Register

•   Requirements of hospitals, long-term care facilities and Resource Centers related to referral and counseling about long-term care options.

Contact Person and Availability of Emergency and Proposed Permanent Rules

The hearing agenda, emergency rules and proposed permanent rules are all available through the Department's web site at: http://www. d hfs.state.wi.us/LTCare/index.htm.

To find out more about the hearing or to request a written copy of the emergency or proposed permanent rules, write, phone or e-mail:

Bonnie Niemann

Office of Strategic Finance

P.O. Box 7850

Madison, Wisconsin 53707-7850

Telephone: [phone]

or, if you are hearing impaired, 608-266-3683 (TTY)

Fax: [phone]

[e-mail]

If you are hearing or visually impaired, do not speak English, or have circumstances which might make communication at a hearing difficult and if you, therefore, require an interpreter or a non-English, large print or taped version of the hearing document, contact the person at the address or phone number shown above. Persons requesting a non-English or sign language interpreter should contact the person at the address or phone number given above at least 10 days before the hearing. With less than 10 days notice, an interpreter may not be available.

Written comments received by mail, fax or e-mail at an above address no later than 5:00 p.m., May 12, 2000, will be given the same consideration as testimony presented at a hearing.

Fiscal Estimate

This order creates rules that specify how the family care benefit, established under ss. 46.2805 to 46.2895, as created by 1999 Wis. Act 9, will be implemented.

These rules provide specificity relating to eligibility and entitlement for the family care benefit, application for the benefit, cost sharing requirements, standards for aging and disability resource centers and for care management organizations, protections of the rights of family care applicants and enrollees, recovery of correctly and incorrectly paid family care benefits, and requirements for hospitals, nursing homes, community-based residential facilities, residential care apartment complexes, and adult family homes to provide information to certain patients, residents and prospective residents and to refer them to aging and disability resource centers.

These rules will not affect the expenditures or revenues of state governmental or local governments. These rules add specificity to the statutory requirements enacted by the Legislature and do not create new requirements that would affect expenditures or revenues. All costs of implementing the family care benefit were taken into consideration by the Legislature during development of the 99-01 biennial budget.

Initial Regulatory Flexibility Analysis

These rules apply to the following organizations: The Department of Health and Family Services, the Division of Hearings and Appeals in the Department of Administration, 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; and hospitals, nursing homes, community-based residential facilities, residential care apartment complexes and adult family homes in areas where an aging and disability resource center is under contract with the Department.

Some affected community-based residential facilities and adult family homes may be “small businesses" as defined in s. 227.114 (1) (a), Stats. These rules implement requirements, established in 1999 Wis. Act 9, that these facilities and homes provide certain information to residents and prospective residents and make certain referrals to an aging and disability resource center. The rules specify that the facility provide to prospective residents information, provided by the Department or by a resource center, obtain written verification that the information was provided and refer the prospective resident to the resource center. The Department has considered the methods for reducing the impact of these rules on small businesses specified in s. 227.114 (2), Stats., and has determined that establishing other standards for small businesses would be contrary to the statutory objectives that are the basis for the proposed rules.

No new professional skills are necessary for facilities and homes to comply with these requirements.

Notice of Proposed Rules

Health and Family Services

(Community Services, Chs. HFS 30--)

(Health, Chs. HFS 110--)

[CR 00-55]

Notice is hereby given that pursuant to ss. 50.02 (2), 50.36 (1), 50.51 (2), 50.95, Stats., and according to the procedures set forth in s. 227.16 (2) (e), Stats., the Department of Health and Family Services will repeal s. HSS 133.03 (6); renumber s. HSS 133.03 (7) to (9); amend ss. HSS 82.03 (2) (a) and Note and (7) and 82.04 (4) (b) and (5), HFS 83.07 (6) (b) 2., (11) (intro.), (13) and Note and (14), HSS 88.03 (2) (a) and Note, (b) 1. and (c), (3) (d) and (7) (a) and 88.04 (4), HSS 131.14 (5) (table) and (5), (6) (title) and (intro.), (8), (10) and (11) (a), HFS 132.14 (6) and 132.31 (6) (e) and HFS 134.14 (5); repeal and recreate ss. HSS 82.03 (4) (a) and (b), HFS 83.07 (7) and Note, HSS 88.03 (4), HSS 131.14 (7) and HSS 133.03 (5); and create ss. HFS 124.03 (7), HFS 132.14 (8), HSS 133.03 (9) and HFS 134.14 (5m), relating to non-expiring licenses for community-based residential facilities (CBRFs), hospices, nursing homes, home health agencies, facilities for the developmentally disabled (FDDs), rural medical centers and certain adult family homes, and for certifying certain adult family homes and for approving hospitals, as herein proposed, without public hearing, unless a petition for a hearing is received by the Department within 30 days after the publication of this notice on April 15, 2000. A petition for a hearing will be accepted if signed by any of the following who will be affected by the proposed rule: 25 persons; the representative of an association that represents a farm, labor, business or professional group; or a municipality.

Contact Information

If you have any questions about this rule or about filing a written petition for a hearing, contact:

Julie Hagen

Telephone [phone]

Bureau of Quality Assurance

P.O. Box 2969

Madison, WI 53701

Analysis Prepared by the Dept. of Health & Family Services

Statutory authority: The Department's authority to repeal, renumber, amend, repeal and recreate and create these rules is found in ss. 50.02 (2), 50.032 (2), 50.033 (2), 50.36 (1), 50.49 (2), 50.51 (2) and 50.95, Stats.

Statutes interpreted: The rules interpret ss. 50.03 (4) (c) 1. and 2., 50.032 (2) and (2r), 50.033 (2) and (2m), 50.355, 50.49 (6) (b) and (d), 50.52 (4), 50.535 and 50.93 (2) (a) and (3m), Stats.

This order amends the Department's rules for licensing community-based residential facilities (CBRFs), hospices, nursing homes, home health agencies, facilities for the developmentally disabled (FDDs), rural medical centers and certain adult family homes, for certifying certain adult family homes and for approving hospitals, to do the following:

1) Provide for non-expiring licenses and certification;

2) Replace a process for applying for renewal of a license or certification with a requirement that the licensee or certificate holder submit an annual or biennial report to the Department in the form and containing the information that the Department requires; and

3) In regard to hospitals, for which there has not been a requirement in statute or rule for renewal of an approval, add a requirement that the approval holder submit an annual report to the Department in the form and containing the information that the Department requires.

These are changes made in the program statutes by 1997 Wis. Act 27.

The order also clarifies in ss. HSS 82.03 (7) and HFS 83.07 (13) (b) that the referenced days are calendar days.

Text of Proposed Rules

SECTION 1. HSS 82.03 (2) (a) and (2) (Note) are amended to read:

HSS 82.03(2) APPLICATION FOR CERTIFICATION. (a) Application for certification or renewal of certification shall be made on a department-approved form provided by the certifying agency. The application form shall be signed by the applicant.

  Note: To obtain a copy of the application form, contact the certifying agency in the county in which the prospective family home is located or write or call: Program Certification Unit, Bureau of Community Programs, Division of Community Services, P.O. Box 7851, Madison, WI 53707, [phone] Resident Care Review Section, Bureau of Quality Assurance, P.O. Box 2969, Madison, WI 53701-0309; [phone].

SECTION 2. HSS 82.03 (4) (a) and (b) are repealed and recreated to read:

HSS 82.03 (4) (a) An adult family home certification is valid indefinitely unless suspended or revoked.

(b) Every 12 months, on a schedule determined by the department, a certified adult family home shall submit an annual report to the certifying agency in the form and containing the information that the department requires. If a complete annual report is not timely filed, the certifying agency shall issue a warning to the sponsor of the certified adult family home. If a certified adult family home that has not filed a timely report fails to submit a complete report to the certifying agency within 60 days after the date established under the schedule determined by the department, the certifying agency may decertify the adult family home.

SECTION 3. HSS 82.03 (7) is amended to read:

HSS 82.03 (7) ADMINISTRATIVE REVIEW. If an applicant or sponsor desires to contest a decision not to certify a home under sub. (3),) not to renew a certification under sub. (4) (b) or to decertify a home under sub. (6), the applicant or sponsor shall, within 15 calendar days after the date of the notice of the decision, submit to the certifying agency a written request for an administrative review of the decision. The request shall include the applicant's or sponsor's reason why he or she disagrees with the action. The administrator of the certifying agency or his or her designee shall review the facts and send a written decision to the applicant or sponsor and, if the certifying agency is not the department, to the department, within 30 calendar days after receipt of the request for review. If the certifying agency is not the department, the applicant or sponsor may, within 15 calendar days after the date of the certifying agency's decision, submit to the department a written request for an administrative review of the applicant or sponsor's original request and the certifying agency's decision. The department shall review the facts and send a written decision to the applicant or sponsor and to the certifying agency within 45 calendar days after the receipt of the request for review. The department's decision shall be final.

SECTION 4. HSS 82.04 (4) (b) and (5) are amended to read:

HSS 82.04 (4) (b) If the certifying agency suspects or has reason to believe that the applicant, sponsor, substitute provider or other household member may pose a threat to the health, safety or welfare of residents, the certifying agency may require a physical examination, an alcohol or drug abuse assessment or a mental health evaluation of the person as a condition of initial or continued certification or renewal of certification.

(5) VEHICLE LIABILITY INSURANCE. An applicant for initial certification or renewal of certification or sponsor who plans to transport residents in his or her vehicle shall provide the certifying agency with documentation of current automobile liability insurance coverage and with documentation of renewal so that coverage is in force for the entire term of certification. The sponsor shall maintain that coverage in force.

SECTION 5. HFS 83.07 (6) (b) 2. is amended to read:

  HFS 83.07 (6) (b) 2. A license is issued only for the premises and persons named in the application and is not transferable or assignable. The license shall be visibly displayed in a public area in the CBRF readily accessible to residents, staff and visitors. Any license granted shall state the maximum resident capacity allowed, which shall include the number of respite care residents, the client group or groups the CBRF may serve, the name of the licensee, the date, the expiration date, any condition of licensure and any additional information that the department may prescribe.

SECTION 6. HFS 83.07 (7) and Note are repealed and recreated to read:

HFS 83.07 (7) REPORTING. A license is valid indefinitely unless suspended or revoked. Every 24 months, on a schedule determined by the department, a licensee shall submit a biennial report in the form and containing the information that the department requires, including payment of the fees required under s. 50.037 (2) (a), Stats. If a complete biennial report is not timely filed, the department shall issue a warning to the licensee. If a licensee who has not filed a timely report fails to submit a complete report to the department within 60 days after the date established under the schedule determined by the department, the department may revoke the license.

  Note: For copies of the application form and the annual report form, DCS 310, write or phone the appropriate regional office of the Department's Division of Supportive Living. See Appendix A for the addresses and telephone numbers of those offices.

SECTION 7. HFS 83.07 (11) (intro.), (13) and (14) are amended to read:

HFS 83.07 (11) LICENSE DENIAL, OR REVOCATION OR NON-RENEWAL. The department may refuse to grant a license or may refuse to renew a license if it determines that the applicant is not fit and qualified pursuant to s. 50.03 (4) (a) 1., Stats., and s. HFS 83.11 (1) or fails to meet the requirements for licensure in this chapter and ch. 50, Stats. The department may revoke or refuse to renew a license pursuant to s. 50.03 (5g), Stats., if the applicant or licensee or any administrator, employe, or any other person affiliated with or living in the CBRF who has contact with residents:

(13) APPEAL. (a) Any person whose application for a license is denied or whose license is revoked or not renewed may request a hearing on that decision under ss. 227.42 and 50.03 (g) (5g) (f), Stats.

(14) POSTING OF CITATIONS AND NOTICES. (a) The licensee shall post next to the CBRF license any citation of deficiency, notice of revocation, notice of non-renewal and any other notice of enforcement action initiated by the department on forms and in correspondence received from the department. Citations of deficiency, notices of revocation and non-renewal and other notices of enforcement action shall be posted immediately upon their receipt. Citations of deficiency shall remain posted for 30 days following receipt or until compliance is achieved, whichever is longer. Notices of revocation, non-renewal and other notices of enforcement action shall remain posted until a final determination is made.

(b) The licensee shall make available, upon request, to a resident or prospective resident, the resident's or prospective resident's guardian, and the resident's or prospective resident's family members, designated representative and case manager, the results of all department license renewal surveys, monitoring visits and complaint investigations, if any, for the period of 12 months preceding the request.

SECTION 8. HSS 88.03 (2) (a) and Note, (b) 1. and (c) and (3) (d) are amended to read:

HSS 88.03 (2) APPLICATION. (a) Application for a license or for renewal of a license shall be made on a department-approved form available from the licensing agency.

  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 Supportive Living. See Appendix A for the addresses and phone numbers of the Division of Supportive Living regional offices.

  (b) 1. Before an applicant for an initial a license 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).

(c) An applicant requesting a license or renewal of 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.

(3) (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 or renewal of a license.

SECTION 9. HSS 88.03 (4) is repealed and recreated to read:

HSS 88.03 (4) LICENSE ISSUANCE. (a) An adult family home license is valid indefinitely unless suspended or revoked.

(b) 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.

SECTION 10. HSS 88.03 (7) (a) is amended to read:

HSS 88.03 (7) (a) Any person whose application for a license is denied under sub. (3) or whose license is not renewed under sub. (4) or revoked under sub. (6) (d) or suspended under sub. (6) (e) may request a hearing on that decision under s. 227.42, Stats.

SECTION 11. HSS 88.04 (4) is amended to read:

HSS 88.04 (4) INSURANCE. (a) Vehicle. An applicant for an initial or a license or for renewal of a license who plans to transport residents in his or her vehicle shall provide the licensing agency with a certificate of insurance documenting liability coverage. If a service provider transports residents under direction of the licensee , the service provider shall have vehicle insurance and a valid driver's license and, if requested by the licensing agency, shall provide evidence to the licensing agency on at 12 month intervals, on a form provided by the licensing agency,of a that the vehicle is in safe operating condition on a form provided by the licensing agency.

(b) Home. An applicant for an initial license or for renewal of a license A license applicant shall provide the licensing agency with documentation of homeowners or renters insurance coverage. The licensee shall maintain coverage in force for the entire term of the license.

SECTION 12. HFS 124.03 (7) is created to read:

HFS 124.03 (7) Every 12 months, on a schedule determined by the department, a hospital shall submit to the department an annual report in the form and containing the information that the department requires, including payment of the fee required under s. 50.135 (2) (a), Stats. If a complete annual report is not timely filed, the department shall issue a warning to the holder of the certificate of approval. If a hospital that has not filed a timely report fails to submit a complete report to the department within 60 days after the date established under the schedule determined by the department, the department may revoke the approval of the hospital.

SECTION 13. HFS 131.14 (5) and (6) (title) and (intro.) are amended to read:

HFS 131.14 (5) INITIAL REGULAR LICENSE. The department shall inspect a hospice prior to issuance of an initial issuing a regular license unless under sub. (3) (a) applies and the hospice need not be inspected. A regular license shall be is valid for 12 months from the date of issuance indefinitely unless sooner revoked or suspended, and may be renewed.