Wisconsin Legislature: DHS 88.09 Note

3. Providing, arranging, transporting or accompanying a resident to medical or other appointments as part of the resident’s individual service plan.

4. Keeping a current record of all medical visits, reports and recommendations for a resident.

5. Monitoring resident health by observing and documenting changes in each resident’s health and referring a resident to health care providers when necessary.

6. Notifying the placing agency, if any, and guardian, if any, of any significant changes in a resident’s medical condition, including any life-threatening, disabling or serious illness, any illness lasting more than 3 days, an injury sustained by the resident, medical treatment needed by the resident or the resident’s absence from the home for more than 24 hours.

(c) Services that are provided shall be services determined by the resident, licensee, service coordinator, if any, placing agency, if any, and guardian, if any, to be needed by the resident and within the capability of the licensee to provide.

(d) A licensee may arrange for or, if qualified, personally provide nursing care to residents. No more than 7 hours of nursing care per week may be provided to a resident.

(e) The licensee shall ensure that each resident has an annual health examination by a physician.

(3) Prescription medications.

(a) Every prescription medication shall be securely stored, shall remain in its original container as received from the pharmacy and be stored as specified by the pharmacist.

(b) A resident has the right to refuse prescription medication unless there is a court order requiring the resident to take the medication. When the resident under court order does not take the medication, the licensee shall notify the court and the responsible physician.

(c) If the licensee or service provider assists a resident with a prescription medication, the licensee or service provider shall help the resident securely store the medication, take the correct dosage at the correct time and communicate effectively with his or her physician.

(d) Before a licensee or service provider dispenses or administers a prescription medication to a resident, the licensee shall obtain a written order from the physician who prescribed the medication specifying who by name or position is permitted to administer the medication, under what circumstances and in what dosage the medication is to be administered. The licensee shall keep the written order in the resident’s file.

(e)

1. The licensee shall keep a record of all prescription medications controlled, dispensed or administered by the licensee which show the name of the resident, the name of the particular medication, the date and time the resident took the medication and errors and omissions. The medication controlled by licensee shall be kept in a locked place.

2. The record shall also contain information describing potential side effects and adverse reactions caused by each prescription medication.

(4) Nutrition.

(a) A licensee shall provide each resident with a quantity and variety of foods sufficient to meet the resident’s nutritional needs and preferences and to maintain the resident’s health.

(b) The licensee shall provide to each resident or ensure that each resident receives 3 nutritious meals each day and snacks that are typical in a family setting.

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

(e) Meals prepared by the licensee shall take into account special physical and religious dietary needs of the residents. A special diet shall be served to a resident if prescribed by the resident’s physician.

History: Cr. Register, January, 1996, No. 482, eff. 2-1-96.

DHS 88.08 Termination of placement. A licensee may terminate a resident’s placement only after giving the resident, the resident’s guardian, if any, the resident’s service coordinator, the placing agency, if any, and the designated representative, if any, 30 days written notice. The termination of a placement shall be consistent with the service agreement under s. DHS 88.06 (2) (c) 7. The 30 day notice is not required for an emergency termination necessary to prevent harm to the resident or other household members.

History: Cr. Register, January, 1996, No. 482, eff. 2-1-96.

DHS 88.09 Records.

(1) Resident records.

(a) The licensee shall maintain a record for each resident. Resident records shall be maintained in a secure location within the home to prevent unauthorized access.

(b) The records of residents shall be confidential. Access to records of a resident’s HIV test results shall be controlled by s. 252.15, Stats. Access to other resident records shall be restricted to the following: the resident, the resident’s guardian, authorized representatives of the department, other persons or agencies with the informed written consent of the resident or resident’s guardian, if applicable, persons or agencies authorized by s. 51.30, Stats., ss. 146.81 to 146.83, Stats., or 42 CFR Part 2, and persons or agencies authorized by other applicable law.

Note: Section 51.30 (4) (b) 5. and 15., Stats., permits sharing of limited information in certain circumstances between the department and a county department established under s. 46.215, 46.22, 46.23, 51.42 or 51.437, Stats.

Note: For information on 42 CFR Part 2 which relates to a resident who is in the home because of alcohol or other drug abuse, write or phone the appropriate regional office of the department’s division of disability and elder services which will refer you to the appropriate county agency in your county. See Appendix A for the addresses and phone numbers of these offices.

Note: The records of residents with mental disabilities are subject to requirements of s. 51.30, Stats., and ch. DHS 92.

(c) Copies of a resident’s record shall be made available on request to the resident, the resident’s guardian or a designated representative of the resident as soon as reasonably practicable if authorized in writing by the resident, at a cost no greater than the cost of reproduction.

(d) A resident’s record shall include all of the following:

1. The resident’s name and date of birth.

2. The name, address, and phone number of the resident’s legal guardian, if any.

3. The name, address and phone number of every person, including the resident’s physician, to be notified in the event of an emergency.

4. The name, address and phone number of the placing agency, if any, and service coordinator, if any.

5. Medical insurance or medical assistance and medicare identification numbers and the name of the pharmacy that the resident uses. In this subdivision, “medical assistance” means the assistance program operated by the department under ss. 49.43 to 49.497, Stats., and “medicare” means the insurance program operated by the U.S. department of health and human services under 42 USC 1395 to 1395.22 and 42 CFR, Pts. 405 to 421.

6. The service agreement required under s. DHS 88.06 (2) (b) and (c).

7. The report of the medical examination required under s. DHS 88.06 (2) (a).

8. The individual service plan required under s. DHS 88.06 (3).

9. The statement indicating that resident rights and grievance procedures have been explained and copies have been provided to the parties as required under s. DHS 88.06 (2) (c) 8.

10. Medication records under s. DHS 88.07 (3) (d) and (e).

11. Records maintained by the licensee of the resident’s finances, including written authorization from the resident or the resident’s guardian to control the resident’s funds.

(e) The licensee shall retain a resident’s record for at least 7 years after the resident’s discharge. The record shall be kept in a secure, dry place.

(2) Service provider and licensee records.

(a) Service provider record. The licensee shall maintain and keep up to date a separate personnel record for each service provider. The licensee shall ensure that all service provider records are adequately safeguarded against destruction, loss or unauthorized use. A service provider record shall include all of the following:

1. Name and address.

2. Social security number.

3. Date of birth.

4. Beginning date of employment.

5. Job-related experience and training.

6. Educational qualifications.

7. Job description.

8. Documentation of successful completion of the training requirements under s. DHS 88.04 (5).

9. The results of screening for communicable disease.

10. Description of any disciplinary action.

11. Date of discharge or resignation.

(b) Licensee record. The licensee shall maintain and keep up to date a separate record for the licensee which shall contain the information listed in par. (a) 1., 2., 3., 5., 6., 8. and 9.

(c) Location and retention period. Service provider and licensee records shall be available at the adult family home for review by the licensing agency. A service provider’s record shall be available while the service provider is employed by the home and for at least 3 years after ending employment.

History: Cr. Register, January, 1996, No. 482, eff. 2-1-96.

DHS 88.10 Resident rights.

(1) Legal rights. A licensee shall comply with all applicable statutes and rules relating to resident rights, including s. 51.61, Stats., chs. 54, 55, and 304, Stats., and chs. DHS 92 and 94.

Note: These laws may clarify or condition a particular resident’s right, depending on the legal status of the resident or a service being received by the resident.

(2) Explanation of resident rights. The licensee shall explain and provide copies of the resident rights under sub. (3) and the grievance procedure under sub. (5) to the person being admitted, that person’s guardian, family members involved in the placement and any designated representative of the person before the service agreement is signed.

(3) Rights of residents. Individuals, except for correctional residents, have basic rights which they do not lose when they enter an adult family home. A resident shall have all of the following rights:

(a) Fair treatment. To be treated with courtesy, respect and full recognition of the resident’s dignity and individuality.

(b) Privacy. To have physical and emotional privacy in treatment, living arrangements and in caring for personal needs, including toileting, bathing and dressing. The resident, resident’s room, any other area in which the resident has a reasonable expectation of privacy, and the personal belongings of a resident shall not be searched without the resident’s permission or permission of the resident’s guardian except when there is a reasonable cause to believe that the resident possesses contraband. The resident shall be present for the search.

(d) Presumption of competency. To be treated as mentally competent unless there has been a court determination of incompetency under ch. 54, Stats. A resident who has been adjudicated incompetent has a right to have his or her guardian fully informed and involved in all aspects of his or her relationship to the adult family home. A resident who has been adjudicated incompetent shall be allowed decision-making participation to the extent that the resident is capable of participating.

(e) Self-direction. To have opportunities to make decisions relating to care, activities and other aspects of life in the adult family home. No curfew, rule or other restrictions on a resident’s freedom of choice shall be imposed unless specifically identified in the home’s program statement or the resident’s individual service plan. An adult family home shall help any resident who expresses a preference for more independent living to contact any agency needed to arrange for it.

(f) Financial affairs. To manage his or her own financial affairs, including any personal allowances under federal or state programs, unless the resident delegates, in writing, responsibility for financial management to the licensee or someone else of the resident’s choosing or the resident is adjudicated incompetent in which case the guardian or guardian’s designee is responsible.

(g) Clothing and possessions. To retain and use personal clothing and effects and to retain, as space permits, other personal possessions in a reasonably secure manner.

(h) Social activity choice. To meet with and participate in social and community activities at the resident’s own discretion.

(i) Choice of providers. To exercise complete choice of providers of physical health care, mental health care and pharmaceutical services.

(j) Treatment choice. To receive all treatments prescribed by the resident’s physician and to refuse any form of treatment unless the treatment has been ordered by a court. The written informed consent of the resident or resident’s guardian is required for any treatment administered by the adult family home.

(k) Religion. To participate in religious activities of the resident’s choice. No resident may be required to engage in any religious activity.

(L) Safe physical environment. To a safe environment in which to live. The adult family home shall safeguard residents who cannot fully guard themselves from environmental hazards to which they are likely to be exposed, including conditions which would be hazardous to anyone and conditions which would be or are hazardous to a particular resident because of the resident’s condition or disability.

(m) Freedom from abuse. To be free from physical, sexual or mental abuse, neglect, and financial exploitation or misappropriation of property.

(n) Freedom from seclusion and restraints.

1. Except as provided in subd. 2., to be free from seclusion and from all physical and chemical restraints, including the use of an as-necessary (PRN) order for controlling acute, episodic behavior.

2. Physical restraints may be used in an emergency when necessary to protect the resident or another person from injury or to prevent physical harm to the resident or another person resulting from the destruction of property, provided that law enforcement or other emergency assistance be summoned as soon as possible and the incident is reported to the licensing agency by the next business day with documentation of what happened, the actions taken by the adult family home and the outcomes.

(o) Labor. To not be required by the licensee to perform labor which is of any financial benefit to the licensee.

(p) Prompt and adequate treatment. To receive prompt and adequate treatment and services appropriate to the resident’s needs.

(q) Medication. To receive all prescribed medications in the dosage and at the intervals prescribed by the resident’s physician, and to refuse medication unless there has been a court order under s. 51.61 (1) (g), Stats., with a court finding of incompetency.

(r) Mail. To receive and send sealed, unopened mail, including packages. The licensee shall give mail to residents on the day it is received or as soon as possible thereafter, unless the licensee has reasonable cause to believe that the mail being sent or received contains contraband, in which case a resident’s mail may be opened by the licensee but only in the presence of the resident.

(s) Telephone calls. To make and receive a reasonable number of telephone calls of reasonable duration and in privacy.

(t) Visits. To have private visitors and have adequate time and private space for visits.

(u) Service charges. To be fully informed in writing before or at the time of admission of all services and charges for the services. Throughout the time a person is a resident of the adult family home, he or she shall be fully informed in writing of any changes in services and related charges at least 30 days before those changes take effect.