Aging and Disability Resource Center Advisory Board Agenda Packet (PDF)

In compliance with the Americans with Disabilities Act, any person needing assistance to participate in this meeting, should contact the Office of the County Clerk at (920)746 2200. Notification 72 hours prior to a meeting will enable the County to make reasonable arrangements to ensure accessibility to that meeting. Notice of Public Meeting Monday, May 18th, 2026 2:00 p.m. Aging and Disability Resource Center (ADRC) Advisory Committee Meeting ADRC / Community Center of Door County 914 North 14th Avenue, Sturgeon Bay, WI 1. Call Meeting to Order 2. Establish a Quorum ~ Roll Call 3. Election of Chair & Vice Chair 4. Adopt Agenda / Properly Noticed 5. Approve Meeting Minutes:  ADRC Advisory Committee from January 19th, 2026 6. Correspondence 7. Public Comment 8. New Business (Review / Action)  Staffing updates  Board member updates  Program Updates  Supervision observations  ADRC Statewide Data  QA project/ADRC Goal  Next of Kin Legislation  Elder Abuse Awareness Week June  Staff of WDOR May 15th, 2026 from 10:20am – 11am/ October 16th 11am 9. Unmet Needs 10. Sustainability Matters to be Considered 11. Legislative Matters to be Considered 12. Matters to be Placed on a Future Agenda or Referred to a Committee, Official, or Employee 13. Meeting Code 14. Next Meeting Date(s) • Monday, July 20th, 2026 at 2pm Adjourn Deviation from Order Shown May Occur Aging and Disability Resource Center Advisory Board - Minutes Monday, January 19th, 2026 at 2:00 p.m. Aging & Disability Resource Center/Community Center – 914 N 14th Ave, Sturgeon Bay, WI 54235 THESE MINUTES HAVE NOT BEEN REVIEWED AND APPROVED BY THIS BOARD AND ARE SUBJECT TO REVIEW AND REVISION BY THE BOARD AT THEIR NEXT REGULARLY SCHEDULED MEETING. Business Meeting 1. Call meeting to order. ● The meeting was called to order at 2:00 p.m. by Marie Massart. 2. Establish a Quorum ~ Roll Call. ● Members Attending: Marie Massart, Nissa Norton, Sandy Brown, Deb Doyle, Sherry Pesch, Kathleen Rothmeyer, Allison Bourdeau and John Koski. Absent: Carol Davis. Other persons present: Jenny Fitzgerald, Nicki Scharrig. Barb Snow took minutes. A quorum was established and the meeting continued. 3. Adopt Agenda/Properly Noticed ● A motion was made by Nissa Norton and seconded by Sandy Brown to adopt the agenda. The motion carried unanimously. 4. Approve Meeting Minutes of the ADRC Advisory Committee Meeting November 17th, 2025 ● A motion was made by Debbie Dahms and seconded by Kathleen Rothmeyer to approve the minutes. The motion was carried unanimously. 5. Correspondence – None 6. Public Comment – None 7. New Business (Review/Action) ● Staffing Updates o The ADRC has 2 new staff members; Emma Walsh, Adult Protective Services and Cheri VanDenBogart, ADRC Specialist. Introductions were made to and from the board members. ● Program Updates o Included in the agenda packet is the “Inform USA (AIRS) Certification Requirement Change” handout. Beginning in 2027 there is no longer a requirement for ADRC’s to have at least one ADRC Specialist certified. o On the same handout listed above; is an update on the DBS Program Age Extension which has been paused and services will continue as they are currently running. ● Program Feedback Survey o Health and Human Services has a QA Project and other goals in our agency. This year we decided to do a survey which includes all areas. How staff are doing and what can we do. We will post this survey in front on the tables and on the nutrition table by the dining room, in the shared office, on the tv above the fireplace, as well as staff handing out copies, and adding the link to our emails. We will collect feedback throughout the year and redistribute the surveys. Jenny will add APS to the survey. The surveys are included in the agenda packet. ● ADRC 2026 team goals o Included in the agenda packet is “Door County Department of Human Services, SMART Goals”. Goal #1 is the Program Service Feedback Survey. Goal #2 is Increasing Community Awareness of the benefits of Power of Attorney- Healthcare (POA-HC) and Power of Attorney of Finance documents. Goal #3 is The APS Team will increase awareness of financial scams among older adults and vulnerable adults by hosting an educational presentation in collaboration with the Door County Sheriff’s Department - Investigation Unit. ● Review Stats o Jenny referred to the handout “Health and Human Services Statistics” a few areas have reported higher. Total participation is about 30460. We have had some new volunteers this year. Liberty Grove congregate is also increasing, as well as Baileys Harbor meals on wheels. This is the first full year in PeerPlace. This will hopefully be more consistent as the year progresses. 8. Unmet Needs-None 9. Sustainability Matters to be Considered – None 10. Legislative Matters to be Considered – None 11. Matters to be Placed on a Future Agenda or Referred to a Committee, Official, or Employee - none 12. Meeting Code – 119 13. Next Meeting Date(s) ● ADRC Advisory Committee meeting, Monday, March 16th, 2026 at 2:00 p.m. Adjourn ● A Motion was made by Nissa Norton and seconded by Sandy Brown to adjourn. ● Meeting was adjourned at 2:48 p.m. The minutes for this meeting were recorded by Barb Snow. ADRC Statewide Data: 2025 Emma Klein ADRC Data Systems Specialist ADRConnect Meeting March 25, 2026 Slide 2 Totals  Wisconsin’s ADRCs, aging units, aging services providers, and Tribal partner programs served 264,089 people in 2025.  Half of those individuals received services from more than one program area (50%). Slide 3 Annual Unique Customers (Trend) ADR program only, includes data submitted to Encounter 155,973 120,000 125,000 130,000 135,000 140,000 145,000 150,000 155,000 160,000 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 Slide 4 Number of Customers Served by Program PeerPlace only 0 50,000 100,000 150,000 Dementia care specialist NFCSP Health promotion Disability benefits specialist Nutrition education Home-delivered meals SHIP Congregate meals Elder benefits specialist ADR specialist Slide 5 Most Common Program Combinations PeerPlace only 0 5,000 10,000 15,000 20,000 EBS, SHIP ADR, DBS HDM, NutrEd CongMeals, NutrEd ADR, EBS, SHIP ADR, EBS ADR, HDM ADR, HDM, NutrEd ADR, CongMeals ADR, DCS Slide 6 Number of Customers Receiving ADR Services PeerPlace only 0 40,000 80,000 120,000 Information and Assistance Functional Screen Options Counseling Other ADRC Spec Enrollment Counseling Medicaid Application Assistance Disenroll Couns-Tranf / Re-enroll Marketing and Outreach Short Term Service Coordination Disenroll Couns-Leaving Program Slide 7 Time Spent Providing Services PeerPlace Only 0 50,000 100,000 150,000 Information and Assistance Functional Screen Options Counseling Other ADRC Spec Enrollment Counseling Medicaid Application Assistance Disenroll Couns-Tranf / Re-enroll Marketing and Outreach Short Term Service Coordination Disenroll Couns-Leaving Program Hours Slide 8 Time Per Customer, By Service Type PeerPlace only 0 2 4 6 Information and Assistance Functional Screen Options Counseling Other ADRC Spec Enrollment Counseling Medicaid Application Assistance Disenroll Couns-Tranf / Re-enroll Short Term Service Coordination Disenroll Couns-Leaving Program Average hours per customer Slide 9 Call Topics PeerPlace and Encounter. Last year #8 Caregiving now #15, #9 Health now #16, #10 IM now #33 0 50,000 100,000 150,000 Public Benefits LTC Programs Public Benefits Other Home Services Housing Insurance Food Transportation Other Assisted Living (AFH, CBRF, RCAC) Adaptive Equipment +1 +4 +5 -1 -2 +6 Slide 10 Call Topic Change PeerPlace and Encounter. Light blue is an increase from 2024 to 2025. Dark blue is a decrease. 0 10 20 Technology COVID-19 ILSP Information Youth in Transition Safety Multiplier for change (e.g. 2x larger) Slide 11 Unmet Needs PeerPlace only 0 1,000 2,000 3,000 4,000 5,000 Dental Prescription Drug Assistance Medication Management Employment MH Services incl. Case Management Utility Assistance Rent/Mortgage Assistance Accessible Housing Home Care (medical) Assisted Living (AFH, CBRF, RCAC) Transportation Housing Other Home Care (non-medical) Slide 12 Unmet Needs by ADRC PeerPlace only Most common unmet need Home Care (non-medical) Housing Multiple Other Transportation None entered Slide 13 Customer Race Distribution, 2017 –2025 PeerPlace and Encounter 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 2017 2018 2019 2020 2021 2022 2023 2024 2025 White Person of color Multiracial Missing Data not requested or declined Slide 14 Customer Disability Type PeerPlace only 0 40,000 80,000 Deaf or Hard of Hearing Visual Disability Substance Use Alzheimer's/Irreversible Dementia Developmental/Intellectual Disability Mental Health Unknown Caregiver Physical Disability Older Adult (60 or older) Missing Slide 15 Customer Living Status PeerPlace only. Percentage is only among known status. 36% 5% 54% 2% 2% 0 20,000 40,000 60,000 Lives Alone Lives in LTC Facility Lives with Others Not Requested Unhoused/Unstable Housing Unknown Slide 16 Customer Poverty Status PeerPlace only. Percentage is only among known status 43% 57% 0 20,000 40,000 60,000 Missing Declined to Answer Data Not Requested At or Below Poverty Above Poverty Slide 17 Memory screens Total of 2,078 memory screens entered in PeerPlace in 2025 Slide 18 Long-Term Care Enrollments 13,612 received enrollment counseling service type 11,459 had enrollment date entered in casework tracker 0 2,000 4,000 6,000 8,000 10,000 PACE Missing Data Partnership IRIS Family Care Questions and Answers Slide 19 Slide 19 Contact Us Slide 20 Contact Us Slide 20 For questions or individual data, contact Emma.Klein@dhs.wisconsin.gov 1 Greater Wisconsin Agency on Aging Resources, Inc. Guardianship Support Center Helpline: 855-409-9410 ⬧ guardian@gwaar.org www.gwaar.org/gsc Wisconsin’s New Patient Representative Law: Frequently Asked Questions Created 04/2026 Disclaimer: Information contained herein is not intended, and should not be used as legal advice. County and facility staff are encouraged to consult with their legal counsel for interpretation of the law. Application of the law depends upon individual facts and circumstances. In addition, statutes, regulations and case law are subject to change without notice. Consult a legal professional for advice and assistance with legal issues. Assembly Bill 598, now known as 2025 Wisconsin Act 115, became law on March 20, 2026. The new law amends existing law to create an alternative track to allow a family member or close friend to admit an incapacitated hospital patient to post-inpatient care without having to seek guardianship first. In addition to the information in this document, Legislative Council has provided an Act Memo explaining the new law. I. Overview a. What does this law do? This law creates an alternative track for admissions to post-inpatient care. If a patient in a hospital inpatient unit is incapacitated and does not have a valid health care power of attorney (HCPOA), the law allows a family member or close friend (a “patient representative”) to consent to admission from the inpatient setting to a skilled nursing facility (SNF) or community-based residential facility (CBRF). The law allows the patient representative to make health care decisions and authorize medical expenditures related to the care and treatment at the care facility to the same extent that a guardian would be able to make those decisions. The law does not require that the patient representative petition for guardianship or protective placement at any point and does not have a time limit on the patient representative’s authority. b. How is it different from previous law? Before this law, if an incapacitated hospital patient did not have a valid power of attorney for health care, a family member or close friend could consent to post-inpatient facility admission after filing petitions for guardianship and protective placement. The family member or friend’s 2 authority was limited to 60 days or until a guardian was appointed, whichever happened first, although it could be extended another 30 days if necessary to plan for discharge from the facility. The new law did not eliminate this process; it provides an alternative track. This process is still available if guardianship and protective placement is still appropriate or necessary for the patient. The patient representative may still consent to admission and make health care decisions and financial decisions related to care while the petitions are pending. c. When is it effective? June 1, 2026. d. Does it have an end date? The law includes a three-year sunset date, meaning that after May 31, 2029, no patients may be admitted to post-inpatient care via the alternative process. e. Does this law replace the need for Powers of Attorney or other advance planning? No. Powers of Attorney for Health Care and Finances offer a number of benefits to the individual beyond what this law allows, including the right to choose who will make decisions and choose alternates, the right to decide what types of decisions their agent will make, the right to have their wishes be followed, and the right to revoke the POA. II. Incapacity a. What does incapacity mean in this law? As defined in this law, incapacity means “unable to receive and evaluate information effectively or to communicate decisions to such an extent that the individual lacks the capacity to manage his or her health care decisions, including decisions about his or her post-hospital care.” In plain English, this means a person lacks the ability to make their own healthcare decisions. This is slightly different from the definition of “incapacity” for the purposes of a healthcare power of attorney, which does not mention decisions about post-hospital care. b. How is incapacity determined? Two physicians, or one physician and one advanced practice clinician (a physician assistant, a nurse practitioner, or a psychologist), must personally examine the individual and sign a statement of incapacity. The statement must include the date and location where the provider examined the patient, any medical conditions that led them to conclude that the patient is incapacitated, the provider’s office address and contact information, and any other information identified by the Department of Health Services. 3 c. Is there going to be a standard form for an incapacity statement? The law requires the Department of Health Services to create and provide a standard form for the incapacity statement. We will update this FAQ to include a link to this form when it is available. d. What happens to the form once it’s signed? The incapacity statement must be added to the person’s medical record (including both the record at the discharging hospital and the accepting facility). It must also be filed with the Register in Probate and sent to Adult Protective Services (APS) for the patient’s county of residence. Note: the new law adds registers in probate to the list of individuals to whom certain medical records may be released without patient consent. This will be at Wis. Stat. § 146.82(2)(a)7m. e. Can this form be used to activate health care POAs? Potentially yes. The definition of incapacity for this law includes the definition of incapacity for a health care POA and the statement includes the information required to activate a health care POA. Since the state does not have a standard form to activate health care POAs, many providers have come up with their own. For those who have not or who would like to standardize their forms for a finding of incapacity, it may be possible to use the new DHS form. It may depend on the final format and content. Providers may also wish to consult with their counsel for guidance once the DHS form is available for review. f. If a provider or hospital already has their own form to activate health care POAs, can that be used for this? Probably not. The incapacity evaluation for this law requires more information from the providers than activating a healthcare POA. For a POA, the medical providers only need to state that they personally examined the patient and found that the patient is incapacitated. As noted above, the statement of incapacity for this law will also require the provider to state the date and location where the provider examined the patient, any medical conditions that led them to conclude that the patient is incapacitated, the provider’s office address and contact information, and any other information identified by the Department of Health Services. g. Are there any exceptions to the types of patients who can have a patient representative appointed under this bill? This process may not be used if: 1. The patient objects to admission to the facility. 4 2. The patient is diagnosed as developmentally disabled or as having a mental illness at the time of the proposed admission. (Note: this is the same standard as for both previous 50.06 and health care POA admissions.) 3. The patient has a valid health care POA with an agent who is willing and able to serve or a guardian of person. III. Decision-Makers a. Who is allowed to make decisions? In order of priority, the people who can serve as patient representative are the incapacitated person’s: 1. Spouse or registered domestic partner 2. Adult child 3. Parent 4. Adult brother or sister 5. Grandparent 6. Adult grandchild 7. Adult close friend b. What happens if family members can’t agree on who should make decisions or what the decisions should be? If a family member at the same level of priority or higher disagrees with the family member who is making the decision to admit to post-inpatient care, then the patient cannot be admitted. Additionally, any person who lives with the patient and is anywhere in the priority list essentially has veto power over the admission, unless the person consenting to the admission lives with the patient or is the patient’s spouse. Examples: 1. Two adult children disagree on whether to admit. Neither lives with the patient. The patient will not be admitted. 2. A spouse (higher priority) wants to admit, and an adult child (lower priority) does not want to admit. The patient will still be admitted over the adult child’s protest. 3. An adult child (higher priority) wants to admit, but an adult grandchild (lower priority) who lives with the patient does not want to admit. The patient will not be admitted, because the adult grandchild lives with the patient. c. Once a family member or close friend agrees to serve, is there something they have to sign? The patient representative will have to sign a sworn declaration acknowledging that they: 5 1. Agree to make health care decisions regarding admission and care at the admitting facility; 2. Agree to make these decisions with care, diligence, and good faith; 3. Agree to authorize medical expenditures at the admitting facility; 4. To the best of their knowledge, no higher priority family member is willing or able to serve; 5. To the best of their knowledge, the incapacitated person does not have a POA agent or guardian of the person; and 6. Understand their role and responsibilities as the patient representative. This declaration must also include a list of all of the patient’s family members to whom the representative will send the declaration. d. What does “sworn declaration” mean? Does that mean the statement must be notarized? The Department of Health Services is reviewing the law and will make a determination as to whether the statement must be notarized. We will update the FAQ with this information when it is available. e. Is there a standard form? The law requires that the Department of Health Services create and provide a standard form for the patient representative statement. We will update this FAQ to include a link to this form when it is available. f. What happens to the form once it has been signed? The signed declaration must be given to the discharging hospital, the admitting facility, all of the patient’s family members that can reasonably be identified, and Adult Protective Services for the patient’s county of residence. It must also be filed with the Register in Probate. Note: the new law states that the patient representative must be the one to send their declaration to family members. The law does not specify who is responsible for filing the form with the Register in Probate or providing it to the discharging hospital, admitting facility, or Adult Protective Services. g. How will the patient representative show they are the patient representative? The sworn declaration itself, or a copy thereof, will likely serve as the patient representative’s statement of authority. h. When does the patient representative’s authority end? The patient representative’s authority ends if any of the following occurs: 6 1. A guardian is appointed; 2. The patient is discharged to a non-facility setting; 3. A healthcare POA is discovered that was not previously known; or 4. The patient is no longer incapacitated. Note: the law does not provide any guidance on whether the patient representative’s authority ends if the patient is subsequently able to create a health care POA. i. Can a patient representative relinquish their responsibilities, and if so, how? What happens? The law does not provide any guidance on whether or how a patient representative can step down or relinquish their responsibilities. The law does not provide for an alternate or allow another family member to step up. If the patient representative is no longer willing or able to serve and the individual has not regained capacity and is not capable of creating a health care POA, it may be necessary to pursue guardianship. IV. Authority a. What types of decisions are covered? The patient representative can consent to the patient’s transfer from a hospital to a skilled nursing facility or community-based residential facility. Once the patient is admitted to the facility, the patient representative can make health care decisions regarding the admission, care, and treatment of the patient to the same extent as the guardian of the person. The patient representative can also authorize expenditures related to health care to the same extent as a guardian of the estate. b. Does this include hospital decision-making? No. The patient representative may consent to a post-inpatient care facility and may make health care decisions at that care facility. They may not make any other decisions while the patient remains in the hospital. c. If the individual is discharged home, can the patient representative continue to make health care or financial decisions? No. The patient representative’s authority is limited to health care and financial decisions at the care facility only. If the patient continues to need a decision-maker post-discharge and is unable to create a health care POA, it may be necessary to pursue guardianship. d. Can the patient representative sign a Medicaid application or renewal? Yes. 7 e. Can the patient representative request a functional screen for community long-term care programs? Yes. f. Can the patient representative access bank accounts or other financial assets? The law allows the patient representative to “authorize expenditures” related to the patient’s care. It is not clear whether banks and other financial institutions will interpret this as allowing access to funds or information about the patient’s assets. Additionally, while the law says a patient representative has all the powers of a guardian of estate, a guardian of estate cannot do things like handle marital property, or retirement accounts, or take action related to real estate, unless they have very specific court authority. As a result, the patient representative’s authority to handle these matters may also be limited. V. Patient Rights a. Can the patient designate their own decision-maker? It is the GSC’s stance that it may be possible for an individual to create a health care POA after incapacity, depending on the individual’s specific circumstances. For additional legal analysis, please see the Wisconsin Board on Aging & Long-Term Care’s Position on Revocation and Re- Execution of POA-HC Documents.1 If the patient is still capable of creating a health care POA, they may designate their own decision-maker through that process and the patient representative process will not apply. If the patient is not capable of creating a health care POA, they are not able to designate their own patient representative. The decision-maker will be determined by the priority list of family members. b. Can the patient object to the choice of decision-maker? The law does not state that the patient may object to the choice of patient representative. c. Can the patient object to the decision to admit to post-inpatient facilities? Yes. The process will work as it has in the existing Wis. Stat. § 50.06; the additional track for admission does not change the patient’s right to object. If the patient objects to the admission, the patient may still be transferred to the facility, but the facility must immediately contact county Adult Protective Services, who will then meet with the patient and determine next steps. If the objection persists and the person cannot safely be 1 https://tinyurl.com/BOALTCPositionPaper 8 discharged to a non-facility setting, guardianship and protective placement orders may be necessary. d. Can the patient ask for their capacity to be reassessed? Yes. Any person, including the patient, may ask for a reassessment of capacity. e. Can the patient ask for the patient representative’s decisions to be reviewed? Yes. Any person, including the patient, may ask a court to review whether the patient representative is acting in accordance with the known wishes of the patient or in the best interest of the patient. f. What can the court do in a patient representative review? The court may order a hearing, but is not required to do so. The court may also issue any order that the court determines necessary to protect the patient, with or without a hearing. This may include directing the patient representative to act in the patient’s best interests, directing the patient representative not to make certain decisions or authorize certain expenditures, requiring an accounting of expenditures, and/or requiring periodical check-ins with the patient representative. g. Does the incapacitated person have a right to counsel? The law does not state that the individual has a right to counsel or that they may request court- appointed counsel. They may retain counsel on their own if they wish. h. Can the court appoint a guardian ad litem? Yes. The court may appoint a guardian ad litem (GAL) to represent the best interests of the patient throughout a court proceeding. i. Who is required to receive notice of a court review of the patient representative’s decisions? The list of individuals who must receive notice of a hearing to review the decisions of the patient representative includes: 1. The patient; 2. The patient’s counsel, if any; 3. The patient’s guardian ad litem, if one is appointed; 4. The patient’s presumptive adult heirs; 5. Any public or private agency from which the individual is receiving aid or assistance; 6. Any other interested persons, unless waived by the court. All of the above must be served at least 10 days before the time set for a hearing. The patient 9 must be notified via personal service. The person who serves the patient must inform them of the complete contents of the petition and hearing notice. All others in the list above may be served via personal service or certified mail. j. Who is responsible for any costs? If a GAL is appointed, the court can order that the GAL’s fees be paid from the patient’s funds, if sufficient. If the patient does not have sufficient funds, the court may order that the GAL’s fees be paid by the county. If the court finds that the patient representative is not acting appropriately, the court can require that the patient representative pay the GAL’s fees. The court can also require the patient representative to personally pay for the costs of the entire proceeding. VI. Facility Responsibilities a. What are the hospital’s responsibilities? The hospital must store the statements of incapacity and the patient representative’s declaration in the patient’s medical records. Note: the new law adds registers in probate to the list of individuals to whom certain medical records may be released without patient consent. This will be at Wis. Stat. § 146.82(2)(a)7m. b. What are the receiving facility’s responsibilities? The receiving facility must store the statements of incapacity and the patient representative’s declaration in the patient’s medical records. The facility, along with the hospital, is responsible for including the signed patient representative declaration in the patient’s medical records. Additionally, if a skilled nursing facility admits a patient under this law and believes the patient representative is not making decisions in the best interests of the patient, the facility must report those concerns as required by state law. VII. County Responsibilities a. What are APS’s responsibilities? The statements of incapacity and patient representative declaration must be sent to Adult Protective Services, but APS is not required to take any specific actions. If the patient objects to the admission, APS must still review the admission, as previously required by Wis. Stat. § 50.06. Likewise, if APS receives reports of abuse, neglect, or exploitation, they must still assess those as they would any other report. 10 VIII. Role of the Courts a. What is the role of the courts? The registers in probate will file these documents for safekeeping. In addition, the Department of Health Services may request that the Register in Probate report on the number of patients admitted using this process. b. Is there a filing fee? Who is responsible for filing the forms? There is an $8 filing fee. The law does not specify who must file the statements of incapacity or the patient representative’s declaration. c. Who will have access to court records? These court filings will not be confidential, but the documents in them will be. Certain people can access them upon request, including: 1. A petitioner in a temporary guardianship proceeding for the patient; 2. A family member listed in the priority list above (but not including an adult close friend); 3. A medical provider examining the patient for a permanent guardianship proceeding; 4. Any court or county corporation counsel; 5. Any other person the court may order, if the person can demonstrate good cause to request the records. d. How long must the Register in Probate maintain these records? The Register in Probate must maintain these records until the patient’s death, in accordance with any protocols established by the Department of Health Services for verifying the death of the individual and destruction of the statements of incapacity and patient declaration. e. Are there any changes to temporary guardianship procedures under this law? Yes. Any person filing a petition for temporary guardianship for a patient admitted under the new process must request a copy of any statements of incapacity filed with the register in probate in the ward’s county of residence prior to the admission. They must make the request as soon as possible after filing the petition and before any hearing on the petition. They must then submit to the court copies of any statements they receive or a statement that they requested the statements and no statements were found. If these statements are located and submitted to the court, the court will inspect them in chambers prior to a hearing. The statements may be taken as evidence that the patients’ particular situation requires immediate appointment of a temporary guardian without further 11 corroboration from the examining provider. If the court determines that they will be used in the temporary guardianship proceeding, the court will order the petitioner to serve copies on the patient, their counsel (if any), the guardian ad litem for the temporary guardianship proceeding, and the petitioner’s attorney (if any). If the patient’s circumstances have changed (e.g., a statement has been submitted showing they have regained capacity), the court may exclude the initial incapacity statements from consideration as part of the temporary guardianship. If the court includes the statements in the temporary guardianship hearing, the finding of incapacity based on these statements can be rebutted if there is a good reason for the court to not take these statements at face value or if there is evidence that the patient’s circumstances have changed. f. Are there any changes to permanent guardianship procedures under this law? Yes. Any physician or psychologist who examines an individual for permanent guardianship must request and review any statements of incapacity filed with the register in probate prior to providing their competency report to the court. They may also review the patient representative’s declaration. QUESTIONS? Call the Wisconsin Guardianship Support Center at 855-409-9410 or email at guardian@gwaar.org. Reproduction of this document is permitted and encouraged, so long as no modifications are made and credit to the Wisconsin Guardianship Support Center of the Greater Wisconsin Agency on Aging Resources, Inc., is retained. This publication is provided for educational purposes only. The information contained herein is not intended, and should not be used, as legal advice. Application of the law depends upon individual facts and circumstances. In addition, statutes, regulations and case law are subject to change without notice. Consult a legal professional for assistance with individual legal issues. To protect and promote the health and safety of the people of Wisconsin Update on Wisconsin Act 115: Next-of-Kin Decision Making DHS Response Laurie Kohler, LCSW APS Program and Policy Specialist April 17, 2026 Wisconsin Department of Health Services 2 Overview of Act 115 • Modifies Wis. Stat. 50.06: o Establishes a new decision maker, Patient Representative o Removes the requirement of guardianship and protective placement petitions to be filed o Allows for the authorization of expenditures related to health care, including Medicaid • Goes into effect June 1, 2026 Wisconsin Department of Health Services 3 Next of Kin Hierarchy Spouse or domestic partner Adult son or daughter Parent Adult sibling Grandparent Adult close friend Wis Stat 50.06(3) Wisconsin Department of Health Services 4 Criteria for Use of Patient Representative • Patient is incapacitated, lacks legal decision maker, and requires post-hospital placement in nursing home or CBRF • Facility admission directly from hospital inpatient unit • Available next of kin resource • Patient and next of kin consent to facility placement. Wisconsin Department of Health Services 5 Disqualifying Criteria for Use of Patient Representative • Incapacitated patient discharged to home • Patient or next of kin object to placement • Disagreement between family members regarding selection of patient representative • Patient has primary mental health or intellectual disability diagnosis Wisconsin Department of Health Services 6 Patient Representative Responsibilities • Sign declaration and notify statutorily defined recipients • Authorize admission to post-hospital facility • Make health care decisions for the patient • Manage the patient’s finances and authorize resources to ensure access to health care • Complete enrollment or annual updates for Medicaid Wisconsin Department of Health Services 7 Patient Representative Authority • Effective upon completion of declaration and patient admission to facility care • Does not have a time limit • Same authority as guardian for managing patient health and finances • Conduct can be reviewed through court process Wisconsin Department of Health Services 8 Expiration of Patient Representative Authority • The patient regains decisional capacity • The patient discharges to a non-facility setting • A guardian is appointed • A valid power of attorney document is found Wisconsin Department of Health Services 9 Comparison of Decision Makers Supported Decision Making Health Care Power of Attorney Patient Representative Guardianship Wisconsin Department of Health Services 10 Process to Establish Patient Representative Incapacitated patient • No advanced planning documents • Discharge to facility-based care Two doctors or doctor and advanced practice clinician complete statement of incapacity • Copy in medical file • Notification to County Probate and APS Hospital selects Patient Representative • Follows Next of Kin hierarchy Patient Representative signs declaration • Notifies Next of Kin • Files copy with County Probate, APS, and medical chart Wisconsin Department of Health Services 11 Statutory Safeguards • Any person may request patient’s capacity be reassessed. • Any person may petition the court to review the actions of the Patient Representative. • Facilities must notify APS regarding concerns about the patient or the Patient Representative. • The court can review and remove the Patient Representative. Wisconsin Department of Health Services 12 DHS Program Readiness • Identify DHS programs that may interface with Patient Representative • Develop educational resources for county and Tribal programs • Update program area guidance, eligibility, and workflow • Communicate updates regarding DHS workplan and program-specific updates Wisconsin Department of Health Services 13 DHS Patient Representative Work Plan Phase 1: By: June 1, 2026 •Engage DHS leaders •Establish workplan •Develop required forms •Post documents and resources to DHS website •Develop a communication plan Phase 2 Q3,Q4 2026 •Coordinate with State Courts for data collection •Update impacted programs •Provide resources for partners •Implement communications plan including website update Phase 3 Q4 2026, 2027 •Increase public awareness of advanced directives •Collect data and send report to legislature (April 2027) Wisconsin Department of Health Services 14 Questions