Area Administration: Family Care Notice of Transfer of Protective Placement County Mailboxes

When a member will be moved to a new protective placement under Wis. Stats. §§ 55.15, either emergency or planned, the Managed Care Organization (MCO) must complete the Notice of Transfer of Protective Placement (Notice of Transfer of Protective Placement Form) as the “County Department or agency with which it contracts."

The form must be submitted to the designated county Adult Protective Services (APS) or other identified county representative. For non-emergency transfers of placement, the form must be submitted at least 10 days prior.

If the new placement is to a more restrictive level of care, the MCO must notify the county, as soon as possible, in order to file a modification of the protective placement order.

If the new placement is to a facility 16 beds or greater, and the member does not currently have a protective placement order, the MCO must notify the county of responsibility of the need for a protective placement order and inform the proposed residential provider.

County contacts for sending transfer of protective placement forms from MCOs

County	Region	County contact
Adams	Southern	fcnotice@co.adams.wi.us
Ashland	Northern	adultservices@ashlandcountywi.gov
Barron	Western	dhhs_intake@co.barron.wi.us
Bayfield	Northern	baycoaps@bayfieldcounty.wi.gov
Brown	Northeastern	BC.HS.APS@browncountywi.gov
Buffalo	Western	mco_alert@co.buffalo.wi.us
Burnett	Western	BurnettCoAPS@burnettcountywi.gov
Calumet	Northeastern	adrc@calumetcounty.org
Chippewa	Western	apsreferral@chippewacountywi.gov
Clark	Western	apsgpp@co.clark.wi.us
Columbia	Southern	adrc@columbiacountywi.gov
Crawford	Southern	humanservices@co.crawford.wi.gov
Dane	Southern	HSAPSGuardianship@danecounty.gov
Dodge	Southern	hsadultprotectiveservices@co.dodge.wi.us
Door	Northeastern	APSIntake@co.door.wi.gov
Douglas	Western	Dave.Longsdorf@douglascountywi.gov
Dunn	Western	bhsaccess@dunncountywi.gov Additional email: dbarnhart@dunncountywi.gov
Eau Claire	Western	nancy.weltzin@eauclairecounty.gov
Florence	Northern	fchsd@florencecountywi.gov
Fond du Lac	Northeastern	adrc@fdlco.wi.gov
Forest	Northern	info@adrcofthenorthwoods.org
Grant DSS	Southern	APSReporting@co.grant.wi.gov
Green	Southern	resourcecenter@gchsd.org
Green Lake	Northeastern	nwienkes@greenlakecountywi.gov
Iowa DSS	Southern	adrc@iowacounty.org
Iron	Northern	levrac@ironcountywi.org Additional email: ironhsd@ironcountywi.org
Jackson	Western	ADSAPS@jacksoncountywi.gov
Jefferson	Southeastern	aps@jeffersoncountywi.gov
Juneau	Southern	JCAPS@Juneaucountywi.gov
Kenosha	Southeastern	aps@kenoshacountywi.gov
Kewaunee	Northeastern	KHSKEW@kewauneeco.org Additional email: konkol.corinne@kewauneeco.org
LaCrosse	Western	apsreferrals@lacrossecounty.org
Lafayette	Southern	ADRC@lchsd.org
Langlade DSS	Northern	See NCHC email address
Lincoln DSS	Northern	See NCHC email address
Manitowoc	Northeastern	jennifersturzl@manitowoccountywi.gov
Marathon DSS	Northern	See NCHC email address
Marinette	Northeastern	adrc@marinettecountywi.gov
Marquette	Northeastern	mcdhs@marquettecountywi.gov
Menominee	Northeastern	swilber@co.menominee.wi.us
Milwaukee	Southeastern	APScommunications@milwaukeecountywi.gov
Monroe	Western	MonroeCountyAPS@co.monroe.wi.us
NCHC (Langlade, Lincoln, Marathon)	Northern	FamilyCareNotification@norcen.org
Oconto	Northeastern	ochs@ocontocountywi.gov
Oneida	Northern	adrc@oneidacountywi.gov
Outagamie	Northeastern	HHSCrisisCoverage@outagamie.org
Ozaukee	Southeastern	aps1@ozaukeecounty.gov
Pepin	Western	mco_alert@co.buffalo.wi.us
Pierce	Western	piercdhs@co.pierce.wi.us
Polk	Western	Ashley.arneson@polkcountywi.gov Additional email: Abigail.johnson@polkcountywi.gov
Portage	Northern	hintzg@co.portage.wi.gov Additional email: ponda@co.portage.wi.gov
Price	Northern	hhsd@co.price.wi.us
Racine	Southeastern	aps@racinecounty.gov
Richland	Southern	aps@co.richland.wi.us
Rock	Southern	Katie.Springer@co.rock.wi.us
Rusk	Western	agranica@ruskcountywi.gov
Sauk	Southern	Accessreferrals@saukcountywi.gov
Sawyer	Northern	rebecca.erickson@sawyercounty.gov
Shawano	Northeastern	DHS.Intake@shawanocountywi.gov
Sheboygan	Northeastern	apsreferrals@sheboygancounty.com
St. Croix	Western	APS@sccwi.gov
Taylor	Northern	tchsfrontdesk@co.taylor.wi.us
Trempealeau	Western	sandra.herfel@co.trempealeau.wi.us
Vernon	Southern	lts@vernoncountywi.gov
Vilas	Northern	Vilashsd@vilascountywi.gov
Walworth	Southeastern	walcoadrc@co.walworth.wi.us
Washburn	Western	humanser@co.washburn.wi.us
Washington	Southeastern	aps@washcowisco.gov
Waukesha	Southeastern	APSintake@waukeshacounty.gov
Waupaca	Northeastern	adrc@co.waupaca.wi.us
Waushara	Northeastern	WCCrisis@wausharacountywi.gov
Winnebago	Northeastern	appr@winnebagocountywi.gov
Wood	Northern	humanservices@woodcountywi.gov

County contacts for sending transfer of protective placement forms from MCOs

Glossary