Adult Family Homes: Rules and Regulations

This information outlines the training requirements for AFH service providers and licensees. It also describes the sources of training that are acceptable to the Wisconsin Department of Health Services (DHS).

Wisconsin Admin. Code § DHS 88.04(5)(a) states that "the licensee and each service provider shall complete 15 hours of training approved by the licensing agency related to health, safety and welfare of residents, resident rights and treatment appropriate to residents served prior to or within six months after starting to provide care." This training shall include training in fire safety and first aid.

Home and community-based services (HCBS) NOTE: Providers who are HCBS compliant should note that all staff must receive initial resident rights during new employee training. This includes both paid and unpaid staff. The training should be repeated each year. Training from a prior facility is acceptable if it was done at a different facility within the same corporation.

NOTE: Although Wis. Admin. Code § DHS 88.04(5)(a) allows for up to six months to obtain training, employees must be competent to provide services and treatment appropriate to meet the needs of the residents. Allowing staff who aren't adequately trained to work in the AFH may result in a condition that puts the health, safety, and welfare of the residents at risk. Per Wis. Admin. Code § DHS 88.04(2)(f), "the licensee may not permit the existence or continuation of a condition in the home which places the health, safety, or welfare of a resident at substantial risk of harm."

Section DHS 88.04(5)(b) states in part that "the licensee and each service provider shall complete eight hours of training approved by the licensing agency related to the health, safety, welfare, rights, and treatment of residents every year beginning with the calendar year after the year in which the initial training is received."

Section DHS 88.09(2)(a) states in part that "the licensee shall maintain and keep up-to-date a separate personnel record for each service provider. The licensee shall ensure that all service provider records are adequately safeguarded against destruction, loss, or unauthorized use. A service provider record shall include all of the following:

1. Name and address.
2. Social security number.
3. Date of birth.
4. Beginning date of employment.
5. Job-related experience and training.
6. Educational qualifications.
7. Job description.
8. Documentation of successful completion of the training requirements under Section DHS 88.04(5).
9. The results of screening for communicable disease.
10. Description of any disciplinary action.
11. Date of discharge or resignation."

Section DHS 88.04(2)(h) requires AFHs to be in compliance with Occupational Safety and Health Act (OSHA) Standard 29 CFR 1910.1030 related to the control of blood-borne pathogens. This OSHA Standard requires an employer to provide training when a worker is assigned tasks where they might be exposed to blood. They should also provide yearly training in the prevention of blood-borne infections. That training should be given to all staff who may come in contact with the blood of a resident.

AFH staff are not required to complete DHS-approved Community-Based Residential Facility Standard Precautions Training courses. However, all DHS-approved community-based residential facility training programs are acceptable. Other training that meets the requirements in Wis. Admin. Code § DHS 88.04(2)(h) includes:

• Training provided by a recognized training entity (i.e., technical college, university, infection control practitioner), which is included in a certified nurse aide training program.
• Training provided by home health agencies, hospitals, nursing homes, public health agencies, etc.
• Training provided by a qualified third-party trainer or consultant.
• Any training program that includes all of the required elements identified in OSHA Standard 29.

• Training in standard precautions, fire safety, first aid and choking, or medication administration. This should be provided by a department-approved trainer for community-based residential facility training. The name of the person who received the training must be included on the Wisconsin Community-Based Care and Treatment Training Registry.
• Training provided by a recognized training entity or an entity with expertise in the subject area (for example: technical college, university, Red Cross, American Heart Association, fire department, hospital or other health care provider, public health department).
• Training provided by a managed care organization (MCO) or county human services department.
• Training provided by an advocacy agency such as the Board on Aging and Long-Term Care Ombudsman or Disability Rights Wisconsin.
• Training provided by a trainer or consultant with expertise in the subject area. The Department will accept a broad spectrum of documentation that supports an individual's knowledge and expertise in the topic area. Acceptable documentation of the trainer's credentials would include, but is not limited to:
  • Documentation such as a license or certificate (i.e., registered nurse (RN) or licensed practical nurse (LPN) license, emergency medical technician (EMT) certification).
  • A valid Instructor Card issued from American Red Cross, American Heart Association.
  • A resume showing experience/knowledge in the subject area.
• Online training, webcasts, and videos are acceptable formats for presenting information. The source of the training needs to be a recognized entity or trainer with experience in the subject area. Training provided by these methods must be documented in the employee's personnel records.

DHS will review documented training to determine if it is appropriate. Appropriate training for AFH service providers and licensees may include:

• Medications and medication administration.
• Standard precautions.
• First aid and procedures to alleviate choking.
• Fire safety and emergency procedures.
• Resident rights.
• Prevention and reporting of abuse, neglect, and misappropriation of resident property.
• Provision of personal care.
• Needs of the client group served.
• Challenging behaviors.

If the person has completed training in standard precautions, fire safety, first aid and choking, or medication administration provided by a DHS-approved trainer for community-based residential facility training on or after April 1, 2010, the person must be included on the Wisconsin Community-Based Care and Treatment Training Registry. For additional information regarding approved community-based residential facility trainers, visit the Wisconsin Community-Based Care and Treatment Training Registry.

For all other training, the personnel record must include documentation of training. The documentation may include:

• The name of the employee.
• The name of the instructor.
• A description of the training content.
• The date of training.
• The length of the training.

If you have questions, please visit Division of Quality Assurance: Bureau of Assisted Living Regional Offices to contact the regional office for the county in which your facility is located.