to provide care coor-
dination by executing memoranda of understanding or other 
forms of interagency agreement with local educational agencies 
or other services or programs that provide services to program 
youth.
(2) This chapter does not modify the educational rights and 
obligations of the youth in the program, any legal representative, 
or any local educational agency providing services in coordina-
tion with a mental health day treatment program certified under 
this chapter.
History: CR 19-018: cr. Register June 2020 No. 774, eff. 7-1-20.
DHS 40.07 Program components. (1) REQUIRED 
POLICIES AND PROCEDURES. A program shall develop and imple-
ment written policies and procedures for:
(a) Admission and orientation.
(b) Fee agreements.
(c) Assessments.
(d) Contents and implementation of individualized treatment 
plans.
(e) Implementation of person-centered care, including:
1. Cultural responsiveness.
2. Developmentally appropriate and age-appropriate service 
planning and delivery.
3. Legal representative involvement.
4. Strength-based approaches and planning.
5. Trauma-informed and responsive approaches and 
planning.
(f) Care coordination.
(fm) Policy on telehealth, including when telehealth can be 
used and by whom, patient privacy and information security con-
siderations, and the right to decline services provided via 
telehealth.
(g) Confidentiality and compliance with 42 CFR part 2 , 45 
CFR parts 160, 162, and 164, s. 51.30, Stats., and ch. DHS 92.
(h) Compliance with Title 2 of the Americans with Disabili-
ties Act of 1990.
(i) Client rights and grievance processes under s. 51.61, Stats., 
and ch. DHS 94.
(j) Crisis prevention and response, including the program’s 
use of support services, seclusion, and physical restraint and the 
process for obtaining a written authorization from a physician 
that allows seclusion and physical restraint for a youth prior to 
utilizing any emergency intervention with that youth.
(k) Services for minor youth transitioning to adulthood.
(L) Discharge, transfer, and continuity of care.
(m) Quality assurance and performance improvement.
(n) Written personnel policies.
(2) INVOLVEMENT IN TREATMENT PLANNING FOR YOUTH. (a) 
A program shall provide all of the following to a youth or legal 
representative upon request:
1. Copies of the policies and procedures, required under sub. 
(1).
2. Written documentation of each staff member’s qualifica-
tions per s. DHS 40.09 (2) to (4).
3. Admission paperwork that explains the program and 
forms required for enrollment prior to the admission meeting, and 
assistance with understanding the paperwork.
4. A copy of ch. DHS 40.
5. Information about fees, payment sources, and how to ac-
cess any applicable financial resources, and other community re-
sources that are potentially helpful and how to access them.
(b) A program shall include the youth or legal representative 
throughout all parts of the treatment process, including screening, 
assessment, treatment, and discharge. A program shall make rea-
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 40.07 WISCONSIN ADMINISTRATIVE CODE 6
sonable efforts to include any persons or family members that the 
youth or legal representative has authorized to participate in treat-
ment or treatment planning. All of the following apply to the pro-
gram’s engagement of the youth or legal representative:
1. The assessment process shall engage the youth or legal 
representative to recognize the strengths and needs of the youth, 
and ensure that the youth or legal representative’s perspectives, 
opinions, and preferences are included as part the treatment plan.
2. A program shall inform the youth or legal representative 
of the proposed services and supports within the treatment plan 
and provide a written copy of the plan.
3. Transition services shall consider the needs and prefer-
ences of the youth or legal representative.
(c) To ensure that the proposed services reflect a partnership 
between the youth or legal representative and program staff, a 
program shall do all of the following, as available and needed:
1. Employ, contract, or coordinate for the services of parent 
peer specialists who can help a youth or legal representative un-
derstand the operations of the program and support effective in-
put in the planning and implementation of services.
2. Establish flexible schedules for meetings and activities so 
that legal representatives can participate without taking time off 
from work.
3. Make arrangements for transportation to the program if 
possible when legal representatives lack the ability to travel to the 
program using their own resources.
4. Adjust program services and activities to accommodate 
cultural and linguistic preferences and needs.
5. Use technological resources to encourage participation 
when in-person meetings are not possible, consistent with re-
quirements to ensure confidentiality of treatment information.
(3) GENERAL REQUIREMENTS. In addition to services that are 
necessary to achieve the treatment objectives identified in each 
youth’s assessment and individual treatment plan, all of the fol-
lowing minimum requirements services shall be provided:
(a) Community-based program. A community-based pro-
gram shall offer all of the following:
1. Individual, group and family psychotherapy provided by 
trained mental health professionals.
2. A structured therapeutic milieu supervised by a clinical 
coordinator.
3. Care coordination.
4. Support services.
5. Crisis response services.
6. Implementation of transition services designed to support 
the reintegration of a youth who is completing the program into 
family, community and school activities and to prevent recur-
rence of the problems which led to the original placement in the 
program.
(b) Intensive hospital-based programs. An intensive hospital-
based program shall offer minimum required services under par. 
(a) and shall increase the hours of direct clinical services under s. 
DHS 40.10 (3) (b) and increase the hours of operation under s. 
DHS 40.10 (4) (b) to meet the needs of youth who have severe 
symptomology and need closer supervision.
(4) SUPPORT SERVICES. Each program shall provide support 
services that include all of the following:
(a) Methods for documenting, measuring, and tracking 
progress on measurable objectives contained in a youth’s treat-
ment plan.
(b) Strategies for all of the following:
1. Reducing or eliminating the use of emergency safety 
interventions.
2. Teaching and increasing positive replacement behaviors, 
based on baseline measures at intake.
3. Building relationships between youth and staff members 
that promote trust and safety.
4. Empowering youth to take responsibility for their behavior 
and regulating their emotions.
5. Sensory interventions within the treatment milieu to en-
hance functioning and assist with behavioral challenges.
(5) VOLUNTARY TIME OUT. Support services shall be pro-
vided to a youth prior to using a voluntary time out. Voluntary 
time out should be used as a least restrictive measure, prior to in-
voluntary seclusion or physical restraint, unless there is imminent 
danger due to a youth’s aggression to self or others. Voluntary 
time out shall be encouraged for the shortest time possible and 
only for the length of time necessary for the youth to de-escalate 
or regulate his or her emotions. Programs shall encourage volun-
tary time out for youth who show signs of agitation or anxiety.
History: CR 19-018: cr. Register June 2020 No. 774, eff. 7-1-20; correction in 
(1) (g) made under s. 35.17, Stats., Register June 2020 No. 774; CR 23-053: cr. (1) 
(fm) Register September 2023 No. 813, eff. 10-1-23; CR 23-046: am. (2) (a) 2. Reg-
ister April 2024 No. 820, eff. 5-1-24.
DHS 40.08 Emergency safety interventions. (1) 
PROHIBITED INTERVENTIONS. Mechanical restraints, with the ex-
ception of procedures in sub. (5) (e) and chemical restraints are 
prohibited.
(2) GENERAL REQUIREMENTS FOR SECLUSION AND PHYSICAL 
RESTRAINT. Seclusion and physical restraint shall comply with 
the requirements under s. 51.61 (1) (i), Stats., s. DHS 94.10, and 
this chapter.
(3) STAFF REQUIREMENTS. Seclusion and physical restraint 
shall only be administered by program staff members who have 
completed orientation described in s. DHS 40.10 (6) (b).
(4) ADMINISTRATION REQUIREMENTS. Seclusion and physi-
cal restraint may only be administered when all of the following 
requirements are met in addition to the requirements under s. 
51.61 (1) (i), Stats., and s. DHS 94.10:
(a) When all other less restrictive methods have been 
exhausted.
(b) For the shortest time possible and only until the youth is 
no longer a danger to self or others.
(c) In a manner that is attentive to, and respectful of the 
trauma history, dignity, and civil rights of the youth.
(d) To avoid or cause the least possible physical or emotional 
discomfort, harm, and pain to the youth.
(e) Allowing adequate access to bathroom facilities, drinking 
water, and necessary medication.
(5) SPECIFIC REQUIREMENTS FOR SECLUSION. (a) Program 
staff members shall provide uninterrupted supervision and moni-
toring of the youth and entire seclusion area during seclusion by 
being in the room with the youth or by observation through a win-
dow into the room.
(b) A program shall maintain an incident log to document the 
use of seclusion. The log shall include the time when the seclu-
sion began, the youth’s behaviors and staff member’s response to 
those behaviors every 5 minutes, and the time seclusion ended.
(c) Seclusion rooms shall be free of objects or fixtures with 
which the youth could inflict bodily harm.
(d) Only a single youth may be placed in a seclusion room.
(e) A youth may only be kept in the seclusion area by means 
of one of the following:
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
7 DEPARTMENT OF HEALTH SERVICES DHS 40.08
1. A staff member is in a position, such as in a doorway, to 
prevent a youth from leaving the seclusion area.
2. A staff member physically holds a door shut to a seclusion 
room.
3. A door to a seclusion room is latched by positive pressure 
applied by a staff member’s hand without which the latch would 
spring back allowing the door to open on its own accord, except 
that a hospital-based program may use a magnetic door lock or a 
lock which requires the turn of a knob to unlock a door. Other 
designs of door locks shall not be used, including padlock, key 
lock, or other locks of similar design.
(6) SPECIFIC REQUIREMENTS FOR PHYSICAL RESTRAINT. (a) 
Physical restraint shall only be administered to a youth during an 
emergency, when there is a serious threat of violence to other 
youth or a staff member, personal injury, or attempted suicide.
(b) At a minimum, two staff members trained in the use of 
emergency safety interventions shall be physically present during 
the administration of physical restraint, and shall continually 
monitor the condition of the youth and the safe use of physical re-
straint throughout the duration of the intervention.
(c) Methods of physical restraint that are likely to cause bod-
ily harm are prohibited, such as:
1. Pressure or weight on the chest, lungs, sternum, di-
aphragm, back, or abdomen, such as straddling or sitting on the 
torso.
2. Pressure, weight, or leverage on the neck or throat, on any 
artery, or on the back of the head or neck, or that otherwise ob-
structs or restricts the circulation of blood or obstructs an airway, 
such as choke holds or sleeper holds.
3. Wrestling holds or martial arts techniques.
4. Covering the face with any object, such as a pillow, towel, 
washcloth, blanket, or other fabric.
5. Pain or pressure points.
6. Hyperextension of limbs, fingers, or neck.
7. Forcible take downs from a standing position to the floor.
8. Restraint in a prone position.
9. Restraint in a supine position.
10. Restraint in a vertical position, with upper body pressed 
against a wall or hard surface.
11. Any other physical restraint that is not administered dur-
ing an emergency, that is administered for longer than necessary 
to prevent immediate injury to a youth or others, or that is admin-
istered for a purpose other than to prevent immediate injury to a 
youth or others.
(d) Immediately upon the termination of a physical restraint, a 
medical staff member, such as a physician, advanced practice 
nurse prescriber, physician assistant, advanced practice nurse, or 
registered nurse, shall conduct a follow-up assessment of the con-
dition of the youth to ensure that the youth was not injured and 
shall document the finding of the assessment in the youth’s file. 
If a staff member who is a doctor or nurse is not present on site, a 
licensed treatment professional shall conduct the face-to-face as-
sessment immediately upon termination of the physical restraint 
and notify a medical staff member.
(e) If any injury is noted following a physical restraint, a staff 
member shall notify the youth’s legal representative, if any, and 
make a referral for medical care.
(7) DEBRIEFING. (a) Following a seclusion or restraint, a 
staff member shall talk with the youth about each of the 
following:
1. The circumstances that contributed to the seclusion or 
physical restraint and what could have been handled differently 
by the staff member.
2. The youth’s psychological well-being and the emotional 
impact of the intervention.
3. What modifications can be made in the youth’s services or 
treatment plan to prevent future seclusion and physical restraint.
(b) The debriefing should occur within 24 hours following a 
seclusion and restraint, with the following exceptions:
1. When clinically contraindicated.
2. When the 24 hour period falls during non-programming 
time such as on a weekend or holiday, then debriefing shall occur 
on the next programming day.
3. When a youth is suspended or discharged from program-
ming following the incident and debriefing is contraindicated due 
to a serious risk of harm by the youth to others or to staff.
(c) A program shall notify a youth’s legal representative, if 
any, of any seclusion or physical restraint on the same day that it 
was administered to the youth. The program shall document in 
the youth’s file any situation in which notification has been at-
tempted and the program has been unable to contact the legal 
representative.
(d) Each administration of seclusion or physical restraint shall 
be documented in the youth’s chart and shall specify all of the 
following:
1. Less restrictive interventions attempted prior to the seclu-
sion or physical restraint.
2. Events precipitating the seclusion or physical restraint.
3. Length of time the seclusion or physical restraint was 
used.
4. Assessment of the appropriateness of the seclusion or 
physical restraint based on threat of harm to self or others.
5. Assessment of any physical injury to the youth, other 
clients, or to staff members.
6. The youth’s response to the emergency safety 
intervention.
(e) A licensed treatment professional shall review all seclu-
sion and physical restraint documentation prior to the end of the 
shift in which the intervention occurred and determine whether 
changes to the youth’s safety plan or treatment plan are necessary.
(f) If seclusion or physical restraint is administered to a youth 
more than three times over a period of five days, or in a single in-
stance for more than 30 minutes within 24 hours, the clinical co-
ordinator, or designee, shall do all of the following:
1. Convene staff to discuss the emergency situation that re-
quired seclusion or physical restraint, including the precipitating 
factors that led up to the intervention and any alternative strate-
gies that might have prevented the use of seclusion or physical re-
straint in those situations.
2. Convene staff to discuss the procedures, if any, to be im-
plemented to prevent further administration of seclusion or phys-
ical restraint.
3. Convene staff to discuss the outcome of the seclusion or 
physical restraint including any injuries.
4. Convene the youth’s interdisciplinary treatment team to 
review the individualized treatment plan and make any necessary 
revisions to reduce the need for and likelihood of further use of 
seclusion or physical restraint, and document the discussion and 
any resulting changes to the plan in the youth’s chart.
5. Determine whether a higher level of care is required for 
the youth and if a referral for inpatient or residential placement is 
necessary.
(8) REPORTING. (a) Programs shall report all incidences of 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 40.08 WISCONSIN ADMINISTRATIVE CODE 8
seclusion, physical restraint, injury, and involvement of law en-
forcement to the department within 24 hours of the incident oc-
curring. Reporting shall be completed through the department’s 
online reporting system.
(b) The department will evaluate the circumstances of each 
incident, conduct any appropriate follow-up, and identify pro-
grams in need of technical assistance, training, policy develop-
ment, or other quality improvement.
Note: The department reporting link is: https://www.dhs.wisconsin.gov/mh/ca-
daytreatmentproviders.htm. Questions and information about reporting may be di-
rected to the Division of Care and Treatment Services at 608-266-2717.
History: CR 19-018: cr. Register June 2020 No. 774, eff. 7-1-20; correction in 
(4) (intro.), (5) (e) 3., (6) (d), (7) (e) made under s. 35.17, Stats., Register June 2020 
No. 774; CR 23-053: am. (7) (a) (intro.) Register September 2023 No. 813, eff. 10-
1-23.
DHS 40.09 Personnel qualifications. (1) MINIMUM 
REQUIREMENTS. (a) Each staff member shall have the profes-
sional certification, training, experience, and ability to carry out 
his or her assigned duties.
(b) Each staff member shall pass a criminal history and pa-
tient abuse record search as provided in s. 50.065, Stats., and a 
caregiver background check under ch. DHS 12, before working 
for the program.
(c) Programs shall comply with caregiver misconduct report-
ing and investigation requirements in ch. DHS 13.
Note: For a state of Wisconsin background check, information on the process 
and fees can be found on-line at: http://www.doj.state.wi.us/dles/cib/Fees.asp, or 
contact the Crime Information Bureau, Wisconsin Department of Justice, P.O. Box 
2718, Madison, WI 53701-2718.
(2) QUALIFICATIONS OF PROGRAM DIRECTOR. The program 
director shall meet all of the following requirements:
(a) Meet the qualifications for any of the program staff listed 
in sub. (3) (a) to (j).
(b) Have at least one year of experience in a mental health set-
ting working with youth.
(c) Have at least 2 years of experience as an administrator of a 
program that provides mental health services to youth and 
families.
(3) QUALIFICATIONS OF PROGRAM STAFF. (a) The clinical 
coordinator shall meet all of the following qualifications:
1. Be a licensed mental health professional.
2. Have at least 1,500 hours of clinical experience in a prac-
tice with youth who have mental illness or severe emotional 
disturbance.
(b) A psychiatrist shall be a physician licensed to practice 
medicine and surgery and meet the requirements for certification 
in child psychiatry by the American board of psychiatry and neu-
rology. If a program can demonstrate that no board-certified or 
eligible child psychiatrist is available, the program may employ a 
psychiatrist who has a minimum of 1 year of clinical experience 
working with youth.
(c) Advanced practice nurse prescribers shall be certified in 
mental health treatment by an appropriate board and shall have 
had either training in providing psychiatric services, including 
work with youth with mental illness or severe emotional distur-
bance, or one year of experience working in a clinical setting with 
youth. An advanced practice nurse prescriber shall issue only 
those prescription orders appropriate to the advanced practice 
nurse prescriber’s areas of competence, as established by his or 
her education, training, or experience. Advanced practice nurse 
prescribers shall facilitate collaboration with other health care 
professionals, at least one of whom shall be a physician. Ad-
vanced practice nurse prescribers shall have completed 3,000 
hours of supervised clinical psychotherapy experience in order to 
also provide psychotherapy.
(d) Licensed mental health professionals shall have a mini-
mum of one year of experience working in a clinical setting serv-
ing youth with mental illness or severe emotional disturbance.
(e) Physician assistants, advanced practice nurses, registered 
nurses, and occupational therapists shall have either training in 
providing services to youth with mental illness or severe emo-
tional disturbance, or one year of experience working in a clinical 
setting with youth.
(f) Qualified treatment trainees shall have one year of a grad-
uate level education program specific to serving youth with men-
tal illness or severe emotional disturbance and shall provide psy-
chotherapy to clients only under clinical supervision.
(g) Occupational therapy assistants shall be certified and re-
ceiving supervision under chs. OT 1 to 5.
(h) Therapeutic specialists shall have one year of experience 
working with, or one year of a formal educational program spe-
cific to serving youth with mental illness or severe emotional 
disturbance.
(i) Mental health support workers shall have a minimum of 
one year of experience or formal education related to working 
with youth who have severe emotion disturbance or mental 
illness.
(j) Mental health technicians and parent peer specialists shall 
be at least 18 years old and have a minimum of 30 hours pre-ser-
vice training on their role in the program.
(4) VOLUNTEERS. A program may use volunteers to support 
the activities of staff. Volunteers shall receive a minimum of 10 
hours pre-service training under the requirements of s. DHS 
40.10 (6) (b) and shall be supervised by a licensed treatment pro-
fessional employed by the program. Each volunteer shall pass a 
criminal history and patient abuse record search state background 
check as provided in s. 50.065, Stats., and a caregiver background 
check under ch. DHS 12, before being allowed to working for the 
program.
History: CR 19-018: cr. Register June 2020 No. 774, eff. 7-1-20; correction in 
(2) (a) made under s. 13.92 (4) (b) 7., Stats., Register June 2020 No. 774.
DHS 40.10 Required personnel and services. (1) 
OPERATIONAL RESPONSIBILITIES. A program shall include all of 
the following administrators:
(a) A program director who is responsible for program opera-
tions and ensuring that the program is in compliance with this 
chapter and other applicable state and federal laws.
(b) A clinical coordinator who is responsible for ensuring that 
all staff members providing mental health services have the qual-
ifications required for their roles in the program and comply with 
all requirements relating to assessment, treatment planning, ser-
vice delivery, and service documentation.
1. The program director may also serve as the clinical coor-
dinator, if the program director is qualified under s. DHS 40.09 
(3) (a).
2. The program director shall identify one or more staff 
members qualified under s. DHS 40.09 (3) (a) to (e) to whom au-
thority may be delegated in the absence of the clinical coordina-
tor. The clinical coordinator or designee shall be on the premises 
at all times that youth are present at a program.
(2) STAFFING REQUIREMENTS. At all times that youth are 
present at a program, the program shall have a minimum of two 
staff members qualified under s. DHS 40.09 (3) on site, at least 
one of whom shall be a mental health professional. The number 
of staff available shall be based on meeting the treatment needs of 
youth based on individualized treatment plans, with additional 
staff present when higher levels of clinical needs are indicated. 
Calculation of the staff-to-client ratios for the program shall not 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
9 DEPARTMENT OF HEALTH SERVICES DHS 40.10
include volunteers. Programs shall meet all of the following 
staffing requirements:
(a) If more than 10 youth are present at a community-based 
program, an additional staff member qualified under s. DHS 
40.09 (3) shall be present for every 10 additional youth.
(b) If more than 10 youth are present at a hospital-based pro-
gram, an additional staff member qualified under s. DHS 40.09 
(3) shall be present for every 5 additional youth.
(3) SERVICE REQUIREMENTS. A program shall make avail-
able at least the following hours of direct clinical services, pro-
vided either by program staff members or professionals under 
contract to the program:
(a) A community-based day treatment program shall comply 
with all of the following:
1. One hour per week of consultation shall be provided by a 
psychiatrist or advanced practice nurse prescriber. If a program is 
unable to utilize a psychiatrist or advanced practice nurse pre-
scriber, they may utilize a psychologist as long as there is a writ-
ten plan in place assuring that consultation with a psychiatrist or 
advanced practice nurse prescriber occurs for medication related 
concerns at least monthly or more frequently based on the indi-
vidual needs of the youth.
2. One hour per week of health-related services shall be pro-
vided by a physician, physician assistant, advanced practice 
nurse, or registered nurse for every 4 full-time youth in the 
program.
3. Six hours per week of group sessions shall be provided in 
the program. Only a master’s-level mental health professional 
may provide psychotherapy group sessions. A mental health sup-
port worker may provide non-psychotherapy group sessions. 
Group sessions shall include no more than 10 youth with one 
staff or a maximum of 12 youth if 2 staff are present with the 
group.
4. One hour per week of care coordination services shall be 
provided by a mental health support worker or a mental health 
professional for every 2 full-time youth in the program.
5. Two hours per week of individual or family psychotherapy 
shall be provided by a mental health professional for each full-
time youth in the program. One of the two required hours may be 
provided by a mental health support worker if they are under the 
supervision of the mental health professional implementing a 
piece of the individualized treatment plan.
6. At least 2 hours per week of support services shall be pro-
vided by mental health professionals, mental health support 
workers, mental health technicians, occupational therapists, or 
therapeutic specialists in the program.
(b) Intensive hospital-based day treatment programs shall 
comply with all of the following:
1. One hour per week of consultation shall be provided by a 
psychiatrist or advanced practice nurse prescriber.
2. One hour per week of health-related services shall be pro-
vided by a physician, physician assistant, advanced practice 
nurse, or registered nurse for every 4 full-time youth in the 
program.
3. Crisis response, medical, and nursing services shall be 
readily available at all times youth are present in the program.
4. A physician, physician assistant, registered nurse, or ad-
vanced practice nurse shall be on duty and on-site in the program 
at all times that youth are present.
5. Eight hours per week of group sessions shall be provided 
in the program. Only a master’s-level mental health professional 
may provide psychotherapy group sessions. A mental health sup-
port worker may provide non-psychotherapy group sessions. 
Group sessions shall include no more than 10 youth with one 
staff or a maximum of 12 youth if 2 staff are present with the 
group.
6. One hour per week of care coordination services shall be 
provided by a mental health support worker or mental health pro-
fessional for every full-time youth in the program.
7. Four hours per week of individual or family psychotherapy 
shall be provided by a mental health professional for each full-
time youth in the program. Two of the four required hours may 
be provided by a mental health support worker if they are under 
the supervision of the mental health professional implementing a 
piece of the individualized treatment plan.
8. At least 4 hours per week of support services shall be pro-
vided by mental health professionals, mental health support 
workers, mental health technicians, occupational therapists, or 
therapeutic specialists in the program.
(4) HOURS OF OPERATION. The amount of time a youth 
spends at a program shall be established by the individual treat-
ment plan developed under s. DHS 40.14 for each youth, but a 
program shall be in operation and able to provide services for the 
following period:
(a) A community-based program shall be in operation and 
available to provide services to youth for a minimum of 4 hours a 
day, 5 days a week, and may suspend operations for no more than 
4 weeks each year.
(b) An intensive hospital-based program shall be in operation 
and available to provide services to youth for a minimum of 6 
hours a day, 5 days a week, and may suspend operations for no 
more than 4 weeks each year.
(c) Any youth participating for less than the minimum hours 
of operation in par. (a) or (b) shall be designated a part-time 
youth. Two part-time youth shall be calculated as the equivalent 
of one full-time youth.
(5) CLINICAL SUPERVISION. (a) The clinical coordinator 
shall have responsibility for oversight of the job performance and 
actions of each staff member who is providing clinical services 
and support services, and require each staff member to adhere to 
all laws and regulations governing care and treatment and the 
standards of practice for their individual professions.
(b) Each program shall develop and implement a written pol-
icy for clinical supervision and clinical collaboration designed to 
provide sufficient guidance to assure the delivery of effective ser-
vices. Each policy shall address all of the following:
1. A system to determine the status and achievement of youth 
outcomes to determine if treatment provided is effective, and a 
system to identify any necessary corrective actions.
2. Identification of clinical issues, including incidents that 
pose a significant risk of an adverse outcome for youth that 
should warrant clinical collaboration, or clinical supervision that 
is in addition to the supervisions specified under s. MPSW 4.01, 
12.01, or 16.04, or s. Psy 2.10, or for a recognized psychotherapy 
practitioner, whichever is applicable.
(c) Clinical supervision shall be documented in a supervision 
or collaboration record, containing entries that are signed and 
dated by the staff member providing supervision.
(d) Clinical supervision shall comply with s. MPSW 4.01, 
12.01, or 16.04, or s. Psy 2.10, whichever is applicable.
(6) PERSONNEL ORIENTATION AND TRAINING. (a) General 
requirement. The program director shall ensure each staff mem-
ber and volunteer receives orientation and ongoing training nec-
essary to perform his or her duties. The program shall develop a 
written orientation policy.
(b) Orientation. The program shall maintain documentation 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 40.10 WISCONSIN ADMINISTRATIVE CODE 10
showing that each new staff member listed under s. DHS 40.09 
(3) (a) to (f) has completed the training requirements specified in 
subds. 1. to 16., either as part of orientation to the program or as 
part of prior education or training. The program director shall re-
quire all other staff members and volunteers to complete only the 
training requirements specified under this paragraph that are nec-
essary, as determined by the program director, for the staff mem-
ber or volunteer to successfully perform job duties. Training re-
quirements include all of the following:
1. A review of this chapter.
2. A review of the program’s policies and procedures.
3. Mental health treatment concepts applicable to providing 
day treatment services, including the principles of trauma-in-
formed services and trauma history as they are specifically im-
plemented through the program’s operations and interactions 
with youth, the manner in which trauma may be a compounding 
variable in treatment, and how to identify and anticipate triggers 
related to trauma that lead to behavior and mental health 
symptoms.
4. Use of sensory interventions and strategies that promote 
self-regulation.
5. Techniques and procedures for providing emergency 
interventions.
6. Principles and techniques for developing and providing 
culturally responsive and gender-sensitive mental health services.
7. The reactions and side effects of psychotropic medication.
8. Techniques for assessing and responding to the needs of 
youth who have challenges with co-occurring illnesses and 
disabilities.
9. How to assess a youth to detect suicidal tendencies and to 
manage youth at risk of attempting suicide or causing harm to self 
or others.
10. Resiliency concepts and principles that ensure connec-
tion to others and to the community.
11. Applicable parts of chs. 48, 51, 55, 115, and 938, Stats., 
and any related administrative rules.
12. The provisions of ch. DHS 94 and s. 51.61, Stats., regard-
ing client rights.
13. Current standards regarding documentation and the pro-
visions of 45 CFR parts 160, 162, 164, 42 CFR part 2 regarding 
confidentiality of treatment records, s. 51.30, Stats., and ch. DHS 
92.
14. The basic provisions of civil rights laws, including the 
Americans with Disabilities Act of 1990 and the Civil Rights Act 
of 1964, as the laws apply to staff members providing services to 
youth with disabilities.
15. Job responsibilities of staff members in the program.
16. Any other subject that the program determines is neces-
sary to enable the staff member to perform the staff member’s 
duties effectively, efficiently, and competently.
(c) Ongoing training. 1. Each program shall develop a writ-
ten training plan for each staff member, which shall include all of 
the following:
a. Time set aside for training.
b. Discussion and presentation of principles and methods of 
treatment for youth with mental illness or severe emotional 
disturbance.
2. Each staff member who provides direct services to youth 
shall participate in a minimum of 30 hours of documented train-
ing each year on topics relevant to that staff member’s responsi-
bilities in the program and specific to the ages of the youth served 
in the program. A maximum of 18 hours of this training may in-
clude in-service and consultation provided by staff members or 
consultants of the program.
(d) Department review of training. Documentation of train-
ing shall be made available to department staff upon request.
History: CR 19-018: cr. Register June 2020 No. 774, eff. 7-1-20; correction in 
(3) (a) 3., (b) 5., (4) (c), (5) (b) 2., (d), (6) (b) (intro.), 13. made under s. 35.17, Stats., 
Register June 2020 No. 774; CR 23-053: am. (2) (intro.) Register September 2023 
No. 813, eff. 10-1-23.
DHS 40.11 Referral and Screening. (1) POLICIES. (a) 
The program director or clinical coordinator or designee shall re-
view all referrals and verify the medical necessity and clinical ap-
propriateness for day treatment services for the referred youth.
(b) A program shall establish written selection criteria for use 
when screening an applicant for admission, including all of the 
following:
1. Sources from which referrals may be accepted by the pro-
gram and how those sources make referrals.
2. Procedures for making admission decisions.
3. Any funding restrictions which will be applied to admis-
sions such as availability of insurance, required support for the 
placement from other agencies or the youth or legal representa-
tives ability to pay.
4. Any client characteristics for which the program has been 
specifically designed, including the nature or severity of disor-
ders, including co-occurring disorders, which can be managed 
within the program, type of needs that can be addressed, whether 
male or female youth, or both, may be admitted, and the length of 
time that services may be provided to a youth.
(2) ADMISSION. A program may not admit a youth unless all 
of the following information has been requested, the request has 
been documented, and reasonable efforts have been made to ob-
tain a complete record of the youth’s mental health needs:
(a) The most recent psychiatric assessment.
(b) The Individualized Education Plan from the local educa-
tion agency that is serving the client if the youth has an Individu-
alized Education Plan.
(c) Discharge summaries from any psychiatric hospitaliza-
tions that have occurred within the past 12 months.
(d) Available information about any prior trauma history that 
the youth may have, and any risks of harm to self or others that 
the youth may present.
(e) Records of all mental health or substance use disorder 
treatment or services that the applicant has received during the 
past 12 months.
(3) SCREENING SUMMARY. (a) Once a program has screened 
an applicant for services and has decided to admit the applicant, a 
mental health professional shall prepare a written screening sum-
mary. The screening summary shall be completed prior to the 
first day of the youth attending the program. The purpose of the 
screening summary is to demonstrate the youth’s appropriateness 
for the type of day treatment being initiated and reveal the diag-
nostic thought process and reasons that led to the decision to 
admit.
(b) The screening summary shall include all of the following:
1. The names of individuals involved in the referral for ad-
mission, those contacted during the screening process, and the 
dates of meetings or other contacts with those individuals.
2. A summary of reviewed materials deemed to be valid, reli-
able, and reflect the current functioning of the youth during the 
screening process.
3. A summary of the reasons for admission or denial.
4. A diagnostic summary and a summary of medications, 
dosages, and dates.
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
11 DEPARTMENT OF HEALTH SERVICES DHS 40.13
5. A profile of the needs and strengths of the youth.
6. A summary of the services which will be offered while the 
assessment and treatment plan are prepared under ss. DHS 40.13 
and 40.14, and setting the date on which the youth may begin at-
tending the program.
7. A description of educational and community resources 
available.
8. A summary of other less and more restrictive service alter-
natives to day treatment that were considered and an explanation 
of why they were determined to not be appropriate to meet the 
youth’s needs.
9. A summary of other less restrictive services to day treat-
ment in which the youth is dually involved and the reason for con-
tinued dual enrollment.
10. An initial discharge plan with measurable criteria for de-
termining how the youth’s needs may be met by less restrictive 
services following discharge.
History: CR 19-018: cr. Register June 2020 No. 774, eff. 7-1-20; correction in 
(3) (b) 4. made under s. 35.17, Stats., Register June 2020 No. 774.
DHS 40.12 Admission. (1) CRITERIA FOR ADMISSION. 
All of the following are required for a program to admit a youth:
(a) The youth has a psychiatric diagnosis of mental illness.
(b) The youth is unable to obtain sufficient benefit from a less 
restrictive treatment program.
(c) The youth is reasonably likely to benefit from the services 
being offered by the program.
(d) The youth is experiencing one or more of the following:
1. Significant dysfunction in 2 or more of the basic domains 
of life and that require the services offered by the program in or-
der to acquire or restore the skills necessary to perform ade-
quately in those areas.
2. Need for a period of transition from a hospital, residential 
treatment center or other institutional setting as part of the 
process of returning to live in the community.
3. A period of acute crisis or other severe stress, so that with-
out the level of services provided by the program, there is a high 
risk of hospitalization or other institutional placement.
(2) AUTHORIZATION FOR SERVICES. (a) Except as provided 
in s. 51.14, Stats., a program may admit a youth only after obtain-
ing the written and informed consent of the youth or legal repre-
sentative, or pursuant to an order of a court with jurisdiction over 
the youth under ch. 48, 55, or 938 Stats., or if authorized by a 
county department under s. 51.42 or 51.437, Stats., to which the 
youth has been committed pursuant to s. 51.20 (13), Stats.
(b) Admission of minors shall comply with the requirements 
of s. 51.13, Stats.
(3) CARE COORDINATION. A program shall assign a care co-
ordinator to each youth and provide the youth or legal representa-
tive with the care coordinator’s contact information, a description 
of the role of the care coordinator, and an explanation of support 
that is available. The care coordinator shall be a mental health 
professional or mental health support worker and shall be respon-
sible for all of the following:
(a) Providing the youth or legal representative with a thorough 
explanation of the nature and goals of the program, and the rights 
and responsibilities of the client.
(b) Facilitating the youth’s assessment, developing and imple-
menting the treatment plan, conducting ongoing case reviews, 
and identifying services to support the youth at discharge.
(c) Coordinating the program’s operations on behalf of the 
youth with other agencies and schools serving the youth.
(d) Maintaining contact and communication with the youth or 
legal representative, facilitating the participation of the youth or 
legal representative in the treatment plan, and encouraging fam-
ily-driven care whenever possible.
(e) Serving as an advocate for the youth or legal representative 
with other agencies and programs to help the youth obtain neces-
sary services and benefits from those other agencies and 
programs.
(4) SAFETY PLAN. An individualized safety plan shall be 
completed prior to the start of services that considers risk factors, 
trauma history, medications and possible side effects, and meth-
ods for de-escalation of behaviors that are designed to avoid the 
use of emergency safety interventions in addressing the needs of 
the youth.
History: CR 19-018: cr. Register June 2020 No. 774, eff. 7-1-20; correction in 
(3) (a) made under s. 35.17, Stats., Register June 2020 No. 774.
DHS 40.13 Assessment. (1) INTERDISCIPLINARY 
TREATMENT TEAM. (a) Within 5 working days following the de-
cision to admit a youth into the program, the care coordinator 
shall assemble an interdisciplinary treatment team to begin an as-
sessment of the strengths, needs, and current status of the youth.
(b) The team shall include all of the following:
1. The youth, to the extent appropriate to his or her age, ma-
turity and clinical condition, if available and willing to 
participate.
2. The youth’s legal representative.
3. The youth’s care coordinator.
4. The program’s clinical coordinator.
(c) The youth or legal representative shall be asked to partici-
pate in identifying additional members of the interdisciplinary 
team. With consent of the youth or legal representative, reason-
able efforts should be made to include all of the following:
1. An occupational therapist or a registered nurse, based on 
youth needs identified in the screening summary.
2. An educational professional from the youth’s school.
3. Representatives of any other profession or agency neces-
sary in order to adequately and appropriately respond to the treat-
ment needs of the youth which were identified in the referral ma-
terials or the intake screening process.
4. Family members who are involved in the life of the youth.
5. If the youth has been placed under the supervision of a 
county department, the social worker who has been assigned to 
the case.
(2) ASSESSMENT. (a) The purpose of the assessment is to 
identify the individual strengths and needs of the youth to address 
the level of functioning as well as specific strategies that will be 
utilized to treat the youth. The clinical coordinator shall prepare 
a written report describing and evaluating all of the following:
1. Biopsychosocial information that is sufficient to identify 
the goals that the youth or legal representative want to accomplish 
through their participation in the program, the needs that will 
have to be addressed to reach those goals, and the strengths of the 
youth that can form the foundation of the individual treatment 
plan to meet the identified needs and achieve the chosen goals, 
through conducting a respectful and thorough series of interviews 
that engage the youth or legal representative. Biopsychosocial in-
formation includes developmental history, significant past events, 
significant past relationships and prominent influences, behav-
ioral history, financial history, and overall life adjustment.
2. The current mental health status of each youth including 
frequency, severity and duration of the symptoms and behaviors 
and the manner in which the symptoms and behaviors impact the 
youth’s ability to function, attitude, judgement, memory, speech, 
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 40.13 WISCONSIN ADMINISTRATIVE CODE 12
thought content, perception, intellectual functioning, general ap-
pearance, diagnosis, or medical impression.
Note: The Diagnostic and Statistical Manual of Mental Disorders is published by 
the American Psychiatric Association: Diagnostic and Statistical Manual of Mental 
Disorders. Washington, DC, American Psychiatric Association, 2013. The Diagnos-
tic and Statistical Manual of Mental Disorders may be ordered through 
http://www.appi.org/Pages/DSM.aspx or other sources.
3. Completing an evaluation of all of the following:
a. Current living arrangements, social relationships, support 
systems, including the youth’s level of social and behavioral func-
tioning in the home, school and community, and the youth’s rela-
tionship with his or her family members, including an assessment 
of family member strengths and weaknesses which might affect 
treatment.
b. A youth’s trauma history and experiences and how treat-
ment approaches will avoid re-traumatization.
c. A youth’s ability to work in a group setting.
d. The youth’s level of academic functioning and educational 
history, including areas where the youth shows interest, skill and 
achievement.
e. A youth’s history of criminal activity, including sexual 
perpetration, peer-to-peer violence, battery, and safety concerns.
f. The youth’s health, medical history, and prescribed medi-
cations, including a youth’s prior history of dangerous reactions 
to psychotropic medications, including procedures for assessing 
and monitoring the desired objectives and side effects of medica-
tions which the youth is taking, dealing with the results of possi-
ble medication interactions, medication overdose, an error in 
medication administration, an unanticipated reaction to the medi-
cation, the effects of a concurrent medical illness or condition oc-
curring while the client is receiving the medication, and monitor-
ing the medication regime to determine if any of the medications, 
solely or in combination, may mask or mimic psychiatric symp-
toms or behaviors.
g. Suicide risk and self-harm history and risk including crite-
ria for deciding when the level of risk of suicide requires the use 
of crisis response services or hospitalization.
h. For a youth over the age of 15, the youth’s vocational and 
independent living history, skills and needs.
i. The youth’s current or recent use of drugs or alcohol and 
the possible presence of any co-occurring disorder that will have 
to be addressed through the treatment plan.
j. Any other assets and needs of the youth which affect the 
youth’s ability to participate effectively in relationships and activ-
ities in home, community and school environments.
k. Past treatment, including where it occurred, for how long, 
and by whom.
L. Recommendations for completing any new test or evalua-
tion which the interdisciplinary treatment team finds is necessary 
for development of an effective treatment plan for the youth, in-
cluding psychological, neuropsychological functional, cognitive, 
behavioral, developmental or early and periodic screening and di-
agnosis under s. DHS 107.22.
(b) The written assessment shall inform and be completed 
prior to development of the treatment plan.
(c) The written assessment shall be signed by the youth or le-
gal representative and the clinical coordinator.
History: CR 19-018: cr. Register June 2020 No. 774, eff. 7-1-20.
DHS 40.14 Treatment Plan. (1) TREATMENT PLAN. (a) 
The interdisciplinary treatment team shall prepare a written treat-
ment plan for a youth based upon the written assessment under s. 
DHS 40.13 (2) within 15 calendar days after admission. The 
treatment plan shall describe measurable objectives that will be 
met and services that will be provided to the youth.
(b) The written treatment plan shall include all of the 
following:
1. The youth’s strengths, treatment strategies, and measur-
able outcomes to be accomplished.
2. Clinical and support services to reduce or eliminate the 
symptoms causing the youth’s problems or inability to function in 
day to day living, and to increase the youth’s ability to function as 
independently as possible.
3. The schedules, frequency, nature of services recom-
mended to support the achievement of the youth’s goals, irrespec-
tive of the availability of services or funding, and the responsible 
party for that intervention.
4. The proposed length of time the youth will participate in 
the program and the amount of time that the youth will attend the 
program each week.
5. The involvement of a youth’s legal representative with the 
program and any services that a legal representative will partici-
pate in while the youth is in the program.
6. A summary of other services the youth will receive while 
enrolled in the program, including educational services, other 
services that the program will be providing for the youth, and ser-
vices and supports that will be provided by other agencies or 
providers and the process by which those educational and other 
services will be coordinated with services provided by the 
program.
6m. If any part of the services will be delivered via tele-
health, a description of those services and clinical justification 
for delivering services via telehealth rather than in person.
7. The procedure for monitoring and managing any risk of 
suicide if the assessment identified risks.
8. Any medication the youth is receiving, the name of the 
physician prescribing the medication, the dosages prescribed, the 
purpose for which it is prescribed, the frequency of administra-
tion, a plan for monitoring its administration and effects by the 
physician, and a plan for care coordination with a psychiatrist or 
advanced practice nurse prescriber.
9. A transition services component that establishes when a 
transition process should begin, the staff member responsible for 
supporting transition services, and a process for the reintegration 
of the youth who is completing the program into family, commu-
nity and school activities.
(c) The treatment plan shall be signed by the youth or legal 
representative and the clinical coordinator. With informed con-
sent, a service provider who is part of the treatment plan may also 
review and sign the treatment plan.
(2) REVIEW OF TREATMENT PROGRESS. (a) At a minimum, 
the care coordinator shall reconvene the interdisciplinary treat-
ment team as follows:
1. In community-based programs, within 30 calendar days 
following approval of the initial treatment plan and at least every 
30 days thereafter.
2. In hospital-based programs, within 15 calendar days fol-
lowing approval of the initial treatment plan and at least every 15 
days thereafter.
(b) In reviewing case progress, the interdisciplinary treatment 
team shall determine all of the following:
1. The degree to which the measurable objectives in the treat-
ment plan have been met.
2. Any significant changes suggested or required in the treat-
ment plan.
3. Whether any additional assessment of functional improve-
ment is recommended as a result of information received or ob-
servations made during the course of treatment.
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
13 DEPARTMENT OF HEALTH SERVICES DHS 40.15
4. The youth’s assessment of functional improvement toward 
meeting treatment goals and suggestions for modification.
(c) As part of its review of case progress, the interdisciplinary 
treatment team shall prepare a written report which includes all 
of the following:
1. A description of the youth’s progress toward measurable 
objectives established in the treatment plan.
2. Documentation of clinical contacts with youth and inter-
ventions required as part of the treatment plan.
3. Identification of all days on which services were actually 
delivered to the client, and the amount of time the client spent in 
the program on those days.
(d) The written report shall be prepared as follows:
1. At least every 30 days in community-based programs.
2. At least every 15 days in hospital-based programs.
(e) The written report shall be maintained as a permanent part 
of the youth’s record.
(f) A youth may continue to participate in a day treatment pro-
gram as long as the review of the youth’s treatment plan under 
par. (b) indicates that the youth remains appropriate for the con-
tinued services being offered and services support the achieve-
ment of the measurable objectives identified in the treatment 
plan.
(3) TERMINATION OF SERVICES. (a) Decision. Services pro-
vided to a youth under an individual treatment plan may be termi-
nated by the program before the youth’s goals for discharge are at-
tained under any of the following circumstances:
1. By agreement between the youth or legal representative, 
the program director, and the clinical coordinator.
2. By direction of the program director and the clinical coor-
dinator acting upon recommendation of the interdisciplinary 
treatment team, if the team determines any of the following:
a. Further participation of the youth in the program is un-
likely to provide any reasonable benefit to the youth.
b. The youth’s condition requires a greater or more restrictive 
level of care than can be provided by the program.
c. The youth’s behavior or condition is such that it creates a 
serious risk of harm to other clients in the program or to program 
staff members and no modifications of the program procedures 
or services are possible which will ensure the safety of other 
clients or staff members.
(b) Notice. 1. Unless the youth poses an immediate risk of 
harm to other clients or staff members or subd. 2. applies, the 
program shall provide the youth or legal representative and other 
agencies providing services to the client pursuant to the treatment 
plan with at least 7 days prior notice of the intent to terminate 
services.
2. When a youth has been placed in the program by order of 
a court under ch. 48, 51, 55, or 938, Stats., the program shall pro-
vide that court and the social worker responsible for supervising 
the implementation of the court order with 14 days prior notice of 
the intent to end services, unless the youth poses an immediate 
risk of harm to other clients or staff members, in order to permit 
the court to enter an alternative order regarding the care of the 
youth.
History: CR 19-018: cr. Register June 2020 No. 774, eff. 7-1-20; correction in 
(3) (b) 2. made under s. 35.17, Stats., Register June 2020 No. 774; CR 23-053: cr. 
(1) (b) 6m. Register September 2023 No. 813, eff. 10-1-23.
DHS 40.15 Client records. (1) LOCATION AND FOR-
MAT. Client records shall be managed in accordance with stan-
dard professional practices and any applicable legal requirements 
for the maintenance of client mental health records, and arranged 
in a format which provides for consistent recordkeeping within 
the program and which facilitates accurate and efficient record 
retrieval.
(2) ELEMENTS. All entries in each client file shall be factual, 
accurate, legible, permanently recorded, dated, and authenticated 
with the signature and license or title of the staff member making 
the entry. An electronic representation of the staff member’s sig-
nature shall be used only by the staff member who makes the en-
try. The program shall possess a statement signed by the staff 
member, which certifies that only that staff member shall use the 
electronic representation via use of a personal password.
(3) CONFIDENTIALITY AND RETENTION OF RECORDS. Client 
records shall be kept confidential and safeguarded and retained as 
required under 42 CFR part 2, 45 CFR parts 160, 162, 164, and s. 
51.30, Stats., ch. DHS 92, and any other applicable law.
(4) CONSENT. The treatment record shall document that the 
youth or legal representative were informed of the nature and 
policies of the program in their primary language and that the 
youth or legal representative understood and agreed to participa-
tion in the program.
(5) CLIENT TREATMENT RECORD. A treatment file or elec-
tronic record shall include all of the following:
(a) Initial referral materials.
(b) Notes and reports made while screening the youth for 
admission.
(c) A copy of the screening summary under s. DHS 40.11 (3).
(d) The safety plan under s. DHS 40.12 (4).
(e) The written, signed assessment under s. DHS 40.13 (2).
(f) Reports and other evaluations of the youth which were 
used in developing the assessment, and any necessary releases or 
authorizations for acquiring and using these reports and 
evaluations.
(g) Results of additional evaluations and other assessments 
performed while the youth is enrolled in the program.
(h) The initial, signed individual treatment plan.
(i) Descriptions of significant events that are related to the 
youth’s treatment plan and contribute to an overall understanding 
of the youth’s ongoing level and quality of functioning.
(j) Any recommended changes or improvements of the treat-
ment plan resulting from clinical collaboration or clinical 
oversight.
(k) Written documentation of the services that have been pro-
vided to the youth or their legal representative as required under 
s. DHS 40.07 (4).
(L) Written summaries of the reviews of the treatment plan 
pursuant to s. DHS 40.14 (2) (c).
(m) Documentation of transition services and discharge plan-
ning, including involuntary discharge.
(n) Informed consent for treatment medication administration 
and medication records, if staff members dispense medications, 
including documentation of both over-the-counter and prescrip-
tion medications dispensed to youth. Medication records shall 
contain documentation of ongoing monitoring of the administra-
tion of medications and detection of adverse drug reactions. All 
medication orders in the youth treatment record shall specify the 
name, type and purpose of the medication, and the dose, route of 
administration, frequency of administration, staff member ad-
ministering, and name of the prescriber who prescribed the 
medication.
(o) Records of referrals of the youth to outside resources.
(p) Written consent, the court order, or county department au-
thorization under s. DHS 40.12 (2) (a) to admission, and any con-
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842
Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.
DHS 40.15 WISCONSIN ADMINISTRATIVE CODE 14
sent for disclosure or authorization for release of information re-
quired under s. 51.30, Stats., and ch. DHS 92.
(q) Treatment plan case reviews and consultation notes.
(r) Care coordination provided with the youth or legal 
representative.
(s) Any other information that is appropriate for the youth 
file.
(6) ELECTRONIC TREATMENT RECORDS. (a) Programs may 
maintain treatment records electronically if the program has a 
written policy describing the records and the authentication and 
security policy.
(b) Electronic transmission of information from treatment 
records to information systems outside the program shall not oc-
cur without voluntary written consent for disclosure from the 
youth or legal representative per s. 51.30, Stats., or as otherwise 
provided by law.
(7) EDUCATION RECORDS. Education records of a youth shall 
be kept separate from the youth’s treatment record, and shall 
comply with federal and state statutes and regulations relating to 
educational records.
Note: Federal and state statutes and regulations relating to educational records 
are found in 20 USC 1232g and 34 CFR Pt. 99, and s. 118.125, Stats.
(8) MAINTENANCE AND SECURITY. The program director is 
responsible for the maintenance and security of client treatment 
records.
(9) DISPOSITION UPON PROGRAM CLOSING. A program shall 
establish a written policy for maintenance and disposition of 
records, in accordance with s. DHS 92.12, in the event the pro-
gram closes.
History: CR 19-018: cr. Register June 2020 No. 774, eff. 7-1-20; correction in 
(3), (5) (k) made under s. 35.17, Stats., Register June 2020 No. 774.
DHS 40.16 Client rights. All programs shall comply 
with s. 51.61, Stats., and ch. DHS 94 on the rights of clients.
History: CR 19-018: cr. Register June 2020 No. 774, eff. 7-1-20.
DHS 40.17 Program evaluation. (1) OUTCOMES. A 
program shall at least annually evaluate the effectiveness of ser-
vices provided to its clients by doing all of the following:
(a) Preparing a statement of the program’s clinical and sup-
port services outcomes for youth stated in objectively measurable 
terms.
(b) Preparing and making available to the public an annual re-
port of youth service outcomes.
(2) OPERATIONS. (a) In addition to the outcome evaluation 
under sub. (1), a program shall arrange for an annual review of its 
program operations, including all of the following:
1. Appropriateness of referrals, admissions, and clients’ 
length of stay.
2. Efficiency of procedures for conducting assessments and 
developing treatment plans.
3. Use of a supportive and trauma-informed treatment mi-
lieu, and improving quality of care and safety of youth.
4. The use of emergency safety interventions, including an 
aggregate review of all incidents of seclusion and physical re-
straint, to assure that the wellbeing of youth is safeguarded and 
that youth rights are protected.
5. Effectiveness of transition planning and discharge.
6. Functionality of care coordination and integration with 
other services.
(b) The review of program operations may be conducted by an 
advisory committee established by the program, an already estab-
lished quality assurance and performance improvement commit-
tee, by a committee of the board of directors of the facility operat-
ing the program, or by any other appropriate and objective body. 
The committee shall include the program director and clinical co-
ordinator, additional program staff members as appropriate, and 
whenever possible include parents and community members.
(c) A summary of the review of program operations shall be 
appended to the annual report prepared under sub. (1) (b) and 
made available to department staff upon request.
History: CR 19-018: cr. Register June 2020 No. 774, eff. 7-1-20; correction in 
(2) (c) made under s. 13.92 (4) (b) 7., Stats., Register January 2021 No. 781.
DHS 40.18 Death Reporting. Each program shall adopt 
written policies and procedures for reporting to the department 
deaths of youth no later than 24 hours after a death due to suicide, 
psychotropic medications, or use of physical restraints, as re-
quired by s. 51.64 (2), Stats.
Note: Copies of the form for reporting these deaths can be obtained from 
https://www.dhs.wisconsin.gov/regulations/report-death/proc-reportingdeath.htm.
History: CR 19-018: cr. Register June 2020 No. 774, eff. 7-1-20.
Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date 
the chapter was last published. 
Register February 2026 No. 842