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Adult-at-Risk Restraining Order
The Individual-at-Risk Restraining Order statute (WI State Stat. 813.123) provides a separate set of remedies that can be used to prevent abuse, neglect and exploitation of individuals at risk and to facilitate investigation and other responses. An individual at risk may file the petition for a restraining order or someone else may file the petition on behalf of the individual at risk. The court may order appointment of a guardian ad litem for the individual at risk if needed [Wis. Stat. § 813.123(3)(b)]. If someone other than the individual at risk files the petition for the temporary restraining order, the court must appoint a guardian ad litem to investigate the situation and report to the court as to whether issuance of the restraining order would be in the best interests of the individual at risk. While there are no fees associated with the filing of a petition for an IAR restraining order, there are no provisions regarding payment of guardian ad litem fees.

Adults-at-Risk Restraining Order and Injunction Checklist

Advanced Directives Information
Find more information about living wills and power of attorney forms here

Power of Attorney for Finances and Property - Updated September 2010

Revoking a Power of Attorney for Finances
Q: How do I revote a Power of Attorney for Finances?

A:  See Wisconsin Statutes Chapter 244 or contact the Wisconsin Guardianship Support Center at GWAAR.

Out-of-State Powers of Attorney for Health Care
Q: Are out-of-state powers of attorney for health care effective in Wisconsin?  Can they be used for nursing home admission?

A:  In general, yes.  Valid powers of attorney for health care created in another state are recognized in Wisconsin as long as the authority granted to the health care agent complies with Wisconsin law.

Confidentiality
Q: Who can receive information about a report of abuse, neglect or exploitation to an elder adult/adult-at-risk? What provisions restrict information to an alleged abuser? What information can be released to an alleged abuser? What information can be released to the individual who reported the abuse, neglect or exploitation?

A: Wisconsin statutes 55.043 (6) and 46.90 (6) outline the release of information about reports of abuse, neglect and financial exploitation. The Chapter 55 Manual Chapter II, Section H provides some helpful information. This memo from DHS Legal Counsel may also be helpful.

Conflict of Interest
Q: What does a county elder adults/adults-at-risk agency need to do when it determines that the county cannot conduct an unbiased response to a report of abuse, neglect or financial exploitation?

A: If a county determines that it needs to transfer an investigation based on the judgment that another county's elder adults/adults-at-risk agency would be better able to conduct an impartial investigation, Wisconsin State Statute §55.043(1r)(a)2. and §46.90(5)(a)2 require the county to notify the Department of Health Services. To simplify this process, the state has developed a form that can be e-mailed or faxed for immediate authorization.

Corporate Guardianship Information
A non-profit corporation that serves as a corporate guardian must be first approved by the Department of Health Services Division of Quality Assurance.

That criteria is established in administrative rule, DHS 85. The Division of Quality Assurance web site has more information on corporate guardians and a list of providers by county.

Corporate Guardians, Contact with Ward

Q: What are the duties of a corporate guardian of the person with regard to visits and other contact with the ward on an annual basis (i.e., yearly)?

A: Pursuant to Wis. Stat. § 54.25(1)(b)(1), all guardians of the person, corporate and non-corporate (e.g., family, friends), are required to engage in "regular inspection, in person, of the ward's condition, surroundings, and treatment." However, there are more specific requirements for corporate guardians. Corporate guardians are required to "have face-to-face contact with the ward at least once every three months and more often as needed to meet the needs of the ward." Corporate guardians must visit the ward in his or her residence at least annually. This is a minimum standard imposed by DHS § 85.14(7).

Under certain circumstances depending on the ward's needs and desires, compliance with the minimum standard by corporate guardians may be insufficient as a matter of law. Contact once every three months may itself be insufficient (e.g., the ward is being actively treated in an acute care facility or is in some other unstable situation requiring more frequent visits).

Contact may also be insufficient as the result of factors other than or in combination with frequency. In addition to the frequency of contact, the setting in which contact occurs and the quality of the contact between the ward and the corporate guardian must be appropriate. It is important that the setting in which contact occurs ensures the ward and the guardian are able to focus on the ward's concerns and wishes without distraction. This, in turn, will affect the quality of the contact.

What is appropriate will differ depending on the ward. However, in all cases, the guardian is responsible for acting in the best interest of the ward and for ensuring that the ward's needs and desires are met. Complaints about corporate guardians are often brought by members of the ward's family or the facility where the ward resides and questions about the frequency and quality of contact have been raised by county APS agencies with regard to requirements for agency contracts with corporate guardian entities. If corporate guardians fail to act accordingly, the guardian is at risk not only of being replaced in a particular case, but of losing his or her status as a corporate guardian.

Questions or concerns about the actions of corporate guardians should be directed to Dinh Tran in the Division of Quality Assurances. Mr. Tran can be reached by email at dinh.tran@wi.gov or by phone at (608) 266-6646.

Durable Medical Equipment
Q: Can Elder Abuse Funds be used for Durable Medical Equipment?

A: Guidelines for Durable Medical Equipment and Elder Abuse Funding

Initial Criteria:

  • The need for Durable Medical Equipment (DME) must be associated with an actual report of abuse or neglect.
  • DME cannot be purchased for prevention purposes.

If the initial criteria is met AND you can answer YES to all the following questions, send a request to your Area Agency on Aging or to the Department of Health Services for a decision. Include information about where the report or complaint came from and who did the investigation.

  1. Did the investigation identify a need for durable medical equipment (i.e. lift chair, wheelchair)
  2. Was it directly related to the abuse or neglect allegation?
  3. Did you substantiate the finding?
  4. Is there no other funding source?
  5. Do you have a certificate of medical necessity from a physician?
Financial Exploitation of Younger Adults at Risk (ages 18 to 59)
Q: The federal Gramm-Leach-Bliley Act prohibits the release of “non-public personal information” except “to protect against or prevent actual or potential fraud, unauthorized transactions, claims and other liability”. Does this exception apply to Elder Adults/Adults-at-Risk agency response to financial exploitation of adults at risk of any age?

A: Wisconsin’s Chapter 46 language protecting elder adults at risk from financial exploitation is identical to the Chapter 55 language protecting younger adults at risk. Therefore, the clarification from the federal government on release of information provides the same protections to ALL adults at risk, regardless of their age. See SafetyNetworks #5, July 2008 for more information about responding to reports of financial exploitation.

Financial Exploitation Records Requests
For more information about responding to reports of financial exploitation, see SafetyNetworks #5. More information:
  • Sample MOU between elder adults/adults-at-risk agency and financial institutions. (under SafetyNetworks #5)
  • Sample financial information request form (under SafetyNetworks #5)

Financial Records Release - Federal Policy
Federal Law: The federal Right to Financial Privacy Act of 1978 does not apply to reports made to state or local authorities.

31 U.S.C. sec. 5318 (g) (3): Any financial institution that makes a disclosure of any possible violation of law or regulations or a disclosure pursuant to this subsection or any other authority, and any director, officer, employee, or agent of such institution, shall not be liable to any person under any law or regulation of the United States or any constitution, law, or regulation of any State or political subdivisions thereof, for such disclosure or for any failure to notify the person involved in the transaction or any other person of such disclosure.

12 U.S.C. 3403 (c):  Nothing in this title shall preclude any financial institution, or any officer, employee or agent of a financial institution, from notifying a Government authority that such institution or officer, employee, or agent has information which may be relevant to a possible violation of any statute or regulation. Such information may involve only the name or other identifying information concerning any individual, corporation or account involved in and the nature of any suspected illegal activity… Any financial institution, or officer, employee, or agent thereof…shall not be liable to the customer under any law or regulation of the United States or any constitution, law or regulation of any State or political subdivision thereof, for such disclosure of or any failure to notify the customer of such disclosure.

In 1999 the Financial Services Modernization Act (often known as the Gramm-Leach-Gliley Act) was passed. This Act contains strong privacy protection and requires notification to customers before disclosures of their records and an opportunity to disapprove the proposed disclosure. However Section 502(e) of the Act contains exceptions to this privacy protection. Three are relevant to state reporting programs:

  • (e)(3)(B) permits disclosure "to protect against or prevent actual or potential fraud, unauthorized transactions, claims, or other liability." 
  • (e)(5) permits disclosure "to the extent specifically permitted or required under other provisions of law…to law enforcement agencies…or for an investigation on a matter related to public safety." 
  • (e)(8) permits disclosure "to comply with Federal, State, or local laws, rules, and other applicable legal requirements."

APS Process Flow Chart
Flow Chart of Elder Adults/Adults-at-Risk Process. See SafetyNetworks #9, February 2009

Guardianships Determined Before Law Changes
Q: With new guardianship laws in effect under Chapter 54, what happens to pre-existing 880 guardianships?

A: Guardians retain the powers specified in the original order but the new laws relating to their duties and standard of conduct take effect. New court permission requirements are also in effect.

General Duties and Powers of Guardian under Chapter 54
All guardians are required to do all of the following [54.18 (2)]:

  • Exercise the degree of care, diligence, and good faith when acting on behalf of a ward that an ordinarily prudent person exercises in his or her own affairs. § 54.18 (2) (a).
  • Advocate for the ward's best interests. § 54.18 (2) (b).
  • Exhibit the utmost degree of trustworthiness, loyalty, and fidelity in relation to the ward. § 54.18 (2) (c).
  • Notify the court of any change of address of the guardian or ward. § 54.18 (2) (d).

Chapter 54 includes a new section on rights retained by wards. [54.25 (2) (b)] Another new section limits the authority of a guardian to consent to participation in experimental treatment [54.25 (2) (d) 2. d.]

Involuntary Administration of Psychotropic Drugs
See Wisconsin Circuit Court Forms

Involuntary Admission to a Facility
Q: Before the law changes in 2006, Act 187 governed involuntary admissions to facilities. Do these requirements still exist?

A: Yes. The laws governing involuntary admissions into a facility can now be found in Wisconsin Statutes 50.06 (exit DHS).

Limited Required Reporters
Q: Who is a Limited Required Reporter? Are they mandatory reporters?

A: Abuse, neglect and financial exploitation must be reported by limited required reporters defined as:

  • An employee of any entity that is licensed, certified, or approved by or registered with the department.
  • A health care provider, as defined in s. 155.01 (7).
  • A social worker, professional counselor, or marriage and family therapist certified under Ch. 457.

A limited required reporter must report if the adult at risk has requested the person to make the report, or if the person has reasonable cause to believe that any of the following situations exist:

  1. The elder adult at risk is at imminent risk of serious bodily harm, death, sexual assault, or significant property loss and is unable to make an informed judgment about whether to report the risk.
  2. An elder adult at risk other than the subject of the report is at risk of serious bodily harm, death, sexual assault, or significant property loss inflicted by a suspected perpetrator.

Wisconsin law does not require reporting if the limited required reporter does not think a report would be in the best interest of the adult at risk or if religious/spiritual treatment or communications restrict reporting. For more information, see:

Medicaid Fraud Contacts in Wisconsin
If you have questions about Medicaid divestment or other public funding fraud, you may wish to contact your local fraud specialist.

Memory Care Clinics
List of Wisconsin Dementia Diagnostic Clinic locations and contact information. For more information about Alzheimer's, contact your area Alzheimer's Association Chapter.

Ombudsman Program
Find your Board on Aging and Long-Term Care Regional Ombudsman program. The Board on Aging and Long Term Care provides service to persons age 60 and older who are consumers of Wisconsin long term care programs.  The Ombudsman Program has authority to obtain access to all residents and tenants of Wisconsin nursing homes, Community Based Residential Facilities (CBRF's), Residential Care Apartment Complexes (RCAC"s), and persons served by the Community Options Program and Family Care/Partnership programs.

Photographic Evidence
Q: How does an elder adults/adult-at-risk agency use photographic evidence? What documentation is needed?

A: See SafetyNetworks #1, June 2007 or find more information in this Power Point presentation from the 2007 Adults at Risk Conference.

Protective Placement, Notice of Transfer
Emergency transfers and transfers to a more restrictive setting require a Notice of Transfer of Protective Placement. Send Wisconsin Circuit Courts form GN-4340 to the Wisconsin Department of Health Services, Attn: Office on Aging, PO Box 7851, Madison WI 53707-7851

Public Sector as Elder Adults/Adults-at-Risk Agency
See SafetyNetworks #7, September 2008 for justification for maintaining Adult Protective Services and Elder Adults/Adults-at-Risk agencies and functions in the public sector (county government).
Reporting Triggers/Red Flags for Non-AAR Staff
Q: When should you refer/report to Elder Adults/Adults-at-Risk Agency?

A: For help with referral decision-making, see SafetyNetworks #10, February 2009

Residency
Q: How to make a determination of the county of residency of persons age 18 years and older in need of services under Chapters 46, 51, and 55.

A: See DHS Residency Manual, January 2007

Restraint
Q: What role do elder adults/adults-at-risk staff have in keeping individuals in the community safe from unreasonable confinement and restraint?

A: See SafetyNetworks #8, October 2008

Wards
Q: Is there a limit on the number of wards for an individual or organization?

A: Yes, guardians of the person are limited to 5 wards: No individual may have guardianship for more than 5 adult wards who are unrelated to the individual, except as deemed appropriate by the court - Wis. stats. 54.15 (9). However, the number of wards allowed to a guardian of the estate is not addressed in the statutes. An approved corporation or association is not limited in the number of adult wards for which the corporation or association may accept appointment by a court as guardian.

Witness, Power of Attorney for Health Care
Q: Who can sign as a witness to a Power of Attorney for Health Care? What nursing home staff can serve as a witness?

A: Persons designated as a social worker or chaplain by the facility qualify as a witness. Other employees do not. Section 155.10 (2), Wis. Stats. lays out the requirements for being a witness to a POAHC. A witness cannot be:

(d) An individual who is a health care provider who is serving the principal at the time of execution, an employee, other than a chaplain or a social worker of the health care provider or an employee, other than a chaplain or social worker, of an inpatient health care facility, in which the principal is a patient.