Amendment ASA1-AB100

AB100-ASA1, s. 1307 Section 1307. 48.67 of the statutes is amended to read:

AB100-ASA1,734,8 48.67 Rules governing child welfare agencies, day care centers, foster homes, treatment foster homes, group homes, shelter care facilities and county departments. The department shall promulgate rules establishing minimum requirements for the issuance of licenses to, and establishing standards for the operation of, child welfare agencies, day care centers, foster homes, treatment foster homes, group homes, shelter care facilities and county departments. These rules shall be designed to protect and promote the health, safety and welfare of the children in the care of all licensees. The department shall consult with the department of commerce and the department of education public instruction before promulgating these rules.

AB100-ASA1, s. 1308 Section 1308. 48.68 (1) of the statutes is amended to read:

AB100-ASA1,734,24 48.68 (1) After receipt of an application for a license, the department shall investigate to determine if the applicant meets the minimum requirements for a license adopted by the department under s. 48.67. In determining whether to issue or continue a license, the department may consider any action by the applicant, or by an employe of the applicant, that constitutes a substantial failure by the applicant or employe to protect and promote the health, safety and welfare of a child. Upon satisfactory completion of this investigation and payment of the fee required under s. 48.615 (1) (a) or (b), 48.625 (2) (a), 48.65 (3) (a) or 938.22 (7) (b), the department shall issue a license under s. 48.66 (1) or, if applicable, a probationary license under s. 48.69 or, if applicable, shall continue a license under s. 48.66 (5). At the time of initial licensure and license renewal, the department shall provide a foster home licensee with written information relating to the age-related monthly foster care rates and supplemental payments specified in s. 48.62 (4), including payment amounts, eligibility requirements for supplemental payments and the procedures for applying for supplemental payments.

AB100-ASA1, s. 1309 Section 1309. 48.68 (2) of the statutes is amended to read:

AB100-ASA1,735,4 48.68 (2) Before renewing continuing the license of any child welfare agency or group home, the department shall consider all formal complaints filed under s. 48.745 (2) and the disposition of each during the current license previous 2-year period.

AB100-ASA1, s. 1310 Section 1310. 48.715 (3) (c) of the statutes is amended to read:

AB100-ASA1,735,6 48.715 (3) (c) Refusal to renew continue a license or a probationary license.

AB100-ASA1, s. 1311 Section 1311. 48.715 (4) (e) of the statutes is created to read:

AB100-ASA1,735,9 48.715 (4) (e) The licensee has failed to apply for a continuance of the license within 30 days after receipt of the warning under s. 48.66 (5).

AB100-ASA1, s. 1312 Section 1312. 48.715 (4m) (b) of the statutes is amended to read:

AB100-ASA1,735,13 48.715 (4m) (b) For revocations under sub. (4) (b) or, (c) or (e), the department may revoke the license or probationary license immediately upon written notice to the licensee of the revocation and the grounds for revocation.

AB100-ASA1, s. 1313 Section 1313. 48.72 of the statutes is amended to read:

AB100-ASA1,735,25 48.72 Appeal procedure. Any person aggrieved by the department's refusal or failure to issue or, renew or continue a license or by any action taken by the department under s. 48.715 has the right to an administrative hearing provided for contested cases in ch. 227. To receive an administrative hearing under ch. 227, the aggrieved person shall send to the department a written request for a hearing under s. 227.44 within 10 days after the date of the department's refusal or failure to issue or, renew or continue a license or the department's action taken under s. 48.715. The department shall hold an administrative hearing under s. 227.44 within 30 days after receipt of the request for the administrative hearing unless the aggrieved person consents to an extension of that time period. Judicial review of the department's decision may be had as provided in ch. 227.

AB100-ASA1, s. 1314 Section 1314. 48.735 of the statutes is amended to read:

AB100-ASA1,736,5 48.735 Immunization requirements; day care centers. The department, after notice to a day care center licensee, may suspend, revoke or refuse to renew continue a day care center license in any case in which the department finds that there has been a substantial failure to comply with the requirements of s. 252.04.

AB100-ASA1, s. 1315 Section 1315. 48.737 of the statutes is amended to read:

AB100-ASA1,736,13 48.737 Lead screening, inspection and reduction requirements; day care centers. The department, after notice to a day care provider certified under s. 48.651, or a day care center that holds a license under s. 48.65 or a probationary license under s. 48.69, may suspend, revoke or refuse to renew or continue a license or certification in any case in which the department finds that there has been a substantial failure to comply with any rule promulgated under s. 254.162, 254.168 or 254.172.

AB100-ASA1, s. 1316 Section 1316. 48.75 (title) of the statutes is amended to read:

AB100-ASA1,736,17 48.75 (title) Foster homes and treatment foster homes licensed by county departments public licensing agencies and by child welfare agencies.

AB100-ASA1, s. 1317 Section 1317. 48.75 (1) of the statutes is renumbered 48.75 (1d) and amended to read:

AB100-ASA1,737,5 48.75 (1d) Child welfare agencies, if licensed to do so by the department, and county departments public licensing agencies may license foster homes and treatment foster homes under the rules promulgated by the department under s. 48.67 governing the licensing of foster homes and treatment foster homes. A foster home or treatment foster home license shall be issued for a term not to exceed 2 years from the date of issuance, is not transferable and may be revoked by the child welfare agency or by the county department public licensing agency because the licensee has substantially and intentionally violated any provision of this chapter or of the rules of the department promulgated pursuant to s. 48.67 or because the licensee fails to meet the minimum requirements for a license. The licensee shall be given written notice of any revocation and the grounds therefor.

AB100-ASA1, s. 1318 Section 1318. 48.75 (1b) of the statutes is created to read:

AB100-ASA1,737,8 48.75 (1b) In this section, "public licensing agency" means a county department or, in a county having a population of 500,000 or more, the department.

AB100-ASA1, s. 1319 Section 1319. 48.75 (1g) (a) (intro.) of the statutes is amended to read:

AB100-ASA1,737,13 48.75 (1g) (a) (intro.) A county department public licensing agency may license a foster home only if the foster home is located in the county of the county department public licensing agency, except that a county department public licensing agency may license a foster home located in another county if any of the following applies:

AB100-ASA1, s. 1320 Section 1320. 48.75 (1g) (a) 2. of the statutes is amended to read:

AB100-ASA1,737,18 48.75 (1g) (a) 2. A foster parent licensed by the county department public licensing agency moves to the other county with a child who has been placed in the foster parent's home and the license will allow the foster parent to continue to care for that child.

AB100-ASA1, s. 1321 Section 1321. 48.75 (1g) (a) 3. of the statutes is amended to read:

AB100-ASA1,737,21 48.75 (1g) (a) 3. The county of the county department public licensing agency issuing the license and the county in which the foster home is located are contiguous.

AB100-ASA1, s. 1322 Section 1322. 48.75 (1g) (a) 4. of the statutes is amended to read:

AB100-ASA1,737,25 48.75 (1g) (a) 4. The county of the county department public licensing agency issuing the license has a population of 500,000 or more and the placement is for adoption under s. 48.833, 48.835 or 48.837.

AB100-ASA1, s. 1323 Section 1323. 48.75 (1g) (c) (intro.) of the statutes is amended to read:

AB100-ASA1,738,10 48.75 (1g) (c) (intro.) No license may be issued under this subsection par. (a) 1., 2. or 3. unless the county department public licensing agency issuing the license has notified the county department public licensing agency of the county in which the foster home will be located of its intent to issue the license and the 2 county departments public licensing agencies have entered into a written agreement under this paragraph. A county department public licensing agency is not required to enter into any agreement under this paragraph allowing the county department public licensing agency of another county to license a foster home within its jurisdiction. The written agreement shall include all of the following:

AB100-ASA1, s. 1324 Section 1324. 48.75 (1g) (c) 1. of the statutes is amended to read:

AB100-ASA1,738,14 48.75 (1g) (c) 1. A statement that the county department public licensing agency issuing the license is responsible for providing services to the child who is placed in the foster home, as specified in the agreement.

AB100-ASA1, s. 1325 Section 1325. 48.75 (1g) (c) 2. of the statutes is amended to read:

AB100-ASA1,738,18 48.75 (1g) (c) 2. A statement that the county department public licensing agency issuing the license is responsible for the costs of the placement and any related costs, as specified in the agreement.

AB100-ASA1, s. 1326 Section 1326. 48.75 (1g) (d) of the statutes is amended to read:

AB100-ASA1,739,2 48.75 (1g) (d) If the county department public licensing agency issuing a license under this subsection par. (a) 1., 2. or 3. violates the agreement under par. (c), the county department public licensing agency of the county in which the foster home is located may terminate the agreement and, subject to ss. 48.357 and 48.64, require the county department public licensing agency that issued the license to remove the child from the foster home within 30 days after receipt, by the county department public licensing agency that issued the license, of notification of the termination of the agreement.

AB100-ASA1, s. 1327 Section 1327. 48.75 (1r) of the statutes is amended to read:

AB100-ASA1,739,9 48.75 (1r) At the time of initial licensure and license renewal, the child welfare agency or county department public licensing agency issuing a license under sub. (1) (1d) or (1g) shall provide the licensee with written information relating to the age-related monthly foster care rates and supplemental payments specified in s. 48.62 (4), including payment amounts, eligibility requirements for supplemental payments and the procedures for applying for supplemental payments.

AB100-ASA1, s. 1328 Section 1328. 48.75 (2) of the statutes is amended to read:

AB100-ASA1,739,14 48.75 (2) Any foster home or treatment foster home applicant or licensee of a county department public licensing agency or a child welfare agency may, if aggrieved by the failure to issue or renew its license or by revocation of its license, appeal as provided in s. 48.72.

AB100-ASA1, s. 1329 Section 1329. 48.831 (4) (c) of the statutes is amended to read:

AB100-ASA1,739,20 48.831 (4) (c) If the court finds that adoption is not in the child's best interest, the court shall order that the child be placed in the guardianship of the department and place the child in the custody of a county department or, in a county having a population of 500,000 or more, the department or an agency under contract with the department.

AB100-ASA1, s. 1330 Section 1330. 48.832 of the statutes is amended to read:

AB100-ASA1,740,11 48.832 (title) Transfer of guardianship upon revocation of guardian's license or contract. If the department revokes the license of a county department licensed under s. 48.57 (1) (e) or (hm) to accept guardianship, or of a child welfare agency licensed under s. 48.61 (5) to accept guardianship, or if the department terminates the contract of a county department licensed under s. 48.57 (1) (e) to accept guardianship, the department shall file a motion in the court that appointed the guardian for each child in the guardianship of the county department or agency, requesting that the court transfer guardianship and custody of the child. The motion may specify a county department or child welfare agency that has consented to accept guardianship of the child. The court shall transfer guardianship and custody of the child either to the county department or child welfare agency specified in the motion or to another county department under s. 48.57 (1) (e) or (hm) or a child welfare agency under s. 48.61 (5) which consents to the transfer. If no county department or child welfare agency consents, the court shall transfer guardianship and custody of the child to the department.

AB100-ASA1, s. 1331 Section 1331. 48.837 (4) (d) of the statutes is amended to read:

AB100-ASA1,740,17 48.837 (4) (d) May, at the request of a petitioning parent, or on its own motion after ordering the child taken into custody under s. 48.19 (1) (c), order the department or a county department under s. 48.57 (1) (e) or (hm) to place the child, pending the hearing on the petition, in any home licensed under s. 48.62 except the home of the proposed adoptive parents or a relative of the proposed adoptive parents.

AB100-ASA1, s. 1332 Section 1332. 48.839 (4) (b) of the statutes is amended to read:

AB100-ASA1,740,21 48.839 (4) (b) Shall transfer legal custody of the child to the department, in a county having a population of 500,000 or more, to a county department or to a child welfare agency licensed under s. 48.60.

AB100-ASA1, s. 1333 Section 1333. 48.88 (2) (c) of the statutes is amended to read:

AB100-ASA1,741,12 48.88 (2) (c) If a stepparent has filed a petition for adoption and no agency has guardianship of the child, the court shall order the department, in a county having a population of 500,000 or more, or a county department or, with the consent of the department in a county having a population of less than 500,000 or a licensed child welfare agency, order the department or the child welfare agency to conduct a screening, consisting of no more than one interview with the petitioner and a check of the petitioner's background through public records, including records maintained by the department or any county department under s. 48.981. The department, county department or child welfare agency that conducts the screening shall file a report of the screening with the court within 30 days. After reviewing the report, the court may proceed to act on the petition, may order the department in a county having a population of 500,000 or more or the county department to conduct an investigation as described under par. (a) (intro.) or may order the department in a county having a population of less than 500,000 or a licensed child welfare agency to make the investigation if the department or child welfare agency consents.

AB100-ASA1, s. 1334 Section 1334. 48.93 (1d) of the statutes is amended to read:

AB100-ASA1,741,17 48.93 (1d) All records and papers pertaining to an adoption proceeding shall be kept in a separate locked file and may not be disclosed except under sub. (1g) or (1r), s. 46.03 (29), 48.432, 48.433, 48.48 (17) (a) 9. or 48.57 (1) (j), or by order of the court for good cause shown.

AB100-ASA1, s. 1335 Section 1335. 48.977 (4) (a) 6. of the statutes is amended to read:

AB100-ASA1,741,21 48.977 (4) (a) 6. A county department under s. 46.22 or 46.23 or, if the child has been placed pursuant to an order under ch. 938, a county department under s. 46.215, 46.22 or 46.23.

AB100-ASA1, s. 1336 Section 1336. 48.981 (1) (ag) of the statutes is created to read:

AB100-ASA1,742,2 48.981 (1) (ag) "Agency" means a county department, the department in a county having a population of 500,000 or more or a licensed child welfare agency under contract with a county department or the department in a county having a population of 500,000 or more to perform investigations under this section.

AB100-ASA1, s. 1337 Section 1337. 48.981 (3) (a) of the statutes is amended to read:

AB100-ASA1,742,17 48.981 (3) (a) Referral of report. A person required to report under sub. (2) shall immediately inform, by telephone or personally, the county department or, in a county having a population of 500,000 or more, the department or a licensed child welfare agency under contract with the department or the sheriff or city, village or town police department of the facts and circumstances contributing to a suspicion of child abuse or neglect or to a belief that abuse or neglect will occur. The sheriff or police department shall within 12 hours, exclusive of Saturdays, Sundays or legal holidays, refer to the county department or, in a county having a population of 500,000 or more, the department or a licensed child welfare agency under contract with the department all cases reported to it. The county department , department or licensed child welfare agency may require that a subsequent report be made in writing. Each county department, the department and a licensed child welfare agency under contract with the department shall adopt a written policy specifying the kinds of reports it will routinely report to local law enforcement authorities.

AB100-ASA1, s. 1338 Section 1338. 48.981 (3) (c) 1. of the statutes is amended to read:

AB100-ASA1,743,19 48.981 (3) (c) 1. Within 24 hours after receiving a report under par. (a), the county department or licensed child welfare agency under contract with the county department agency shall, in accordance with the authority granted to the department under s. 48.48 (17) (a) 1. or the county department under s. 48.57 (1) (a), initiate a diligent investigation to determine if the child is in need of protection or services. The investigation shall be conducted in accordance with standards established by the department for conducting child abuse and neglect investigations. If the investigation is of a report of abuse or neglect or threatened abuse or neglect by a caregiver specified in sub. (1) (am) 5. to 8. who continues to have access to the child or a caregiver specified in sub. (1) (am) 1. to 4., or of a report that does not disclose who is suspected of the abuse or neglect and in which the investigation does not disclose who abused or neglected the child, the investigation shall also include observation of or an interview with the child, or both, and, if possible, an interview with the child's parents, guardian or legal custodian. If the investigation is of a report of abuse or neglect or threatened abuse or neglect by a caregiver who continues to reside in the same dwelling as the child, the investigation shall also include, if possible, a visit to that dwelling. At the initial visit to the child's dwelling, the person making the investigation shall identify himself or herself and the county department or licensed child welfare agency involved to the child's parents, guardian or legal custodian. The county department or licensed child welfare agency under contract with the county department agency may contact, observe or interview the child at any location without permission from the child's parent, guardian or legal custodian if necessary to determine if the child is in need of protection or services, except that the person making the investigation may enter a child's dwelling only with permission from the child's parent, guardian or legal custodian or after obtaining a court order to do so.

AB100-ASA1, s. 1339 Section 1339. 48.981 (3) (c) 2. a. of the statutes is amended to read:

AB100-ASA1,744,2 48.981 (3) (c) 2. a. If the person making the investigation is an employe of the county department or, in a county having a population of 500,000 or more, the department or a licensed child welfare agency under contract with the department and he or she determines that it is consistent with the child's best interest in terms of physical safety and physical health to remove the child from his or her home for immediate protection, he or she shall take the child into custody under s. 48.08 (2) or 48.19 (1) (c) and deliver the child to the intake worker under s. 48.20.

AB100-ASA1, s. 1340 Section 1340. 48.981 (3) (c) 3. of the statutes is amended to read:

AB100-ASA1,744,13 48.981 (3) (c) 3. If the county department or, in a county having a population of 500,000 or more, the department or a licensed child welfare agency under contract with the department determines that a child, any member of the child's family or the child's guardian or legal custodian is in need of services, the county department, department or licensed child welfare agency shall offer to provide appropriate services or to make arrangements for the provision of services. If the child's parent, guardian or legal custodian refuses to accept the services, the county department, department or licensed child welfare agency may request that a petition be filed under s. 48.13 alleging that the child who is the subject of the report or any other child in the home is in need of protection or services.

AB100-ASA1, s. 1341 Section 1341. 48.981 (3) (c) 4. of the statutes is amended to read:

AB100-ASA1,745,4 48.981 (3) (c) 4. The county department or, in a county having a population of 500,000 or more, the department or a licensed child welfare agency under contract with the department shall determine, within 60 days after receipt of a report, whether abuse or neglect has occurred or is likely to occur. The determination shall be based on a preponderance of the evidence produced by the investigation. A determination that abuse or neglect has occurred may not be based solely on the fact that the child's parent, guardian or legal custodian in good faith selects and relies on prayer or other religious means for treatment of disease or for remedial care of the child. In making a determination that emotional damage has occurred, the county department or, in a county having a population of 500,000 or more, the department or a licensed child welfare agency under contract with the department shall give due regard to the culture of the subjects and shall establish that the person alleged to be responsible for the emotional damage is neglecting, refusing or unable for reasons other than poverty to remedy the harm. This subdivision does not prohibit a court from ordering medical services for the child if the child's health requires it.

AB100-ASA1, s. 1342 Section 1342. 48.981 (3) (c) 5. of the statutes is amended to read:

AB100-ASA1,745,12 48.981 (3) (c) 5. The county department and licensed child welfare agency under contract with the county department agency shall maintain a record of its actions in connection with each report it receives. The record shall include a description of the services provided to any child and to the parents, guardian or legal custodian of the child. The county department and licensed child welfare agency under contract with the county department agency shall update the record every 6 months until the case is closed.

AB100-ASA1, s. 1343 Section 1343. 48.981 (3) (c) 6. of the statutes is amended to read:

AB100-ASA1,745,18 48.981 (3) (c) 6. The county department or licensed child welfare agency under contract with the county department agency shall, within 60 days after it receives a report from a person required under sub. (2) to report, inform the reporter what action, if any, was taken to protect the health and welfare of the child who is the subject of the report.

AB100-ASA1, s. 1344 Section 1344. 48.981 (3) (c) 6m. of the statutes is amended to read:

AB100-ASA1,746,13 48.981 (3) (c) 6m. If a person who is not required under sub. (2) to report makes a report and is a relative of the child, other than the child's parent, that person may make a written request to the county department or licensed child welfare agency under contract with the county department agency for information regarding what action, if any, was taken to protect the health and welfare of the child who is the subject of the report. A county department or licensed child welfare An agency that receives a written request under this subdivision shall, within 60 days after it receives the report or 20 days after it receives the written request, whichever is later, inform the reporter in writing of what action, if any, was taken to protect the health and welfare of the child, unless a court order prohibits that disclosure, and of the duty to keep the information confidential under sub. (7) (e) and the penalties for failing to do so under sub. (7) (f). The county department or licensed child welfare agency may petition the court ex parte for an order prohibiting that disclosure and, if the county department or licensed child welfare agency does so, the time period within which the information must be disclosed is tolled on the date the petition is filed and remains tolled until the court issues a decision. The court may hold an ex parte hearing in camera and shall issue an order granting the petition if the court determines that disclosure of the information would not be in the best interests of the child.

AB100-ASA1, s. 1345 Section 1345. 48.981 (3) (c) 7. of the statutes is amended to read:

AB100-ASA1,746,24 48.981 (3) (c) 7. The county department or, in a county having a population of 500,000 or more, the department or a licensed child welfare agency under contract with the department shall cooperate with law enforcement officials, courts of competent jurisdiction, tribal governments and other human service services agencies to prevent, identify and treat child abuse and neglect. The county department or, in a county having a population of 500,000 or more, the department or a licensed child welfare agency under contract with the department shall coordinate the development and provision of services to abused and neglected children and to families where abuse or neglect has occurred or to children and families where circumstances justify a belief that abuse or neglect will occur.

AB100-ASA1, s. 1346 Section 1346. 48.981 (3) (c) 8. of the statutes is amended to read:

AB100-ASA1,747,14 48.981 (3) (c) 8. Using the format prescribed by the department, each county department shall provide the department with information about each report that it the county department receives or that is received by a licensed child welfare agency that is under contract with the county department and about each investigation it that the county department or a licensed child welfare agency under contract with the county department conducts. Using the format prescribed by the department, a licensed child welfare agency under contract with the department shall provide the department with information about each report that the child welfare agency receives and about each investigation that the child welfare agency conducts. This information shall be used by the department to monitor services provided by county departments or licensed child welfare agencies under contract with county departments or the department. The department shall use nonidentifying information to maintain statewide statistics on child abuse and neglect, and for planning and policy development.

AB100-ASA1, s. 1347 Section 1347. 48.981 (3) (c) 9. of the statutes is amended to read:

AB100-ASA1,747,17 48.981 (3) (c) 9. The county agency may petition for child abuse restraining orders and injunctions under s. 48.25 (6).

AB100-ASA1, s. 1348 Section 1348. 48.981 (3) (cm) of the statutes is amended to read:

AB100-ASA1,748,2 48.981 (3) (cm) Contract with licensed child welfare agencies. A county department may contract with a licensed child welfare agency to fulfill its the county department's duties specified under par. (c) 1., 2. b., 5., 6., 6m. and 8. The department may contract with a licensed child welfare agency to fulfill the department's duties specified under par. (c) 1., 2. a., 3., 4., 5., 6., 6m., 7., 8. and 9. in a county having a population of 500,000 or more. The confidentiality provisions specified in sub. (7) shall apply to any licensed child welfare agency with which a county department or the department contracts.

AB100-ASA1, s. 1349 Section 1349. 48.981 (3) (d) of the statutes is amended to read:

AB100-ASA1,748,10 48.981 (3) (d) Independent investigation. 1. In this paragraph, "agent" includes, but is not limited to, a foster parent, treatment foster parent or other person given custody of a child or a human services professional employed by a county department under s. 51.42 or 51.437 or by a child welfare agency who is working with the child under contract with or under the supervision of the department in a county having a population of 500,000 or more or a county department under s. 46.215 or 46.22.

AB100-ASA1,749,5 2. If an agent or employe of a county department or licensed child welfare agency under contract with the county department an agency required to investigate under this subsection is the subject of a report, or if the county department or licensed child welfare agency under contract with the county department agency determines that, because of the relationship between the county department or licensed child welfare agency under contract with the county department agency and the subject of a report, there is a substantial probability that the county department or licensed child welfare agency under contract with the county department agency would not conduct an unbiased investigation, the county department or licensed child welfare agency under contract with the county department agency shall, after taking any action necessary to protect the child, notify the department. Upon receipt of the notice, the department, in a county having a population of less than 500,000 or a county department or child welfare agency designated by the department in any county shall conduct an independent investigation. If the department designates a county department under s. 46.215, 46.22, 46.23, 51.42 or 51.437, that county department shall conduct the independent investigation. If a licensed child welfare agency agrees to conduct the independent investigation, the department may designate that the child welfare agency to do so. The powers and duties of the department or designated county department or child welfare agency making an independent investigation are those given to county departments under par. (c).

AB100-ASA1, s. 1350 Section 1350. 48.981 (5) of the statutes is amended to read:

AB100-ASA1,749,15 48.981 (5) Coroner's report. Any person or official required to report cases of suspected child abuse or neglect who has reasonable cause to suspect that a child died as a result of child abuse or neglect shall report the fact to the appropriate medical examiner or coroner. The medical examiner or coroner shall accept the report for investigation and shall report the findings to the appropriate district attorney,; to the department, or, in a county having a population of 500,000 or more, to a licensed child welfare agency under contract with the department; to the county department and, if the institution making the report initially is a hospital, to the hospital.