- Establish minimum staff training requirements regarding medication administration, standard precautions, changes of condition, challenging behaviors, abuse, neglect and misappropriation, fire safety and first aid and choking.
- Clarify medication administration requirements and the monitoring of psychotropic medication.
- Clarify nurse delegation responsibilities to a non-licensed caregiver to address acuity and allow the facility to provide appropriate care in a time of limited nurse availability.
- Promote the use of nationally recognized standards of practice.
- Provide or arrange for services to meet the needs of residents in the areas of personal care, supervision, leisure time activities, community activities, family and social contacts, communication skills, health monitoring, and behavior management.
- Update provisions relating to reporting, investigating, and documenting allegations of caregiver misconduct to include resident protection.
- Establish an infection control program based on current standards of practice to prevent the development and transmission of communicable disease and infection.
- Modernize environmental accessibility requirements to meet the needs of residents with physical and intellectual disabilities.
4. Analysis of policy alternative
The department has determined that oversight of AFHs is not adequate to ensure a minimum standard of care for vulnerable residents, and to protect the health, safety, and rights residents. There are no reasonable alternatives to updating the rule.
5. Statutory authority for the rule
a. Explanation of authority to promulgate the proposed rule
b. The department is authorized to establish requirements for certification, certification application procedures and forms, standards for operation, and procedures for monitoring, inspection, decertification and appeal of decertification for adult family homes. The rules must be designed to protect and promote the health, safety and welfare of the disabled adults receiving care and maintenance in certified adult family homes. The department is also authorized to promulgate rules that establish minimum requirements for licensure, licensure application procedures and forms, standards for operation and procedures for monitoring, inspection, revocation and appeal of revocation.
Statute/s that authorize/s the promulgation of the proposed rule
The department shall promulgate all of the following rules with respect to adult family homes: 50.02(2)(am)1.
1. For the purposes of s. 50.032, defining the term “permanent basis" and establishing minimum requirements for certification, certification application procedures and forms, standards for operation and procedures for monitoring, inspection, decertification and appeal of decertification. The rules shall be designed to protect and promote the health, safety and welfare of the disabled adults receiving care and maintenance in certified adult family homes. 50.02(2)(am)2.
2. For the purposes of s. 50.033, establishing minimum requirements for licensure, licensure application procedures and forms, standards for operation and procedures for monitoring, inspection, revocation and appeal of revocation. Regulation. Except as provided in sub. (2d), standards for operation of certified adult family homes and procedures for application for certification, monitoring, inspection, decertification and appeal of decertification under this section shall be under rules promulgated by the department under s. 50.02 (2) (am) 1. An adult family home certification is valid until decertified under this section. Certification is not transferable.
Regulation. Except as provided in sub. (2d), standards for operation of licensed adult family homes and procedures for application for licensure, monitoring, inspection, revocation and appeal of revocation under this section shall be under rules promulgated by the department under s. 50.02 (2) (am) 2. An adult family home licensure is valid until revoked under this section. Licensure is not transferable. The biennial licensure fee for a licensed adult family home is $171, except that the department may, by rule, increase the amount of the fee. The fee is payable to the county department under s. 46.215, 46.22, 46.23, 51.42 or 51.437, if the county department licenses the adult family home under sub. (1m) (b), and is payable to the department, on a schedule determined by the department if the department licenses the adult family home under sub. (1m) (b).
c. Statute/s or rule/s that will affect the proposed rule or be affected by it
The department is not aware of other statutes or rules that will affect the proposed rule or be affected by it.
6. Estimates of the amount of time that state employees will spend to develop the rule and other necessary resources
The department estimates that staff will spend approximately 1040 staff hours for rulemaking. The department may form an advisory committee to assist in developing the rule.
7. Description of all of the entities that may be affected by the rule, including any local governmental units, businesses, economic sectors, or public utility ratepayers who may reasonably be anticipated to be affected by the rule
The entities that may be affected by the proposed rule are licensed AFHs, residents and resident representatives of licensed AFHs, AFH staff, Managed Care Organizations, and Provider Associations.
8. Summary and preliminary comparison of any existing or proposed federal regulation that is intended to address the activities to be regulated by the rule
There appear to be no existing or proposed federal regulations that address the activities to be regulated by the proposed rule.
9. Anticipated economic impact, locally or statewide
The proposed rule will have minimal or no economic impact.
10. Agency contacts
Pat Benesh, Policy Advisor
608-264-9896
