"Mental abuse" means a single or repeated act of force, harassment, including sexual harassment, deprivation, neglect or mental pressure which reasonably could cause mental anguish or fear, which may include persistent or excessive negative comments, threats, deliberate inducement of anxiety or singling out a resident for inappropriate criticism or encouraging the resident's peers to do the same.
"Neglect" means significant danger presented to a person's physical or mental health because the person responsible for his or her care is unable or fails to provide adequate food, shelter, clothing, medical care or dental care.
"Nursing care" means nursing procedures, excluding personal care, which under ch. N 6
, standards of practice for registered nurses and licensed practical nurses, may be performed only by a registered nurse or a licensed practical nurse directly on a resident.
"Personal care" means help with eating, dressing, bathing, ambulation and other self-care activities of daily living.
"Personal housekeeping" means the performance of routine housekeeping and household tasks.
"Physical abuse" means the willful infliction of physical pain or injury or unreasonable confinement, Including but not limited to direct beating, choking, sexual touching, unreasonable physical restraint or pain without physical marks.
"Physical restraint" means any manual method or any article, device or garment interfering with the free movement of a resident or the normal functioning of a portion of the resident's body or normal access to a portion of the body, and which the individual is unable to remove easily, or confinement in a locked room.
"Place" means a building or portion of a building which is self-sufficient for living, dining and sleeping and the provision of care, treatment or services to its residents.
"Placing agency" means the agency responsible for placing a resident in an adult family home.
"Primary function" means the basic or essential care, treatment or services provided to residents of the home.
"Protest" means make more than one discernible negative response, other than mere silence, to the offer of, recommendation for, or other proffering of voluntary receipt of psychotropic medication. "Protest" does not mean a discernible negative response to a proposed method of administration of the psychotropic medication.
"Psychotropic medication" means a prescription drug, as defined in s. 450.01 (20)
, Stats., that is used to treat or manage a psychiatric symptom or challenging behavior.
"Relative" means a spouse, parent, step-parent, child, step-child, sibling, grandchild, grandparent, aunt, uncle, niece or nephew.
"Resident" means an adult, unrelated to the licensee, who lives and sleeps in the home and receives care, treatment or services in addition to room and board.
"Respite care" means temporary placement in an adult family home for maintenance of care, treatment or services, as established by the agency or individual responsible for planning, arranging or providing services to the individual, in addition to room and board, for no more than 14 consecutive days at a time.
"Seclusion" means physical or social separation from others by action of the licensee, service provider or others in the home, but does not include separation in order to prevent the spread of a communicable disease or a cool down period in an unlocked room as long as being in the room is voluntary on the resident's part.
"Service coordinator" means a person not affiliated with a adult family home who has primary responsibility for arranging, coordinating, managing and monitoring the care and services needed by a resident, including services provided outside of the adult family home.
"Service provider" means a person or persons who provide direct care or supervision for a resident of the adult family home, either as an employee of the licensee or as a volunteer.
"Type of individuals" means individuals grouped according to one of the following disabilities, conditions or statuses:
A functional impairment that commonly accompanies advanced age.
An individual under the legal custody of a government corrections agency or under the legal jurisdiction of a criminal court.
"Unrelated adult" means an adult who is not a relative of the licensee.
"Voluntary" means according to a resident's free choice if the resident is competent, or by choice of the resident's guardian if the resident is under guardianship.
"Volunteer" means a person who provides services for residents without compensation, except for reimbursement for out-of-pocket expenses.
DHS 88.02 History
Cr. Register, January, 1996, No. 482
, eff. 2-1-96; corrections in (4) (a) made under s. 13.93 (2m) (b) 7., Stats., Register, August, 2000, No. 536
; correction in (4) (a) made under s. 13.93 (2m) (b) 7., Stats., Register December 2003 No. 576
; CR 07-042
: cr. (14m), (27g) and (27r) Register October 2007 No. 622
, eff. 11-1-07; corrections in (4) (a), (b) and (12) made under s. 13.92 (4) (b) 6. and 7., Stats., Register November 2008 No. 635
Licensing administration. DHS 88.03(1)
No person may operate an adult family home unless a licensing agency determines that the home is in compliance with all requirements of s. 50.033
, Stats., and this chapter, and issues a license to that person.
Application for a license shall be made on a department-approved form available from the licensing agency.
DHS 88.03 Note
Note: To obtain a copy of the application form, contact the county agency in which the home is located or write or phone the appropriate regional office of the Department's Division of Disability and Elder Services. See Appendix A for addresses and phone numbers of the Division of Disability and Elder Services regional offices.
Before an applicant may be licensed to operate an adult family home, the applicant shall submit to the licensing agency a completed and signed application form, the program statement described under subd. 2.
, the licensure fee required under s. 50.033 (2)
, Stats., and a check or money order in an amount sufficient to cover the fees for conducting the criminal records check required under sub. (3) (b)
A home's program statement shall describe the number and types of individuals the applicant is willing to accept into the home and whether the home is accessible to individuals with mobility problems. It shall also provide a brief description of the home, its location, the services available, who provides them and community resources available to residents who live within the home. A home shall follow its program statement. If a home makes any change in its program, the home shall revise its program statement and submit it to the licensing agency for approval 30 days before implementing the change.
An applicant requesting a license shall provide any additional information requested by the licensing agency that may assist the agency in evaluating the applicant or licensee's character or qualifications. In assessing character and qualifications, the licensing agency may consider evidence of abuse or fraud, substantial or repeated violations of applicable or related statutes and rules in the licensee's operation of or employment in any service or facility serving adults or children or in the licensee's care of dependent persons, or a conviction or a pending criminal charge for a crime substantially related to caring for a dependent population or the funds or property of adults or minors or activities of the adult family home.
If a home is to be licensed as an adult family home and the home is also licensed as a children's foster home under ch. DCF 56
, the combined licensed bed capacity shall not exceed 4.
DHS 88.03(3)(a)(a) Action by licensing agency.
The licensing agency shall review the application form and program statement and any supporting documents, including criminal records checks, and shall interview the applicant and conduct an on-site visit of the home to determine if the requirements for a license set out in this chapter are met. If the requirements for a license are met and the applicant has paid the applicable fees, a license shall be issued. If requirements for a license are not met, the licensing agency shall send a written notice to the applicant stating the reasons for not approving the application and shall inform the applicant of the opportunity for a hearing under sub. (7)
. The licensing agency shall issue the license or the notice of denial within 70 days after receiving a complete application and the program statement and any supporting documents and following the on-site visit.
(b) Criminal records check.
Prior to issuing an initial license the licensing agency shall ask the Wisconsin department of justice to conduct a criminal records check on the license applicant and on any other adult household member. The licensee shall arrange for a criminal records check of all service providers. At least every second year following the issuance of an initial license the licensing agency shall request a criminal records check on the licensee and all other adult household members and the licensee shall arrange for a criminal records check on any service provider. In addition, during the period of licensure, the licensee shall arrange for a criminal records check on any new service provider. If any of these persons has a conviction record or a pending criminal charge which substantially relates to the care of a dependent population, the funds or property of adults or minors or activities of the adult family home, the licensing agency may deny, revoke, refuse to renew or suspend a license, initiate other enforcement action provided in this chapter or in ch. 50, Stats.
, or place conditions on the license.
DHS 88.03 Note
Note: Examples of actions the Department will consider in making a determination that an act substantially relates to the care of adults or minors, the funds or property of adults or minors or activities of the adult family home are: abuse, neglect, sexual assault, indecent exposure, lewd and lascivious behavior, or any crime involving non-consensual sexual conduct; child abuse, sexual exploitation of children, child abduction, child neglect, contributing to the delinquency or neglect of a child, enticing a child, enticing a child for immoral purposes, exposing a minor to pornography or other harmful materials, incest, or any crime involving children as victims or participants; armed robbery, aggravated battery, false imprisonment, kidnaping, homicide, any crimes involving bodily harm or threat of bodily harm, any crime involving the use of a dangerous weapon or any crime evidencing disregard to health and safety; cruelty, neglect or abandonment of animals and instigating fights between animals; burglary, extortion, forgery, concealing identity, embezzlement and arson; crimes involving a substantial misrepresentation of any material fact to the public including bribery, fraud, racketeering or allowing an establishment to be used for illegal purposes; offenses involving narcotics, alcohol or controlled substances that result in a felony conviction, operating a motor vehicle while under the influence of an intoxicant or other drug, operating after revocation and leaving the scene of an accident after injury or death to a person or damage to a vehicle driven or attended by any person.
DHS 88.03 Note
Wisconsin's Fair Employment Act, ss. 111.31
, Stats., prohibits discrimination because of a criminal record or a pending charge, unless the record or charge substantially relates to the circumstances of the particular job or licensed activity.
(c) Nurse aide registry check.
If the applicant, licensee or any non-resident adult living in the home of the applicant or licensee or any other occupant of the home has experience as a nurse assistant, home health aide or hospice aide, as defined under ch. DHS 129
, the licensing agency shall check the department's registry for nurse assistants, home health aides and hospice aides under s. DHS 129.10
to determine if there is on the registry a substantiated finding that the person abused or neglected a client or misappropriated the funds or property of a client. If there is a substantiated finding of one or more of these offenses, the licensing agency may deny, revoke, refuse to renew or suspend a license, initiate other enforcement action provided for in this chapter or in ch. 50, Stats.
, or place conditions on the license.
DHS 88.03 Note
Note: The department's registry for nurse assistants, home health aides and hospice aides can be reached by calling (608) 266-5545 to receive the information you need from an automated voice response unit, or you may call (608) 267-2374.
DHS 88.03 Note
Refer to the note under s. DHS 88.03 (3) (b)
for examples of actions to be considered in making a determination that an act substantially relates to the care of adults or minors, the funds or property of adults or minors or activities of the adult family home.
(d) Health check.
If the licensing agency suspects or has reason to believe that a license applicant, licensee, service provider or household member may pose a threat to the health, safety or welfare of residents, the licensing agency may require a physical examination, an alcohol or drug abuse assessment or a mental health evaluation of the person as a condition for issuance of a license.
An adult family home license is valid indefinitely unless suspended or revoked.
Every 24 months, on a schedule determined by the department, a licensed adult family home shall submit a biennial report to the licensing agency in the form and containing the information that the department requires, including payment of the fee required under sub. (2)
. If a complete biennial report is not timely filed, the department shall issue a warning to the licensee. If a licensed adult family home that has not filed a timely report fails to submit a complete report to the licensing agency within 60 days after the date established under the schedule determined by the department, the licensing agency may revoke the license.
The licensee shall provide, in a format approved by the department, information required by the department to assess the facility's compliance with s. 55.14
, Stats., relating to involuntary administration of psychotropic medication to a resident.
(5) Changes to be reported to licensing agency.
A licensee shall report to the licensing agency within 7 days, unless otherwise specified, the following changes:
A significant and ongoing change in the type or amount of services the licensee offers to provide if the change adversely affects any resident who needs the service.
Within 48 hours, that the licensee or service provider has pending or has been charged with or convicted of any crime which is substantially related to caring for dependent persons.
A change in the home's structure or damages to the home that may present a hazard to the residents.
Within 24 hours, a significant change in a resident's status, such as but not limited to an accident requiring hospitalization, missing from the home or a reportable death. A death shall be reported if there is reasonable cause to believe the death was related to use of a physical restraint or psychotropic medication, was a suicide or was accidental.
A death due to incident or accident not related to use of a restraint, psychotropic medications or suicide shall be reported to the licensing agency within 3 days. In addition the home shall;
Record the date, time and circumstance of the resident's death in the resident: record, including the name of the person to whom the body is released.
DHS 88.03 Note
Note: Deaths not to be reported to the licensing agency are those resulting from natural causes such as heart attach, a stroke or an illness when none of the circumstances in par. (e) 1. and 2. exist.
DHS 88.03 Note
Note: Providing notice under this subsection does not relieve the licensee or other persons of any obligation to report an incident to any other agency including law enforcement.
(6) Action by licensing agency to enforce this chapter. DHS 88.03(6)(a)1.1.
A licensing agency when it issues a notice of violation may require the licensee to submit a plan of correction for approval of the licensing agency. The licensee shall submit the plan of correction to the licensing agency not more than 30 days after the date of the notice or within a shorter period of time, as specified by the licensing agency, if the licensing agency determines that continuation of the violation may be harmful to the health, safety, welfare or rights of residents.
The licensing agency may require modifications in a proposed plan of correction before approving it or may substitute its own plan of correction.
(b) Placing limits on type of individuals.
A licensing agency may, at any time, following notice to the licensee and by modifying a license, limit the types of individuals served by an adult family home or the number of residents served by an adult family home for any of the following reasons:
The licensee and service providers do not have the appropriate training to serve the residents.
The licensee is unable to demonstrate that the needs of residents as identified in their individual service plans under s. DHS 88.06 (3)
are being met.
(c) Placing conditions on license.
A licensing agency may place a condition on a license if the licensing agency finds that a condition or occurrence relating to the operation and maintenance of the adult family home directly threatens the health, safety or welfare of a resident.
A licensing agency may revoke an adult family home's license if the licensing agency determines that the home has intentionally and substantially violated a requirement of this chapter or fails to meet the minimum requirements for licensure. The licensing agency shall give the licensee written notice of revocation and the grounds for the revocation and shall inform the licensee of the right to appeal that decision under sub. (7)
A licensing agency may summarily suspend a license when it finds that there is imminent danger to the health, safety or welfare of the residents in care. A finding of imminent danger may be based on but is not limited to any of the following:
Failure of the licensee to provide environmental protections such as heat, water, electricity or telephone service.
The licensee, a service provider or any other person affiliated with or living in the adult family home or who has contact with residents has been convicted of or has a pending charge for a crime against life or for causing bodily harm.
The licensee, a service provider or any other person living in the adult family home or who has contact with residents has been convicted of a felony, misdemeanor or other offense or has a pending criminal charge which is substantially related to the care of the residents or activities of the home.
The licensee, a service provider or any other person living in the adult family home or who has contact with residents is the subject of a current investigation of alleged abuse or neglect of a resident.
Pursuant to s. 50.033 (5)
, Stats., a licensing agency may commence an action in circuit court to enjoin the operation of an adult family home that is not licensed under this chapter or that is licensed and has repeatedly used methods of operation in substantial violation of this chapter, or that endangers the health, safety or welfare of any adult receiving care and maintenance in the home.
A licensing agency shall provide an adult family home with written notice of any sanction to be imposed on the adult family home. The notice shall include:
The grounds for a sanction based on an investigation made by the licensing agency.
An explanation of the types of sanctions that the licensing agency is imposing under this section.