Chapter DHS 82

DHS 82.06(3)(b) (b) The sponsor shall ensure that a written agreement for each resident placed in the home is developed and kept up to date by the service coordinator, referring agency, sponsor or the department. If the referring agency or service coordinator does not develop the service agreement in accordance with this subsection and the sponsor is unable to develop it, the sponsor shall immediately notify the certifying agency and the department that the resident is placed in the home and lacks an up-to-date service agreement. A current resident may continue in the placement for an additional 90 days until the department can arrange for or develop the service agreement.

DHS 82.06 Note Note: If a resident does not have a service agreement, the sponsor should notify the director of the Developmental Disabilities Office, Bureau of Community Programs, Division of Community Services, P.O. Box 7851, Madison, WI 53707 [phone].

DHS 82.06(3)(c) (c) The parties to an agreement shall include the resident, the resident’s guardian, if any, the sponsor, the referring agency and the service coordinator.

DHS 82.06(3)(d) (d) The agreement shall be completed by the end of the seventh day after a new resident enters the home or within 30 days after initial certification for each current resident, shall be signed by and a copy given to all persons listed in par. (b), shall contain the date on which it was signed and an expiration date which may not be more than 12 months from the date on which it was signed and shall be reviewed and updated when it expires. After the seventh day for a new resident and after 30 days following initial certification for a current resident, no resident may maintain his or her placement unless there is an up-to-date service agreement except as provided in par. (b).

DHS 82.06(3)(e) (e) In addition to the written consent required in par. (a), the service agreement shall include:

DHS 82.06(3)(e)1. 1. Designation of a service coordinator who shall ensure that needed services provided by the sponsor and outside agencies are arranged and monitored;

DHS 82.06(3)(e)2. 2. The individualized service plan under sub. (5);

DHS 82.06(3)(e)3. 3. A description of the roles, responsibilities and expectations of the sponsor in providing the services that are specified in the individualized service plan under sub. (5), of the resident entering or residing in the home and of the referring agency or service coordinator providing assistance to the resident or sponsor, including whether the service coordinator is responsible for developing, monitoring and updating the service agreement and individualized service plan;

DHS 82.06(3)(e)4. 4. The amount, source and method of payment for providing care and maintenance to the resident of the home, specifying any costs for which the resident will be liable and whether the service coordinator agrees to be responsible for meeting the financial security requirement under s. DHS 82.04 (3). If the service coordinator is responsible for financial security, the agreement shall describe how resources will be made available to the sponsor in the event that payments to the sponsor for resident are not received;

DHS 82.06(3)(e)5. 5. A statement about who will exercise control over the resident’s funds, which shall be a decision of the resident or the resident’s guardian, if any, and whether or not those funds will be maintained in a bank account. If the sponsor agrees to exercise control over the resident’s funds, the sponsor shall deposit resident funds in a separate bank account opened for the resident if the balance of the resident’s personal funds exceed $200, shall keep records that account for the receipt and expenditure of all of the resident’s funds which the sponsor controls, including any interest or dividends earned, and shall provide the resident or the resident’s guardian, if any, with an accounting of the resident’s funds on request;

DHS 82.06(3)(e)6. 6. A statement that the sponsor shall give at least 30 days written notice to all parties involved if the sponsor wants to terminate the placement, change the services or change the charges for services;

DHS 82.06(3)(e)7. 7. A description of any personal housekeeping the resident will be required to perform or, if applicable, any compensated work the resident has agreed to do for the sponsor, including the terms of compensation. A resident shall be allowed to refuse work other than personal housekeeping. In this subdivision, “personal housekeeping” means the performance of routine housekeeping and household tasks in areas of the home assigned to the resident or in areas used communally in proportion to the amount of resident use if equitably distributed among all household members capable of performing the necessary tasks. This may include cleaning of common areas, doing the laundry, shoveling snow, cooking, washing dishes and taking care of the lawn;

DHS 82.06(3)(e)8. 8. A statement that the resident’s rights and the grievance process under s. 51.61, Stats., and ch. DHS 94 have been explained to the resident and to the resident’s guardian, if any; and

DHS 82.06(3)(e)9. 9. A statement which identifies whether the sponsor, service coordinator, referring agency or county agency is responsible for each of the following functions;

DHS 82.06(3)(e)9.a. a. Obtaining informed consent as required under s. DHS 94.03;

DHS 82.06(3)(e)9.b. b. Notifying residents of their rights under this chapter and ch. DHS 94; and

DHS 82.06(3)(e)9.c. c. Maintaining a grievance procedure which conforms to s. DHS 94.27.

DHS 82.06(4) (4) Health assessment.

DHS 82.06(4)(a) (a) Each resident shall have a medical examination by a physician to identify any health problems and to screen for communicable disease within 30 days after placement in the adult family home and annually thereafter unless the resident is being seen regularly by a physician. Sponsors shall keep a written record of all medical examinations and shall retain any reports made by these health care providers.

DHS 82.06(4)(b) (b) The sponsor shall immediately notify the service coordinator of any life-threatening, disabling or serious illness or injury sustained by a resident which requires medical treatment or absence from the home for more than 24 hours.

DHS 82.06(5) (5) Individualized service plan. The sponsor shall ensure that a written service plan is developed for each resident within 30 days after initial certification of the home and within 7 days after the placement of a new resident. The plan shall be developed with the resident’s service coordinator and with involvement and approval of the resident and the resident’s guardian, if any. The sponsor may arrange for the referring agency or service coordinator to develop the plan in accordance with this subsection. The plan shall be:

DHS 82.06(5)(a) (a) Developed by the referring agency, service coordinator or the sponsor, with the resident participating in a manner that is appropriate for the resident’s level of understanding and method of communication. The plan shall contain a description of the services the sponsor shall provide, shall identify how the resident will obtain access to community activities and services under s. DHS 82.05 (1), shall describe the extent of supervision the sponsor will provide and specify whether the resident is capable of being left alone in the home or in the community without supervision and may also contain a description of services provided by other service providers;

DHS 82.06(5)(b) (b) Agreed to and signed by all persons involved in developing it, and a copy given to each of these persons;

DHS 82.06(5)(c) (c) Monitored by the sponsor or service coordinator, as provided in the plan, to ensure that it is implemented as intended; and

DHS 82.06(5)(d) (d) Reviewed at least once every 6 months by the sponsor or by the service coordinator if the service coordinator has agreed to assume this responsibility in the service agreement. This review is to determine continued appropriateness of the plan and to update the plan as necessary. A plan shall be updated whenever the resident’s needs or preferences substantially change or when requested by the resident or the resident’s guardian.

DHS 82.06 History History: Cr. Register, December, 1989, No. 408, eff. 1-1-90; cr. (2m), Register, October, 2000, No. 538, eff. 11-1-00; corrections in (2) (a), (2m), (3) (e) 8. and 9. made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635; CR 23-046: am. (2m) Register April 2024 No. 820, eff. 5-1-24.

DHS 82.07 DHS 82.07 Resident care.

DHS 82.07(1) (1) General requirements.

DHS 82.07(1)(a) (a) The sponsor shall provide a safe, emotionally stable, homelike and humane environment which encourages a resident’s autonomy, addresses a resident’s need for physical and emotional privacy and takes a resident’s preferences and choices and status as an adult into consideration while providing care and supervision.

DHS 82.07(1)(b) (b) The sponsor shall plan activities and services with the residents to accommodate individual resident needs and preferences and shall provide opportunities for the residents to participate in cultural, religious, political, social and intellectual activities within the home and community. Residents may not be compelled to participate in these activities.

DHS 82.07(1)(c) (c) The sponsor shall allow a resident to participate in all activities that the resident selects and is capable of learning unless the resident’s individualized service plan indicates otherwise.

DHS 82.07(1)(d) (d) The sponsor shall arrange for a substitute provider when the sponsor is gone overnight or when the sponsor’s absence prevents the resident from receiving the services or supervision specified in the individualized service plan developed under s. DHS 82.06 (5).

DHS 82.07(2) (2) Services.

DHS 82.07(2)(a) (a) The sponsor shall provide or arrange for the provision of those services specified in the individualized service plan that are the sponsor’s responsibility. A resident may refuse any service. Services shall be directed to the goals of assisting, teaching and supporting the resident to promote his or her health, well-being, self-esteem, independence and quality of life and may include:

DHS 82.07(2)(a)1. 1. Supervising or assisting residents with or teaching residents about activities of daily living;

DHS 82.07(2)(a)2. 2. Providing, arranging, transporting or accompanying residents to leisure and recreational activities; and

DHS 82.07(2)(a)3. 3. Monitoring resident health by observing and documenting changes in each resident’s health status and referring a resident to health care providers when necessary.

DHS 82.07(2)(b) (b) Services that are provided shall be services determined by the sponsor or service coordinator and the resident, or the resident’s guardian, if any, to be needed by the resident and within the capability of the sponsor to provide.

DHS 82.07(2)(c) (c) A sponsor may not directly and personally provide nursing care to residents. The sponsor may arrange nursing care if the care is needed or if it is specified in the service plan. No more than 2 residents may routinely need or receive nursing care in excess of 7 hours per week. If nursing care in excess of 7 hours per week is routinely required by more than 2 residents, the sponsor shall either notify the certifying agency and each resident’s service coordinator in writing that a change of placement is needed for at least one resident or the sponsor shall apply for a license to operate a nursing home. The sponsor is not responsible for finding an alternative placement.

DHS 82.07(3) (3) Prescription medications.

DHS 82.07(3)(a) (a) Containers. Every container in which prescription medication is stored shall have a label permanently attached to the outside which lists the name of the person for whom the medication is prescribed, the physician’s name, the prescription number, the name and dosage of the medication, directions for use, the date the medication was issued, an expiration date for time-dated medication, and the name, address and telephone number of the pharmacy from which the medication was obtained.

DHS 82.07(3)(b) (b) Control and administration.

DHS 82.07(3)(b)1. 1. A resident shall control and administer his or her own medications except when the resident is not able to do so, as determined by the resident’s physician, or when the resident or resident’s guardian, if any, requests the sponsor’s assistance.

DHS 82.07(3)(b)2. 2. A resident may not be forced to take medications except by order of a court. If the resident refuses to take a prescribed medication, the sponsor shall inform the resident’s guardian and service coordinator about the resident’s refusal.

DHS 82.07(3)(b)3. 3. For the sponsor to administer any prescription medication, the sponsor shall obtain a written order from the physician who prescribed the medication. The written order from the physician shall specify under what conditions and in what dosages the medication is to be administered.

DHS 82.07(3)(b)4. 4. The sponsor may not administer a medication to a resident when there is a court order that directs the resident to take the medication. If the sponsor provided assistance with a medication, the sponsor shall help the resident safely store the medication, take the correct dosage at the correct time and communicate effectively with his or her physician or pharmacist.

DHS 82.07(3)(c) (c) Records. Records shall be kept by the sponsor of all prescription medications controlled or administered by the sponsor, which shall show the name of the resident, the name of the particular medication, the date and time of administration by the sponsor and the dose administered.

DHS 82.07(4) (4) Nutrition.

DHS 82.07(4)(a) (a) The sponsor shall provide each resident with a quantity and variety of foods sufficient to meet the resident’s nutritional needs and preferences and to maintain his or her health.

DHS 82.07(4)(b) (b) The sponsor shall provide to each resident or ensure that each resident receives 3 nutritious meals each day. This requirement does not apply to the sponsor if a meal is included in other programming in which the resident participates and is paid for by the provider of that programming.

DHS 82.07(4)(c) (c) Food shall be prepared in a sanitary manner.

DHS 82.07(4)(d) (d) Residents shall be routinely served their meals in common dining areas with other household members.

DHS 82.07(4)(e) (e) Meals prepared by the sponsor shall take into account special physical and religious dietary needs of residents.

DHS 82.07 History History: Cr. Register, December, 1989, No. 408, eff. 1-1-90.

DHS 82.08 DHS 82.08 Termination of placement. A sponsor may terminate a resident’s placement only after giving the resident, the resident’s guardian, if any, and the resident’s service coordinator 30 days written notice, except that 30 days notice is not required for an emergency termination necessary to prevent harm to the health and safety of the resident or other household members.

DHS 82.08 History History: Cr. Register, December, 1989, No. 408, eff. 1-1-90.

DHS 82.09 DHS 82.09 Records and information requests.

DHS 82.09(1) (1) Resident records. The sponsor shall maintain a record for each resident. Resident records shall be maintained in a secure location within the home. A resident or the resident’s guardian shall be given access to the resident’s record upon request. The record shall be kept confidential in accordance with s. 51.30, Stats., and ch. DHS 92. Each record shall contain:

DHS 82.09(1)(a) (a) The resident’s name and date of birth;

DHS 82.09(1)(b) (b) If the resident has a guardian, the name, address and phone number of the guardian;

DHS 82.09(1)(c) (c) The name, address and phone number of every person, including the physician, to be notified in the event of an emergency;

DHS 82.09(1)(d) (d) The name, address and phone number of the referring agency and the service coordinator;

DHS 82.09(1)(e) (e) Medical insurance identification numbers and the name of any pharmacy that the resident uses;

DHS 82.09(1)(f) (f) The agreement for services required under s. DHS 82.06 (3);

DHS 82.09(1)(g) (g) The report of the medical examination required under s. DHS 82.06 (4);

DHS 82.09(1)(h) (h) The individualized service plan required under s. DHS 82.06 (5); and

DHS 82.09(1)(i) (i) Evidence that the resident and the resident’s guardian, if any, received notification of residents’ rights specified in s. 51.61, Stats., and ch. DHS 94, as required under s. DHS 82.10 (5).

DHS 82.09(2) (2) Information requests. The sponsor shall comply with all department and certifying agency requests for information about the residents, services or operation of the adult family home.

DHS 82.09 History History: Cr. Register, December, 1989, No. 408, eff. 1-1-90; corrections in (1) (intro.) and (i) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635.

DHS 82.10 DHS 82.10 Resident rights.

DHS 82.10(1) (1) No sponsor or any other household member may subject a resident to mental, physical or sexual abuse or to neglect or otherwise mistreat a resident. Mental abuse includes but is not limited to persistent or excessive negative comments, deliberate inducement of anxiety, singling out one resident for inappropriate criticism or encouraging the resident’s peers to do the same and similar acts when the resident has requested that these acts cease.

DHS 82.10(2) (2) No resident may be placed in isolation or physical restraints by a sponsor except in emergency situations when there is physical danger to another person or the resident. The sponsor shall immediately notify the service coordinator, the resident’s guardian, if any, the resident’s physician and the crisis intervention program designated by the certifying agency if isolation or physical restraint is needed or used. Use of isolation or physical restraint shall be governed in accordance with s. 51.61 (1) (i), Stats., and s. DHS 94.10.

DHS 82.10(3) (3) Residents shall be permitted to send and receive mail without any restrictions except as provided in s. 51.61 (1) (cm) 1., Stats. The sponsor shall give mail to residents on the day it is received or, if a resident is absent from the home, shall keep the resident’s mail in a safe, private location. The sponsor may not open or read any mail without the permission of the resident or the resident’s guardian, if any.

DHS 82.10(4) (4) A resident may receive a reasonable number of visitors at reasonable times. The sponsor may deny access to the home to particular persons whom the sponsor finds undesirable, and may restrict the number of visitors allowed at one time, the number of visits permitted per day or week and the times or days of the week visits are permitted, but the sponsor may not restrict visits of the resident’s guardian, if any. The sponsor shall notify the resident of all restrictions on visits.

DHS 82.10(5) (5) Residents of adult family homes shall have the rights set forth in s. 51.61, Stats., and ch. DHS 94. The sponsor shall be familiar with these rights and, as a condition or certification, shall comply with the provisions of s. 51.61, Stats., and ch. DHS 94 that apply to adult family homes. The sponsor shall also ensure that each resident and the resident’s guardian, if any, are notified in writing of the resident rights under s. 51.61, Stats., and ch. DHS 94 that apply to adult family homes immediately after the placement is made. Notification may be done by the sponsor, the resident’s service coordinator or the referring agency.

DHS 82.10(6) (6) A resident may file a grievance if he or she or the resident’s guardian, if any, believes that a right recognized or established under this section has been violated. The sponsor shall ensure that residents have access to a grievance procedure established in accordance with s. DHS 94.27. The grievance procedure may be established by the certifying agency or by the agency that employs the service coordinator when either agency agrees to perform this function.

DHS 82.10 History History: Cr. Register, December, 1989, No. 408, eff. 1-1-90; correction in (3) made under s. 13.93 (2m) (b) 7., Stats., Register December 2004 No. 588; corrections in (2), (5) and (6) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635.