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Bureau of Assisted Living
Online License and Certification Continuations
via e-Renewal
STATE OF WISCONSIN
Division of Quality Assurance
Bureau of Assisted Living
P-01731 (11/2020)
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Contents
Overview of e-Renewal for Wisconsin Assisted Living License/Certification Continuation.............................................................................. 3
System Highlights.................................................................................................................................................................................... 4
License/Certification Continuation Process – Paper and Electronic ........................................................................................................... 5
Instructions to Sign Up for e-Renewal License Continuation and Assign Roles for the Facility Reporter and Facility Payer Roles .................. 8
Instructions for the Facility Mailing Contact Role in License/Certification Continuations ............................................................................... 10
Example of Email Notification to the Facility's Designated Mailing Contact .............................................................................................. 10
Example of Past Due Email Notification to the Facility's Designated Mailing Contact ............................................................................... 11
Instructions for the Facility “Sign” Role in License/Certification Continuations ............................................................................................. 12
Information to Prepare for the Biennial/Annual Report ............................................................................................................................ 12
Logging In ............................................................................................................................................................................................. 13
Instruction Screen ................................................................................................................................................................................. 14
Facility Selection Screen and e-Renewal Status..................................................................................................................................... 15
If Facility has Closed ............................................................................................................................................................................. 16
Changes that Require Working with Regional Office............................................................................................................................... 17
Completing a Biennial or Annual Report................................................................................................................................................. 19
Facility Information............................................................................................................................................................................. 20
Licensee Information ......................................................................................................................................................................... 21
Pop-Up Error Messages..................................................................................................................................................................... 22
Mailing Contact Information................................................................................................................................................................ 23
License/Certification Details ............................................................................................................................................................... 24
Other Licenses/Certifications ............................................................................................................................................................. 25
Public Funding................................................................................................................................................................................... 26
Monthly Rates and Expenses............................................................................................................................................................. 27
Other Sources of Income ................................................................................................................................................................... 28
Non-Client Residents ......................................................................................................................................................................... 29
When Residents are at Facility ........................................................................................................................................................... 33
CBRF Only – Report Residents’ Rights Complaint.............................................................................................................................. 35
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Uploading Supporting Documents ...................................................................................................................................................... 36
Sign and Submit the Biennial or Annual Report .................................................................................................................................. 42
Completed Report – View, Save, and Print ......................................................................................................................................... 45
Instructions for the Facility “Pay” Role in License/Certification Continuations .............................................................................................. 48
Logging In ............................................................................................................................................................................................. 49
Instruction Screen ................................................................................................................................................................................. 50
Facility Selection Screen and e-Renewal Status..................................................................................................................................... 51
Facility Payment Confirmation Screen.................................................................................................................................................... 52
Facility Payment Screen ........................................................................................................................................................................ 53
Confirm Payment................................................................................................................................................................................... 56
Payment Confirmation Screen ............................................................................................................................................................... 57
Email Payment Confirmation.................................................................................................................................................................. 58
Instructions for How to Notify the Bureau of Assisted Living of Changes Related to e-Renewal ……………………………………………...59
Additional Help or Reporting Problems
Contact the Wisconsin Help Desk if you encounter problems or have additional questions. Use "Assisted Living e-Licensing” as the reason or
system in your call or email. This helps route the information to the correct staff to address your call or email.
By Phone: Madison: 608-261-4400
Toll Free: 1-866-335-2180
By Email: helpdesk@wi.gov
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Overview of e-Renewal Process for Wisconsin Assisted Living License/Certification Continuation
Submitting your biennial/annual reports and license/certification continuation payments has become easier using a new online system
developed by the Department of Health Services. Once registered, facilities will be able to submit their biennial/annual report online and
submit an online payment. If needed, you will be able to upload supporting documentation for your facility.
System Highlights
• Facilities that have been issued a regular license or certification are able to register for the new online process.
NOTE: Facilities with Community-Based Residential Facility (CBRF) probationary licenses are not eligible.
• Each registered facility’s official designated mailing contact will receive notification via email rather than postal mail.
• Ability to designate one individual to the role of submitting the biennial/annual report
• Ability to designate one individual to the role of making payment online using a credit card or electronic funds transfer/ automatic clearing
house (ACH) via the US Bank secure site
• Ability to have one individual assigned both roles, the report submitter and the payer
• Ability to upload supporting documents such as contract verification with waiver agencies for public funding, revised program statements,
etc.
• Ability to save your progress and return at a later time to complete and submit the biennial/annual report
• Ability to print your completed biennial/annual report after submission
• Email confirmation of the license/certification payment
• Email reminder to the facility mailing contact at due date if the report and payment have not yet been submitted
• Ability to note in the online system that facility has a change requiring approval or different fees and allowing the regional office to
complete the changes and license continuation for this cycle via paper. The e-renewal system will still be available for use during the next
license/certification cycle.
• Removes the “wait” time in the process for mail and Bureau of Assisted Living processing time
NOTE: It is the facility's responsibility to keep the Bureau of Assisted Living (BAL) informed of all changes to the official mailing contact. If
registered for e-renewal, it is also the facility's responsibility to inform the BAL of any changes to the “Sign” and “Pay” roles defined within
this document. Report changes to the regional office serving your facility at https://www.dhs.wisconsin.gov/dqa/bal-regionalmap.htm
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License/Certification Continuation Process – Paper and Electronic
Time Frame
Current Paper Process
New e-Licensure Process
60 days prior to current
license or certification end
date
License and certification continuation letters and blank
biennial/annual reports are printed and mailed to the
facility's mailing contact.
Email is generated and sent to the facility mailing contact
email address on the 25
th
day of the second month
preceding license/certification expiration with a copy of
the license/certification notice letter as an attachment.
Facility mailing contact forwards report to the individual
within the facility or company approved to complete the
biennial/annual report.
Facility mailing contact forwards the email and attachment
to the individual(s) that are documented as (1) completing
the biennial/annual report and (2) paying the
license/certification fee. (These roles may be completed by
the same person or two different individuals at the
facility.)
The individual approved to complete the report completes
the paper report and forwards on for payment processing.
The individual approved to complete the report completes
and submits the online report. The payment for the facility
may now be completed online by the individual approved
to complete the online payment.
A payment in the form of check or money order is created
and mailed in. Both the paper biennial/annual report and
the fee must be received by Division of Quality Assurance
(DQA) in order to process.
An online payment is made; all information submitted in
the biennial/annual report is automatically processed. The
payer will receive a confirmation email.
NOTE: Facilities registered for e-renewal must submit
payment online. Facilities may not complete the
biennial/annual report online and the submit payment via
paper check.
BAL staff review the biennial/annual report for
completeness and changes made to the BAL facility
database, if needed. The current license/certification period
is modified to reflect the new effective and end dates.
BAL staff follow-up as needed based on changes entered
online in the biennial/annual report. This includes tasks
such as reviewing a revised program statement, printing a
new facility license if the facility name has changed, etc.
BAL staff follows up, as needed, based on the type of
notice created by the automated system. This includes
tasks such as reviewing a revised program statement,
printing a new facility license if the facility name has
changed, etc.
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30 days prior to current
license/certification end date
Late reminder notice is sent via mail.
NOTE: This notice used to be processed on the current
license/certification end date. It will now be processed and
mailed soon after the current due date.
Late reminder email will be sent to facility mailing
contact’s email address.
CBRF Only: If no report or fee is received, CBRF
accruement of daily penalty fee starts per Wis. Stat. §
50.037(2)(c).
CBRF Only: If no report or fee is received, CBRF
accruement of daily penalty fee starts per Wis. Stat. §
50.037(2)(c).
License/certification current
end date
If appropriate fee and/or report are not received, a late
reminder notice is sent via mail.
If appropriate fee and/or report are not received, the e-
renewal process is marked “Expired” online and the online
system is no longer available. The facility will need to
contact the regional office to discuss options for
completing the license/certification renewal cycle.
30 days after current
license/certification end date
If no report and/or fee are received, BAL Regional
Director is notified; facility will receive a statement of
deficiency (SOD) with enforcement.
If no report and/or fee are received, BAL Regional
Director is notified; facility will receive a statement of
deficiency (SOD) with enforcement.
10 days after SOD is issued
(a minimum of 40 days after the
current license/certification process
end date)
If no report and/or fee are received, license/certification is
revoked.
If no report and/or fee are received, license/certification is
revoked.
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License/Certification Continuation Process Flowchart
Date Current
License/Certification
Period Ends
30 Days
License/
certification is
revoked.
“Past due” notice is
sent.
“Due” notice
for license/
certification fee
and biennial/
annual report is
sent.
Fee and report
are due.
Fee or report are
not received.
CBRF Only
Daily fee
accruement
begins per
Wis. Stat.
§ 50.037(2)(c).
30 Days
10 Days
30 Days
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Instructions to Sign Up for e-Renewal License Continuation and Assign Roles for the Facility Reporter
and Facility Payer Roles
To use the BAL e-renewal system, you must first create an account on the Wisconsin Web Access Management System (WAMS). The steps
involved in creating a WAMS account are as follows:
1. Access the WAMS web site at https://on.wisconsin.gov/WAMS/SelfRegController.
2. Read the overview information and User Acceptance Agreement. Click the “Accept” button at the bottom of the screen.
3. Follow the self-registration instructions. When completing the self-registration information, it is not necessary to enter your “Home
Resident Address” or your “Home Mailing Address;” both areas can be left blank.
NOTE: The email address you enter under “Profile Information” will be used to send the confirmation message in step 7 below. If
you are creating more than one WAMS account for your facility (one for the individual who will complete the annual/biennial
report and a second for the individual who will submit the license/certification payment), you must use different email addresses
for the two accounts. The email addresses you supply in this step are ONLY used for the WAMS account registration process. All
email correspondence the BAL sends to the e-renewal system users will go to the MAILING CONTACT EMAIL ADDRESS that
BAL has on file for your facility. Your contact email address and the WAMS account email address do not need to be the same .
4. YOUR WAMS ID MUST BE UNIQUE. Most commonly, IDs consist of some variant of the individual’s name, such as the last name
followed by the first and middle initials. However, if you attempt to create an account using an ID that has already been registered, you will
be required to choose another ID. You may need to include numbers or special characters in your ID if you have a common name.
If you already have a WAMS ID, do not create another one. Many other Wisconsin government programs or agencies utilize the Web
Access Management System to provide external users with access to online applications. If you have an existing WAMS account but do
not remember your ID or password, use the WAMS account recovery process to reactivate it rather than creating another account.
The account recovery process can be accessed by clicking on the “Account Recovery” link at the bottom of the WAMS main page at
https://on.wisconsin.gov/WAMS/home.
5. After creating your WAMS ID, follow the requirements for creating a valid password.
6. Under “Account Recovery,” enter a secret question and answer. You will need to provide the answer to your secret question if you ever
need to recover your account, most commonly because you’ve forgotten your password. Please note that BAL does not have a record of
your password and cannot reset it for you, so it is advisable to write down your WAMS ID, the associated WAMS account email address,
and your password and keep them in a secure location.
7. Upon receiving your confirmation email (at the email address you supplied in step 3 above), use the link in the email to activate your
WAMS account.
8. After you have activated your WAMS account, you will need to notify the BAL so that we can register you as a user of the e-renewal
system. To notify BAL, send an email to dhsdqabalregistration@dhs.wisconsin.gov listing (1) your WAMS ID, (2) the role(s)/function(s)
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you will perform using the account, and the name and license number of the facility(s) whose license(s)/certification(s) continuation you
will process using this account. The available roles are:
a. SIGN – Annual/biennial report completion and attestation only;
b. PAY – License/certification fee payment only; or
c. SIGNPAY – Both report completion and payment.
For an illustration of the preferred email format, see below:
FROM: yourname@yourdomain.com
TO: DHSDQABALRegistration@dhs.wisconsin.gov
CC:
SUBJECT: BAL e-Renewal WAMS Account Registration
Please register the following WAMS account for use with the BAL e-renewal system:
WAMS ID: yourWAMSID
Role: SIGNPAY
Facility(s):
Facility 1 – Facility Name and License No. (example: 0012345)
Facility 2 – Facility Name and License No. (example: 0067890)
Facility 3 – Facility Name and License No. (example: 0097531)
If you have questions or encounter problems while creating your WAMS account, you may contact DQA’s Information Management Section
for assistance by phone or email at:
608-264-9898 or Richard.Betz@dhs.wisconsin.gov
414-227-4509 or Anthony.Luckett@dhs.wisconsin.gov
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Instructions for the Facility Mailing Contact Role in License/Certification Continuations
The designated mailing contact for the facility will receive an email approximately 65 days prior to the end date of the current
license/certificate. The email will have an attachment containing the same letter that is received via the paper process. The mailing contact
should forward the email to the appropriate personnel responsible for submitting the biennial/annual report and submitting payment.
Example of Email Notification to the Facility's Designated Mailing Contact
From: DHSDQABALSROLCC@dhs.wisconsin.gov
To: Dennis Silver <dsilver@sharpiehouse.com>
Cc: DHS DQABALSRO LCC
Subject: Certification continuation for APPLEWOOD II NEW BERLIN (0010265)
Date: Friday, November 11, 2016 10:40 AM
Attachments: ContinuationLetter.pdf
This email was sent to DENNIS SILVER for SHARPIE HOUSE, License 0009180.
This facility has an online certification continuation fee and/or annual report due. The annual certification continuation notice is attached. The
individual(s) approved to complete the annual report and/or pay the continuation fee for this facility must log in to the e-renewal system at
https://health.wisconsin.gov/apis/secure/ALL1.html and complete the process by the date indicated on the attached notice.
If you have any questions, please contact your regional office.
Thank you,
State of Wisconsin, Department of Health Services
Division of Quality Assurance, Bureau of Assisted Living
Southern Regional Office
PO Box 7940
Madison, WI 53707-7940
608-266-8598
DHSDQABALSROLCC@dhs.wisconsin.gov
NOTICE: This email and any attachments may contain confidential information. Use and further disclosure of the information by the recipient must
be consistent with applicable laws, regulations and agreements. If you received this email in error, please notify the sender; delete the email; and do
not use, disclose or store the information it contains.
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Example of Past Due Email Notification to the Facility's Designated Mailing Contact
The designated mailing contact for the facility will receive an email when the facility has not submitted the biennial/annual report and payment
on the due date. The email will have an attachment containing the same letter that is received via the paper process. The mailing contact
should follow-up with the appropriate personnel responsible for submitting the biennial/annual report and submitting payment. If the
facility is a community-based residential facility (CBRF), the daily late fee starts to accrue. The total late fee assessed will be calculated the day
the online payment is made.
From: DHSDQABALSROLCC@dhs.wisconsin.gov
To: Dennis Silver <dsilver@sharpiehouse.com>
Cc: DHS DQABALSRO LCC
Subject: Non-payment continuation for APPLEWOOD II NEW BERLIN (0010265)
Date: Monday, January 2, 2017 10:40 AM
Attachments: ContinuationLetter.pdf
This email was sent to DENNIS SILVER for SHARPIE HOUSE, License 0009180.
This facility has a past due license continuation fee and/or biennial report. Attached is a warning notice outlining the potential impact of the past
due continuation fee and/or report. The individual(s) approved to complete the biennial report and/or pay the license continuation fee for this
facility must log in to the e-renewal system at https://health.wisconsin.gov/apis/secure/ and complete the process.
If you have any questions, please contact your regional office.
Thank you,
State of Wisconsin, Department of Health Services
Division of Quality Assurance, Bureau of Assisted Living
Southern Regional Office
PO Box 7940
Madison, WI 53707-7940
608-266-8598
DHSDQABALSROLCC@dhs.wisconsin.gov
NOTICE: This email and any attachments may contain confidential information. Use and further disclosure of the information by the recipient must
be consistent with applicable laws, regulations and agreements. If you received this email in error, please notify the sender; delete the email; and
do not use, disclose or store the information it contains.
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Instructions for the Facility “Sign” Role in License/Certification Continuations
The facility mailing contact receives the email notification of the license/certification continuation process starting for a facility. The mailing
contact is responsible to notify the individuals assigned the role of “Sign” and “Pay” for the facility. This person with the role of “Sign”
prepares and submits the biennial/annual report. The biennial/annual report contains the same information that was requested on the paper
version of the report. The person with the role of “Pay” submits the electronic payment for the license/certification continuation fee.
The online report will show the information that the BAL currently has on the facility. The report submitter will review, verify, and change any
information prior to submitting the report. The license/certificate continuation fee may not be paid until the online report is submitted.
NOTE: Facilities registered for e-renewal must submit payment online. Facilities may not complete the biennial/annual report online and then
submit payment via paper check.
Information to Prepare for the Biennial/Annual Report
The reporting process will be completed very quickly if the following information is ready for each facility:
• Current contact information for the facility, the administrator, the licensee, and the designated mailing contact
• If changing the facility name, an electronic copy of the new program statement for the facility
• If the licensee is a company name, the Federal Employer Identification Number (FEIN)
• Other types of licenses/certificates the licensee has in addition to this facility
• If accepting public pay residents or participants, an electronic copy of the public funding agency contracts that include the agency name,
term, and signatures
• Minimum and maximum monthly rates if the facility is an adult family home (AFH), community-based residential facility (CBRF), or
residential care apartment complex (RCAC)
• Monthly expenses for salaries, lease/mortgage, and a total for all other expenses if AFH, CBRF, or adult day care (ADC)
• Other sources of income if the facility is an AFH or CBRF
• If the facility is an AFH or CBRF, information on all non-client residents 10 years of age or older that live at the facility, including first,
middle, and last name; relationship to the licensee; and date of birth
• If the facility is an AFH or CBRF, hours residents are not at the facility
• If the facility is an ADC, hours residents are at the facility
• If the facility is a CBRF and reporting a resident rights complaint, an electronic copy of the completed DQA form F-62430, Community-
Based Residential Facility Residents’ Rights Complaint Report
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Logging In
Click on the link provided in the license/certification email: https://health.wisconsin.gov/apis/secure/ALL1.html. Enter your Wisconsin Access
Management System (WAMS) ID and password. Please note that your screen will not have the “Acceptance Environment” title that may
appear on the screen shots in this document.
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Instruction Screen
Review the instructions on the next screen and select “Continue.”
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Facility Selection Screen and e-Renewal Status
This screen will display any facilities associated with the WAMS account of the person logged in that has started the online e-renewal process,
provided that person has either the “SIGN” or “SIGNPAY” role. Individuals with only a “SIGN” role will not see facilities listed once the
license/certification fee is paid. Individuals with only the “PAY” role will not see a facility listed until the annual/biennial report has been
submitted. Each facility will have one of the following statuses displayed:
NOT STARTED – The biennial/annual report has not been started.
IN PROCESS – The biennial/annual report has been started, but not submitted.
REPORT COMPLETED – The biennial/annual report has been submitted. No further changes may be made. (The individual who is
assigned to pay the license continuation fee is now able to select the facility for payment from their facility list.)
PAID – The biennial/annual license continuation fee has been paid and the process is now completed for this license/certificate period.
Please note that individuals with only the “SIGN” role will not see facilities on the list that have a status of “PAID.”
OFFLINE – A facility closure or change was indicated that could not be processed online. The license continuation process must be
completed with the regional office for this license period, if needed.
EXPIRED – The biennial/annual report was not submitted and/or the license fee payment was not made by the prescribed date. The
license continuation process must be completed with the regional office for this license period.
Facility ID
Facility
Payment Due Date
e-Licensure Status
View Report
0012676
BADGER ADULT DAY SERVICES
2016-05-31
EXPIRED
0013645
HOLIDAY DAY CENTERS
2017-01-01
NOT STARTED
0009109
MICHIGAN HOUSE
2017-01-01
OFFLINE
0009180
SHARPIE HOUSE
2017-01-01
NOT STARTED
0008736
FAMILY HOLIDAYS
2017-01-01
NOT STARTED
0009211
FOX VALLEY GROUP HOME
2017-01-01
REPORT COMPLETED
View Report
0010251
FOREST GLEN APARTMENTS
2017-01-01
IN PROCESS
0010265
HOME LIFE ASSISTED LIVING 2
2017-01-01
NOT STARTED
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If Facility has Closed
If the facility has closed, but the license/certification process was started, you must log in to the system, indicate that the facility closed and the
reason for the closure, then select “Continue.” You will receive a message, "Please contact your regional office." Select “Return to Previous
Screen.” You will not need to complete the biennial/annual report. Please follow-up with your regional office to provide information on the
closure. Please note that selecting “Exit” will take you back to the facility selection screen.
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Changes that Require Working with Regional Office
Some changes will require that you indicate the change in the e-renewal system and continue the license/certification process manually with the
BAL regional office. Listed below are the changes that require (1) prior approval, (2) approval and a change in fees, or (3) facility closure and
new application process.
• Facility Type Change (Examples: change to non-ambulatory, change from AFH to CBRF)
• Facility Address Change
• Licensee Name Change
• Resident Capacity Change or Number of Apartments Change
• Client Group Served Change
• Ownership Change (Examples: Partnership to LLC, or Individual to Corporation)
If one or more of these changes occur, log into the system and select the facility. Check the box to the left of the change you are making, then
select “Continue.” You will receive a message, "Please contact your regional office." Select “Return to Previous Screen.”
You will not need to complete the biennial/annual report online using the e-renewal program. Follow up with your regional office to provide
information on the change you are making and to receive a paper copy of the biennial/annual report to complete and submit payment via paper
check.
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Completing a Biennial or Annual Report
The online license/certification report contains the same information that is supplied on the paper copy of the report. The information that the
BAL has in its database will be displayed. The online system allows you to make changes to the data displayed for many of the fields, if
needed. The changes will be reflected in the database once the continuation fee is paid. If the facility is open and you have none of the changes
listed on the first page, select “Continue.”
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Facility Information
Review the facility information and make changes as needed. Be careful when entering information that the numbers and spelling are correct.
Select “Continue.”
• If you make a facility name change, you will be mailed a revised license/certificate along with a request to return your old
license/certificate.
• A FEIN will be required if a corporate licensee name exists.
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Licensee Information
Review the contact information for the license and update as needed. Select “Continue.”
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Pop-Up Error Messages
If you make an entry error (e.g., an invalid zip code or telephone number), a pink, highlighted, error message will appear next to the field
containing the error. Correct the information as needed. Select “Continue.”
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Mailing Contact Information
Review the contact information for the official mailing contact assigned for the facility and update as needed. Select “Continue.”
NOTE: If you change the email address of the mailing contact, the change does not take place until the license continuation fee is paid. If a late
notice email is sent, it will go to the email address originally shown on the mailing contact information screen.
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License/Certification Details
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Other Licenses/Certifications
Indicate all other types of licenses and certifications that the licensee holds by checking the box to the left of each applicable
license/certification type.
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Public Funding
If your facility serves residents or participants receiving public funding, indicate “Yes” to this question and supply the names of the agencies
with which the facility has an agreement or contract. You will be required to upload an electronic document that shows the funding agency
name, the expiration date, and signature for all agreements on a subsequent screen.
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Monthly Rates and Expenses
Review and revise the minimum and maximum monthly rate at your facility. This information is not required if the facility is an ADC.
If the facility is a CBRF, AFH, or ADC enter the monthly amounts for salary, lease or mortgage, and all other expenses. The total monthly
expenses will be calculated automatically. The expense information is not displayed if the facility is an RCAC.
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Other Sources of Income
If the facility is a CBRF or AFH and there are other sources of income, check the box to the left of each applicable source. This screen will not
be displayed if the facility is an RCAC or ADC.
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Non-Client Residents
If the facility is a CBRF or AFH, this screen will be displayed. If there are individuals over 10 years of age living at the facility but they are not
“resident clients” of the facility, they must be reported. BAL will verify that a criminal background check has been completed and is on file
with the Office of Caregiver Quality (OCQ). If there are no non-client residents, select “Continue.”
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To add names of non-client residents, select “Add Non-Client Resident.”
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Enter the requested information for the non-client resident, and select “Add Non-Client Resident.”
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The non-client resident just added will be displayed. To add additional non-client residents, select “Add Non-Client Residents” again. When
finished, select “Continue.”
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When Residents are at Facility
If the facility is a CBRF or AFH and residents are usually at the facility 24 hours per day/7 days per week, select the checkbox to the left.
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If the facility is a CBRF or AFH and the residents are usually NOT at the facility during certain days/hours, use the drop down menus to enter
the days and times when they are absent. For example, if residents are absent Monday through Friday between the hours of 10:00 AM and 2:00
PM, you would enter Monday for the “Begin Day of the Week,” Friday for the “End Day of the Week,” 10:00 AM as the “Begin Time,” and
2:00 PM as the “End Time.” Select “Continue” when finished.
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CBRF Only – Report Residents’ Rights Complaint
If the facility is a CBRF, this screen will be displayed. If you have a residents’ rights complaint to report, select the “Yes” checkbox. You will
be required to upload an electronic copy of form DQA form F-62430, Community-Based Residential Facility Residents’ Rights Complaint
Report, on the next screen. Select the “No” checkbox if you did not have a residents’ rights complaint. Select “Continue.”
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Uploading Supporting Documents
You may be required to upload certain documents based on your report entries. You may also upload documents if you would like BAL to have
updated copies of your facility information. Documents should be in Adobe (.pdf), Word (.doc or docx), or picture (.jpg) format. For each
document type you want to upload, begin by clicking the “Browse” button to the right of the applicable document type.
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Use the drop-down arrow to select the drive where your document is stored and navigate to the appropriate folder to find the file you wish to
upload.
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When you find your file, highlight it and select “Open.” The file name should appear in the box labeled “File Name.”
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On the Uploaded Documents screen, the file you just selected should be listed in the box immediately to the right of the applicable document
type. Note that the location (drive and folder) of the file is also shown. Repeat this process until you have located and saved all the documents
you need to upload.
NOTE: The documents are not yet uploaded.
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When you have located and saved all files to be uploaded, select “Upload” below the list of documents.
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Note the individual document names are now listed on the screen. Select “Continue.”
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Sign and Submit the Biennial or Annual Report
If you are not ready to submit your report, use “Return to Previous Screen” to go back to previous screens and review the information that was
entered.
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Select “Exit” to return to the Facility Selection screen. If you have not submitted your report, the status will be displayed as “In Process.” Note
that the continuation fee may not be paid until the report has been submitted.
To finish, select the facility that is “In Process.” You will need to click through each screen to confirm the information already entered and
make any necessary changes.
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When you are ready to sign the report, select the checkbox to the left of the attestation statement. Select “Submit” to submit the report. At this
point you will be unable to make any further changes to your report.
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Completed Report – View, Save, and Print
Note that the “e-Renewal Status” now indicates the report for that facility is completed.
Click “View Report.” A dialog will open giving you the option to open or save your report. The report is an Adobe (.pdf) document and you
may need to download a copy of the free Adobe Reader if it is not already installed on your computer.
Once the report opens, use Adobe Reader options to “Print” or “Save” your biennial/annual report.
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Example: Page 1 of the Biennial/Annual Report (Note that your copy will be unique to your facility and information.)
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Example: Page 2 of the Biennial/Annual Report
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Instructions for the Facility “Pay” Role in License/Certification Continuations
The designated mailing contact for the facility will receive an email approximately 65 days prior to the end date of the current
license/certificate. The mailing contact is responsible for forwarding this email or otherwise notifying the appropriate personnel
responsible for submitting the biennial/annual report and submitting the license/certification continuation payment.
Once the individual fulfilling the “SIGN” role has completed the biennial/annual report submission process, the individual fulfilling the “PAY”
role will be able to submit the required license/certification continuation payment. The license/certificate continuation fee may not be paid until
the online report is submitted and the “e-Renewal Status” field on the facility selection screen shows a status of “REPORT COMPLETED” for
the facility in question.
NOTE: The individual performing the “PAY” role will not see the facility listed on their selection screen until the biennial/annual
report has been successfully submitted.
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Logging In
Click on the link provided in the license/certification email. It is https://health.wisconsin.gov/apis/secure/ALL1.html. Enter your Wisconsin
Access Management System (WAMS) ID and password. Note that your screen will not have the “Acceptance Environment” or “Test
Environment” messages that appear on the screen shots in this document.
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Instruction Screen
Review the instructions on the next screen and select “Continue.”
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Facility Selection Screen and e-Licensure Status
Users assigned only the “PAY” role in the e-renewal system will see (1) facilities listed where the individual with the “SIGN” role has
submitted the monthly report and the license/certification continuation fee is ready to be paid and (2) facilities where the fee has already been
paid. Facilities listed will display one of two statuses in the “e-Renewal Status” column:
REPORT COMPLETED – The biennial/annual report has been submitted. No further changes may be made to the report. The individual
who is assigned to pay the license continuation fee is now able to select the facility for payment from their facility list.
PAID – The biennial/annual license continuation fee has been paid and the process is now completed for this license/certificate period.
The selection button for these facilities will be “greyed out” and it will not be possible to select them. You may still view the completed
biennial/annual report by clicking the “View Report” link.
NOTE: Users with the “SIGNPAY” role will see all facilities associated with their WAMS ID, regardless of status.
Facility ID
Facility
Payment Due Date
e-Licensure Status
View Report
0014986
DANE SUPPORTIVE ADULT FAMILY HOME
2016-05-31
PAID
View Report
0009211
FOX VALLEY GROUP HOME
2017-01-01
REPORT COMPLETED
View Report
0009180
SHARPIE HOUSE
2017-01-01
REPORT COMPLETED
View Report
To start the payment process, click on the selection button to the left of the facility for which you are submitting payment.
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Facility Payment Confirmation Screen
The first payment screen shows the facility and the payment due. Note that you may select “Print Application/Report” to view, save, or print
the biennial/annual report. Select “Submit and Pay” to be routed to the payment screen to pay online using a credit card or electronic funds
transfer/Automatic Clearing House (ACH) via the US Bank secure site.
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Facility Payment Screen
The US Bank e-payment screen will appear. Note that you will not see the “test site” message or background. Enter the required information to
make the online payment.
Top portion of screen:
NOTE: The email address entered in the Contact Information section will receive a payment confirmation email once the transaction is
completed. This email address need not be the same as the email address associated with the WAMS account of the individual making
the payment.
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Bottom portion of screen:
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When finished entering the required information, select “Continue.” Note that any errors in data entry will result in an error message in red,
with the field containing the error highlighted. Correct any errors and click “Continue.”
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Confirm Payment
Review your information and select “Confirm” to complete your payment. Select “Back” if you need to return to the previous screen and make
corrections.
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Payment Confirmation Screen
The confirmation screen will provide a confirmation number. Select “Continue to State Agency website” to return to the facility selection
screen. You may process payments for additional facilities or log off by clicking “Exit.”
The “e-Renewal Status” on the facility selection screen now indicates “PAID.”
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Email Payment Confirmation
A confirmation email containing the confirmation number, payment amount, facility ID, and payer information will be sent to the email address
that was entered under Contact Information.
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Instructions for How to Notify the Bureau of Assisted Living of Changes Related to e-Renewal
It is the facility’s responsibility to keep the Bureau of Assisted Living (BAL) informed of all changes to the facility’s official mailing contact
on record.
If the facility is registered for e-renewal, it is also the facility’s responsibility to inform the BAL of any changes to the “Sign” and “Pay” roles
associated with the e-renewal program. This includes specifying the facilities for which individual(s) will be completing the annual/biennial
reports and/or submitting payments.
SIGN – Annual/biennial report completion and attestation only
PAY – License/certification fee payment only
SIGNPAY – Both report completion and payment
Report changes via email to the BAL regional office serving your facility. Locate the appropriate regional office at
https://www.dhs.wisconsin.gov/dqa/bal-regionalmap.htm. Include the following in your notification:
Facility name and ID
Updated information (new mailing contact email address, new WAMS account associated with facility, etc.)