DHS 68.03 Allocation of funds. DHS 68.04 Selection and reporting responsibilities of administering agencies. DHS 68.05 Program budget requirement; county, tribal, or nonprofit agency. DHS 68.06 Allowable use of funds. DHS 68.07 Client eligibility. DHS 68.08 Determination of need. DHS 68.09 Method of payment. DHS 68.11 Exceptions to requirements. Ch. DHS 68 NoteNote: Chapter HSS 68 is renumbered chapter HFS 68 under s. 13.93 (2m) (b) 1.,Stats., and corrections made under s. 13.93 (2m) (b) 6. and 7., Stats., Register, July, 1997, No. 499. Chapter HFS 68 was renumbered to chapter DHS 68 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 68.01(1)(1) Authority and purpose. This chapter is promulgated pursuant to ss. 46.87 and 227.11 (2) (a), Stats., section 3023 (28m) of 1985 Wis. Act 29, and 2015 Wis. Act 273 to establish procedures and criteria for distributing funds for the provision of service payments, goods and services to persons with dementia and to their caregivers. The payments, goods and services provided in accordance with this chapter are intended to help make available a diverse array of community services directed at preventing or delaying institutionalization of persons who have dementia and enhancing the quality of their lives, and to provide assistance to family members and others who take care of persons with dementia without compensation. DHS 68.01(2)(2) To whom the chapter applies. The chapter applies to the department, county boards, administering agencies designated by county boards under s. 46.87 (3) (c), Stats., tribes, and private nonprofit organizations selected by the department under s. DHS 68.04. DHS 68.02DHS 68.02 Definitions. In this chapter: DHS 68.02(1)(1) “Administering agency” means any of the following: DHS 68.02(2)(a)(a) A home certified by a county department of social services established under s. 46.215 or 46.22, Stats., or a county department of human services established under s. 46.23, Stats., in which one or 2 adults unrelated to the operator reside and which provides a structured living arrangement for residents whose physical, developmental and emotional functioning is likely to be maximized in this family-type living arrangement; or DHS 68.02(4)(4) “Caregiver” means any person other than a paid provider who provides care for a person with dementia. DHS 68.02(5)(5) “Community-based residential facility” or “CBRF” means a facility licensed under ch. DHS 83 in which 3 [5] or more unrelated adults reside and receive care and treatment or services above the level of room and board but not including nursing care. DHS 68.02(6)(6) “County agency” means an agency designated by a county board under s. 46.87 (3) (c), Stats., to administer the program, namely, a county department of social services created under s. 46.215 or 46.22, Stats., a county department of human services created under s. 46.23, Stats., a county aging unit, or a resource center authorized under s. 46.283, Stats., and ch. DHS 10. DHS 68.02(6m)(6m) “Dementia” means a degenerative disease of the central nervous system characterized especially by premature cognitive deterioration. This includes Alzheimer’s disease and related diagnoses which are similarly marked by irreversible deterioration of intellectual faculties with concomitant emotional disturbance resulting from organic brain disorder, such as: DHS 68.02(6m)(j)(j) Any other neurocognitive brain disorder that results in the irreversible deterioration of intellectual faculties. DHS 68.02(7)(7) “Department” means the Wisconsin department of health services. DHS 68.02(8)(8) “Expand services” means to expand the staffing, size of physical plant, or programming for an existing service offered by a service provider and included in a category listed under s. DHS 68.06 (2) (b) in order to increase by at least 10% over the number served prior to expansion the number of persons with dementia or their caregivers who are served by the provider, or to significantly improve, in the judgment of the administering agency contracting with the provider, the quality of services or service delivery for persons with dementia or for their caregivers. A service is no longer defined as “expanded” 3 years after the starting date of its expansion. DHS 68.02(9)(9) “Goods and services” means, unless otherwise qualified, goods and services purchased or provided under any of the categories listed under s. DHS 68.06 (2) (b). DHS 68.02(10)(10) “Household” means a person with dementia living alone or a person with dementia and the caregiver or caregivers with whom he or she lives, except that for purposes of determining financial eligibility under s. DHS 68.07 (3) and for purposes of determining ability to pay for the cost of program goods and services under s. DHS 68.08, “household” means only the person with dementia and spouse. DHS 68.02(11)(11) “Income” means gross earnings including money, wages or salary, net income from non-farm self-employment and net income from farm self-employment, and unearned income including social security, dividends, interest on savings or on money loaned, income from estates or trusts, net rental income or royalties, public assistance, pensions or annuities, unemployment compensation, worker’s compensation, maintenance payments under s. 767.56, Stats., child support, family support, veterans’ pensions, and educational grants given for living expenses. DHS 68.02 NoteNote: “Public assistance” includes but is not limited to programs such as aid to families with dependent children (AFDC) and supplemental security income (SSI).
DHS 68.02(12)(12) “Medical assistance” means the assistance program operated by the department under ss. 49.43 to 49.497, Stats. DHS 68.02(13)(13) “New program” means any goods or services under one or more of the categories listed under s. DHS 68.06 (2) developed or offered for the first time by a service provider under contract with an administering agency, to clients or beneficiaries, at least half of whom are persons with dementia or their caregivers. A program is no longer defined as “new” 3 years after its starting date. DHS 68.02(14)(14) “Private nonprofit organization” has the meaning prescribed for“nonprofit organization” in s. 108.02 (19), Stats. DHS 68.02(15)(15) “Program” means, unless otherwise qualified, the Alzheimer’s family and caregiver support program under s. 46.87, Stats. DHS 68.02(16)(16) “Residential facility” means an adult family home or a community-based residential facility. DHS 68.02(17)(17) “Respite” means temporary relief from caregiving responsibilities. DHS 68.02(18)(18) “Respite services” means any service granting respite, which is provided at home, such as assisting services, help with household chores, assistance with providing personal care, medication management or wound care for the person with dementia, or provided by an adult day center or short-term in an institutional setting. Respite services may also include expenses related to caregivers attending support groups, receiving individual counseling, activities related to maintaining the caregiver’s physical or psychological well-being, or other services approved by the administering agency. DHS 68.02(19)(19) “Tribal government” means a governing body of a tribe. DHS 68.02(20)(20) “Tribal service area” means the geographic area designated by a tribe, and approved by the U.S. Bureau of Indian Affairs or Indian Health Service, in which a tribal government provides services to its members. DHS 68.02 HistoryHistory: Cr. Register, March, 1989, No. 399, eff. 4-1-89; correction in (2) (b) made under s. 13.93 (2m) (b) 7., Stats., Register December 2004 No. 588; corrections in (2) (b), (5), (7) and (11) made under s. 13.92 (4) (b) 6. and 7., Stats., Register November 2008 No. 635; CR 17-032: r. and recr. (1), r. (3), am. (4), (6), cr. (6m), am. (8), (10), (13), cr. (17) to (21) Register June 2018 No. 750, eff. 7-1-18; correction in (6), (10), (18) made under s. 35.17, Stats., Register June 2018 No. 750. DHS 68.03DHS 68.03 Allocation of funds. Each administering agency shall receive no less than $5,000 per year in funds available under s. 20.435 (7) (b) and (o), Stats. DHS 68.03 HistoryHistory: Cr. Register, March, 1989, No. 399, eff. 4-1-89; corrections made under s. 13.93 (2m) (b) 7., Stats., Register, October, 2000, No. 538; corrections in (1) (intro.) and (2) made under s. 13.93 (2m) (b) 7., Stats., Register December 2004 No. 588; CR 17-032: r. and recr. Register June 2018 NO. 750, eff. 7-1-18. DHS 68.04DHS 68.04 Selection and reporting responsibilities of administering agencies. DHS 68.04(1)(a)(a) Letter of intent. A county board or tribal government may apply to serve as the administering agency by submitting to the department an initial letter of intent that includes all of the following: DHS 68.04(1)(a)2.2. The name and contact information for the responsible contact person. DHS 68.04(1)(a)3.3. A description of the program and services related to dementia that will be provided. DHS 68.04(1)(a)4.4. A description and contact information for any service provider contracted with to provide the program and services described in subd. 3. DHS 68.04(1)(a)5.5. An estimate of the number of households and residents of residential facilities to be served over the next calendar year. DHS 68.04(1)(a)6.6. The maximum amount payable in a calendar year to or on behalf of any person participating in the program and services described in subd. 3. DHS 68.04(1)(a)8.8. Any other information relating to the program’s knowledge of dementia, ability to manage supportive service programs, and its experience in assessing and meeting the needs of persons with dementia and their caregivers. DHS 68.04(1)(b)(b) Exemption. The following are not required to submit letters of intent under par. (a): DHS 68.04(1)(b)1.1. A county board or tribal government that submitted a letter of intent prior to the effective date of this chapter and that served as the administering agency each year following approval by the department. DHS 68.04(1)(b)2.2. A county board, tribal government, or private nonprofit organization that submits an initial letter of intent to the department, receives approval by the department to serve as the administering agency, and continues to serve as the administering agency each year following approval. DHS 68.04(2)(2) Administration by private nonprofit organization. DHS 68.04(2)(a)(a) The department shall solicit letters of intent from private nonprofit organizations, and may approve one or more private nonprofit organizations to administer the program for the following calendar year, if any of the following occur: DHS 68.04(2)(a)1.1. Neither a county agency nor a tribal government submits a letter of intent under sub. (1). DHS 68.04(2)(a)2.2. Both the county agency and tribal government notify the department that they do not intend to administer the program for the following calendar year. DHS 68.04(2)(a)3.3. The department denies approval to administer the program for the following calendar year to the county agency and tribal government that submitted letters of intent under sub. (1) (a) or were exempt from submitting a letter of intent under sub. (1) (b). DHS 68.04(2)(b)(b) A private nonprofit organization may apply to administer the program under par. (a) by submitting to the department an initial letter of intent, as provided in sub. (1) (a). DHS 68.04(3)(a)(a) The department may approve county board, tribal government, or private nonprofit organization to serve as the administering agency as provided in this section, if it determines that the county board, tribal government, or private nonprofit organization is able to administer the program as required under this chapter. DHS 68.04(3)(b)(b) The department may deny approval of a county board, tribal government, or private nonprofit organization to serve as the administering agency for the following calendar year if it determines that the information provided in the letter of intent is incomplete or inaccurate, or the county board, tribal government, or private nonprofit organization is unable to adequately administer the program as provided under this chapter. DHS 68.04(4)(4) Change of administering agency. If a county board or tribal government that is not serving as the administering agency for the program submits a letter of intent to participate under this section, the private nonprofit organization selected by the department to administer the program shall continue to serve as the administering agency for the remainder of the calendar year. DHS 68.04(5)(5) Notification to the department of changes. Pursuant to s. 46.87 (7), Stats., the county board or tribal government or the private nonprofit organization selected under sub. (3) to serve as the administering agency for the program shall notify the department in writing within 15 working days after any of the following occurs: DHS 68.04(5)(a)(a) The county board or tribal government designates a new agency. DHS 68.04(5)(b)(b) The administering agency decides to terminate participation in the program. DHS 68.04(5)(c)(c) The administering agency decides to make a change in the program or services which would result in a substantial difference from the description of the county’s program and services contained in the letter of intent or budget most recently submitted to the department. The administering agency shall notify the department when it does any of the following: DHS 68.04(5)(c)1.1. Contracts with a service provider to develop a new program or expand services. DHS 68.04(5)(c)4.4. Establishes a maximum payment of less than $4,000 in a calendar year for each person with dementia who is participating in the program.
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