Chapter DHS 88

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.

DHS 88.05(3)(e)2. 2. The heating system shall be inspected as follows, with written documentation of the inspections maintained in the home:

DHS 88.05(3)(e)2.a. a. An oil furnace shall be inspected and serviced every 2 years by a heating contractor.

DHS 88.05(3)(e)2.b. b. A gas furnace shall be inspected and serviced every 3 years by a heating contractor or local utility company.

DHS 88.05(3)(e)2.c. c. The chimney shall be visually inspected by the inspector at the interval identified in subd. 2. a. or b.

DHS 88.05(3)(e)2.d. d. Any woodburning stove or fireplace in an adult family home shall have a flue separate from the one used by a gas or oil fired furnace or boiler. The flue shall be cleaned as often as necessary but not less than 2 times during each heating season, except that when a woodburning stove or fireplace is used for no more than 4 days each month of the heating season, the flue shall be cleaned at least once during each heating season.

DHS 88.05(3)(f) (f) The home shall have functioning support services, including refuse removal and access to laundry facilities.

DHS 88.05(3)(g) (g) The home shall have ventilation for health and comfort. There shall be at least one window which is capable of being opened to the outside in each resident sleeping room and each common room used by residents. Windows used for ventilation shall be screened during appropriate seasons of the year.

DHS 88.05(3)(h) (h) The home shall have space to accommodate all household activities and members comfortably as follows:

DHS 88.05(3)(h)1. 1. There shall be large enough common areas with sufficient furnishings so that all occupants of the home can comfortably share the space at the same time.

DHS 88.05(3)(h)2. 2. There shall be sufficient space and equipment in the kitchen for the sanitary preparation and storage of food.

DHS 88.05(3)(h)3. 3. The dining room or other dining area shall be large enough so that all household members may dine together.

DHS 88.05(3)(h)4. 4. There shall be at least one bathroom with at least one sink, stool and shower or tub for every 8 household members and towel racks with sufficient space for each household member.

DHS 88.05(3)(h)5. 5. A resident bedroom may accommodate no more than 2 persons. A resident bedroom shall have a floor area of at least 60 square feet per resident in shared bedrooms and 80 square feet in single occupancy rooms. For a person requiring a wheelchair, the bedroom space shall be 100 square feet for that resident.

DHS 88.05(3)(h)6. 6. Each resident shall be provided conveniently located individual storage space in the resident’s bedroom sufficient for hanging clothes and for storing clothing, toilet articles, towels and other personal belongings.

DHS 88.05(3)(i) (i) The door of each bathroom shall have a lock which can be opened from the outside in an emergency.

DHS 88.05(3)(j) (j) A resident’s bedroom may not be used by anyone else to get to any other part of the home.

DHS 88.05(3)(k) (k) Persons of the opposite sex shall not be required to occupy the same sleeping room. Accommodations shall be made for couples who wish to share a sleeping room.

DHS 88.05(3)(L) (L) A resident’s bedroom shall provide comfort and privacy, shall be enclosed by full height walls and shall have a rigid door that the resident can open and close.

DHS 88.05(3)(m) (m) No resident may regularly sleep in a basement bedroom or in a bedroom above the second floor of a single family dwelling unless there are 2 exits to the grade from that floor level.

DHS 88.05(3)(n) (n) The home shall have clean, functioning and safe household items and furnishings, including the following:

DHS 88.05(3)(n)1. 1. A separate bed for each resident unless a couple chooses to share a bed. The bed shall be clean, in good condition and of proper size and height for the comfort of the resident.

DHS 88.05(3)(n)2. 2. Appropriate bedding and linens that are maintained in a clean condition. When a waterproof mattress cover is used, there shall be a washable mattress pad, the same size as the mattress, over the waterproof mattress cover.

DHS 88.05(3)(o) (o) The home shall not be used for any business purpose that regularly brings customers to the home so that the residents’ use of the home as their residence or the residents’ privacy is adversely affected.

DHS 88.05(4) (4) Fire safety.

DHS 88.05(4)(a) (a) Fire extinguishers. Every adult family home shall be equipped with one or more fire extinguishers on each floor. Each required fire extinguisher shall have a minimum 2A, 10-B-C rating. All required fire extinguishers shall be mounted. A fire extinguisher is required at the head of each stairway and in or near the kitchen except that a single fire extinguisher located in close proximity to the kitchen and the head of a stairway may be used to meet the requirement for an extinguisher at each location. Each required fire extinguisher shall be maintained in readily usable condition and shall be inspected annually by an authorized dealer or the local fire department and have an attached tag showing the date of the last dealer or fire department inspection.

DHS 88.05(4)(b) (b) Smoke detectors.

DHS 88.05(4)(b)1. 1. Every adult family home shall be equipped with one or more single station battery operated, electrically interconnected or radio signal emitting smoke detectors on each floor level. Required smoke detectors shall be located in each habitable room except the kitchen and bathroom and specifically in the following locations: at the head of each open stairway, at the door leading to every enclosed stairway, on the ceiling of the living room or family room, on the ceiling of each sleeping room and in the basement.

DHS 88.05(4)(b)2. 2. The licensee shall maintain each required smoke detector in working condition and test each smoke detector monthly to make sure that it is operating. If a unit is found to be not operating, the licensee shall immediately replace the battery or have the unit repaired or replaced.

DHS 88.05(4)(c) (c) Exiting from the first floor.

DHS 88.05(4)(c)1. 1. The first floor of the home shall have at least 2 means of exiting which provide unobstructed access to the outside.

DHS 88.05(4)(c)2. 2. Exits shall be doors.

DHS 88.05(4)(d) (d) Fire safety evacuation plan.

DHS 88.05(4)(d)1. 1. The licensee shall have a written plan for the immediate and safe evacuation of all occupants of the home in the event of a fire. The plan shall identify an external meeting place.

DHS 88.05(4)(d)2. 2.

DHS 88.05(4)(d)2.a. a. The licensee shall review the fire safety evacuation plan with each new resident immediately following placement and shall evaluate the resident using a form provided by the department to determine whether the resident is able to evacuate the home without any help within 2 minutes.