DDES Memo Series 2006-21
Date: September 15, 2006
To: Listserv
For: Area Administrators / Human Services Area Coordinators
Bureau Directors
Coordinated Service Teams/Integrated Service Program Directors
County Departments of Community Programs Directors
County Departments of Developmental Disabilities Services Directors
County Departments of Human Services Directors
County Departments of Social Services Directors
County Family Support Coordinators
Community Integration Specialists (CIS)
Licensing Chiefs / Section Chiefs
Tribal Chairpersons / Human Services Facilitators
From: Sinikka Santala
Administrator
Subject: Children’s
Long-Term Support Home and Community-Based Services Waivers (CLTS
Waivers)
Document Summary
This memo describes county responsibility for implementing all target
groups of the Children's Long-Term Support Medicaid Home and
Community-Based Services Waivers (CLTS Waivers). This memo replaces
DDES 2003-10, which outlined original implementation requirements of
the CLTS Waivers.
The CLTS Waivers are Medicaid 1915(c) Home and Community-Based
Services Waivers (HCBSW) approved by the Centers for Medicare and
Medicaid Services (CMS). There are three approved CLTS Waivers in
Wisconsin that relate to the following federal target groups:
developmental disabilities, physical disabilities, and substantial
mental health needs. The CLTS Waivers began operation January 1, 2004.
The CLTS Waivers have an upper age limit of 22 years. A broad array
of services and support are available under the CLTS Waivers that are
comparable to services delivered under other HCBSW. Unique services
under the CLTS Waivers include childcare, consumer and family-directed
services, and intensive autism treatment services.
The CLTS Waivers are one component of Children's Long-Term Support
Redesign. The CLTS Waivers offer a more family-directed set of services
and supports while maximizing revenue opportunities for the long-term
support system. The CLTS Waivers offer opportunities to counties to
maximize state General Purpose Revenue (GPR) funds available under such
programs as the Community Aids, the Family Support Program or the
Community Options Program, as well as county funding through local Tax
Levy, by providing the required non-federal match to leverage Federal
Financial Participation (FFP) funds.
Counties use the Human Services Reporting System (HSRS) - Long-Term
Support Module to track individual costs under the waivers. Costs are
tracked to each individual target group using HSRS so that county
reporting under the state-county contracting system will be as simple as
possible.
Additional policies and procedures for operating the CLTS Waivers are
available in the DHFS Interim HCBS Waiver Manual (http://dhfs.wisconsin.gov/bdds/waivermanual/index.htm).
County Operation of the CLTS Waivers
The CLTS Waivers are approved through the CMS as statewide programs.
Every county is required to implement operation of all three CLTS
Waivers, including the following target groups: developmental
disabilities, physical disabilities, and substantial mental health
needs. The CLTS Waivers must be operated statewide for all target groups
per federal HCBSW requirements. A county may choose to have different
county departments administer different target groups for the CLTS
Waivers, or may choose to contract with another county to offer services
for a particular target group.
For children from any target group whose families contact the county
for long-term support services, the county must assess the child's
eligibility for services under the CLTS Waivers or other relevant
programs including the Family Support and Community Options Program.
This determination of eligibility for long-term support services is
consistent with the requirements under Wisconsin statute 46.985 (6)(a).
The Children's Long-Term Support Functional Screen facilitates this
process by determining eligibility for six program areas relevant to
children with disabilities and long-term support needs. If the child is
eligible for the CLTS Waiver for any target group, but funding is not
available for a slot, the county must create and maintain a waiting list
of those children. The county agency does not need to complete a
comprehensive assessment until such time that funding is available. This
waiting list may be maintained concurrently with the Family Support or
Community Option s Program wait lists. All policies regarding HCBSW
waiting lists may be found in the DHFS
Interim HCBS Waiver Manual.
For counties that are administering Intensive In-Home Autism
Treatment Services directly, counties are required to administer these
services both to children who are in the developmental disabilities and
substantial mental health needs target groups.
For those counties that chose in 2003 to decline participation in
administering Intensive In-Home Autism Treatment Services, the State
will continue to administer these services for children with
developmental disabilities and substantial mental health needs. For all
children applying for long-term support services other than Intensive
In-Home Autism Treatment Services (Intensive Services) in counties not
administering Intensive Services, a county must follow the procedures
outlined in this Memo.
The Children's Services Section in the Bureau of Long-Term Support is
available to support counties as needed in implementing the CLTS
Waivers.
To summarize, as relates to the CLTS Waivers, a county must:
- Administer all three CLTS Waivers, including all three federal
target groups;
- Assess the eligibility for all children who come to the county for
long-term support services for any relevant program including the
CLTS Waivers;
- Create a waiting list per the DHFS Interim Waiver Manual for the
CLTS Waivers if a child is eligible and funding is not currently
available, and
- Once funding is available and a child is enrolled in the waiver,
assure that individualized services and supports are identified and
provided per the Individual Service Plan.
REGIONAL OFFICE CONTACT: Human Services Area Coordinator
CENTRAL OFFICE CONTACT:
Beth
Wroblewski, Manager
Children’s Services Section
Bureau of Long Term Support
1 West Wilson St., Room 418
P.O. Box 7851
Madison, WI 53707-7851
608 266-7469
wroblbm@dhfs.state.wi.us
Jeffrey
Hinz, Supervisor
Women, Youth and Families Unit
Bureau of Mental Health & Substance Abuse Services
1 West Wilson St., room 850
P.O. Box 7851
Madison, WI 53707-7851
608 266-2861
hinzje@dhfs.state.wi.us
MEMO WEB SITE: http://dhfs.wisconsin.gov/dsl_info/
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