On Thursday, March 3, WHCA/WiCAL staff participated in a quarterly meeting with the Bureau of Assisted Living (BAL) and Wisconsin’s long-term care provider associations. Attending from BAL were Director Dan Perron and Deputy Director Kathy Lyons. Also on the call was DQA Deputy Director Alfred Johnson, as well as staff from DPH.

Perron announced that the comprehensive BAL State of Assisted Living document will be available in the near future. WHCA/WiCAL will publish this document for members when it is made available. Perron will also present on the State of Assisted Living at WHCA/WiCAL’s Spring Conference.

Perron also announced that BAL is planning once again to move forward with a comprehensive review of DHS Ch. 88, the administrative code regulating Adult Family Homes (AFH) in Wisconsin. BAL had intended to begin this process in early 2020, but the project was put on hold due to COVID-19. WHCA/WiCAL Director of Govt Relations and Regulatory Affairs Jim Stoa requested that providers be included in any discussions of revisions to the Chapter.

Lyons announced that BAL’s E-Licensure initiative continues to progress. E-licensure for CBRF was implemented in the Fall of 2021, and AFH E-licensure is about to go live – perhaps as early as March 15, but by April 1 at the latest. Stoa asked about the timeline for RCAC E-licensure, and Lyons said they’ll start working on it once AFH E-Licensure is live.

BAL was asked if they intend to relax any AL-specific COVID-19 guidelines for assisted living facilities given the current decline in COVID-19 statewide. Perron and DPH staff said that BAL relies on DPH guidance for health care facilities, which in turn is dependent on CDC guidance. So, Perron said BAL guidance will change as CDC guidance for health care settings changes.

Perron also reviewed top-10 citations for AL settings in Wisconsin. Perron prefaced his review with an announcement that BAL’s State of Assisted Living presentation will go into greater detail than what was presented to provider associations today.

Top 10 citations by AL setting:

• CBRF
  1. 83.35(3)(d) – Service Plans Updated Annually or on Changes (81)
  2. 83.20(2)(a)-(d) – Department Approved Training Courses (80)
  3. 83.47(2)(e) – Other Evacuation Drills (69)
  4. 83.25 – Continuing Education (68)
  5. 83.32(3)(h) – Rights of Residents: to Receive Medication (62)
  6. 83.45(3) – Toxic Substances (62)
  7. 83.47(2)(d) – Fire Drills (60)
  8. 83.43(1) – Environment Safe, Clean and Comfortable (56)
  9. 83.17(2)(a) – Employees Screened for Communicable Disease (54)
  10. 84.41(3)(b) – Food Safety (52)
• AFH
  • WHCA/WiCAL was unable to obtain this data during the conversation and has requested the top 10 for AFH from BAL. This article will be updated once that information is available.
    
• RCAC
  1. 89.23(4)(d)1 – Services/Safety Training (6)
  2. 89.34(16) – Tenant Rights/Medication (5)
  3. 89.23(3)(f) – Services/Meals and Snacks (4)
  4. 89.23(4)(b)1 – Service Manager (4)
  5. 89.23(4)(d)2.a – Services/Staff Training (4)
  6. 89.26(4) – Annual Review (4)
  7. 89.28(6) –  Updating Risk Agreement (4)
  8. 89.34(17) – Tenant Rights/Safe Environment (4)
  9. 89.23(2)(a)2.c – Services/Nursing Services (3)
  10. 89.26(1) – Comprehensive Assessment (3)
  11. 89.27(1) – Service Agreement (3)

Perron also reviewed the recent Gov-D communication on the waiver process for using COVID-19 positive staff in AFH and CBRF settings. Perron said that since the Gov-D was issued, they have worked to consider waiver requests quickly. He said the one waiver request they will continue to reject is when a facility submits a request for future use, if they are not currently in need of using COVID-positive staff but want to have the waiver in hand in case they are in the need in the future. Perron said the waiver is meant to address current needs.

If you have any questions about this information, please contact Jim Stoa or Jena Jackson.