Dane County
Department of Human Services
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Adult Family Homes

Description | Certification Process | Sponsor Qualifications | Home Qualifications
To Apply | Additional Help | Contact

Description

Key contact numbers
  • Adult Family Homes: (608) 242-6466
  • Adult Family Homes for Older Adults: (608) 261-9886
  • Adult Family Homes for Individuals with Mental Illness: (608) 221-8443
  • Adult Family Homes for Individuals with Developmental Disabilities: (608) 280-0206 ext. 261

Adult Family Homes are places where 1-4 adults reside and receive care or services that are above the level of room and board and may include up to 7 hours per week of nursing care. Adult Family Homes serve persons with advanced age, dementia, mental health issues, developmental disabilities, traumatic brain injury, AIDS, alcohol and other drug abuse, correctional clients, and/or persons with a terminal illness.

The Dane County Department of Human Services certifies homes where one or two persons reside while the State licenses homes where three or four people reside. Certificates are issued for one year and may be renewed provided all standards continue to be met.

The commitment to become a certified Adult Family Home provider is 24 hours per day, 7 days per week. It requires a desire to share one's home and life with 1-2 other people while protecting each individual's right to privacy and to have his/her own life; to be able to develop a caring relationship with that individual; and to treat the other person as a family member. It is not a commitment to take lightly.

Briefly, the Adult Family Home certification process requires:

  • Submission of a completed application
  • Provision of three (3) personal references
  • Background checks on all persons age 18 and older in the home
  • Medical certification including a recent physical exam and tuberculosis (TB) test - signed for all persons age 18 and older in the home
  • Home visit/inspection to determine if the requirements for certification are met
  • Interview with the potential provider

For further information on the requirements, please refer to the State Web Site

At the time of certification and renewal, the sponsor must meet the following standards:

Personal Qualification - The sponsor, and every substitute provider, shall be at least 18 years of age and shall be physically, emotionally and mentally capable of providing adult family home care. The sponsor and all substitute providers shall be persons who are responsible, mature and of reputable character, who exercise sound judgement and display the capacity to successfully care for people with disabilities or frail elderly.

Caregiver Background Check - Prior to issuing a certificate and every 4 years thereafter a caregiver background check is conducted on the applicant and all household members age 18 and older.

Financial Security - The sponsor may be requested to present evidence of having or having access to sufficient financial reserves to meet the needs of all residents and of all members of the household for whom the sponsor is financially responsible and to ensure the adequate functioning of the home for a period of at least 30 days without receiving payment for the care of any resident.

Health

Physical Exam - The applicant for an initial certification and all members of the household shall submit a statement from a physician, physician's assistant or nurse practitioner certifying that a physical examination was completed and that the applicant or any household member does not have an illness or condition that would threaten the health, safety or welfare of residents or interfere with the person's capacity to provide care. The statement may not be dated more than one (1) year prior to the date of the application.

Communicable Disease Control - The sponsor shall obtain documentation from a physician, physician's assistant, a clinical nurse practitioner, or a licensed registered nurse indicating that the sponsor and any adult household member have been screened for clinically apparent communicable diseases and tuberculosis (TB). The statement may not be dated more than 90 days prior to the date of the application. Screening for communicable diseases should be conducted using Center for Disease Control standards. Any juvenile household member with symptoms of a communicable disease which present a safety or health risk may not be in contact with the resident. The certifying agency may require a screen for communicable diseases for any juvenile household member.

Other Health Exams - If, at any time, the certifying agency suspects or has reason to believe that the applicant, sponsor, substitute provider or other household member has been exposed to a potentially dangerous disease or infection, or may pose a threat to the health, safety or welfare of residents, the certifying agency may require a physical exam, a screen for communicable disease, including TB, an alcohol or drug abuse assessment or a mental health evaluation of the person.

Liability Insurance

Vehicle - An applicant or sponsor who plans to transport residents in his or her vehicle shall have a valid driver's license and shall provide the certifying agency with documentation of liability insurance coverage. If a substitute provider or household member transports residents under the direction of the sponsor, the substitute provider or household member shall have vehicle insurance and a valid driver's license.

Home - An applicant or sponsor shall provide the certifying agency with documentation of sufficient insurance coverage to provide liability protection.

Training - There are certain requirements for training that need to be met during the first year of certification and on an ongoing basis.

There are a number of physical requirements that must be met in order for a home to be certified.

For further information on the requirements, please refer to the State Web Site.

Contact the Community Services Consultant:

Maya Fairchild, Community Services Consultant
Dane County Department of Human Services
1202 Northport DR/3rd FL
Madison, WI  53704
(608) 242-6466
fairchild@co.dane.wi.us

Wisconsin Department of Health and Family Services - Adult Family Homes - this portion of the State web site provides a variety of information, such as: consumer information, rules and regulations, forms, and other publications related to Adult Family Homes.

For more information on becoming a certified adult family home provider, contact:

Maya Fairchild, Community Services Consultant
Dane County Department of Human Services
1202 Northport DR/3rd FL
Madison, WI  53704
(608) 242-6466
fairchild@co.dane.wi.us

For more information on Language Services, please visit out Language Services page.





Last Revised: July 10, 2008


Copyright © 2006 - 2009 Dane County Department of Human Services



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