Register May 2011 No. 665
Chapter DHS 88
LICENSED ADULT FAMILY HOMES
DHS 88.01 Authority, purpose and scope. DHS 88.03 Licensing administration. DHS 88.04 Licensee and service provider. DHS 88.08 Termination of placement. DHS 88.10 Resident rights. DHS 88.11 Reporting of abuse and neglect. Ch. DHS 88 NoteNote: Chapter HSS 88 was created as an emergency rule effective June 1, 1995. Chapter HSS 88 was renumbered Chapter HFS 88 under s. 13.93 (2m) (b) 1., Stats. and corrections made under s. 13.93 (2m) (b) 6. and 7., Stats., Register, December, 1999, No. 528. Chapter HFS 88 was renumbered to chapter DHS 88 under s. 13.92 (4) (b) 1., Stats., and corrections made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635. DHS 88.01DHS 88.01 Authority, purpose and scope. DHS 88.01(1)(1) Authority and purpose. This chapter is promulgated under the authority of ss. 50.02 (2) (am) 2. and 50.033 (2), Stats., to establish licensing standards for the operation of adult family homes in order to protect and promote the health, safety and welfare of persons residing in and receiving care and maintenance in these homes. DHS 88.01(2)(a)(a) Applicability. This chapter applies to the department, county licensing agencies, adult family home license applicants and licensees, and service providers. DHS 88.01(2)(b)(b) Exception to a requirement. The licensing agency may grant an exception to any requirement in this chapter except a resident right under s. DHS 88.10 if the licensee requests the exception in writing on a form provided by the department and presents a convincing argument that the proposed exception will not jeopardize the health, safety or welfare of residents or violate the rights of residents. The licensing agency shall respond in writing to the request within 45 days after receiving it. An exception may be granted only when it would not adversely affect the ability of the licensee to meet the residents’ needs and if the exception will not jeopardize the health, safety or welfare of residents or violate the rights of residents. The licensing agency may impose conditions or time limitations on an exception. Violation of a condition under which the exception is granted constitutes a violation of this chapter. DHS 88.01 NoteNote: For copies of the form for requesting an exception to a requirement, contact the licensing agency or write or phone the appropriate regional office of the Department’s Division of Disability and Elder Services. See Appendix A for the addresses and phone numbers of those offices.
DHS 88.01 HistoryHistory: Cr. Register, January, 1996, No. 482, eff. 2-1-96. DHS 88.02DHS 88.02 Definitions. In this chapter: DHS 88.02(1)(1) “Abuse” means conduct which is not accidental and which causes or could reasonably be expected to cause harm to a resident, and which may be physical abuse, mental abuse or material abuse. DHS 88.02(2)(2) “Accessible” means the absence of barriers that would prevent a person who is semiambulatory or nonambulatory or has a functional limitation caused by impairment of sight, hearing, coordination or perception from entering, leaving or functioning within an adult family home without physical help. DHS 88.02(3)(a)(a) Activities relating to the performance of self-care and engaging in leisure or recreational activities. “Self-care” includes dressing, eating, bathing, grooming, toileting, mobility, object manipulation, ambulation and rest. DHS 88.02(3)(b)(b) Activities relating to home and household management, including preparing meals, shopping and chores, personal housekeeping, using the telephone, managing one’s personal finances, and health care activities including taking medicine, applying or changing dressings and using a medical device. DHS 88.02(3)(c)(c) Activities involving movement about in one’s community, for purposes that include getting to and participating in vocational, recreational and social activities in the community with other members of the community. DHS 88.02(4)(4) “Adult” means an individual 18 years of age or over except that it does not mean either of the following: DHS 88.02(4)(a)(a) An individual 18 years of age or over whose placement in a home licensed under ch. DCF 56 or 57 is funded by state or federal foster care funds or youth aid funds under s. 48.645, Stats., and who was placed in the home while under 18 years of age and became 18 years of age while a resident of the home. DHS 88.02(4)(b)(b) An individual 18 years of age or older who is a resident of a facility licensed under ch. DCF 52. DHS 88.02(5)(5) “Adult family home” or “home” means a place where 3 or 4 adults not related to the licensee reside in which care, treatment or services above the level of room and board but not including nursing care are provided to persons residing in the home as a primary function of the place except that it does not mean a place described in s. 50.01 (1g) (a) to (d), Stats. DHS 88.02(6)(6) “Ambulatory” means able to walk without difficulty or help. DHS 88.02(7)(7) “Building” means a structure entirely enclosed under one roof. DHS 88.02(8)(8) “Chemical restraint” means a psychopharmacologic drug that is used for discipline or convenience and not required to treat medical symptoms. DHS 88.02(9)(9) “Continuous care” means the need for supervision, intervention or services on a 24-hour basis to prevent, control and ameliorate a constant or intermittent mental or physical condition which may break out or become critical during any time of the day or night. DHS 88.02 NoteNote: Examples of persons who need continuous care are wanderers, persons with irreversible dementia, persons who are self abusive or who become agitated or emotionally upset and persons whose changing or unstable health condition requires monitoring.
DHS 88.02(10)(10) “Contraband” means any item the possession of which is illegal, contrary to the purpose of the resident’s stay in the adult family home or poses a physical danger to other residents or to staff or both. DHS 88.02(11)(11) “County agency” means a county department of social services established under s. 46.215 or 46.22, Stats., a county department of human services established under s. 46.23, Stats., or a county department of community programs established under s. 51.42, Stats. DHS 88.02(12)(12) “Department” means the Wisconsin department of health services. DHS 88.02(13)(13) “Designated representative” means a person or agency designated in writing by a resident or by the resident’s guardian to aid a resident or act on the resident’s behalf, but not including the licensee or a service provider or a relative of the licensee or a service provider. DHS 88.02(14)(14) “Household member” means any person living in an adult family home, except a resident. DHS 88.02(14m)(14m) “Involuntary administration of psychotropic medication” means any of the following: DHS 88.02(14m)(a)(a) Placing psychotropic medication in an individual’s food or drink with knowledge that the individual protests receipt of the psychotropic medication. DHS 88.02(14m)(b)(b) Forcibly restraining an individual to enable administration of psychotropic medication. DHS 88.02(14m)(c)(c) Requiring an individual to take psychotropic medication as a condition of receiving privileges or benefits. DHS 88.02(15)(15) “Licensee” means a person or persons licensed to operate an adult family home. DHS 88.02(16)(16) “Licensing agency” means a county agency in a county that elects to license adult family homes located in the county, or the department in a county where no county agency has been designated to license adult family homes. DHS 88.02(17)(17) “Material abuse” means the misuse of a person’s property or financial resources, which may include financial deception, diverting income, mismanagement of funds or taking money against a person’s will. DHS 88.02(18)(18) “Mental abuse” means a single or repeated act of force, harassment, including sexual harassment, deprivation, neglect or mental pressure which reasonably could cause mental anguish or fear, which may include persistent or excessive negative comments, threats, deliberate inducement of anxiety or singling out a resident for inappropriate criticism or encouraging the resident’s peers to do the same. DHS 88.02(19)(19) “Neglect” means significant danger presented to a person’s physical or mental health because the person responsible for his or her care is unable or fails to provide adequate food, shelter, clothing, medical care or dental care. DHS 88.02(20)(20) “Nursing care” means nursing procedures, excluding personal care, which under ch. N 6, standards of practice for registered nurses and licensed practical nurses, may be performed only by a registered nurse or a licensed practical nurse directly on a resident. DHS 88.02(21)(21) “Personal care” means help with eating, dressing, bathing, ambulation and other self-care activities of daily living. DHS 88.02(22)(22) “Personal housekeeping” means the performance of routine housekeeping and household tasks. DHS 88.02(23)(23) “Physical abuse” means the willful infliction of physical pain or injury or unreasonable confinement, Including but not limited to direct beating, choking, sexual touching, unreasonable physical restraint or pain without physical marks. DHS 88.02(24)(24) “Physical restraint” means any manual method or any article, device or garment interfering with the free movement of a resident or the normal functioning of a portion of the resident’s body or normal access to a portion of the body, and which the individual is unable to remove easily, or confinement in a locked room. DHS 88.02(25)(25) “Place” means a building or portion of a building which is self-sufficient for living, dining and sleeping and the provision of care, treatment or services to its residents. DHS 88.02(26)(26) “Placing agency” means the agency responsible for placing a resident in an adult family home. DHS 88.02(27)(27) “Primary function” means the basic or essential care, treatment or services provided to residents of the home. DHS 88.02(27g)(27g) “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 88.02(27r)(27r) “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 88.02(28)(28) “Relative” means a spouse, parent, step-parent, child, step-child, sibling, grandchild, grandparent, aunt, uncle, niece or nephew. DHS 88.02(29)(29) “Resident” means an adult, unrelated to the licensee, who lives and sleeps in the home and receives care, treatment or services in addition to room and board. DHS 88.02(30)(30) “Respite care” means temporary placement in an adult family home for maintenance of care, treatment or services, as established by the agency or individual responsible for planning, arranging or providing services to the individual, in addition to room and board, for no more than 14 consecutive days at a time. DHS 88.02(31)(31) “Seclusion” means physical or social separation from others by action of the licensee, service provider or others in the home, but does not include separation in order to prevent the spread of a communicable disease or a cool down period in an unlocked room as long as being in the room is voluntary on the resident’s part. DHS 88.02(32)(32) “Service coordinator” means a person not affiliated with a adult family home who has primary responsibility for arranging, coordinating, managing and monitoring the care and services needed by a resident, including services provided outside of the adult family home. DHS 88.02(33)(33) “Service provider” means a person or persons who provide direct care or supervision for a resident of the adult family home, either as an employee of the licensee or as a volunteer. DHS 88.02(34)(34) “Type of individuals” means individuals grouped according to one of the following disabilities, conditions or statuses: DHS 88.02(34)(a)(a) A functional impairment that commonly accompanies advanced age. DHS 88.02(34)(h)(h) An individual under the legal custody of a government corrections agency or under the legal jurisdiction of a criminal court. DHS 88.02(35)(35) “Unrelated adult” means an adult who is not a relative of the licensee. DHS 88.02(36)(36) “Voluntary” means according to a resident’s free choice if the resident is competent, or by choice of the resident’s guardian if the resident is under guardianship.
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