DHS 10.13(1)(b)6.b.b. The plan does not provide sufficient care, treatment, or support to meet the enrollee’s needs and identified family care outcomes. DHS 10.13(1)(b)6.c.c. The plan requires the enrollee to accept care, treatment or support items that are unnecessarily restrictive or unwanted by the enrollee. DHS 10.13(1)(b)8.8. The denial of functional eligibility under s. DHS 10.33 as a result of the care management organization’s administration of the long-term care functional screen, including a change from a nursing home level of care to a non-nursing home level of care. DHS 10.13(1)(b)9.9. The denial of an enrollee’s request to dispute a financial liability, including copayments, premiums, deductibles, coinsurance, other cost sharing, and other member financial liabilities. DHS 10.13(1)(b)10.10. The denial of an enrollee, who is a resident of a rural area with only one care management organization, to obtain services outside of the care management organization’s network of contracted providers. DHS 10.13(1)(c)(c) Any of the following failures on the part of a care management organization: DHS 10.13(1)(c)1.1. The failure to provide services and support items included in the individualized service plan in a timely manner, as defined in the department’s contract with care management organizations. DHS 10.13(1)(c)2.2. The failure to act in a timely manner as specified in subch. V of this chapter to resolve grievances or appeals. DHS 10.13(1m)(1m) “Activities of daily living” or “ADLs” means bathing, dressing, eating, mobility, transferring from one surface to another such as bed to chair and using the toilet. DHS 10.13(3)(3) “Adult protective services” means protective services for individuals with intellectual disabilities and other developmental disabilities, for individuals with degenerative brain disorder, for individuals with chronic mental illness, and for individuals with other like incapacities incurred at any age as defined in s. 55.02, Stats. DHS 10.13(3m)(3m) “Appeal” means a request for review of an adverse benefit determination. DHS 10.13(4)(4) “Applicant” means a person who directly or through a representative makes application for the family care benefit. DHS 10.13(5)(5) “Assets” means any interest in real or personal property that can be used for support and maintenance. “Assets” includes motor vehicles, cash on hand, amounts in checking and savings accounts, certificates of deposit, money market accounts, marketable securities, other financial instruments and cash value of life insurance. DHS 10.13(6)(6) “Assistance” means cueing, supervision or partial or complete hands-on assistance from another person. DHS 10.13(8)(8) “Care management organization” or “CMO” means an entity that is certified as meeting the requirements for a care management organization under s. 46.284 (3), Stats., and this chapter and that has a contract under s. 46.284 (2), Stats., and s. DHS 10.42. “Care management organization” does not include an entity that contracts with the department to operate a PACE or Wisconsin partnership program. DHS 10.13(8m)(8m) “Choice counseling” means information and services designed to assist eligible applicants in making enrollment decisions. DHS 10.13(9)(9) “Client” means a person applying for eligibility for the family care benefit, an eligible person or an enrollee. DHS 10.13(10)(10) “Community-based residential facility” or “CBRF” has the meaning specified in s. 50.01 (1g), Stats. DHS 10.13(11)(11) “Community spouse” means an individual who is legally married as recognized under state law to a family care spouse. DHS 10.13(13)(13) “Countable assets” means assets that are used in calculating financial eligibility and cost sharing requirements for the family care benefit. DHS 10.13(14)(14) “County agency” means a county department of aging, multicounty consortium, social services or human services, an aging and disability resource center, a family care district or a tribal agency, that has been designated by the department to determine financial eligibility and cost sharing requirements for the family care benefit. DHS 10.13(14m)(14m) “Day” means calendar day, unless otherwise indicated. DHS 10.13(15)(15) “Department” means the Wisconsin department of health services.