Chapter DHS 88

DHS 88.05(4)(b) (b) Smoke detectors.

DHS 88.05(4)(b)1. 1. Every adult family home shall be equipped with one or more single station battery operated, electrically interconnected or radio signal emitting smoke detectors on each floor level. Required smoke detectors shall be located in each habitable room except the kitchen and bathroom and specifically in the following locations: at the head of each open stairway, at the door leading to every enclosed stairway, on the ceiling of the living room or family room, on the ceiling of each sleeping room and in the basement.

DHS 88.05(4)(b)2. 2. The licensee shall maintain each required smoke detector in working condition and test each smoke detector monthly to make sure that it is operating. If a unit is found to be not operating, the licensee shall immediately replace the battery or have the unit repaired or replaced.

DHS 88.05(4)(c) (c) Exiting from the first floor.

DHS 88.05(4)(c)1. 1. The first floor of the home shall have at least 2 means of exiting which provide unobstructed access to the outside.

DHS 88.05(4)(c)2. 2. Exits shall be doors.

DHS 88.05(4)(d) (d) Fire safety evacuation plan.

DHS 88.05(4)(d)1. 1. The licensee shall have a written plan for the immediate and safe evacuation of all occupants of the home in the event of a fire. The plan shall identify an external meeting place.

DHS 88.05(4)(d)2. 2.

DHS 88.05(4)(d)2.a. a. The licensee shall review the fire safety evacuation plan with each new resident immediately following placement and shall evaluate the resident using a form provided by the department to determine whether the resident is able to evacuate the home without any help within 2 minutes.

DHS 88.05(4)(d)2.b. b. Each resident shall be evaluated annually for evacuation time, using the department’s form. All service providers who work on the premises shall be made aware of each resident having an evacuation time of more than 2 minutes.

DHS 88.05(4)(d)2.c. c. The licensee shall conduct semi-annual fire drills with all household members with written documentation of the date and evacuation time for each drill maintained by the home.

DHS 88.05 Note Note: Licensees are encouraged to consult with their local fire department in preparing a fire safety evacuation plan.

DHS 88.05 Note Note: For a copy of the resident evaluation form to determine evacuation time, contact the county agency in the county in which the home is located or write or phone the appropriate regional office of the Department’s Division of Disability and Elder Services. See Appendix A for addresses and phone numbers of the Division of Disability and Elder Services regional offices.

DHS 88.05(4)(e) (e) Report of a fire. The licensee shall report to the licensing agency within 72 hours after the event the occurrence of a fire in the home which required the assistance of the fire department.

DHS 88.05(4)(f) (f) Resident incapable of self-evacuation. If a resident who is incapable of self-evacuation in an emergency is present in the home, the licensee or service provider shall be in the home.

DHS 88.05(5) (5) Telephone. A home shall provide a non-pay telephone for residents to make and receive telephone calls. The home may require that long distance calls be made at a resident’s own expense. Emergency telephone numbers, including numbers for the fire department, police, hospital, physician, poison control center and ambulance, shall be located on or near each telephone.

DHS 88.05(6) (6) Household pets.

DHS 88.05(6)(a) (a) Pets may be allowed on the premises of an adult family home. Cats, dogs and other pets vulnerable to rabies which are owned by any resident or household member shall be vaccinated as required under local ordinance. A pet suspected of being ill or infected shall be treated immediately for its condition or removed from the home.

DHS 88.05(6)(b) (b) Pens and cages shall be kept clean.

DHS 88.05(6)(c) (c) Pets shall be kept and handled in a manner which protects the well-being of both residents and pets.

DHS 88.05(6)(d) (d) The wishes of residents shall be considered before a new pet is allowed on the premises.

DHS 88.05 History History: Cr. Register, January, 1996, No. 482, eff. 2-1-96; correction in (3) (d) under s. 13.92 (4) (b) 7., Stats., Register May 2011 No. 665.

DHS 88.06 DHS 88.06 Placement.

DHS 88.06(1) (1) Preadmission.

DHS 88.06(1)(a) (a) A licensee shall provide the following information, in writing, to a prospective resident and that person’s guardian, if any:

DHS 88.06(1)(a)1. 1. Information regarding filing a complaint when the home or a service provider does not comply with this chapter.

DHS 88.06(1)(a)2. 2. The amount, possible sources and acceptable methods of payment for providing care and maintenance to a resident of the home, specifying any costs for which the resident will be liable.

DHS 88.06(1)(a)3. 3. A description of the roles, responsibility and expectations of all parties involved in providing services. This shall include reviewing the content of the home’s program statement and describing any personal housekeeping the resident will be requested to perform. A resident shall be allowed to refuse to perform this work and any other work for the home.

DHS 88.06(1)(b) (b) A copy of this chapter shall be made available upon request by the prospective new resident or that person’s guardian if any.

DHS 88.06(1)(c) (c) The licensee shall give a prospective new resident an opportunity to meet current residents, spend time in the house and become familiar with the household routines. This may include visits during the day and an overnight stay.

DHS 88.06(1)(d) (d) The licensee shall discuss the religious and cultural beliefs of the licensee and residents of the home with a prospective resident because these may affect how comfortable the prospective resident may feel in the home.

DHS 88.06(1)(e) (e) The licensee shall obtain information from a prospective resident necessary to determine whether the person’s needs can be met with the services identified in the home’s program statement.

DHS 88.06(2) (2) Admission.

DHS 88.06(2)(a) (a) Except as provided in subd. 2., the licensee shall ensure that a new resident of an adult family home receives a health examination by a physician to identify health problems and is screened for communicable disease, including tuberculosis. Screening for communicable disease may be provided by a physician, a registered nurse or a physician assistant. The health examination and screening shall take place within 90 days prior to admission to the home or within 7 days after admission.

DHS 88.06(2)(a)2. 2. No health examination is required for a person admitted for respite care who will not be staying in a home more than 7 days and will not be placed in the home more than once in a calendar year.

DHS 88.06(2)(b) (b) An adult family home shall have a service agreement with each person to be admitted to the home except a person being admitted for respite care. The service agreement shall be completed prior to admission and revised at least 30 days prior to any change. The service agreement shall be dated and signed by the licensee and the person being admitted or that person’s guardian or designated representative. Copies shall be provided to all parties and to the placing agency, if any.

DHS 88.06(2)(c) (c) A service agreement shall specify all of the following:

DHS 88.06(2)(c)1. 1. The names of the parties to the agreement.

DHS 88.06(2)(c)2. 2. The services that will be provided and a description of each.

DHS 88.06(2)(c)3. 3. Charges for room and board and services and any other applicable expenses, and the amount of the security deposit, if any.

DHS 88.06(2)(c)4. 4. The frequency, amount, source and method of payment.

DHS 88.06(2)(c)5. 5. The policy on refunds.

DHS 88.06(2)(c)6. 6. How personal funds will be handled.

DHS 88.06(2)(c)7. 7. Conditions for transfer or discharge and the assistance a licensee will provide in relocating a resident.

DHS 88.06(2)(c)8. 8. A statement indicating that the resident rights and grievance procedures have been explained and copies provided to the resident and the resident’s guardian or designated representative, if any.

DHS 88.06(3) (3) Individual service plan and assessment.

DHS 88.06(3)(a) (a) The licensee shall ensure that a written assessment and individual service plan are completed and developed for each resident within 30 days after placement.

DHS 88.06(3)(b) (b) The individual service plan and written assessment shall be developed by the placing agency, if any, the service coordinator, if any, the licensee, the resident and the resident’s guardian, if any, and designated representative, if any, with the resident participating in a manner appropriate for the resident’s level of understanding and method of communication.

DHS 88.06(3)(c) (c) The assessment shall identify the person’s needs and abilities in at least the areas of activities of daily living, medications, health, level of supervision required in the home and community, vocational, recreational, social and transportation.

DHS 88.06(3)(d) (d) The individual service plan shall contain at least the following:

DHS 88.06(3)(d)1. 1. A description of the services the licensee will provide to meet assessed need.

DHS 88.06(3)(d)2. 2. Identification of the level of supervision required in the home and community.

DHS 88.06(3)(d)3. 3. Descriptions of services provided by outside agencies.

DHS 88.06(3)(d)4. 4. Identification of who will monitor the plan.

DHS 88.06(3)(d)5. 5. A statement of agreement with the plan, dated and signed by all persons involved in developing the plan.

DHS 88.06(3)(e) (e) A copy of the individual service plan shall be provided to all persons involved in the development of it.

DHS 88.06(3)(f) (f) The individual service plan shall be reviewed at least once every 6 months by the licensee, the resident or the resident’s guardian, the service coordinator, if any, the designated representative, if any, and, if applicable, the placing agency with the resident participating in a manner appropriate for the resident’s level of understanding and method of communication. This review is to determine continued appropriateness of the plan and to update the plan as necessary. A plan shall be updated, in writing, whenever the resident’s needs or preferences change substantially or when requested by the resident or the resident’s guardian.

DHS 88.06 History History: Cr. Register, January, 1996, No. 482, eff. 2-1-96; cr. (1) (a) 4. and (4), Register, October, 2000, No. 538, eff. 11-1-00; reprinted to restore dropped copy in (1) Register December 2003 No. 576; corrections in (1) (a) 4. and (4) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635; CR 10-091: r. (1) (a) 4. Register December 2010 No. 660, eff. 1-1-11; CR 10-145: r. (4) Register May 2011 No. 665, eff. 6-1-11.

DHS 88.07 DHS 88.07 Resident care.

DHS 88.07(1) (1) General requirements.

DHS 88.07(1)(a) (a) The licensee shall provide a safe, emotionally stable, homelike and humane environment for residents.

DHS 88.07(1)(b) (b) The licensee shall encourage a resident’s autonomy, respect a resident’s need for physical and emotional privacy and take a resident’s preferences, choices and status as an adult into consideration while providing care, supervision and training.

DHS 88.07(1)(c) (c) The licensee shall plan activities and services with the residents to accommodate individual resident needs and preferences and shall provide opportunities for each resident to participate in cultural, religious, political, social and intellectual activities within the home and community. A resident may not be compelled to participate in these activities.

DHS 88.07(1)(d) (d) The licensee shall allow a resident to participate in all activities that the resident selects unless contrary to the resident’s individualized service plan or the home’s program statement.

DHS 88.07(1)(e) (e) The licensee shall arrange for a service provider to be present in the home when the licensee is gone overnight or when the licensee’s absence prevents the resident from receiving the services, training or supervision specified in the resident’s individual service plan under s. DHS 88.06 (3).

DHS 88.07(2) (2) Services.

DHS 88.07(2)(a) (a) The licensee shall provide or arrange for the provision of individualized services specified in a resident’s individual service plan that are the licensee’s responsibility.

DHS 88.07(2)(b) (b) Services shall be directed to the goal of assisting, teaching and supporting the resident to promote his or her health, well-being, self-esteem, independence and quality of life. The services shall include but are not limited to:

DHS 88.07(2)(b)1. 1. Supervising or assisting a resident with or teaching a resident about activities of daily living.

DHS 88.07(2)(b)2. 2. Providing, arranging, transporting or accompanying a resident to leisure and recreational activities, employment and other activities identified in the resident’s individual service plan.

DHS 88.07(2)(b)3. 3. Providing, arranging, transporting or accompanying a resident to medical or other appointments as part of the resident’s individual service plan.

DHS 88.07(2)(b)4. 4. Keeping a current record of all medical visits, reports and recommendations for a resident.

DHS 88.07(2)(b)5. 5. Monitoring resident health by observing and documenting changes in each resident’s health and referring a resident to health care providers when necessary.

DHS 88.07(2)(b)6. 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.

DHS 88.07(2)(c) (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.

DHS 88.07(2)(d) (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.

DHS 88.07(2)(e) (e) The licensee shall ensure that each resident has an annual health examination by a physician.

DHS 88.07(3) (3) Prescription medications.

DHS 88.07(3)(a) (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.

DHS 88.07(3)(b) (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.

DHS 88.07(3)(c) (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.

DHS 88.07(3)(d) (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.

DHS 88.07(3)(e) (e)

DHS 88.07(3)(e)1. 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.

DHS 88.07(3)(e)2. 2. The record shall also contain information describing potential side effects and adverse reactions caused by each prescription medication.

DHS 88.07(4) (4) Nutrition.

DHS 88.07(4)(a) (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.

DHS 88.07(4)(b) (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.