Wisconsin Legislature: Ch. DHS 131 TOC

Ch. DHS 131 NoteNote: Chapter HSS 131 was renumbered Chapter HFS 131 under s. 13.93 (2m) (b) 1., Stats., and corrections made under s. 13.93 (2m) (b) 6. and 7., Stats., Register, July, 1999, No. 523. Chapter HFS 131 was renumbered chapter DHS 131 under s. 13.92 (4) (b) 1., Stats., and corrections made under s. 13.92 (4) (b 7., Stats., Register January 2009 No. 637. Chapter DHS 131 as it existed on September 30, 2010 was repealed and a new chapter DHS 131 was created, effective October 1, 2010.

subch. I of ch. DHS 131Subchapter I — General Provisions

DHS 131.11DHS 131.11 Authority and purpose. This chapter is promulgated under the authority of s. 50.95, Stats., to establish minimum standards for the operation of hospice programs in Wisconsin. The purpose of the chapter is to ensure that hospice patients receive safe and adequate care and support and that the health and safety of hospice patients, employees and volunteers are protected.

DHS 131.11 HistoryHistory: CR 10-034: cr. Register September 2010 No. 657, eff. 10-1-10.

DHS 131.12DHS 131.12 Applicability. This chapter applies to all organizations, programs and places operating as hospices in Wisconsin.

DHS 131.12 HistoryHistory: CR 10-034: cr. Register September 2010 No. 657, eff. 10-1-10.

DHS 131.13DHS 131.13 Definitions. In this chapter:

DHS 131.13(1)(1) “Advance directive” means a written instruction, such as a living will under ch. 154, Stats., or a power of attorney for health care under ch. 155, Stats., or as otherwise recognized by the courts of the state, relating to the provision or nonprovision of health care when the individual is incapacitated.

DHS 131.13(2)(2) “Advanced practice nurse” means a person who is certified as an advanced practice nurse as provided in ch. N 8.

DHS 131.13(3)(3) “Attending physician” means a person who is either a doctor of medicine or osteopathy legally authorized to practice medicine and surgery under ch. 448, Stats., physician assistant or a nurse practitioner who meets the training, education, and experience requirements specified in s. DHS 105.20 (1) and the who identified by the patient, at the time he or she elects to receive hospice care, as having the greatest overall role in the determination and delivery of the individual’s medical care.

DHS 131.13(4)(4) “Bereavement services” means emotional, psychosocial, and spiritual support and services provided before and after the death of the patient to assist with issues related to grief, loss, and adjustment.

DHS 131.13(5)(5) “Core team” means a defined group within the hospice’s interdisciplinary group that has represented on it physician, nurse, social worker and bereavement or other counseling services and that is responsible for all aspects of care and services to a patient and the patient’s family.

DHS 131.13(6)(6) “Department” means the Wisconsin department of health services.

DHS 131.13(7)(7) “Employee” means a person who:

DHS 131.13(7)(a)(a) Works for the hospice and for whom the hospice is required to issue a W–2 form on his or her behalf.

DHS 131.13(7)(b)(b) If the hospice is a subdivision of an agency or organization, an employee of the agency or organization who is appropriately trained and assigned to the hospice.

DHS 131.13(7)(c)(c) Is a volunteer under the jurisdiction of the hospice.

DHS 131.13(8)(8) “Family member” means an individual with significant personal ties to the hospice patient who is designated a family member by mutual agreement between the individual and the patient.

DHS 131.13(9)(9) “Hospice” means any of the following:

DHS 131.13(9)(a)(a) An organization that primarily provides palliative care and supportive care to an individual with terminal illness where he or she lives or stays and, if necessary to meet the needs of an individual with terminal illness, arranges for or provides short-term inpatient care and treatment or provides respite care.

DHS 131.13(9)(b)(b) A program within an organization that primarily provides palliative care and supportive care to an individual with terminal illness where he or she lives or stays, that uses designated staff time and facility services, that is distinct from other programs of care provided by the organization and, if necessary to meet the needs of an individual with terminal illness, that arranges for or provides short-term inpatient care and treatment or respite care.

DHS 131.13(9)(c)(c) A place, including a freestanding structure or a separate part of a structure in which other services are provided, that primarily provides palliative and supportive care and a place of residence to individuals with terminal illness and provides or arranges for short-term inpatient care as needed.

DHS 131.13(10)(10) “Hospice patient” or “patient” means an individual in the terminal stage of illness who has an anticipated life expectancy of 12 months or less and who has been admitted to the hospice.

DHS 131.13(11)(11) “Interdisciplinary group” or “IDG” means the group of hospice employees which has represented on it the core team services and may, in addition, have physical therapy, occupational therapy, speech pathology and nurse aide services.

DHS 131.13(11m)(11m) “Nonambulatory” means unable to walk.

DHS 131.13(12)(12) “Nurse aide” means an individual employed by or under contract to a hospice to provide nurse aide services as specified in s. DHS 131.26 (2) (b) under the supervision of a registered nurse.

DHS 131.13(12m)(12m) “Semiambulatory” means able to walk with difficulty or able to walk only with the assistance of an aid, such as crutches, a cane, or a walker.

DHS 131.13(13)(13) “Palliative care” means patient and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering. Palliative care throughout the continuum of illness involves addressing physical, intellectual, emotional, social, and spiritual needs and to facilitate patient autonomy and access to information.

DHS 131.13(14)(14) “Physician” means a person licensed to practice medicine or osteopathy under ch. 448, Stats.

DHS 131.13(15)(15) “Plan of care” means the written information that describes a patient’s needs and related needs of the patient’s family, goals and interventions by specified hospice employees or volunteers as well as a means for evaluating the effectiveness of the interventions.

DHS 131.13(16)(16) “Registered nurse” means a person licensed as a registered nurse under ch. 441, Stats.

DHS 131.13(17)(17) “Representative” means an individual who has the authority under s. 50.94, Stats., to authorize or terminate medical care or to elect or revoke the election of hospice care on behalf of a terminally ill patient who is mentally or physically incapacitated. This may include a legal guardian.

DHS 131.13(18)(18) “Respite care” means care provided to a terminally ill individual in order to provide temporary relief to the primary caregiver.

DHS 131.13(19)(19) “Restraint” means any of the following:

DHS 131.13(19)(a)(a) Any manual method, physical or mechanical device, material, or equipment that immobilizes or reduces the ability of a patient to move his or her arms, legs, body, or head freely, not including devices, such as orthopedically prescribed devices, surgical dressings or bandages, protective helmets, or other methods that involve the physical holding of a patient for the purpose of conducting routine physical examinations or tests, or to protect the patient from falling out of bed, or to permit the patient to participate in activities without the risk of physical harm that does not include a physical escort.

DHS 131.13(19)(b)(b) A drug or medication when it is used as a restriction to manage the patient’s behavior or restrict the patient’s freedom of movement and is not a standard treatment or dosage for the patient’s condition.

DHS 131.13(20)(20) “Seclusion” means the involuntary confinement of a patient alone in a room or an area from which the patient is physically prevented from leaving.

DHS 131.13(20m)(20m) “Semiambulatory” means able to walk with difficulty or able to walk only with the assistance of an aid, such as crutches, a cane, or a walker.

DHS 131.13(21)(21) “Short-term inpatient care” means care provided to a terminally ill individual in an inpatient setting for brief periods of time for the purpose of pain control or acute or chronic symptom management.

DHS 131.13(22)(22) “Social worker” means an individual who holds a social worker certificate or a clinical social worker license under s. 457.08, Stats.

DHS 131.13(23)(23) “Supportive care” means services provided during the final stages of an individual’s terminal illness and dying and after the individual’s death to meet the psychosocial, social and spiritual needs of family members of the terminally ill individual and other individuals caring for the terminally ill individual.

DHS 131.13(24)(24) “Terminal illness” means a medical prognosis by a doctor of medicine or osteopathy that an individual’s life expectancy is less than 12 months.

DHS 131.13(25)(25) “Volunteer” means an uncompensated staff person.

DHS 131.13 HistoryHistory: CR 10-034: cr. Register September 2010 No. 657, eff. 10-1-10; CR 19-092: r. and recr. (3), cr. (11m), (20m) Register July 2020 No. 775, eff. 8-1-20; correction in (3) made under s. 35.17, Stats., Register July 2020 No. 775.

DHS 131.14DHS 131.14 License.

DHS 131.14(1)(1) License requirement.

DHS 131.14(1)(a)(a) No person may conduct, maintain, operate or otherwise participate in conducting, maintaining or operating a hospice unless the hospice is licensed by the department.

DHS 131.14(1)(b)(b) A hospice program may have more than one office or facility. Multiple units do not need to be separately licensed if the hospice is able to demonstrate supervision and administration from the central office.