Chapter DHS 88

DHS 88.03(6)(a)2. 2. The licensing agency may require modifications in a proposed plan of correction before approving it or may substitute its own plan of correction.

DHS 88.03(6)(b) (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:

DHS 88.03(6)(b)1. 1. The types of individuals are not compatible.

DHS 88.03(6)(b)2. 2. The licensee and service providers do not have the appropriate training to serve the residents.

DHS 88.03(6)(b)3. 3. 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.

DHS 88.03(6)(c) (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.

DHS 88.03(6)(d) (d) Revocation. 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).

DHS 88.03(6)(e) (e) Suspension. 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:

DHS 88.03(6)(e)1. 1. Failure of the licensee to provide environmental protections such as heat, water, electricity or telephone service.

DHS 88.03(6)(e)2. 2. 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.

DHS 88.03(6)(e)3. 3. 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.

DHS 88.03(6)(e)4. 4. 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.

DHS 88.03(6)(f) (f) Injunction. 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.

DHS 88.03(6)(g) (g) Sanctions.

DHS 88.03(6)(g)1. 1. 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:

DHS 88.03(6)(g)1.a. a. The grounds for a sanction based on an investigation made by the licensing agency.

DHS 88.03(6)(g)1.b. b. An explanation of the types of sanctions that the licensing agency is imposing under this section.

DHS 88.03(6)(g)1.c. c. An explanation of the process under sub. (7) for appealing an appealable sanction.

DHS 88.03(6)(g)2. 2. The licensing agency may order any of the following actions:

DHS 88.03(6)(g)2.a. a. That a person stop conducting, maintaining or operating an adult family home if the adult family home is without a valid license.

DHS 88.03(6)(g)2.b. b. That a licensee stop violating any provision of its license or of this chapter.

DHS 88.03(6)(g)2.c. c. That a licensee submit a plan of correction under par. (a) for violation of any provision of its license or of this chapter.

DHS 88.03(6)(g)2.d. d. That a licensee implement and comply with a plan of correction previously submitted by the licensee and approved by the licensing agency.

DHS 88.03(6)(g)2.e. e. That a licensee implement and comply with a plan of correction developed by the licensing agency.

DHS 88.03(6)(g)2.f. f. That a licensee accept no additional residents until all violations are corrected.

DHS 88.03(6)(g)2.g. g. That a licensee provide or secure training in one or more specific areas for the licensee or service provider.

DHS 88.03(6)(h) (h) Penalties. Pursuant to s. 50.033 (6), Stats., any person who violates s. 50.033, Stats., or this chapter may be fined not more than $500 or imprisoned for not more than one year in the county jail or both.

DHS 88.03(7) (7) Appeal.

DHS 88.03(7)(a) (a) Any person whose application for a license is denied under sub. (3) or revoked under sub. (6) (d) or suspended under sub. (6) (e) may request a hearing on that decision under s. 227.42, Stats.

DHS 88.03(7)(b) (b) A request for a hearing shall be in writing, shall be filed with the department of administration’s division of hearings and appeals and shall be sent to that office so that it is received there within 10 days after the date of the notice under sub. (3), (4) or (6) (d).

DHS 88.03 Note Note: A request for a hearing should be submitted to the Division of Hearings and Appeals, P.O. Box 7875, Madison, Wisconsin 53707.

DHS 88.03(8) (8) Monitoring of home.

DHS 88.03(8)(a) (a) The licensee shall comply with all department and licensing agency requests for information about the residents, services or operation of the home.

DHS 88.03(8)(b) (b) A licensing agency and service coordinator may, without notice, visit a home at any time to evaluate the status of resident health, safety or welfare or to determine if the home continues to comply with this chapter. The licensee shall permit the licensing agency and service coordinator to enter the home.

DHS 88.03(8)(c) (c) A licensing agency may require a licensee to request fire, health, sanitation or safety officials to inspect the home and premises to assist in evaluating the safety of the home. Any inspection shall be at the licensee’s expense.

DHS 88.03 History History: Cr. Register, January, 1996, No. 482, eff. 2-1-96; am. (2) (a), (b) 1., (c), (3) (d), (7) (a), r. and recr. (4), Register, August, 2000, No. 536, eff. 9-1-00; CR 07-042: cr. (4) (c) Register October 2007 No. 622, eff. 11-1-07; corrections in (2) (d) and (3) (c) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635.

DHS 88.04 DHS 88.04 Licensee and service provider.

DHS 88.04(1) (1) Qualifications.

DHS 88.04(1)(a) (a) A licensee shall be at least 21 years of age and shall be physically, emotionally and mentally capable of providing care for residents of the adult family home.

DHS 88.04(1)(b) (b) A service provider shall be at least 18 years of age.

DHS 88.04(1)(c) (c) The licensee and service provider shall be persons who are responsible, mature and of reputable character and who exercise and display the capacity to successfully provide care for 3 or 4 unrelated adult residents as identified in the home’s program statement.

DHS 88.04(2) (2) Responsibilities.

DHS 88.04(2)(a) (a) The licensee shall ensure that the home and its operation comply with this chapter and with all other laws governing the home and its operation.

DHS 88.04(2)(b) (b) The licensee shall ensure that he or she or a service provider is present and awake at all times if any resident is in need of continuous care.

DHS 88.04(2)(c) (c) The licensee shall report in writing to the licensing agency any change in the type of individual served at least 30 days before the change. A 30 day written notice of any change in type of individual served shall also be provided to each resident and each resident’s guardian, designated representative, service coordinator, placing agency and third party payee.

DHS 88.04(2)(d) (d) The licensee shall ensure that at least one copy of ch. DHS 88 is in the home at all times and is available for review by any resident, any resident’s guardian or designated representative or any service provider.

DHS 88.04(2)(e) (e)

DHS 88.04(2)(e)1. 1. The licensee shall refer a resident to the county protective services agency designated under s. 55.02, Stats., if the licensee believes the resident is incompetent as defined in s. 54.10 (3), Stats., for an evaluation to determine if a competency proceeding under ch. 54, Stats., is needed.

DHS 88.04(2)(e)2. 2. If a guardian of a person who has been found incompetent under ch. 54, Stats., places a person in the home and the resident objects to the placement, the licensee shall notify the agency designated under ch. 55, Stats., for the county in which the person is living.

DHS 88.04(2)(f) (f) The licensee may not permit the existence or continuation of a condition in the home which places the health, safety or welfare of a resident at substantial risk of harm.

DHS 88.04(2)(g) (g)

DHS 88.04(2)(g)1. 1. The licensee shall obtain documentation from a physician, a registered nurse or a physician’s assistant indicating that the licensee and any service provider has been screened for illness detrimental to residents, including for tuberculosis. The documentation is to be completed within 90 days before the start of providing service. The documentation shall be kept confidential except that the licensing agency shall have access to the documentation for verification.

DHS 88.04(2)(g)2. 2. The licensee shall ensure that no one who has a communicable disease reportable under ch. DHS 145 may work in a position in the adult family home where the disease would present a significant risk to the health or safety of residents.

DHS 88.04 Note Note: For information on diseases reportable under ch. DHS 145, contact your city or county health department.

DHS 88.04(2)(h) (h) The licensee and all service providers involved in the operation of the adult family home shall comply with the universal precautions contained in the U.S. Occupational Safety and Health Administration Standard 29 CFR 1910.1030 for the control of blood-borne pathogens.

DHS 88.04 Note Note: Information about universal precautions may be obtained from a county or city health department or from the Department’s Bureau of Occupational Health, telephone [phone].

DHS 88.04(2)(i) (i) Neither the licensee nor a service provider may sell real or personal property to a resident or prospective resident, or purchase, borrow or accept money for real or personal property from a resident or prospective resident. Gifts offered by a resident on a festive occasion are allowable if permitted by the resident’s finances.

DHS 88.04(3) (3) Financial security. A licensee or license applicant, on request of the licensing agency, shall produce evidence of financial stability to permit operation of the home for at least 60 days.

DHS 88.04 Note Note: Program contracts or agency agreements would meet the intent of this requirement.

DHS 88.04(4) (4) Insurance.

DHS 88.04(4)(a) (a) Vehicle. An applicant for 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 at 12 month intervals, on a form provided by the licensing agency that the vehicle is in safe operating condition.

DHS 88.04 Note Note: Form DCS-52, Safety Inspection for Day Care Vehicles, may be obtained from any regional office of the Department’s Division of Disability and Elder Services. See Appendix A.

DHS 88.04(4)(b) (b) Home. A license applicant shall provide the licensing agency with documentation of home owners or renters insurance coverage. The licensee shall maintain coverage in force for the entire term of the license.

DHS 88.04(5) (5) Training.

DHS 88.04(5)(a) (a) The licensee and each service provider shall complete 15 hours of training approved by the licensing agency related to health, safety and welfare of residents, resident rights and treatment appropriate to residents served prior to or within 6 months after starting to provide care. This training shall include training in fire safety and first aid.

DHS 88.04(5)(b) (b) Except as provided in pars. (c) and (d), the licensee and each service provider shall complete 8 hours of training approved by the licensing agency related to the health, safety, welfare, rights and treatment of residents every year beginning with the calendar year after the year in which the initial training is received.

DHS 88.04(5)(c) (c) The licensing agency may require the licensee and service providers to obtain training in amounts that exceed the minimum required under par. (b) to ensure that resident health, safety and welfare are protected and promoted.

DHS 88.04(5)(d) (d) The licensing agency may approve alternatives to the training requirements in pars. (a) and (b) at a licensee’s request and if the licensing agency determines that any of the following has occurred:

DHS 88.04(5)(d)1. 1. The person has successfully completed substantially similar or related training.

DHS 88.04(5)(d)2. 2. The person has successfully completed course work or an academic degree program related to the care, maintenance and treatment of the type of individuals served by the adult family home as identified in the home’s program statement or other persons in need of care, maintenance or treatment.

DHS 88.04(5)(d)3. 3. The person has acquired substantial and up-to-date knowledge concerning care, maintenance, treatment and health, safety, welfare and rights appropriate to a resident being served through prior experience in licensed or certified programs which are substantially similar to adult family homes.

DHS 88.04 History History: Cr. Register, January, 1996, No. 482, eff. 2-1-96; am. (4), Register, August, 2000, No. 536, eff. 9-1-00; corrections in (2) (e) made under s. 13.93 (2m) (b) 7., Stats., Register October 2007 No. 622; correction in (2) (g) 2. made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635.

DHS 88.05 DHS 88.05 Home.

DHS 88.05(1) (1) Location and access to the community. An adult family home shall be located so that residents can easily get to community activities and supportive services by walking or by means of convenient private or public transportation, or the licensee shall ensure that residents receive the assistance necessary to enable them to get to those activities and services. The home shall be located in a residential area which is typical of residential areas in that community.

DHS 88.05(2) (2) Resident access to the home and within the home. An adult family home shall be physically accessible to all residents of the home. Residents shall be able to easily enter and exit the home, to easily get to their sleeping rooms, a bathroom, the kitchen and all common living areas in the home, and to easily move about in the home. Additional accessibility features shall be provided as follows, if needed to accommodate the physical limitations of a resident or if specified in the resident’s individual service plan:

DHS 88.05(2)(a) (a) If a resident is not able to walk at all or able to walk only with difficulty, or only with the assistance of crutches, a cane, or walker or is unable to easily negotiate stairs without assistance:

DHS 88.05(2)(a)1. 1. The exits from the home shall be ramped to grade with a hard surfaced pathway with handrails.

DHS 88.05(2)(a)2. 2. All entrance and exit doors and interior doors serving all common living areas and all bathrooms and bedrooms used by a resident not able to walk at all shall have a clear opening of at least 32 inches.

DHS 88.05(2)(a)3. 3. Toilet and bathing facilities used by a resident not able to walk at all shall have enough space to provide a turning radius for the resident’s wheelchair and provide accessibility appropriate to the resident’s needs.

DHS 88.05(2)(b) (b) Grab bars shall be provided for toilet and bath fixtures in those bathing and toilet facilities used by residents not able to walk at all or only with difficulty, or by other residents with physical limitations that make transferring difficult.

DHS 88.05(2)(c) (c) If any resident has either manual strength or dexterity limitations, the home shall have levered handles on all doors, bathroom water fixtures and other devices normally used by that resident if these can be replaced and if replacement is readily achievable.

DHS 88.05(2)(d) (d) Any resident who is unable to easily negotiate stairs without assistance shall have his or her bedroom, toilet and bathing facilities and all common living areas on the first floor.

DHS 88.05(3) (3) Home environment.

DHS 88.05(3)(a) (a) An adult family home shall be safe, clean and well-maintained and shall provide a homelike environment.

DHS 88.05(3)(b) (b) The home shall be free from hazards and kept uncluttered and free of dangerous substances, insects and rodents.

DHS 88.05(3)(c) (c) The home shall have heating, hot and cold water and electrical, plumbing, sewerage and lighting systems that meet local building codes.

DHS 88.05(3)(d) (d) Where a public water supply is not available water samples shall be taken from the well and tested at the state laboratory of hygiene or other laboratory approved under ch. NR 149 at least annually.

DHS 88.05(3)(e) (e)

DHS 88.05(3)(e)1. 1. The home shall have a heating system capable of maintaining a temperature of 74°F. The temperature in habitable rooms shall not be permitted to fall below 70° F. during periods of occupancy, except that the home may reduce temperatures during sleeping hours to 67° F. Higher or lower temperatures, for certain residents, including but not limited to residents of advanced age and residents with physical disabilities, shall be provided to the extent possible when requested by a resident.