The Bureau of Assisted Living determines the need for licensure of a
community living arrangement based on the following definitions:
Ch. 50.01(1)(b) defines an Adult family home (AFH) as "[a] place
where 3 or 4 adults who are not related to the operator reside and receive
care, treatment or services that are above the level of room and board and
that may include up to 7 hours per week of nursing care per resident."
Ch. 50.01(1g) defines a Community-based residential facility (CBRF) as
"[a] place where 5 or more adults who are not related to the operator
or administrator and who do not require care above intermediate level
nursing care reside and receive care, treatment or services that are above
the level of room and board but that include no more than 3 hours of nursing
care per week per resident."
Ch. 50.01(1d) defines a Residential care apartment complex (RCAC) as
"[a] place where 5 or more adults reside that consists of independent
apartments, each of which has an individual lockable entrance and exit, a
kitchen, including a stove, and individual bathroom, sleeping and living
areas, and that provides, to a person who resides in the place, not more
than 28 hours per week of services that are supportive, personal and nursing
services."
The Bureau of Assisted Living continues to receive inquiries related to
the need for licensure of community living arrangements having unique
physical layouts, program services and staffing patterns.
This memo provides a description of various scenarios that have been
reviewed, and Bureau of Assisted Living's determination regarding licensure.
Each individual scenario was evaluated based on distinct characteristics of
the living arrangement and the statutory definitions above.
In considering the following guidelines for licensure, it is important to
note the following:
If you have questions regarding this information, please contact the
Assisted Living Regional Director for the appropriate Bureau of Assisted
Living region. Contact information can be found at: http://www.dhs.wisconsin.gov/rl_DSL/Contacts/ALSreglmap.htm
|
SCENARIO |
DETERMINATION |
| 1. Side-by-side units, two
people on each side; interior door access between units; shared staff. |
Requires 4-bed AFH licensure |
| 2. Up-down units, two people
in each unit; interior door access between units; shared staff. |
Requires 4-bed AFH licensure |
| 3. Side-by-side units, two
people on each side; no interior door access between units; shared
staff. |
AFH licensure not required |
| 4. Up-down units, two people
in each unit; no interior door access between units; shared staff. |
AFH licensure not required |
| 5. Side-by-side units, two
people on each side; interior door access + between units; no shared
staff.* |
AFH licensure not required |
| 6. Up-down units, two people
in each unit; interior door access + between units; no shared staff |
AFH licensure not required |
| 7. Side-by-side units, two
people on each side; no interior door access between units; no shared
staff.* |
AFH licensure not required |
| 8. Up-down units, two people
in each unit; no interior door access between units; no shared staff.* |
AFH licensure not required |
| 9. Side-by-side units, two
people in each unit; no interior door access; dedicated staff during
day, shared staff at night. |
AFH licensure not required |
| 10. Up-down units, two people
in each unit; no interior door access; dedicated staff during day,
shared staff at night. |
AFH licensure not required |
| 11. Side-by-side units,
separated by a garage, two people in each unit. |
AFH licensure not required
(does not provide interior access) |
| 12. Side-by-side units, four
people in each unit; interior door access; shared staff. |
Requires licensure as an 8-bed
CBRF |
| 13. Side-by-side units, four
people in each unit; no interior door access; no shared staff.* |
Licensure required as two
4-bed AFHs |
| 14. Side-by-side units, four
people in each unit; interior door access +; no shared staff.* |
Licensure required as two
4-bed AFHs |
| 15. Up-down units, four people
in each unit; interior door access; shared staff. |
Requires licensure as an 8-bed
CBRF |
| 16. Up-down units, four
people in each unit; no interior door access; shared staff. |
Not licensable as two 4-bed
AFHs because staff cannot be shared between two 4-bed AFHs;
Not licensable as an 8-bed CBRF because there is no interior door
access |
| 17. Up-down units, four people
in each unit; interior door access +; no shared staff.* |
Requires licensure as two
4-bed AFHs |
| 18. Up-down units, four people
in each unit; no interior door access; no shared staff.* |
Requires licensure as two
4-bed AFHs |
| 19. Side-by-side units
separated by a garage, four people in each unit. |
Not licensable as a CBRF
because it does not provide interior access; Licensable as two 4-bed
AFHs and staff would be required on each side |
| 20. Persons receiving respite
care in a 1-2 bed certified AFH. |
Does not require licensure as
an AFH because there are not 3 or 4 people living there permanently |
| 21. Persons receiving respite
care in a 4-bed AFH or a CBRF. |
The number of residents plus
the number of persons receiving respite care cannot exceed the
capacity of the AFH or CBRF |
| 22. 4-bed AFH attached to an
8-bed CBRF. |
Requirements in DHS
83.57(1)(b) must be met |
| 23. Four independent
apartments providing care and services above the level of room and
board for 5 people. |
Not an RCAC - an RCAC must
consist of 5 independent apartments |
| 24. Individual apartment or
apartments situated within an apartment complex, providing care and
services above the level of room and board for 3 to 4 people; No
shared staff.* |
Each individual apartment is a
3 or 4-bed AFH only if each apartment has 2 exits |
| 25. Individual apartment or
apartments situated within an apartment complex, providing care and
services above the level of room and board for 3 to 4 people per
apartment; shared staff. |
Prohibited |
| 26. Facility providing respite
care services only, regardless of the number of people served. |
If a facility is providing
respite care services only, the length of stay does not exceed 28 days
and the facility is not the person's residence, the facility does not
require state licensure |
| 27. One roof/one license- two
CBRFs in one structure. |
Policies pertaining to
"one roof-one license" were created prior to DHS 83. There
currently exists no statutory or code provisions prohibiting the
licensure of two CBRFs under 'one roof'.
Note: Must meet the requirements of DHS 83.57(1)(b) and may not share
staff between the 2 licensed CBRFs. |
| 28. Triplex or quadruplex
apartments; occupancy of each unit is up to 2; no interior door access
and no common space. |
Triplex and quadruplex
apartments do not meet the threshold definition of a minimum of 5
independent units required for that of an RCAC. Each apartment unit is
considered "a place" for the purpose of determining
licensure definition. The occupancy of each unit in both the triplex
and quadruplex apartments is up to 2 tenants, which is less than the 3
or 4 unrelated adults required to be licensed as an AFH.
Does not meet the definition of a CBRF. |
| 29. Apartment complex
consisting of 5 units; 1 or 2 people per unit; staff resides in the
5th unit. |
As long as the 5th unit is
occupied by staff, this would not meet the definition of an RCAC.
Does not meet the definition of a CBRF as there is no interior access
and no common space. |
| 30. Apartment complex; 1 to 4
people in each apartment; interspersed; shared staff. |
Can't be licensed as an AFH
because of shared staff.
Does not meet CBRF requirement at DHS 83.57(1)(b).
Could be an RCAC if there are 5 or more apartments. |
*No shared staff: The term "no shared staff" means that
programs have essential/separate staff; separate programming, separate
budgets, separate living situations, and that staff do not travel back and
forth to work between units. The program is intended to be two or more
separate living situations. Additional float staff may work between units.
+Interior Door Access: Staff and/or residents do not travel back and
forth between living units. Each unit operates as a separate program.
Side-by- side/Up-down units: The term "side-by-side" or
"up-down" means a dwelling built per Chapters Comm 20-25, Wis.
Admin. Code, One and Two Family Dwellings Standards.
