SB82-SSA1,9,2521 48.685 (5m) Notwithstanding s. 111.335, the department may refuse to license
22a person to operate an entity, a county department or a child welfare agency may
23refuse to license a foster home under s. 48.62, and an entity may refuse to employ or
24contract with a caregiver or permit a nonclient resident to reside at the entity or with
25a caregiver specified in sub. (1) (ag) 1. am. of the entity if the person has been

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1convicted of an offense that is not a serious crime, but that is, in the estimation of the
2department, county department, child welfare agency, or entity, substantially
3related to the care of a client. Notwithstanding s. 111.335, the department may
4refuse to license a person to operate a child care center, the department in a county
5having a population of 500,000 or more, a county department, or an agency
6contracted with under s. 48.651 (2) may refuse to certify a child care provider under
7s. 48.651, a school board may refuse to contract with a person under s. 120.13 (14),
8and a child care center that is licensed under s. 48.65 or established or contracted for
9under s. 120.13 (14) or a child care provider that is certified under s. 48.651 may
10refuse to employ or contract with a caregiver or permit a nonclient resident to reside
11at the child care center or child care provider if the person has been convicted of or
12adjudicated delinquent on or after his or her 12th birthday for an offense that is not
13a serious crime, but that is, in the estimation of the department, county department,
14contracted agency, school board, child care center, or child care provider,
15substantially related to the care of a client.

SB82-SSA1,10,2517 48.685 (6) (am) Except as provided in this paragraph, every 4 years an entity
18shall require all of its caregivers and all nonclient residents of the entity or of a
19caregiver specified in sub. (1) (ag) 1. am. of the entity to complete a background
20information form that is provided to the entity by the department. Every year a day
21child care center that is licensed under s. 48.65 or established or contracted for under
22s. 120.13 (14) or a day child care provider that is certified under s. 48.651 shall
23require all of its caregivers and nonclient residents to complete a background
24information form that is provided to the day child care center or day child care
25provider by the department.

SB82-SSA1,11,10 248.979 Delegation of power by parent. (1) (a) A parent who has legal
3custody of a child, by a power of attorney that is properly executed by all parents who
4have legal custody of the child, may delegate to an agent, for a period not to exceed
5one year, any of his or her powers regarding the care and custody of the child, except
6the power to consent to the marriage or adoption of the child, the performance or
7inducement of an abortion on or for the child, the termination of parental rights to
8the child, or the enlistment of the child in the U.S. armed forces. A delegation of
9powers under this paragraph does not deprive the parent of any of his or her powers
10regarding the care and custody of the child.

SB82-SSA1,11,2111 (b) If a delegation of powers to an agent under par. (a) is facilitated by an entity,
12as defined in s. 48.685 (1) (b), that entity shall obtain the information specified in s.
1348.685 (2) (b) 1. with respect to the proposed agent and any nonclient resident, as
14defined in s. 48.685 (1) (bm), of the proposed agent. Subject to s. 48.685 (5), if that
15information indicates that the proposed agent may not be a contractor, as defined in
16s. 48.685 (1) (ar), of the entity or that a nonclient resident of the proposed agent may
17not be permitted to reside with the proposed agent for a reason specified in s. 48.685
18(4m) (b) 1. to 5., the entity may not facilitate a delegation of powers to the proposed
19agent under par. (a). The entity shall provide the department of health services with
20information about each person who is denied a delegation of powers or permission
21to reside under this paragraph for a reason specified in s. 48.685 (4m) (b) 1. to 5.

SB82-SSA1,11,2522 (c) A parent who has legal custody of a child may not place the child in a foster
23home, group home, or inpatient treatment facility by means of a delegation of powers
24under par. (a). Those placements may be made only by means of a court order or as
25provided in s. 48.63 or 51.13.

SB82-SSA1,12,2

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1(d) A delegation of powers under par. (a) does not prevent or supersede any of
2the following:

SB82-SSA1,12,43 1. An agency, a sheriff, or a police department from receiving and investigating
4a report of suspected or threatened abuse or neglect of the child under s. 48.981.

SB82-SSA1,12,65 2. The child from being taken into and held in custody under ss. 48.19 to 48.21
6or 938.19 to 938.21.

SB82-SSA1,12,77 3. An intake worker from conducting an intake inquiry under s. 48.24 or 938.24.

SB82-SSA1,12,108 4. A court from exercising jurisdiction over the child under s. 48.13 or 938.13.
9This subdivision does not preclude a delegation of powers under par. (a) that is not
10in conflict with a court order granted in the exercise of that jurisdiction.

SB82-SSA1,12,1511 (e) A parent who has delegated his or her powers regarding the care and
12custody of a child under par. (a) may revoke that delegation at any time by executing
13a written revocation and notifying the agent in writing of the revocation. A written
14revocation invalidates the delegation of powers except with respect to acts already
15taken in reliance on the delegation of powers.

SB82-SSA1,12,17 16(2) A power of attorney complies with sub. (1) (a) if the power of attorney
17substantially conforms to the following form:

SB82-SSA1,12,20 20Authorized by s. 48.979, Wis. Stats.

SB82-SSA1,12,2121 NAME(S) OF CHILD(REN)

SB82-SSA1,12,2322 This power of attorney is for the purpose of providing for the care and custody
23of:

SB82-SSA1,12,2424 Name, address, and date of birth of child ....

SB82-SSA1,12,2525 Name, address, and date of birth of child ....

SB82-SSA1,13,1

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1Name, address, and date of birth of child ....

SB82-SSA1,13,22 DELEGATION OF POWER TO AGENT

SB82-SSA1,13,43 I, .... (name and address of parent), state that I have legal custody of the
4child(ren) named above. (Only a parent who has legal custody may use this form.)

SB82-SSA1,13,55 I delegate my parental power to:

SB82-SSA1,13,66 Name of agent ....

SB82-SSA1,13,77 Agent's address ....

SB82-SSA1,13,88 Agent's telephone number(s) ....

SB82-SSA1,13,99 Agent's e-mail address ....

SB82-SSA1,13,1010 Relationship of agent to child(ren) ....

SB82-SSA1,13,1111 The parental power I am delegating is as follows:

SB82-SSA1,13,1413 (Check if you want to delegate full parental power regarding the care and
14custody of the child(ren) names above.)

SB82-SSA1,13,1615 .... Full parental power regarding the care and custody of the child(ren) named
16above

SB82-SSA1,13,1918 (Check each subject over which you want to delegate your parental power
19regarding the child(ren) names above.)

SB82-SSA1,13,2020 .... The power to consent to all health care; or

SB82-SSA1,13,2121 .... The power to consent to only the following health care:

SB82-SSA1,13,2322 .... Ordinary or routine health care, excluding major surgical procedures,
23extraordinary procedures, and experimental treatment

SB82-SSA1,13,2424 .... Emergency blood transfusion

SB82-SSA1,13,2525 .... Dental care

SB82-SSA1,14,1

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1.... Disclosure of health information about the child(ren)

SB82-SSA1,14,22 .... The power to consent to educational and vocational services

SB82-SSA1,14,33 .... The power to consent to the employment of the child(ren)

SB82-SSA1,14,54 .... The power to consent to the disclosure of confidential information, other
5than health information, about the child(ren)

SB82-SSA1,14,66 .... The power to provide for the care and custody of the child(ren)

SB82-SSA1,14,87 .... The power to consent to the child(ren) obtaining a motor vehicle operator's
8license

SB82-SSA1,14,99 .... The power to travel with the child(ren) outside the state of Wisconsin

SB82-SSA1,14,1010 .... The power to obtain substitute care, such as child care, for the child(ren)

SB82-SSA1,14,1411 .... Other specifically delegated powers or limits on delegated powers (Fill in the
12following space or attach a separate sheet describing any other specific powers that
13you wish to delegate or any limits that you wish to place on the powers you are
14delegating.) ....

SB82-SSA1,14,1715 This delegation of parental powers does not deprive a custodial or noncustodial
16parent of any of his or her powers regarding the care and custody of the child,
17whether granted by court order or force of law.

SB82-SSA1,14,2418 THIS DOCUMENT MAY NOT BE USED TO DELEGATE THE POWER TO
19CONSENT TO THE MARRIAGE OR ADOPTION OF THE CHILD(REN), THE
20PERFORMANCE OR INDUCEMENT OF AN ABORTION ON OR FOR THE
21CHILD(REN), THE TERMINATION OF PARENTAL RIGHTS TO THE
22CHILD(REN), THE ENLISTMENT OF THE CHILD(REN) IN THE U.S. ARMED
23FORCES OR TO PLACE THE CHILD(REN) IN A FOSTER HOME, GROUP HOME,
24OR INPATIENT TREATMENT FACILITY.

SB82-SSA1,14,2525 EFFECTIVE DATE AND TERM OF THIS DELEGATION

SB82-SSA1,15,8

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1This Power of Attorney takes effect on .... and will remain in effect until .... If
2no termination date is given or if the termination date given is more than one year
3after the effective date of this Power of Attorney, this Power of Attorney will remain
4in effect for a period of one year after the effective date, but no longer. This Power
5of Attorney may be revoked in writing at any time by a parent who has legal custody
6of the child(ren) and such a revocation invalidates the delegation of parental powers
7made by this Power of Attorney, except with respect to acts already taken in reliance
8on this Power of Attorney.

SB82-SSA1,15,99 SIGNATURE(S) OF PARENT(S)

SB82-SSA1,15,1010 Signature of parent .... Date ....

SB82-SSA1,15,1111 Parent's name printed ....

SB82-SSA1,15,1212 Parent's address ....

SB82-SSA1,15,1313 Parent's telephone number ....

SB82-SSA1,15,1414 Parent's e-mail address ....

SB82-SSA1,15,1515 Signature of parent .... Date ....

SB82-SSA1,15,1616 Parent's name printed ....

SB82-SSA1,15,1717 Parent's address ....

SB82-SSA1,15,1818 Parent's telephone number ....

SB82-SSA1,15,1919 Parent's e-mail address ....

SB82-SSA1,15,2020 WITNESSING OF SIGNATURE(S) (OPTIONAL)

SB82-SSA1,15,2121 State of ....

SB82-SSA1,15,2222 County of ....

SB82-SSA1,15,2323 This document was signed before me on .... (date) by .... (name(s) of parent(s)).

SB82-SSA1,15,2424 Signature of notary ....

SB82-SSA1,15,2525 My commission expires: ....

SB82-SSA1,16,1

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1STATEMENT OF AGENT

SB82-SSA1,16,82 I, .... (name and address of agent), understand that .... (name(s) of parent(s)) has
3(have) delegated to me the powers specified in this Power of Attorney regarding the
4care and custody of .... (name(s) of child(ren)). I further understand that this Power
5of Attorney may be revoked in writing at any time by a parent who has legal custody
6of .... (name(s) of child(ren)). I hereby declare that I have read this Power of Attorney,
7understand the powers delegated to me by this Power of Attorney, am fit, willing, and
8able to undertake those powers, and accept those powers.

SB82-SSA1,16,99 Agent's signature .... Date ....

SB82-SSA1,16,1010 APPENDIX

SB82-SSA1,16,1211 (Here the parent(s) may indicate where they may be located during the term of
12the Power of Attorney if different from the address(es) set forth above.)

SB82-SSA1,16,1313 .... I can be located at:

SB82-SSA1,16,1414 Address(es) ....

SB82-SSA1,16,1515 Telephone number(s) ....

SB82-SSA1,16,1616 E-mail address(es) ....

SB82-SSA1,16,1717 .... Or, by contacting:

SB82-SSA1,16,1818 Name ....

SB82-SSA1,16,1919 Address ....

SB82-SSA1,16,2020 Telephone number ....

SB82-SSA1,16,2121 E-mail address ....

SB82-SSA1,16,2222 .... Or, I cannot be located

SB82-SSA1,16,23 23(3) (a) In this subsection:

SB82-SSA1,16,2524 1. "Agent" means a person to whom delegation of the care and custody of a child
25under this section is facilitated by an organization.

SB82-SSA1,17,2

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12. "Organization" means an organization that facilitates delegations of the care
2and custody of children under this section.