DHS 68.06(2)(b)27.
27. Any other goods and services that are necessary to maintain the person with Alzheimer's disease as a member of the household.
DHS 68.06(3)
(3) Administration. Administering agencies may use program funds to pay for the cost of administering the program only if the costs are incurred under one or both of the following categories:
DHS 68.06 Note
Note: For descriptions of the categories listed under subs.(2) and (3), write the Division of Disability and Elder Services, Bureau on Aging and Long-Term Care Resources, P.O. Box 7851, Madison, Wisconsin 53707.
DHS 68.06 History
History: Cr.
Register, March, 1989, No. 399, eff. 4-1-89.
DHS 68.07
DHS 68.07
Client eligibility. In accordance with s.
46.87 (5), Stats., the administering agency in each county shall determine the eligibility of each household or person living in a residential facility in that county who applies to participate in that county's program by establishing that the household or person meets all of the following conditions:
DHS 68.07(1)
(1) Diagnosis of condition. At least one member of the household or the person who lives in a residential facility has received a final, tentative or preliminary written diagnosis of Alzheimer's disease from a physician;
DHS 68.07(2)(a)(a) The person in the household who has Alzheimer's disease or that person's caregiver resides in the county; or
DHS 68.07(2)(b)
(b) The person with Alzheimer's disease lives in a residential facility located in the county; and
DHS 68.07(3)
(3) Household income. The person with Alzheimer's disease and that person's spouse are expected to have a joint income of no more than $40,000 for the 12-month period immediately following application for the program, except that in determining the income of a household with a joint gross income of more than $40,000, the administering agency shall subtract any expenses attributable to the Alzheimer's-related needs of the person with Alzheimer's disease or of the person's caregiver. If the net income determined by subtracting Alzheimer's-related expenses for a household is $40,000 or less, the household shall be considered as having met the household income eligibility condition.
DHS 68.07 History
History: Cr.
Register, March, 1989, No. 399, eff. 4-1-89.
DHS 68.08(1)(1)
Determination of need. For the purpose of calculating the funds to be paid to or expended for a household or individual participating in the program, the administering agency in the county shall determine:
DHS 68.08(1)(a)
(a) The goods and services needed by the household to enable it to maintain the person with Alzheimer's disease as a member of the household, or the goods and services needed by a person with Alzheimer's disease living in a residential facility;
DHS 68.08(1)(c)
(c) The ability of the household to pay for the goods and services identified under
par. (a), using as the basis for this determination the uniform system of fees for services established by the department under s.
46.03 (18), Stats., and
ch. DHS 1, except that in determining income of eligible households with gross incomes of more than $40,000 the administering agency shall use gross income and not net income as the basis for determining ability to pay.
DHS 68.08(2)
(2) Cost sharing. If the administering agency determines under
sub.(1) (c) that an applicant household or person with Alzheimer's disease is able to pay for goods and services identified under
sub.(1) (a), the administering agency:
DHS 68.08(2)(a)
(a) Shall require as a condition of participation that the household or person pay for all or a portion of the costs of goods and services to accomplish the purposes under
s. DHS 68.06 (1) (a). The amount of payment shall be determined according to the uniform system of fees for services established by the department under s.
46.03 (18), Stats., and
ch. DHS 1; and
DHS 68.08(2)(b)
(b) May require the household or person to pay for all or a portion of the costs of goods and services to accomplish the purposes under
s. DHS 68.06 (1) (b). The amount of payment shall be determined according to the uniform system of fees for services established by the department under s.
46.03 (18), Stats., and
ch. DHS 1.
DHS 68.08(3)
(3) Application of revenues. If revenues are received by an administering agency from cost-sharing payments, these revenues may only be used for the non-administrative purposes under
s. DHS 68.06 (1) (a) to
(d) and only for the goods and services under
s. DHS 68.06 (2).
DHS 68.08(4)
(4) Limit. The administering agency in each county may pay to or expend on behalf of a participating household or on behalf of a person with Alzheimer's disease living in a residential facility the costs of any goods and services identified under
sub.(1) (a) minus the amount the household or person with Alzheimer's disease is able to pay, as determined under
sub.(1) (c), except that the amount paid or expended may not exceed $4,000 in any calendar year for each person with Alzheimer's disease in the household or for each person with Alzheimer's disease living in a residential facility.
DHS 68.08 History
History: Cr.
Register, March, 1989, No. 399, eff. 4-1-89; corrections in (1) (c), (2) (a) and (b) made under s.
13.92 (4) (b) 7. Stats.,
Register November 2008 No. 635.
DHS 68.09
DHS 68.09
Method of payment. The payment by an administering agency for goods and services shall be made using one or more of the following methods:
DHS 68.09(1)
(1) Payment made to a service provider on behalf of the person with Alzheimer's disease or of the person's caregiver;
DHS 68.09(2)
(2) Payment made to a service provider under contract with the administering agency to develop new programs or to expand services;
DHS 68.09(3)
(3) Payment made to the household of a person with Alzheimer's disease pursuant to accounting requirements set forth by the administering agency; or
DHS 68.09(4)
(4) Payment made to the manager of a residential facility in which a person with Alzheimer's disease resides for the purchase of goods or services, or both, pursuant to accounting requirements set forth by the administering agency.
DHS 68.09 History
History: Cr.
Register, March, 1989, No. 399, eff. 4-1-89.
DHS 68.10(1)(1)
Jurisdiction. Any household or individual participating in the program or caregiver may appeal the following actions by an administering agency:
DHS 68.10(1)(a)
(a) Denial of an application to participate in a county's program;
DHS 68.10(1)(b)
(b) The calculation of funds to be paid to or expended for a household or a person with Alzheimer's disease living in a residential facility and participating in the program;
DHS 68.10(1)(c)
(c) Reduction, suspension, limitation or termination of goods and services provided under this chapter;
DHS 68.10(1)(d)
(d) Change of provider of goods and services provided under this chapter;
DHS 68.10(1)(e)
(e) Change of method of payment for goods and services provided under this chapter; and
DHS 68.10(1)(f)
(f) Change of the maximum amount payable in a calendar year to or on behalf of any participating person with Alzheimer's disease.
DHS 68.10(2)
(2) Notification of appeal rights. At the time an administering agency takes any of the actions under
sub. (1), it shall inform the household, individual participating in the program, any caregiver, and any guardian or protective payee, in writing, of the right to a hearing under this chapter and of the procedure for requesting a hearing.
DHS 68.10(3)
(3) Request for hearing. A household or individual participating in the program or caregiver wishing to contest an action under
sub. (1) shall file a written request for a hearing with the department of administration's division of hearings and appeals within 45 days after the date of the action for which review is sought. A hearing request shall be considered filed on the date of receipt by the division of hearings and appeals.
DHS 68.10 Note
Note: The mailing address of the Office of Administrative Hearings is P.O. Box 7875, Madison, Wisconsin 53707-7875.
DHS 68.10(4)
(4) Arrangements for a hearing. In response to a request for a hearing under this section, the director of the office of administrative hearings shall appoint a hearing examiner, set a date for the hearing and notify the parties at least 10 days before the hearing of the date, time and place of the hearing and of the procedures to be followed.
DHS 68.10 History
History: Cr.
Register, March, 1989, No. 399, eff. 4-1-89.
DHS 68.11
DHS 68.11
Exceptions to requirements. The department may grant an exception to an administering agency of any requirement made of the administering agency under this chapter, except a requirement under
s. DHS 68.03 or
68.10 (2), if the department is convinced that an alternative to the requirement meets the intent of and is in compliance with s.
46.87, Stats. The department shall respond in writing to a written request for an exception within 30 days after receiving the request.
DHS 68.11 History
History: Cr.
Register, March, 1989, No. 399, eff. 4-1-89.
