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. DHS 68.04(6)(6) Notice to participants of changes. The administering agency shall notify each affected caregiver in writing of any change identified under sub. (5) (b) or (c) 2. or 5. at least 10 working days prior to implementing that change. DHS 68.04(7)(7) Records and reports. The administering agency shall maintain program records and submit reports as required by the department. DHS 68.04 HistoryHistory: Cr. Register, March, 1989, No. 399, eff. 4-1-89; am. (1), Register, October, 2000, No. 538, eff. 11-1-00; correction in (1) (b) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635; CR 17-032: r. and recr. (1) to (3), am. (4), (5) (intro.), (a), (b), (c) (intro.), 1. to 4. Register June 2018 No. 750, eff. 7-1-18; correction in (2) (a) 3., (b), (5) made under s. 35.17, Stats., Register June 2018 No. 750. DHS 68.05DHS 68.05 Program budget requirement; county, tribal, or nonprofit agency. DHS 68.05(1)(1) An administering agency shall annually prepare a budget for the program and shall submit the budget to the department each year by November 30. This budget shall be part of either the proposed budget required under s. 46.031, Stats., or the plan for older people required by the department and prepared by the county or tribal aging unit under s. 46.87 (3) (c) 4., Stats. The budget shall include at least, all the following information: DHS 68.05(1)(a)(a) The total amount of allocated funds anticipated for the program for the calendar year. DHS 68.05(1)(b)(b) The number of households anticipated to be enrolled and served for the calendar year. DHS 68.05(1)(e)(e) The maximum amount payable in a calendar year to or on behalf of any participating person with dementia, if that amount is less than $4,000. DHS 68.05(1)(f)(f) A brief description of any limitations on goods and services that are to be provided, purchased or contracted for. DHS 68.05(1)(g)(g) Brief descriptions of any new programs or expanded services. DHS 68.05(1)(i)(i) The name and phone number of the principal contact person at the county, tribal, or nonprofit agency for the program. DHS 68.05(2)(2) The department may terminate an administering agency’s participation in the program if it determines that the information provided by the administering agency in the distinct budget is insufficient or inconsistent with the purposes and procedures of the program as defined in s. 46.87, Stats., and this chapter, or the agency does not submit the distinct budget by November 30. DHS 68.05(3)(3) The administering agency’s contract with the department under s. 46.031 (2g) (a), Stats., shall include the name of the agency and the amount of the allocation for the contract year. DHS 68.05 HistoryHistory: Cr. Register, March, 1989, No. 399, eff. 4-1-89; CR 17-032: am. (1), r. (2) Register June 2018 No. 750, eff. 7-1-18; renum. (1) to DHS 68.05 under s. 13.92 (4) (b) 1., Stats., Register June 2018 No. 750. DHS 68.06(1)(1) Purposes. As permitted by s. 46.87 (5), Stats., the administering agency may use allocated funds for any of the following purposes: DHS 68.06(1)(a)(a) To pay for the cost of goods and services provided to or purchased for or by households and for limited transportation and supplemental services for a caregiver of a person living in a residential facility who is found eligible to participate in the program under s. DHS 68.07. The program may not be used to pay fees associated with the cost of permanent placement in an assisted living facility or other living arrangement that is not a CBRF or adult family home as defined under s. DHS 68.02. DHS 68.06(1)(b)(b) To contract with service providers to develop new programs or expand services. DHS 68.06(1)(c)(c) To provide outreach, that is, to search out persons in need of support by the program, or to provide activities designed to develop or enhance public awareness of dementia. DHS 68.06(1)(d)(d) To develop or assist support groups for persons with dementia and caregivers. DHS 68.06(1)(e)(e) To pay for program administration, except that no more than 10% of funds allocated for the program may be used for this purpose. DHS 68.06(2)(a)(a) A household or a person living in a residential facility who is participating in the program may not be restricted from purchasing goods and services listed under this subsection and identified under s. DHS 68.08 from providers who are located outside of the county to which application is made. DHS 68.06(2)(b)(b) The administering agency at the time of need determination under s. DHS 68.08 shall enumerate to households and individuals participating in the program the goods or services that may be purchased or provided to accomplish the purposes listed under sub. (1), which shall be limited to goods and services that can be provided under any of the following categories: DHS 68.06(2)(b)12.12. Home-delivered meals for people with dementia and caregivers that are not Title III-C2 eligible. DHS 68.06(2)(b)15.15. Inpatient treatments not covered by the person’s primary health insurance. DHS 68.06(2)(b)20.20. Recreation and social activities, including Memory Cafés and social events. DHS 68.06(2)(b)24.24. Any other goods and services necessary to maintain the person with dementia 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 NoteNote: 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(4)(4) Non-Supplanting. Program funds may not be used to purchase goods and services that are otherwise covered by a person’s private health or long term care insurance, or be spent in place of other federal, state or local programs that would, in the absence of the Alzheimer’s and Dementia Family Caregiver Program, be available to the family. DHS 68.06 HistoryHistory: Cr. Register, March, 1989, No. 399, eff. 4-1-89; CR 17-032: am. (1) (intro.), (a) to (d), r. and recr. (2) (b), am. (3) (a), cr. (4) Register June 2018 No. 750, eff. 7-1-18; correction in (2) (a), (b) (intro.) made under s. 13.92 (4) (b) 7., Stats., Register June 2018 No. 750. DHS 68.07DHS 68.07 Client eligibility. In accordance with s. 46.87 (5), Stats., the administering agency of each county or tribe shall determine the eligibility of each household that applies to participate in that county or tribe’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 documented diagnosis of dementia from a physician or other qualified medical provider. DHS 68.07(2)(2) residency. The person in the household who has dementia, or that person’s caregiver, meets one of the following conditions: DHS 68.07(2)(b)(b) The person with dementia lives in a residential facility located in the county or tribal service area. DHS 68.07(3)(3) Household income. The person with dementia and that person’s spouse are expected to have a joint income of no more than $48,000 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 $48,000, the administering agency shall subtract any expenses attributable to the dementia-related needs of the person with a dementia diagnosis or of the person’s caregiver. If the net income determined by subtracting dementia-related expenses for a household is $48,000 or less, the household shall be considered as having met the household income eligibility condition. DHS 68.07 HistoryHistory: Cr. Register, March, 1989, No. 399, eff. 4-1-89; CR 17-032: am. Register June 2018 No. 750, eff. 7-1-18; correction in (2) (b) made under s. 35.17, Stats., Register June 2018 No. 750. DHS 68.08DHS 68.08 Determination of need. The amount paid or expended for each person diagnosed with dementia may not exceed $4,000 in any calendar year. 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 shall conduct a needs assessment to determine all of the following: DHS 68.08(1)(1) The goods and services needed by the household to enable it to maintain the person with dementia as a member of the household. DHS 68.08(2)(2) The goods and services reasonably needed by a person with dementia living in a residential facility that are not included in residential fees paid to the facility.
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Department of Health Services (DHS)
Chs. DHS 30-100; Community Services
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