Register November 2015 No. 719
Chapter DHS 10
Subchapter I — General Provisions
Authority and purpose.
Subchapter II — Aging and Disability Resource Centers
Standards for performance by resource centers.
Department responsibilities for monitoring resource center quality and operations.
Subchapter III — Access to the Family Care Benefit
Application and eligibility determination.
General conditions of eligibility.
Conditions of functional eligibility.
Financial eligibility and cost sharing.
Protections against spousal impoverishment.
Eligibility and entitlement.
Private pay individuals.
Subchapter IV — Family Care Benefit; Delivery Through Care Management Organizations (CMOs)
Family care services.
Certification and contracting.
CMO certification standards.
Standards for performance by CMOs.
Operational requirements for CMOs.
Department responsibilities for monitoring CMO quality and operations.
Subchapter V — Protection of Applicant, Eligible Person and Enrollee Rights
Continuation of services.
Cooperation with advocates.
Subchapter VI — Recovery of Paid Benefits
Recovery of incorrectly paid benefits.
Recovery of correctly paid benefits.
Subchapter VII — Assuring Timely Long-term Care Consultation
Certification by secretary of availability of resource center.
Information and referral requirements for hospitals.
Information and referral requirements for long-term care facilities.
Requirements for resource centers.
Ch. DHS 10 Note
Chapter HFS 10 was created as an emergency rule effective February 1, 2000.
Chapter HFS 10 was renumbered to chapter DHS 10 under s. 13.92 (4) (b) 1., Stats., and corrections made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635
DHS 10.11 Authority and purpose.
This chapter is promulgated under the authority of ss. 46.286 (4)
, 46.287 (2) (a) 1. (intro.)
, 50.02 (2) (d)
, and 227.11 (2) (a)
, Stats., to implement a program called family care that is designed to help families arrange for appropriate long-term care services for older family members and for adults with physical or developmental disabilities. The chapter does all the following:
Establishes functional and financial eligibility criteria, entitlement criteria and cost sharing requirements for the family care benefit, including divestment of assets, treatment of trusts and spousal impoverishment protections.
Establishes the procedures for applying for the family care benefit.
Establishes standards for the performance of aging and disability resource centers.
Establishes certification standards and standards for performance by care management organizations.
Provides for the protection of applicants for the family care benefit and enrollees in care management organizations through complaint, grievance and fair hearing procedures.
Provides for the recovery of correctly and incorrectly paid family care benefits.
Establishes requirements for the provision of information about the family care program to prospective residents of long-term care facilities and for referrals to resource centers by hospitals and long-term care facilities.
DHS 10.11 History
Cr. Register, October, 2000, No. 538
, eff. 11-1-00; correction in (intro.) made under s. 13.92 (4) (b) 7.
, Stats., Register November 2008 No. 635
DHS 10.12 Applicability.
This chapter applies to all of the following:
County agencies designated by the department to determine financial eligibility for the family care benefit.
All organizations seeking or holding contracts with the department to operate an aging and disability resource center or a care management organization.