HomeMy WebLinkAboutHuman Services Board - Agenda - 5/23/2024K:Agendas & Minutes/DHS Board/Agendas 2024
FROM:
Elizabeth Skulan, Director
DATE:
May 14, 2024
RE: MEETING NOTICE
The Bayfield County Department of Human Services Board will hold the regular monthly meeting on
Thursday, May 23, 2024, at 4:00 p.m. An in person and remote meeting will originate from the
Emergency Operations Center (EOC) of the Bayfield County Courthouse Annex, Washburn, Wisconsin.
Remote participation is available via Microsoft Teams or by phone using the information below.
________________________________________________________________________________
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Notice is hereby given, in the event the standing committee does not have a quorum,
the County Board Chair or Vice Chair may act as an ex officio member (County
ordinance, Chapter 3, section 2-3-1(c).
Department of Human Services 117 East Fifth Street P.O. Box 100 Washburn, WI 54891 - 0100 Telephone (715) 373 - (715 Fax 6144 - )373 - 6130 Email: baycodhs@bayfieldcounty.wi.gov
K:Agendas & Minutes/DHS Board/Agendas 2024
Any person wishing to attend who, because of a disability, requires special accommodation, should
contact the Department of Human Services at 715-373-6144, at least 24 hours before the scheduled
meeting time, so appropriate arrangements can be made.
The agenda: Approval of the April 22, 2024, Meeting Minutes; Consideration for a New Position in
the 2025 Budget; Appointment to the Family & Behavioral Health Services Advisory Committee;
Review and Approval of Updated Policies; 2025 Budget Planning; Program Presentation; Department
Section Reports; Monthly Financial and Training Reports; Informational Items; and other business
that may come before the Board.
c: County Board Chair
County Board of Supervisors
Post (bulletin boards and website)
e-mailed:
DES Ashland Health Department
DCS, Rhinelander New Day Shelter
Greater Wisconsin Agency on Aging Resources, Inc. Daily Press
Department of Human Services
117 East Fifth Street
P.O. Box 100
Washburn, WI 54891-0100
Telephone (715) 373-6144 Fax (715-)373-6130
Email: baycodhs@bayfieldcounty.wi.gov
BAYFIELD COUNTY DEPARTMENT OF HUMAN SERVICES BOARD MEETING
James Crandall Marty Milanowski Mary Dougherty
Susan Rosa Madelaine Rekemeyer Vacant-Citizen Member
Lona Schmidt Stephanie Defoe-Haskins Patrick Irvine
RE: May 23, 2024, Department of Human Services Board Meeting
Notice is hereby given, in the event the standing committee does not have a quorum, the
County Board Chair or Vice Chair may act as an ex officio member (County ordinance,
Chapter 3, section 2-3-1(c).
Dear Committee Members:
Please be advised that the monthly meeting of the Bayfield County Department of Human
Services Board will be held on Thursday, May 23, 2024, at 4:00 p.m. Remote connectivity
is available. The meeting will originate from the Emergency Operations Center of the
Bayfield County Courthouse Annex, Washburn, Wisconsin. Remote participation is
available via Microsoft Teams or by phone using the information listed below.
Microsoft Teams Need help?
Join the meeting now
Meeting ID: 270 380 626 990
Passcode: ggBVrV
Dial in by phone
+1 715-318-2087,,505271556# United States, Eau Claire
Find a local number
Phone conference ID: 505 271 556#
For organizers: Meeting options | Reset dial-in PIN
________________________________________________________________________________
Join on your computer, mobile app or room device
To join on your computer or mobile app, please ‘Control, Click’ the link below or left click and
choose ‘Open Hyperlink” to connect.
Any person wishing to attend who, because of a disability, requires special accommodations, should contact the
Department of Human Services at 715 -373-6144 at least 24 hours before the scheduled meeting time, so
appropriate arrangement can be made.
The agenda for this meeting is as follows:
AGENDA
1. Call to Order
2. Welcome and Introductions
3. Opportunity for Public Comment (Limit 3 minutes please.)
4. Discussion and Possible Action – Review and approval of the April 22, 2024, meeting minutes
5. Program Presentation, Aging and Disability Services
6. Monthly Section Reports
A. Behavioral Health and Community Programs – Tom Croteau
B. Economic Support Services – Jeanine Spuhler
C. Family Services – Mary Anich
D. Support Services – Stephanie Eder
E. Aging & Disability Services – Carrie Linder
7. Monthly Reports
A. Financial
B. Training
8. Discussion and Possible Action – Recommendation to Support the Request for a new CCS
Service Facilitator position in the 2025 DHS Budget
9. Discussion and Possible Action – Review and consideration for approval of reappointment of
Beverly Patterson to Family Services and Behavioral Health Advisory Committee retroactive to
July 2023
10. Discussion and Possible Action – Review and consideration for approval, updated Emergency
Detention Policy
11. Discussion and Possible Action – Review and consideration for approval, updated Consumer
Repayment Policy (formerly Collections Repayment Policy)
12. 2025 Budget Planning – Review documents
13. Other (Informational Items)
A. Economic Support Specialist and Case Manager’s Week Proclamation
B. Tribal High Cost Pool Award
C. ARPA HCBS Social Isolation and Loneliness Grant Award
D. May 7, 2024, email from Steve Budnik, Northern Income Maintenance Consortium
regarding Economic Support Specialist Jessica Soulier
E.
14. Future Meetings
A. June 27, 2024, in the County Board Room, will include the Public Hearing on the 2024
DHS Buade and Opportunity for Comments Regarding Bayfield County’s Policies and
Procedures for Equal Opportunity in Employment, Service Delivery, and Language
Access
B. July/August Meeting August 15, 2024 (Please note special meeting date)
C. September 26, 2024
15. Discussion and Possible Action - Motion or Chair’s Statement to Adjourn
Thank you and have a safe trip home!
Sincerely,
Elizabeth A. Skulan
Elizabeth A. Skulan, Director
c: Mr. Mark Abeles Allison, County Administrator
Bayfield County Board of Supervisors
Bayfield County Department of Human Services Board
Bayfield County Department of Human Services Managers
Lynn Divine, Bayfield County Clerk
Email to: Other Interested Parties Requesting
K/agendas & minutes/DHS Board/agendas
K: agendas & minutes/DHS Board/agendas/agenda narrative
DEPARTMENT OF HUMAN SERVICES (DHS) BOARD MEETING
May 23, 2024
4:00 PM
AGENDA NARRATIVE
8. Recommendation for New Position – Due to projected increases in the Comprehensive
Community Services enrollment in 2025, the department requests support for including
another fully funded position in the 2025 budget.
9. Reappointment of Beverly Patterson – Beverly Patterson has indicated her interest in
continuing to serve as a member of the Family Services/Behavioral Health Advisory
Committee. The committee has recommended her appointment retroactive to July 2023. An
updated application is included in the board packet.
10. Review and Consideration for Approval Emergency Detention Policy – Since the death
of Northland Counseling Director Carol Lund last year, the Department has been updating
policies and procedures with the new owners of Northland Counseling. A draft of the
updated policy is included in the packet.
11. Review and Consideration for Approval Consumer Repayment Policy – A recent review
of the policy indicated the document should be modified. A draft of the updated policy is
included with modifications highlighted.
12. 2025 Budget Planning – Three of the documents that will be issued in the planning process
for next year’s budget are included in the packet for the Board’s review. A Public Hearing
will be held during the June meeting.
Department of Human Services
117 East Fifth Street
P.O. Box 100
Washburn, WI 54891-0100
Telephone (715) 373-6144 Fax (715-)373-6130
Email: baycodhs@bayfieldcounty.wi.gov
BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING
EOC & Virtual
April 22, 2024
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Board Members Present: James Crandall, Sue Rosa (virtual), Lona Schmidt, Marty Milanowski, Mary
Dougherty, Patrick Irvine (virtual)
Not Present: Madeline Rekemeyer, Stephanie Defoe-Haskins
Others Present: Elizabeth Skulan, Stephanie Eder, Tom Croteau, Carrie Linder, Jeanine
Spuhler, Val Levno, Teri Ovaska, Julie Winter
Call to Order and Introductions
Crandall called the meeting to order at 4:03 p.m. Introductions were made.
Opportunity for Public Comment (Limit 3 minutes please)
No Public Comment
Discussion and Possible Action – Review and approval of the March 28, 2024, meeting minutes.
Motion by Milanowski, seconded by Schmidt to approve the March 28, 2024, meeting minutes.
Motion passed.
Discussion and Possible Action – Nominations and Election of DHS Chair. Crandall opened the floor for
nominations for DHS Chair (three times, no seconds required). Sue Rosa nominated Jim Crandall. Mary
Dougherty also nominated Jim Crandall.
Motion by Dougherty, seconded by Schmidt to approve Crandall for DHS Chair. Motion passed.
Discussion and Possible Action – Nominations and Election of DHS Vice Chair – Crandall opened the floor
for nominations for DHS Vice Chair (three times, no seconds required). Milanowski nominated
Dougherty. Dougherty declined and nominated Milanowski. Schmidt also nominated Milanowski.
Motion by Schmidt, seconded by Dougherty to approve Milanowski for DHS Vice Chair. Motion
passed.
Skulan answered board questions on vacancies. Rosa has taken Jeremy Oswald’s place as a county board
member representative. Rosa’s vacancy as a citizen member is now open. Rosa is actively recruiting for a
citizen member from Cable to fill the vacancy.
Program Presentation – Behavioral Health and Community Programs – Val Levno, CCS Administrator,
2023 Bayfield County Community Services (BCCS) Satisfaction Survey Results
Val Levno, CCS Administrator, introduced her successor, Teri Ovaska, to the DHS board.
Levno noted that a mental health statistical improvement program (MHSIP) survey was designed to
measure the satisfaction of participants of public mental health and substance abuse service, such as
CCS. Counties and tribes across the state use these surveys to gauge and improve satisfaction among
adult, youth and family participants who receive mental health and/or substance abuse services.
DRAFT:
Subject to change at
the next BCDHS Board
meeting
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Bayfield County surveys are distributed annually by a service facilitator to participants who were in the
program more than six months in the prior year. Adult surveys are completed by the participant. Youth
surveys are filled out by the caregiver of the child. Results are sealed and compiled anonymously. A $5.00
gift card is provided as an incentive to complete and return the survey.
Crandall asked how many surveys were returned. Levno reported that 23 of the 29, or 79% of adult
surveys were returned and two out of the three, 67% of youth responded. No family surveys were
distributed since there is only one family in the CCS program and they would lose anonymity.
Levno reviewed the results of the 2023 Bayfield County CCS satisfaction surveys provided in the board
meeting packet. Levno noted Bayfield County met or exceeded the minimum expectations in all
satisfaction categories. Levno reported the Bayfield County CCS team has a lot of heart, is extremely
skillful, and the satisfaction survey scores reflect this.
Information from the survey is used to set goals for the next year. The 2024 goals include improving the
functions and use of the new electronic health record system and increasing the CCS participants’
perception of functioning.
Rosa asked for examples of survey questions. Levno provided a few examples and reported the survey
can be accessed on the WI Department of Health Services website for more information about the
survey and how it is administered.
Levno, who is retiring on May 3, 2024, noted that it has been a pleasure working with Bayfield County
over the years. Levno also thanked the board members for support. The DHS Board commended Levno
for a job well done.
Monthly Section Reports
Behavioral Health and Community Programs – Tom Croteau
• Teri Ovaska was hired as Val Levno successor as Comprehensive Community Services (CCS)
administrator.
• Croteau noted that an additional CCS position was created to help with quality assurance, Julie
Winter was hired for this position. Winter previously worked for Bayfield County in the CCS
program. Welcome Julie.
• Mental health professional position remains posted after six months. Hoping for the right
candidate to come along.
• Partnered with Department of Vocational Rehab (DVR) to hire CCS scanning intern, Richard
Carbon. Carbon joined the team April 9th and will assist with a backlog of historical documents
that need to be scanned and uploaded to the new electronic health record.
• Croteau states that CCS and Community Support Programs (CSP) numbers remain steady. A few
participants are transitioning from CCS to CSP, now that Northland Counseling has additional
capacity. CSP offers coordinated professional care and treatment to adults who live with severe
mental illness. CCS service facilitators work hard to assess complex situations, stabilize and move
participants to the most appropriate program.
BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING
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• Jamie Allen and Hailey BeBeau, behavioral health case managers, workloads continue to grow.
Allen and BeBeau also work hard at helping shift participants to the right program. Shifting
participants to tribal, CST, CCS, CSP and Family Care not only helps the participant get the proper
help for their situation but helps the case managers reasonably manage their caseloads.
• Placements for emergency detentions continue to grow. Budget is at 82% in the first three
months of 2024.
• Croteau will be attending treatment court training in Wisconsin Dells with Bayfield County
treatment court staff.
• Dougherty started discussion about Pigeon Lake property as a treatment center location for
youth. Participants discussed disrepair and staffing issues that may make this a heavy feat.
Economic Support Services – Jeanine Spuhler
• Spuhler was happy to announce that Colleen Detjens was hired for the vacant Economic Support
(ES) position. Detjens first day of work will be Monday, April 29, 2024.
• Spuhler stated that with the moratorium for utility cut-off ended April 15, 2024, and calls
regarding disconnections are increasing. Staff are working with customers to help avoid
disconnection.
• The state will provide a summer bulk fuel program again this year.
• Spuhler stated as of July 1, 2024 “unwinding” the public health emergency rules will be complete
and the consortium will be operating under post-pandemic policies.
• Due to additional funding provided by the state, the consortium allowed any interested staff the
opportunity to work up to an additional ten hours a week to assist in the unwinding. The
additional funding will lapse at the end of June.
• Crandall asked what the term “unwinding” refers to. Per Spuhler, program rule changes (e.g.,
leniencies in some requirements) available to individuals or households during the pandemic are
reverting to regular policy. Spuhler noted that things that had been waived, such as regular
renewals, changes in income, co-payments, and timely reporting of some additional information
would need to be updated. Some of those changes once reported, will make some individuals
and/or households no longer eligible for benefits. Staff are both responding to many questions
and providing alternative options or resources when benefits are lost.
Family Services – Elizabeth Skulan (for Mary Anich)
• Anich remotely attended the quarterly regional child welfare supervisors meeting where WiLearn
was discussed. WiLearn is the child welfare training in Wisconsin for those entering jobs within
the child protective services/child welfare area. It is a comprehensive protocol where the staff
member attends all training within their cohort. A second staff member is also taking the training.
There has been good feedback that it is an especially helpful process for those entering the field
without social work or human services related degrees.
• Anich attended the monthly Childcare Program Committee Meeting on April 17th. Anich is the
childcare certifier for Bayfield County.
• Anich attended the statewide HIPPA training.
• Anich continues to gain knowledge about the Coordinated Services Team (CST) process. DHS has
requested contact info for several good examples of this program around the state that works
with youth with complex behavioral needs who are involved with at least two systems such as
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child protection, youth justice, special education, mental health, etc. CST is new (again) to
Bayfield County in 2024. Most counties and tribal governments currently have CST programs at
some level of success.
• Anich attended the swearing in of the new Bayfield County Board of Supervisors.
• Family Services has been handling drug testing for the Economic Support unit. Staff covering
Family Services access complete the testing. Currently, there are one to two tests a week and the
numbers are increasing.
• Anich accepted the resignation of Val Gurske-Westlund, effective April 26th. Gurske-Westlund is a
Family Specialist that works with parents and children with several challenges across child
protective services, youth justice and behavioral health. Anich wishes Gurske-Westlund the best
of luck in her future pursuits.
• Anich is currently on vacation, as it is important to take time off and recharge from challenging
work.
Support Services – Stephanie Eder
• Eder and Skulan are working on a new position in Support Services. Several factors including
program and census increases have led to additional work. Additional program staff have been
hired to compensate for a heavier workload, but support staff have not. Position would be 80%
funded with CCS and CLTS funding and 20% county levy, if approved.
• Everything else is going well.
Aging & Disability Services – Carrie Linder
• Linder has returned from vacation.
• Linder and staff have been busy getting information for three year aging plan. Survey was created
and distributed. Hoping for a lot of feedback to help set transportation goals for the next three
years.
• Linder has additional ARPA funds that need to be expended by September. Linder is working with
an engaged group in Port Wing for an additional exercise class option for the elderly. The UW-
Extension StrongBodies program was researched as an option. Linder approached Extension with
the idea of having volunteers to help run a class. Two people are currently training to become
leaders. Linder is working with them to develop a budget and fine tune equipment. Class will be
held in the Port Wing town hall. Milanowski asked how often the classes will be held. Linder
noted that they would take place twice a week for eight weeks.
• Linder worked with Health Department last year on a vaccination grant. Linder found out the
grant was funded but is now short on five months of planning. Linder notes that they are
retooling and reorganizing the grant to bring vaccinations to the elderly into communities using
meal outreach sites.
• Linder also applied for a social isolation grant with the Cable community repair café piolet project
in mind. Linder will have more information April 30th on whether the project was selected for
funding. Linder is hoping State will take into consideration that although not as populated,
Bayfield County is one of the five oldest counties in the state.
• Linder noted that the Cable meal site has been very well received. Crandall noted that he had
attended Cable and Barnes and noted the difference in attendance. Linder stated that even
BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING
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though participants in Barns are far less than Cable, Barnes has grown significantly from three
participants to fourteen.
• Rosa commented that the public awareness steering committee’s next project is ‘make music’
day. Make music day is an international event that originated in France forty-one years ago. Event
is free and open to public and takes place on summer solstice, June 21st.
Monthly Reports
Monthly Financial and Training reports were reviewed and retained.
Discussion and Possible Action – Recommendation to Support the Request for a new Clerk III position in
the 2025 DHS Budget
Skulan requested the DHS Board consider support for funding of a new Support Staff that would be 80%
funded by CCS and CLTS programs. Approximately 20% of the position would include general clerical duties
covered by county funding.
Crandall questioned if the CCS and CLTS funding will be available in the future. Skulan noted that yes,
historically both programs have remained funded and believes they will continue to be funded in the
future.
Motion by Milanowski, seconded by Dougherty, to support request of a Clerk III position to the
County Board. Motion passed.
Other (Informational Items)
Future Meetings
• May 23, 2024
• June 27, 2024, in the County Board Room, will include the Public Hearing on the 2024 Buade
Opportunity for Comments Regarding Bayfield County’s Policies and Procedures for Equal Opportunity
in Employment, Service Delivery and Language Access.
• July/August meeting August 15, 2024 (please note special meeting day). Review of the budget.
Crandall adjourned the meeting at 5:09 p.m.
Submitted by Sarah Traaholt, Clerk III
(715) 373-6144 Phone/TDD • (715) 373-6130 FAX • www.bayfieldcounty.org • baycodhs@bayfieldcounty.org
Department of Human Services
117 East Fifth Street
P.O. Box 100
Washburn, WI 54891-0100
EMERGENCY DETENTION POLICY
Purpose: Wisconsin State law requires that a county human services department may not approve the
detention of a person unless a physician who has completed a residency in psychiatry, a licensed
psychologist, or a mental health professional as determined by the Department has performed a crisis
assessment on the individual and agrees for the need for detention. The crisis assessment may be
conducted in person, by telephone, via telemedicine or videoconferencing. This document outlines the
process for meeting this requirement.
Procedure: Human Services staff recognizes the combined experience and expertise of local law
enforcement and mental health professionals in determining if an individual should be hospitalized as an
emergency detention. Northland Counseling has been chosen as the Department’s designee to meet the
statutory requirements by assigning a mental health professional to conduct the assessment to determine
if an emergency detention is needed. Please see accompanying Memorandum of Understanding (MOU).
Law enforcement will contact Northland Counseling to conduct the assessment. Prior authorization for
payment will be made by DHS staff, either immediately following the assessment or, if the emergency
detention occurs outside of regular work hours, during the next business day.
Person(s)
Responsible
Action
Law Enforcement
Responds to a call regarding a mental health and/or substance abuse issue.
Determines that the individual meets the statutory requirements of 51.15(1)
for an emergency detention.
Calls Northland Counseling to conduct an assessment to determine if an
emergency detention is needed and transports the individual to Northland’s
Crisis Facility in Ashland if directed or to the hospital’s Emergency
Department for medical attention and evaluation.
Uses the following contact information for Northland Counseling:
• During regular workday at pager number at 715-746-1515. If there is
no response, use alternate number 715-682-2141.
• Outside regular business hours, uses monthly schedule provided by
Northland Counseling to determine number to call. If there is no
response, use alternate number 218-341-6871.
Retains the individual in protective custody and provides transportation if it is
determined the individual must be transported to a provider for care.
Person(s)
Responsible
Action
Law Enforcement
(continued)
Completes form ME-901 (Statement of Emergency Detention) and submits to
DHS Behavioral Health staff as soon as possible and not later than the
morning of the next business day.
Once detained, the individual may be found suitable for a settlement
agreement and released with conditions. If a settlement agreement is not
appropriate, a preliminary hearing is required within 72 hours exclusive of
Saturdays, Sundays, and legal holidays.
Prepares to testify at the hearing if needed.
Northland Counseling
Consults with Law Enforcement and conducts an assessment to determine if
an emergency detention is needed.
Conducts the assessment by phone, video, or in-person.
Helps Law Enforcement determine if the individual’s needs can be met at
their facility or if the patient’s needs are better met at local medical center in
Ashland.
If patient is transported to Northland Counseling:
• Admits the individual, if appropriate, and assumes custody of the
individual.
• If the individual is stabilized; is not appropriate to admit; and/or
agrees to a safety plan; the individual may be allowed to leave the
facility either alone or with informal support, such as a friend,
neighbor, or family member.
• If the patient is determined not appropriate to admit, the Mental
Health Professional recommends hospitalization and advises Law
Enforcement that the individual be transported to Memorial Medical
Center at 1615 Maple Lane, Ashland.
o If Bayfield County Law Enforcement personnel are still present,
they will provide the transport.
o If Bayfield County Law Enforcement personnel are no longer
present, Northland Counseling staff will contact the City of
Ashland Police Department to transport the individual to
Memorial Medical Center.
Local Medical Center Staff
Attends to any medical needs and medically clears individual.
If space is available in the Behavioral Health Unit, admits patient, and
assumes custody of the individual.
Person(s)
Responsible
Action
Provider of Services
(Northland Counseling or
Memorial Medical Center)
Notifies Bayfield County Behavioral Health and Community Programs staff of
the emergency detention as soon as possible and not later than the next
business day after the individual was admitted.
Completes form F-21189 (Rights of Detention) with individual and submits
completed form to DHS Behavioral Health staff as soon as possible and not
later than the morning of the next business day.
Contacts the individual’s third-party insurance or Medical Assistance HMO to
prior authorize services and ensure payment from those sources.
If the individual has no insurance, works with the individual to determine
eligibility for medical assistance and helps them apply if applicable.
As the payer of last resort, Bayfield County will only provide payment if the
individual is income eligible and has no other resources for payment of
service.
Bayfield County does not provide co-pays, co-insurance, or deductibles for
individuals with insurance. The services provided will be subject to the local
collections policy.
Submits invoice(s) to Bayfield County Department of Human Services, if
appropriate.
Bayfield County Behavioral
Health Staff
Obtains and completes appropriate forms/documentation and sends to
Corporate Counsel for processing and filing with the court.
Processes invoices for payment of provider bills.
Consumer Repayment Policy
Purpose: To provide a standard, legal, and equitable policy that allows for the collection of outstanding debt owed
to the department and to provide for a standard assessment of consumers’ ability to repay Bayfield County for
services that have been provided to them.
Policy: It is the philosophy of the Bayfield County Department of Human Services that services provided are more
meaningful to consumers if they have a vested interest in the provision of those services. In keeping with this
philosophy, all individuals who request or require financial assistance to facilitate the payment of services will be
assessed both on their eligibility for funding through Bayfield County and for their ability to pay. A standard process
will be used and anyone receiving services may be required to enter into a repayment agreement and be billed for
the full cost of their care. This information will then be used to facilitate the development of a payment plan in which
consumers will be charged in compliance with State Statute, administrative code, and program regulations. It will
allow for good stewardship of scarce public resources, and it will accommodate the needs of the consumer.
Individuals may be subject to the repayment of:
1.) Voluntary services provided.
2.) Services the Department is not mandated to provide.
3.) The cost of secure detention related to dependent youth.
4.) Costs levied as included in court orders.
If an individual is unable to make repayment in full, they can be referred to Economic Support to establish a
repayment plan. They will routinely be referred if it is likely that they or their family may be eligible for Medical
Assistance.
Financial assistance will not be provided for the payment of deductibles, co-payments, or amounts that a provider
bills a consumer over and above the rate negotiated on the county contract. Collection of any portion of service
fees that are not paid by a consumer’s medical insurance company, Medical Assistance, Medicare, or under the
county contract, that result in deductibles or co-payments is the sole responsibility of the provider. DHS does not
pay amounts subject to the limits of third-party payers, for services to individuals who have access to medical
insurance, or for expenses related to physical medical care (as opposed to mental health or substance use disorder
services).
The cost for generic brand psychotropic medications will be covered provided the consumer applies for a patient
assistance program within seven days. Coverage will be extended for a period of 30 days while the consumer
completes the necessary paperwork and awaits confirmation that he/she is covered. In very limited instances, an
extension of an additional 30 days of medication may be approved, but only if copies of documentation supporting
that a patient assistance program was applied for in a timely fashion are submitted. The cost of non-psychotropic
medication may also be considered for approval, but only in cases where the non-psychotropic medication is
needed to ensure mental health stabilization.
The cost of medications will be subject to the collections policy if:
1.) A patient assistance program is not applied for as required.
2.) It is determined that medications were purchased by the Department and the consumer was not
compliant in taking their medication.
Department of Human Services
117 East Fifth Street
P.O. Box 100
Washburn, WI 54891-0100
Telephone (715) 373-6144 Fax (715-)373-6130
Email: baycodhs@bayfieldcounty.org
K:\Policy & Procedures\Policies\Consumer Repayment Policy
Approved by DHS Board on ______________
3.) If the parent of a dependent child who is placed out of home refuses to provide the medication the child
needs in a timely manner and the Department must pay to provide it.
After meeting with Economic support, a monthly payment will be assessed using the Uniform Fee Schedule
provided by the State of Wisconsin and using a minimum monthly payment rate of $25.00 per month or 3% of gross
income, whichever is less. The agency may consider and agree to an extended payment plan or a temporary
waiver of the minimum payment with any responsible party who can provide proof that the monthly payment
established would place a burden on the responsible party’s family or jeopardize a treatment plan. An extended
plan or temporary waiver can be made at the sole discretion of the Director and would simply mean that the
responsible party will pay the amount due over a longer period of time. The total amount expected to be paid would
remain the same.
If the consumer is a minor, there is a written informed consent form that must be signed. The party who signs the
consent is financially responsible for the consumer and must complete the financial assistance application. Should
the consumer be married, the spouse will be billed if the consumer is personally unable to pay for the services
rendered. The guardian of the estate of a person adjudged incompetent under Chapter 880 will be billed or a
representative payee who is designated for Social Security or SSI benefits may be billed. All payments will be
applied to the oldest liabilities first.
The monthly payment rate should be reviewed annually or when the individual’s financial circumstances change. If
the individual is making regular payments as defined in the initial payment plan, the annual review can be waived. A
re-determination shall be made at any time the Department identifies a significant change has occurred in available
income. Consumers are required to report significant changes to the Department. A new rate may be applied
retroactively or prospectively.
An account is considered delinquent when a determination has been made that an ability to pay exists, but no
payment has been made over a period of 90 days. Individuals/families who can pay but who do not make the
minimum monthly payment and allow their account to fall into delinquent status will have the debt certified with the
Wisconsin Department of Revenue (DOR) and tax intercepts may will be used to resolve overdue debt.
Those individuals who allow their account to enter delinquent status, are found to have provided incorrect financial
information, refuse to provide financial information, or do not report changes in financial status may be denied
further financial assistance and will be responsible for the full cost of their care.
The Director of Bayfield County Department of Human Services may temporarily waive or reduce the repayment
requirement based on individual circumstances, and/or may enter into an agreement where a discounted lump-sum
payment may be considered as payment in full of outstanding accounts. Decisions made by the Director are final.
There are no appeal rights.
It is our intention to provide fair and equitable treatment to consumers who receive services. Billing and collection
activity will be done with consideration to the rights and dignity of and with respect to the consumer.
Persons(s)
Responsible
Action
Individual
Seeking
Services
Comes into the system on a voluntary or involuntary basis and cannot pay a provider
directly at the time of service for the cost of their care
Must be a resident of Bayfield County or qualify for services that Bayfield County is
mandated to provide to non-residents.
Is responsible for assessments required under legal proceedings except for those defined
as the county’s responsibility under Chapters 48, 938, 51, and/or 55.
Completes appropriate releases of information, repayment agreement, and the DMT 130
State Form, Financial Assistance Application.
K:\Policy & Procedures\Policies\Consumer Repayment Policy
Approved by DHS Board on ______________
Provider
Makes an initial assessment, recommends services, provides individual seeking services
with necessary paperwork to complete.
Informs individual seeking services:
• They may be financially responsible for payment for services provided.
• The Department may pay for some or all the services.
• DHS will pay the entire bill when due and bill the client, if applicable
Reviews forms for completion and accuracy.
Submits forms to DHS.
Contacts DHS to request authorization for services.
Submits bills directly to DHS.
Collects any no show fees, deductibles, co-payments, third party collections or amounts
billed to consumer over and above the rate negotiation on the county contracts, if
applicable, directly from the individual.
DHS Staff
Reviews assessment and any other paperwork submitted by the provider and makes
recommendations for service.
When applicable, inform the individual getting the services what they will be financially
responsible for and inform them that they can apply for financial assistance through DHS
to pay the bill initially.
Individual who
Received
Services
Reimburses DHS in full or contacts DHS Support Staff reception to schedule an
appointment with the ES Manager to establish a repayment agreement.
DHS Support
Staff
Reviews the ES Manager calendar, schedules the appointment, and emails the ES
Manager to inform them of the appointment.
DHS Economic
Support
Manager
Meets with the consumer to verify financial eligibility for funding.
Verifies financial information submitted.
Establishes repayment agreement and monthly payment amount and completes the
Collections-Repayment Checklist.
Provides the checklist to the DHS Support Staff billing person to begin monthly billings.
DHS Support
Staff
Initiates regular monthly billing to consumer.
Monitors accounts to ensure timely payment.
Informs other DHS staff if payments are not being made on a timely basis and it affects
requests for additional service.
K:\Policy & Procedures\Policies\Consumer Repayment Policy
Approved by DHS Board on ______________
DHS Support
Staff
Processes consumer-reported changes and determines if the established monthly
payment amount should change.
Refers consumer annually to ES to review financial data and determine if the established
monthly payment amount should change, if applicable.
Refers account to an outside collection agency for resolution and registers account for a
tax intercept.
DHS Staff
May deny additional requests for service if repayment agreement is not being adhered to.
Individual who
Received
Services
May make an appointment with the DHS Director to request a temporary waiver or
reduction of payments.
Must bring personal financial information for the DHS Director’s review to justify the
request.
DHS Director
Invites a Section Manager to the meeting scheduled with the individual.
Together, they consider:
• The individual’s household income and expenses.
• Whether continued payment would result in financial hardship to an individual or
their family.
• If failing to reduce or postpone payment is likely to have an adverse effect on
treatment.
With input from the Section Manager, approves or denies:
• Requests for temporary waiver or reduction of payments.
• Requests to reduce payments due to unusual circumstances.
• Requests for discounted payments.
• Requests to accept a lump sum payment.
• Requests to release the debt in its entirety.
May negotiate a different outcome (e.g. temporary waiver rather than releasing the debt).
Documents decision and provides a copy to the Section Manger who participated in the
process, to DHS staff working directly with the individual, and DHS Support Staff.
The DHS Director’s decision is final. There is no appeal process.
(715) 373-6144 Phone/TDD • (715) 373-6130 FAX • www.bayfieldcounty.org • baycodhs@bayfieldcounty.org
Department of Human Services
117 East Fifth Street
P.O. Box 100
Washburn, WI 54891-0100
BAYFIELD COUNTY
DEPARTMENT OF HUMAN SERVICES
DHS 2025 BUDGET
REQUEST FOR PUBLIC INPUT
AND COMMENTS REGARDING THE DEPARTMENT’S
2025 BUDGET AND BAYFIELD COUNTY’S POLICIES
AND PROCEDURES FOR EQUAL OPPORTUNITY IN EMPLOYMENT,
SERVICE DELIVERY, AND LANGUAGE ACCESS
THURSDAY, JUNE 27, 2024, AT 4:00 P.M
COUNTY BOARD ROOM, WASHBURN
The Bayfield County Department of Human Services (DHS) will soon be preparing
its budget request for the year 2025. DHS is seeking input from consumers of
services and/or their family members as well as the public. DHS would like
information related to an individual’s experience with services; their opinion
regarding the services that Bayfield County provides; and input regarding the
future provision of services. Comments regarding Bayfield County’s policies and
procedures for equal opportunity in employment, service delivery, and language
access are also welcome during the Public Hearing.
Individuals are welcome to provide information to be presented to the Human
Services Board at its 2025 DHS Budget Public Hearing. Individuals are invited to
provide testimony at the Public Hearing in person or remotely. Written comments
will also be accepted prior to the meeting and may sent to the Department via the
U.S. Postal Services at P.O. Box 100, Washburn, WI 54891; faxed to (715) 373-
6130; e-mailed to BaycoDHS@bayfieldcounty.wi.gov; or left in the mail drop box at
the Bayfield County Courthouse (located at the East entrance on Sixth Street).
Comments can also be made by telephoning DHS. (715) 373-6144.
Remote access to the Public Hearing will be provided via Microsoft Teams via
video or by telephone (715)318-2087. The link and meeting ID information can be
found on the DHS website or it may be obtained by contacting Stephanie Eder for
at stephanie.eder@bayfieldcounty.wi.gov or call (715)373-6144, extension 83341
no less than 24 hours before the public hearing.
Thank you.
(715) 373-6144 Phone/TDD • (715) 373-6130 FAX • www.bayfieldcounty.org • baycodhs@bayfieldcounty.org
Department of Human Services
117 East Fifth Street
P.O. Box 100
Washburn, WI 54891-0100
TO: Providers of Services to Bayfield County Consumers
FROM: Elizabeth Skulan, Director
DATE: May 24, 2024
RE: REQUEST FOR PROVIDER INPUT - BUDGET 2025 and Opportunity for Comments
Regarding Bayfield County’s Policies and Procedures for Equal Opportunity in
Employment, Service Delivery and Language Access
Please take this opportunity to provide Bayfield County Department of Human Services (DHS) with
suggestions and recommendations that can be used to develop the Department’s 2025 budget. It is also
an opportunity to provide comments on Bayfield County’s policies and procedures related to equal
opportunity in employment, service delivery, and language access.
Attached is a memo with questions designed to stimulate ideas about how DHS may improve service
delivery in the next year. Please feel free to use it and include additional pages if needed. This format is
not a requirement, all comments and input via letter, e-mail, etc. are also welcome.
All input received prior to the meeting will be included in the annual Public Hearing, scheduled for June
27, 2024, the Bayfield County Board Room at 4:00 p.m.
Responses should be submitted before the meeting on June 27, 2024. Copies can be faxed to (715)373-
6130, e-mailed to Elizabeth.skulan@bayfieldcounty.wi.gov, or mailed to Bayfield County DHS. Phone
calls can be made directly to Elizabeth Skulan 715-373-6144, extension 83340.
Thank you for taking the time to provide input and for your continued commitment to serve the
residents of Bayfield County.
Provider Input – Budget 2025 Session
Provider: ______________________________________
Name: _______________________________________
Phone/Fax Numbers: _____________________________________
1.) Please take a moment to provide a short summary of the services your organization provides.
2.) Has your organization made any changes or modification to the services you provide or the
populations you serve in the past year?
3.) What increased needs for services do you anticipate in the future? What might be your
organization’s role in addressing these needs?
4.) What concerns do you have regarding your organization’s ability to provide services in the future?
How might those concerns be addressed?
5.) Workforce issues are a significant barrier to providing service. How might we partner in the future
to ensure the quality of services available to Bayfield County residents?
6.) Do you have other comments that you would like the Board to consider?
Department of Human Services
117 East Fifth Street
P.O. Box 100
Washburn, WI 54891-0100
Telephone (715) 373-6144 Fax (715-)373-6130
Email: baycodhs@bayfieldcounty.org
Public Participation Planning Process
2025 Budget
Regional Office
Date Activity Monitoring
May 23, 2024 Draft budget materials provided to the
Human Services Board for review and approval
May 24, 2024 Two memos issued to agency receptionist
with instructions for distribution of
2025 budget documents
May 24, 2024 Input solicited from service providers
using the attached format.
May 24, 2024 Notice of 2025 Budget Hearing and opportunity
to comment on Bayfield County’s policies and
procedures regarding equal opportunity in
employment, service delivery, and language
access sent to the County Journal, the Daily Press,
the Evergreen Shopper, The South Shore
Connection, and to local Radio stations
WATW, WBSZ, WJJH, WEGZ, and WNXR
(attached)
May 24, 2024 Request to staff and providers to offer
notice of the public hearing to consumers they
had contact with before the meeting date.
May 24, 2023 County Board of Supervisors, Advisory Committee
Members, and Human Services Board members
notified of public hearing.
June 27, 2024 Budget Hearing. Afterwards, meeting minutes
issued to the Regional Office.
An Overview for ACL’s Network:
On May 7,2024,the Administration for Community Living (ACL)reieased a final rule to establish the
first federal regulations for adult protective services (APS)programs.The new regulations will take
effect on June 7 of this year,but regulated entities have until lVlay 8,2028 to fully comply.ACL
looks forward to working with stakeholders to implement the final rule and will provide robust
technical assistance and other resources in the coming months.Additional information can be found
at:ACLgov/APSrule.
Summary
The APS final rule was developed in response to long—
standing requests from the APS community,Congress,
and other stakeholders for federal guidance,leadership,
stewardship,resources,and support forAPS systems
and victims of adult maltreatment.
Those requests became particularly urgent in recent
years,when ACL received appropriations to fund —for
the first time —the state APS formula grant program
that was authorized by the Elder Justice Act in 2010.(ln2021,ACL received one—time COVID-19 supplemental
appropriations to fund start-up costs and fund the
program for two years.In 2023,the program was added
to ACL’s ongoing annual appropriations.)
The new regulations promote high—quality APS and will
improve consistency in services across states.With the
final rule,ACL aims to support the national network that
delivers APS,with the ultimate goal of better meeting
the needs of adults who experience,or are at risk of,
maltreatment or self-neglect.To those ends,the final rule:
°Establishes a set of national standards for the
operation ofAPS programs that all state APS systems
must meet.These standards codify —and build
upon —the existing National Voluntary Consensus
Guidelines for State APS Systems.It‘s important
to note that these standards represent the “floor”—
states are encouraged to adopt services,practices,
and processes that exceed them.
Establishes definitions for terms that are foundational
to APS practice to improve information sharing,data
collection,and program standardization between and
within states,but does not require states to adopt
them verbatim.
Creates a tiered assessment system to differentiate
between cases that represent immediate risk (defined
as those that are life-threatening or likely to cause
irreparable harm or significant loss of income,assets,
or resources)and those that do not,and establishes
response timelines for each.
Requires APS programs to provide at least two ways
for reports of adult maltreatment and self neglect to
be made 24 hours per day,seven days per week
At least one must be an online method such as a
secure email inbox
Emphasrzes person directedness and least restrictive
alternatives as core values in APS practice
Requrres robust conflict of Interest polrcres to support
ethical APS practice.
Promotes coordination and collaboration wrth other
entities such as state Medicaid agenCies long term
care ombudsmen,tribal APS,and law enforcement.
Requires state APS entities to create state plans at
least every five years and to submit annual program
perfoma
.—m~m-m
-Last Updated:XX/2024
The Administration for Community Living is an Operating division of
the U.S.Department of Health and Human Services.Visit ACL.gov.rACL
Admmsimiicn (or Cisrnmuniiy dwinc
The final rule is the culmination of many years of
engagement with stakeholders from APS,as well as
aging and disability advocates,from across the country.
In September 2023,ACL issued a proposed ruie that
incorporated input received through several listening
sessions;extensive research;and analysis of data from
a 2021 survey of 51 APS systems,ACL’s National Adult
Maltreatment Reporting System,and policy profiles from
APS programs in all states and territories.
The final rule reflects the thoughtful,detailed input
received on the proposed rule from more than 170
commenters.Overall,the comments supported the
goals and content of the proposed rule,but some state
APS programs raised concerns about the administrative
burden and expense of implementing its requirements,
particularly given the limited federal funding for the
programs.To address those concerns,ACL deleted or
significantly modified a number of polices in the final rule.
For example,the timeline for compliance is lengthened
from three years to four,and the final rule does not
include requirements for staff-to-client ratios.We have
highlighted the significant changes from the proposed
rule in the “key provisions"section of this fact sheet.
Background on Adult Maltreatment and
Adult Protective Services
Research shows that at least 1 in 10 older adults who live
in the community experiences some form of maltreatment
each year —and this is likely an undercount,because
only1 in 14 cases is reported.We also know that adults
with disabilities experience abuse and neglect far more
often than their peers without disabilities,although
estimates of the prevalence vary significantly from one
study to the next.
This can have serious physical and mental health,
financial,and social consequences.People who
experience abuse have higher rates of depression,
hospitalization,and institutionalization —and they are
more likely to die prematurely.They also may experience
deteriorated family relationships,diminished autonomy,
and institutionalization as the direct result of maltreatment.
APS programs across the country support older adults and
adults with disabilities who experience,or who are at risk
of,maltreatment or self-neglect.APS programs investigate
reports of maltreatment;conduct case planning,monitoring,and evaluation;and provide (or connect
people to)a variety of medical,social service,economic,
legal,housing,law enforcement,and other protective,
emergency,or support services to help them recover.
APS has been funded and administered wholly at the
state or local level until recently.Consequently,there is
wide variation in APS services and practices between,
and even within,states.
Key Provisions of the Final Rule
Following is a brief overview of some of the key
provisions of the final rule.lt was written with the goal of
being easier to understand for people who do not have
an in-depth understanding of APS or a legal background.
It does not include all of the provisions or complete
details of the summarized provisions.Please use this
document as a tool to help navigate the final rule;it
should NOT be considered a substitute.Provisions
that are significantly different from those found in the
proposed rule are italicized and noted with an asterisk.
Establishing a common vocabulary for APS
APS terminology varies significantly between states,
which may have a direct effect on service availability,the
types of cases APS programs accept for investigation,
and the ability to collect and share data across
states.The final rule defines a number of terms that
are foundational to APS practice but allows states
considerable flexibility in implementation.APS systems
must collectively incorporate every term defined in the
rule —and all elements of each definition —into their
definitions;but they are not required to adopt each
definition verbatim.§1324.402(a)(5)
The rule:
'Defines “adult maltreatment"and its component
parts,including “abuse,”“neglect,”“financial
exploitation,”“sexual abuse."§1324.401
'Defines and c/arifies “self-neg/ect"and separates it
from the definition of adu/t maltreatment,recognizing,
that unlike abuse,neglect,financial exploitation,and
sexual abuse,there is no perpetrator in self-neglect
cases and APS must offer a differentiated response.*
§1324.401
'Removes the requirement ofa “trust relationship”
between an alleged perpetrator and victim from the
definition of “adult maltreatment.”instead,the final
rule encourages states to prioritize cases involving a
trust relationship.*§1324.401
-Adds a definition of “APS response”to more
accurately reflect the holistic nature ofAPS service
provision and investigatory functions.*§1324.401
Accepting and Responding to Reports
Because timely response to reports can mean the
difference between life and death or risk of serious harm,
the final rule establishes requirements for APS programstoacceptandrespondtoreportsswiftlyandeffectively
while balancing staffing and resource constraints.It also
establishes requirements for ensuring simpie,readily
accessible reporting channels.For example,the final rule:
‘Requires that states maintain at least two ways to
report adult maltreatment and self-neglect that are
accessible 24 hours per day,seven days per week.
§1324.405(a)
In a change from the proposed ru/e,the final rule:
»Adds a requirement that one of the two reporting
methods be online,such as a secure web portal or
email inbox.*
»Clarifies that while the reporting methods must be
available at all times,APS can retrieve reports the
next business day.*
~Requires APS to maintain a tiered system that,
at a minimum,differentiates between cases that
represent immediate risk (defined as those that are
life-threatening or likely to cause irreparable harm or
significant loss of income,assets,or resources)and
those that do not.§1324.402(b)(2)
»For reports that represent immediate risk,the
final rule requires APS to initiate a response
within 24 hours of screening.The final rule also
clarifies that this response may be fulfilled through
a partnership with Emergency Management
Systems,law enforcement,or other appropriate
community resources with 24-hour response
capability.
»For reports that do not represent immediate risk,
response must begin within seven calendar days.
'Narrows the requirements for a feedback loop
between APS programs and mandated reporters.
7 In response to comments regarding the proposed
rule’s general requirement that APS programs contact
mandated reporters after receiving a report of adult
maltreatment or self-neglect,the final rule only
requires APS programs to contact mandated
reporters who make a report in the course of their
professional duties.The alleged victim must also
consent to any release of information,and the APS
program is limited in the type ofinformation they
must provide a mandated reporter.*§1324.405(b)
Conflict of Interest
Conflicts of interest arise when the financial or personalinterestsofastateemployee,APS worker,or APS
program influence —or are at odds with —the interests of
a client or group of clients.A conflict of interest also may
arise when an APS worker has a “dual relationship"with
a client,meaning they serve in multiple roles —which
could be at odds with each other —for a single client.The
final rule contains several provisions to reduce the risks
of conflicts of interest.For example,it:
'Requires APS programs to establish monitoring and
oversight procedures to identify conflicts of interest.
§1324.404
'Requires APS programs to have mechanisms to
identify,remove,and remedy any actual or perceived
conflicts of interest at organizational and individual
levels.§1324.404
-Establishes requirements for dual relationships.
Specifically,the rule:
»Prohibits dual relationships,unless they are
unavoidable.§1324.404(d)
-In addition,the rule generally prohibits APS
programs from petitioning for guardianship or
serving as a guardian by establishing narrow
circumstances under which such a dual
relationship can be considered “unavoidable.”
§1324.404(d)(1)
»Requires APS programs to implement safeguards
for unavoidable dual relationships.§1324.404(d)
»Requires APS programs to document all dual
relationships in the case record,including steps
taken to address the conflicts of interest.*
§1324.404(d)(2)
Person-Directed Practice and Least-restrictive
Alternatives
The principles of self-determination are foundational to
the final rule.The rule requires APS systems to ensure
that planning and delivery of all services respect the
fundamental right of adults to make their own life choices
and that services are driven by the person receiving them,
based on their unique needs,strengths,preferences,and
experiences.For example,the final rule:
-Requires state APS systems to receive and respond
to reports of adult maltreatment and self-neglect
in a manner that incorporates principles of person-
directed services and planning and emphasizes
strong preference for least restrictive alternatives.
'{T§)\CL
Adminisuonon for Community swing
-Requires APS workers to relay to clients their rights
related to APS under state law during their first
meeting.These rights may include the right to refuse
to speak to APS,to accept or decline services,and
their right to confidentiality.§1324.403(c)
'Requires APS programs to develop service pians in
consuitation with the client,and to directly provide or
refer to services that respect the autonomy of clients,
as well as the client’s views about safety and qualityoflife.§1324.403(e)
-Establishes stronger protections forAPS clients
subject to,or at risk of,guardianship by prohibiting
APS from serving as a guardian or petitioningforguardianshipunlessitisunavoidable,and by
requiring enhanced documentation and mitigation
measures in such cases.§1324.404(d)(1)
°Clarifies that emergency protective action is permitted
only as a measure of last resort to protect the life and
safety of the client,either from harm by others or from
self-harm.§1324.401 §1324.404(d)(1)
-Emphasizes that adults are presumed to have the
capability to make decisions about how to live
and care for themselves unless a court of/aw has
determined otherwise,and clarifies that WW”
re rvention only in cases where there
ishserious risk of imminent harm to oneself or to
others *§1324.401
Coordination with Other Entities
Coordination with partners maximizes the resources
of APS systems,improves investigation capacity,and
ensures APS response is effective.Entities other than
APS also have authority to investigate or advocate on
behalf of adults who experience adult maltreatment or
self-neglect depending on who is eligible for the entity’s
programs,who is the alleged perpetrator,and where the
maltreatment took place.An effective,evidence-based,
and holistic response to adult maltreatment must include
all concerned entities working in coordination.Therefore,
the final rule:
-Requires APS systems to ensure coordination with
other entities engaged in the detection,prevention,
investigation,and remediation of adult maltreatment
and self-neglect.The rule also requires coordination
with other government agencies,tribes and tribal APS
programs,law enforcement bodies,and advocacy
organizations,among others.The preamble of the
rule also emphasizes the importance of coordination
with tribes and tribal APS programs.*§1324.406(a)
-Requires APS systems to ensure coordination with
other entities but provides flexibility to choose from
a variety of means.These include the development
of formal multidisciplinary and cross-agency
teams,memoranda of understanding,data-sharing
agreements,or other less formal arrangements.
§1324.406(b)
‘Encourages APS systems to coordinate with state
Medicaid agencies around critical incidents and other
issues,to the extent permitted by state law.
§1324.406(a)(2)(i)
-Clarifies that while state privacy laws may preventsharingcertainclientinformation,at a minimum,APS
systems should work with other entities to coordinate
their work around prevention and the sharing of
promising practices to address adult maltreatment
and self-neglect.§1324.406
Program Performance Data
Under the final rule,APS systems are required to
report performance data,which will provide valuable
information to help APS systems understand and improve
their operations and help drive ongoing performanceimprovement.This data will supplement public health
surveillance data on adult maltreatment and self-neglect
currently collected by ACL through the National Adult
Maltreatment Reporting System.The final rule:
-Requires states to submit performance data annually.
§1324.407(a)
'Requires APS systems to retain individual case data
obtained from APS investigations for a minimum of
five years.§1324.407(b)
Submission of State Plans
The final rule requires the state APS entity to develop
and submit a single state plan to ACL at least every five
years.The state plan must describe which populationswillbeserved,which services will be provided,and
which entities will oversee the provision of those services
and contain assurances that the state APS system
will develop and adhere to all policies and proceduresrequiredbytherule.§1324.400
Effective Date
The final rule will take effect on June 7,2024 (3O days
after it is officiaHy published),and regulated APS
entities have until May 8,2028 to comply.
In the coming months,ACL will share resources and
provide robust technical assistance to support state APS
systems,local APS programs,and others in meeting
the requirements of the new regulations.ACL also will
work with regulated APS entities through a supportive
corrective action process if more time is needed to fully
comply with specific provisions.
Learn More
Informational Webinar:Join ACL for an introductory
overview of the new regulation on Tuesday,May 14
at 3 p.m.(Eastern).
More information,including registration details for the
informational webinar,a link to the final rule,and
links to resources and technical assistance can be
found at ACL._qov/APSrule.
sNACLAdministruhonfor Community iiving