LeadingAge Wisconsin continues to advocate for Wisconsin's Adult Family Home (AFH) providers as the Wisconsin Department of Health Services (DHS) considers a sweeping rewrite of DHS Chapter 88, the administrative code governing 3- and 4-bed Adult Family Homes.

The proposed rule would significantly expand requirements for staffing, employee training, nursing oversight, and physical building standards. While intended to modernize regulations that have remained largely unchanged for decades, providers are concerned that the proposal would impose substantial new costs without corresponding increases in reimbursement. Many fear the changes could force existing homes to close, discourage new providers from entering the field, and ultimately reduce access to home-like long-term care options across Wisconsin.

LeadingAge Wisconsin has been actively engaged throughout the rulemaking process. Upon the release of the proposed rule's economic analysis, the association joined the Wisconsin Health Care Association/Wisconsin Center for Assisted Living, the Wisconsin Assisted Living Association, and the Disability Service Provider Network in submitting a collaborative statement challenging the Department's assumptions and conclusions. The statement argued that the analysis substantially underestimates the true costs of implementing the proposed requirements, including expenses related to staff training, registered nurse oversight, facility renovations, fire safety systems, and ongoing compliance.

As part of those advocacy efforts, LeadingAge Wisconsin worked with member Mary Ognenoff, manager of assisted living facilities for Dodge County's Northview Heights CBRF, Trailview AFH, and Community AFH, to develop testimony presented during the June 7 public hearing on the proposed rule.

In her testimony, Ognenoff emphasized the unique challenges the proposal would create for county-operated Adult Family Homes, which rely on county levy funding and have limited flexibility to absorb new regulatory costs. She warned that the proposal could force counties to seek additional taxpayer funding, reduce services, or close facilities altogether. She also noted that the proposed 31-day implementation timeline is unrealistic for providers—particularly public entities operating on annual budget and levy cycles.

The testimony urged DHS to withdraw the current proposal and restart the rulemaking process in collaboration with providers and other stakeholders. Alternatively, it called for a minimum one-year implementation period and the creation of a hardship waiver process to give providers adequate time to comply with any new requirements.

LeadingAge Wisconsin will continue working with members and partner organizations to advocate for regulations that support resident safety while preserving access to affordable, community-based care throughout Wisconsin.