10. “Department” means the Wisconsin department of health services.
11. “Legal representative” means any of the following:
a. The health care agent under an activated power of attorney for health care under ch. 155, Stats. b. A person appointed as a durable power of attorney under ch. 244, Stats. c. A guardian, guardian of the estate, or guardian of the person, as defined in s. 54.01 (10), (11), or (12), Stats. 12. “Medication administration” means the direct injection, ingestion or other application of a prescription or over-the-counter drug or device to a participant by any of the following:
a. A practitioner.
b. The practitioner’s authorized agent.
c. An ADCC caregiver, or the participant, at the direction of the practitioner.
d. Medication administration does not include reminders to take medication.
13. “Misappropriation of property” has the meaning given in s. DHS 13.03 (12). 15. “Nursing care” means nursing procedures, other than personal or supportive care, that a registered nurse or a licensed practical nurse performs directly on or to a participant.
16. “Occupant” means any of the following:
a. A person who lives and sleeps in the ADCC, but who is not a participant.
b. A non-client resident, as defined in 50.065 (1) (cn), Stats.
17. “Operator” means an individual or business entity to whom a certification is granted and is legally responsible for the operation of the ADCC.
18. “Participant” means an adult who attends the ADCC during listed hours of operation and receives care, treatment, or services.
19. “Participant group” means a group of participants who need similar services because of a common disability, condition, or status. A participant group includes a group of individuals who have any of the following:
a. Functional impairments commonly associated with advanced age.
b. Irreversible dementia, such as Alzheimer's disease.
c. Developmental disability, as defined in s. 51.01 (5), Stats. d. An emotional disturbance or a mental illness as defined in s. 51.01 (13) (a), Stats. e. Physical disability.
f. Traumatic brain injury.
20. “Physical restraint” means any manual method, article, device, or garment interfering with the free movement of the participant or the normal functioning of a portion of the participant’s body or normal access to a portion of the participant’s body, and which the participant is unable to remove easily, or confinement of a participant in a locked room.
21. “Program Director” means an employee who is responsible for the management and day-to-day operation of the ADCC. A program director includes any of the following:
a. The operator.
b. An employee designated by the operator.
22. “Psychotropic medication” means a prescription drug, defined in s. 450.01 (20), Stats., that is used to treat or manage a psychiatric symptom or challenging behavior. 23. “Qualified Caregiver” means an employee who is at least 18 years of age and has successfully completed all of the applicable orientation and training under sub. (4), pars. (a) and (b) of this section.
24. a. “Seclusion” means physical or social separation of a participant from others by actions of caregivers.
b. “Seclusion” does not include separation to prevent the spread of communicable disease or voluntary cool-down periods in an unlocked room.
25. “Serious injury” means an injury from any incident or accident which results in any of the following:
a. A temporary or permanent increase in the level of assistance needed in one or more ADL categories, such as bathing, eating, oral hygiene, dressing, toileting, incontinence care, or mobility and transferring.
b. A fracture.
c. A pronounced decline in communication or cognitive abilities.
26. “Significant change” in a participant’s physical or mental condition means any of the following:
a. A decline in a participant’s medical condition that results in further impairment.
b. A decline in 2 or more ADLs.
c. A pronounced decline in communication or cognitive abilities.
d. A decline in behavior or mood which requires either a temporary or permanent increase in the level of assistance needed in one or more ADL categories, such as bathing, eating, oral hygiene, dressing, toileting, incontinence care, or mobility and transferring.
27. “Standard precautions” are a set of infection control practices used to prevent transmission of diseases that can be acquired by contact with blood, body fluids, non-intact skin (including rashes), and mucous membranes. These measures are used when providing care to all individuals, whether or not they appear infectious or symptomatic.
28. a. “Supervision” means oversight of a participant’s functioning.
b. Supervision includes keeping track of a participant’s whereabouts and providing guidance and intervention when needed by a participant.
29. “Transferor” means the current operator in a change of ownership process who will voluntarily relinquish the current certification.
30. “Transferee” means the recipient of a property or business in a change of ownership process who will submit application for a new certification.
31. “Utensils” means dishes, silverware and pots and pans used for storing, preparing, serving, or consuming food.
32. “Variance” means an alternate means of meeting a requirement in this section, as approved by the department under par. (c).
33. “Volunteer” means any person who provides services for participants without compensation.
34. “Waiver” means an exemption from a requirement in this section, as approved by the department under par. (c).
(c) Variances and waivers.
1. The department may grant approval of a waiver or variance if the department determines that the proposed waiver or variance will not jeopardize the health, safety, welfare or rights of any participant.
2. A written request for a waiver or variance shall be sent to the department and include justification that the waiver or variance will not adversely affect the health, safety or welfare of any participant for the requested action.
3. A written request for a variance shall include a description of an alternative means planned to meet the intent of the requirement.
4. The department may terminate approval of a waiver or variance if any of the following occurs:
a. The department determines the waiver or variance has adversely affected the health, safety, well-being or welfare of a participant.
b. The ADCC fails to comply with any of the conditions of the waiver or variance as granted.
c. A change in circumstances from the time the waiver or variance approval was initially granted.
d. The ADCC failed to disclose a fact that is material to the approval.
(2) Certification.
(a) General requirements.
1. No person may receive reimbursement under s. 46.27 (11), Stats., for the provision of services to a participant in an ADCC unless the ADCC is certified by the department. A person who assumes ownership interest in a certified ADCC, regardless of whether the transfer includes title to the real estate, or changes the location of the ADCC shall complete an application as required under this subsection. 2. An application for certification shall be on a form or web-based application provided by the department and shall include all of the following:
a. A program description as specified under par. (b) of this subsection.
b. A floor plan specifying dimensions of the ADCC, including exits and planned room usage.
c. A fire inspection report.
d. All required fees.
e. A balance sheet.
f. Evidence that the applicant has 60 days of projected operating funds in reserve.
g. Proof of transportation liability insurance if the ADCC provides transportation.
h. Well water test results if the ADCC uses well water.
i. A program evaluation plan.
j. Any additional information requested by the department.
3. An ADCC may not be located on a parcel of land zoned for industrial or manufacturing use.
(b) Program description.
1. The program description included as part of an application under par. (a), subd. 2. of this subsection shall include all of the following:
a. The name of the operator, the program director, and the caregiver position in charge when the operator or program director is away from the ADCC.
b. The participant capacity of the ADCC.
c. A definition of the program goals and a description of the services provided or made available to participants at the ADCC.
d. The days and hours of operation of the ADCC.
e. A description of any limits the program establishes for providing service to a participant with specific care needs.
f. A fee schedule which includes the daily charges and additional fees for specific services, goods, or supplies that are not included in the daily charge, and the method for notifying a participant or a legal representative of fee changes.
g. A procedure for informing the participant’s legal representative, family, or caregiver of any major change in the participant’s general functioning or medical condition.
h. A procedure for documenting any incident occurring at the site which would affect the health, safety or welfare of a participant.
i. The participant group to be served and, if serving more than one participant group, an explanation acceptable to the department of how each participant group is compatible with one another.
j. A grievance procedure for investigating and resolving complaints made by a participant, legal representative, family member, caregiver, or other interested persons about the services provided by the ADCC which includes informing such persons of appropriate local, county and/or state agency contacts and informing such persons that pursuant to s. DHS 13.05 (4) (a) and s. 146.40 (4r) (a), Stats., any individual may report to the department that he or she believes that any person employed by or under contract with the ADCC has neglected or abused a participant or misappropriated the participant’s property. k. The criteria for voluntary and involuntary discharge of a participant from the program as defined in sub. (5), par. (c) of this section.
2. Before finalizing an agreement to provide care, the ADCC shall provide its program description to each person seeking services or to the person’s legal representative, or both.
