Chapter DHS 134

DHS 134.13 DHS 134.13 Definitions. In this chapter:

DHS 134.13(1) (1) “Abuse” has the meaning specified under s. DHS 13.03 (1).

DHS 134.13(2) (2) “Active treatment” means an ongoing, aggressive and consistently applied program of training and treatment services to allow the client to function as independently as possible and maintain his or her maximum functional abilities.

DHS 134.13(3) (3) “ADL” or “activities of daily living” means personal skills essential for privacy and independence including toilet training, personal hygiene, self feeding, bathing, dressing, grooming and communication of basic needs.

DHS 134.13(4) (4) “Administrator” means a person who is licensed under ch. 456, Stats., and who is responsible for the total operation of the facility.

DHS 134.13(4m) (4m) “Advanced practice nurse prescriber” means a person who has been granted a certificate to issue prescription orders under s. 441.16 (2), Stats.

DHS 134.13(5) (5) “Ambulatory” means able to walk independently or with limited assistance from a person or equipment, such as a walker or cane.

DHS 134.13(6) (6) “Behavior management” means a method used to establish, alter, maintain or eliminate specified behaviors by providing reinforcement that increases the strength of appropriate behaviors and decreases the strength of inappropriate behaviors.

DHS 134.13(7) (7) “Center for the developmentally disabled” means a department-operated residential institution for the care of people with developmental disabilities.

DHS 134.13 Note Note: There are 3 state centers for people with developmental disabilities in Wisconsin: Central Center, Northern Center and Southern Center.

DHS 134.13(8) (8) “Department” means the Wisconsin department of health services.

DHS 134.13(9) (9) “Developmental disability” means intellectual disability or a related condition such as cerebral palsy, epilepsy or autism, but excluding mental illness and degenerative brain disorder, which is:

DHS 134.13(9)(a) (a) Manifested before the individual reaches age 22;

DHS 134.13(9)(b) (b) Likely to continue indefinitely; and

DHS 134.13(9)(c) (c) Results in substantial functional limitations in 3 or more of the following areas of major life activity:

DHS 134.13(9)(c)1. 1. Self-care;

DHS 134.13(9)(c)2. 2. Understanding and use of language;

DHS 134.13(9)(c)3. 3. Learning;

DHS 134.13(9)(c)4. 4. Mobility;

DHS 134.13(9)(c)5. 5. Self-direction; and

DHS 134.13(9)(c)6. 6. Capacity for independent living.

DHS 134.13(10) (10) “Dietitian” means a person who is any of the following:

DHS 134.13(10)(a) (a) Certified with the state of Wisconsin under s. 448.78, Stats.; or

DHS 134.13(10)(b) (b) Licensed or certified as a dietitian in another state.

DHS 134.13(11) (11) “Existing facility” means a facility that was licensed under ch. H 34 or 132 on July 1, 1988.

DHS 134.13(12) (12) “Facility” means a facility serving people with developmental disabilities.

DHS 134.13(13) (13) “FDD” or “facility serving people with developmental disabilities” means a residential facility with a capacity of 4 or more individuals who need and receive active treatment and health services as needed.

DHS 134.13(14) (14) “Full-time” means at least 37.5 hours each week devoted to facility business.

DHS 134.13(15) (15) “Habilitation” means treatment provided to promote and maintain the individual’s highest level of physical, social and economic functioning and to prevent further loss of functioning, and includes treatment following rehabilitation which is necessary to maintain the achieved level of functioning and to prevent further loss of functioning.

DHS 134.13(16) (16) “Health services supervisor” means a registered nurse or licensed practical nurse who is responsible for supervising health care provided to facility residents.

DHS 134.13(17) (17) “Interdisciplinary team” means the persons who possess the knowledge, skills and expertise necessary to accurately identify the comprehensive array of the client’s needs and design a program that is responsive to those needs.

DHS 134.13(18) (18) “IPP” or “individual program plan” means a written statement of the services which are to be provided to a resident based on an interdisciplinary assessment of the individual’s developmental needs, expressed in behavioral terms, the primary purpose of which is to provide a framework for the integration of all the programs, services and activities received by the resident and to serve as a comprehensive written record of the resident’s developmental progress.

DHS 134.13(18m) (18m) “Involuntary administration of psychotropic medication” means any of the following:

DHS 134.13(18m)(a) (a) Placing psychotropic medication in an individual’s food or drink with knowledge that the individual protests receipt of the psychotropic medication.

DHS 134.13(18m)(b) (b) Forcibly restraining an individual to enable administration of psychotropic medication.

DHS 134.13(18m)(c) (c) Requiring an individual to take psychotropic medication as a condition of receiving privileges or benefits.

DHS 134.13(19) (19) “Licensed practical nurse” means a person licensed as a practical nurse under ch. 441, Stats.

DHS 134.13(20) (20) “Life safety code” means the National Fire Protection Association’s standard 101.

DHS 134.13(21) (21) “Living unit” means the area of a facility that houses the residents’ bedrooms and may include dining and activity areas.

DHS 134.13(22) (22) “Medical care plan” means a formal plan for providing physician services and related medical care services.

DHS 134.13(23) (23) “Mobile nonambulatory” means unable to walk without assistance, but able to move from place to place with the use of a device such as a walker, crutches, a wheel chair or a wheeled platform.

DHS 134.13(23m) (23m) “Neglect” has the meaning specified under s. DHS 13.03 (14).

DHS 134.13(24) (24) “New construction” or “newly constructed” means construction for the first time of any building or addition to an existing building, for which the plans are approved by the department after July 1, 1988.

DHS 134.13(25) (25) “New facility” means a facility that was not licensed under ch. H 34 or 132 on July 1, 1988.

DHS 134.13(26) (26) “NFPA” means national fire protection association.

DHS 134.13(27) (27) “Nonambulatory” means unable to walk without assistance.

DHS 134.13(28) (28) “Nonmobile” means unable to move from place to place.

DHS 134.13(29) (29) “Nurse” means a registered nurse or a licensed practical nurse.

DHS 134.13(30) (30) “Nurse practitioner” means a registered professional nurse who meets the requirements of s. DHS 105.20.

DHS 134.13(31) (31) “Nursing assistant” means a person who is employed primarily to provide direct care services to residents but is not registered or licensed under ch. 441, Stats.

DHS 134.13(32) (32) “Pharmacist” means a person registered as a pharmacist under ch. 450, Stats.

DHS 134.13(33) (33) “Physical therapist” means a person licensed to practice physical therapy under ch. 448, Stats.

DHS 134.13(34) (34) “Physician” means a person licensed to practice medicine or osteopathy under ch. 448, Stats.

DHS 134.13(35) (35) “Physician extender” means a person who is a physician’s assistant or a nurse practitioner acting under the general supervision and direction of a physician.

DHS 134.13(36) (36) “Physician assistant” means a person certified under ch. 448, Stats., to perform as a physician assistant.

DHS 134.13(37) (37) “Practitioner” means a physician, dentist, podiatrist or other person permitted under Wisconsin law to distribute, dispense and administer prescription drugs, including controlled substances, in the course of professional practice.

DHS 134.13(38) (38) “Primarily serves” means that at least 51% of an existing facility’s residents, calculated on an annual basis, have a developmental disability, and 100% of a new facility’s residents have a developmental disability.

DHS 134.13(38g) (38g) “Protest” means make more than one discernible negative response, other than mere silence, to the offer of, recommendation for, or other proffering of voluntary receipt of psychotropic medication. “Protest” does not mean a discernible negative response to a proposed method of administration of the psychotropic medication.

DHS 134.13(38r) (38r) “Psychotropic medication” means a prescription drug, as defined in s. 450.01 (20), Stats., that is used to treat or manage a psychiatric symptom or challenging behavior.

DHS 134.13(39) (39) “QIDP” or “qualified intellectual disabilities professional” means a person who has specialized training in intellectual disabilities or at least one year of experience in treating or working with people with intellectual disabilities or other developmental disabilities, and is one of the following:

DHS 134.13(39)(a) (a) A psychologist licensed under ch. 455, Stats.;

DHS 134.13(39)(b) (b) A physician;

DHS 134.13(39)(c) (c) A social worker with a graduate degree from a school of social work accredited or approved by the council on social work education or with a bachelor’s degree in social work from a college or university accredited or approved by the council on social work education;

DHS 134.13(39)(d) (d) A physical or occupational therapist who meets the requirements of s. DHS 105.27 or 105.28;

DHS 134.13(39)(e) (e) A speech pathologist or audiologist who meets the requirements of s. DHS 105.30 or 105.31;

DHS 134.13(39)(f) (f) A registered nurse;

DHS 134.13(39)(g) (g) A therapeutic recreation specialist who is a graduate of an accredited program or who has a bachelor’s degree in a specialty area such as art, dance, music, physical education or recreation therapy; or

DHS 134.13(39)(h) (h) A human services professional who has a bachelor’s degree in a human services field other than those listed in pars. (a) to (g), such as rehabilitation counseling, special education or sociology.

DHS 134.13(40) (40) “Recuperative care” means care anticipated to be provided for a period of 90 days or less for a resident whose physician has certified that he or she is convalescing or recuperating from an illness or a medical treatment.

DHS 134.13(41) (41) “Registered nurse” means a person who holds a certificate of registration as a registered nurse under ch. 441, Stats.

DHS 134.13(42) (42) “Rehabilitation” means treatment provided to restore the individual to the fullest possible level of physical, social and economic functioning until the individual’s level and patterns of needs and abilities do not show significant change. “Rehabilitation” may include medical treatment, psychiatric treatment, physical therapy, occupational therapy, speech and hearing therapy, nursing care, vocational counseling, social services or recreational therapy.

DHS 134.13(43) (43) “Resident” means a person cared for or treated in any facility on a 24-hour basis.

DHS 134.13(44) (44) “Respite care” means care anticipated to be provided for a period of 28 days or less for the purpose of temporarily relieving a family member or other caregiver from his or her daily caregiving duties.

DHS 134.13(45) (45) “Short-term care” means recuperative care or respite care.

DHS 134.13(46) (46) “Small facility” means a facility licensed to serve 16 or fewer persons.

DHS 134.13(47) (47) “Specialized consultation” means the provision of professional or technical advice such as systems analysis, crisis resolution or inservice training, to assist the facility in maximizing service outcomes.

DHS 134.13(48) (48) “Supervision” means at least intermittent face-to-face contact between a supervisor and his or her assistant, with the supervisor instructing and overseeing the assistant, but does not require the continuous presence of the supervisor in the same building as the assistant.

DHS 134.13(49) (49) “Unit dose drug delivery system” means a system for the distribution of medications in which single doses of medications are individually packaged and sealed for distribution to residents.

DHS 134.13 History History: Cr. Register, June, 1988, No. 390, eff. 7-1-88; corrections in (30), (39) (d) and (e) made under s. 13.93 (2m) (b) 7., Stats., Register, April, 2000, No. 532; CR 03-033: am. (7), (10) (a), (12), (13), (17) and (39) (intro.) Register December 2003 No. 576, eff. 1-1-04; CR 04-053: r. and recr. (1), (2) and (3), am. (4), (5), (10) and (13), cr. (4m) and (23m) Register October 2004 No. 586, eff. 11-1-04; CR 07-042: cr. (18m), (38g) and (38r) Register October 2007 No. 622, eff. 11-1-07; corrections in (1), (8), (23m), (30), (39) (d) and (e) made under s. 13.92 (4) (b) 6. and 7., Stats., Register January 2009 No. 637; 2019 Wis. Act 1: am. (9) (intro.), (39) Register May 2019 No. 761, eff. 6-1-19; CR 23-046: am. (9) (intro.) Register April 2024 No. 820, eff. 5-1-24.

DHS 134.14 DHS 134.14 Licensure.

DHS 134.14(1) (1) Application. Application for a license to operate an FDD shall be made on a form provided by the department.

DHS 134.14 Note Note: To obtain a copy of the application form for a license to operate an FDD, write: Division of Quality Assurance, P.O. Box 2969, Madison, Wisconsin 53701-2969.

DHS 134.14(2) (2) Restrictions.

DHS 134.14(2)(a) (a) A new FDD may not have more than 16 residents, except that:

DHS 134.14(2)(a)1. 1. A center serving people with developmental disabilities may have more than 16 residents; and

DHS 134.14(2)(a)2. 2. A home licensed under ch. DHS 132 on July 1, 1988 which under ch. DHS 122 has converted or converts all of a building or a physically identifiable distinct part of a building to be an FDD may have a capacity that is equal to the total number of beds approved under s. DHS 122.07 (2).

DHS 134.14(2)(b) (b) A home licensed under ch. DHS 132 may not be issued a license to operate as an FDD after July 1, 1988 if it is not an FDD on July 1, 1988, except as provided in par. (a) 2.

DHS 134.14(3) (3) Requirements for a license.

DHS 134.14(3)(a) (a) An applicant for a license shall submit the following information to the department: