Summary of Revisions to the Medicaid Home and Community-Based Services Waiver Manual for the Children’s Long-Term Support Waiver Program
The updates included in the most recent (October 2024) version of the Medicaid Home and Community-Based Services (HCBS) Waiver Manual for the CLTS Waiver Program, P-02256 (PDF), are summarized below.
Chapter 1–Overview and Administration
No changes
Chapter 2–Eligibility
§ 2.5: clarification that verifying non-financial eligibility for MA is handled outside of the CLTS Waiver Program, and removed “If the participant is eligible for a type of non-Client Assistance for Re-employment and Economic Support System (CARES) MA, such as Foster Care MA, Adoption Assistance MA, SSI MA, or Katie Beckett MA, the participant is not referred to IM.”
Chapter 3–Financial Eligibility
No changes
Chapter 4–Provider Requirements and Allowable Services
- § 4.6.4.1: added the children’s foster care service must be operationalized in accordance with Memo 2024-01 “Children’s Long-Term Support Program Funding Guidance for Children’s Foster Care Services”
- § 4.6.2: clarification that approval only from the Department of Children and Families (DCF) Exceptions Panel is required for the placement of any Children’s Long-Term Support (CLTS) Waiver Program participant in a level 5 foster home.
- § 4.6.4.4: added the following children’s foster care service exclusion:
- The basic maintenance rate is excluded and may not be billed to the CLTS Waiver Program.
- § 4.6.4.6: removed referral to the Children’s Long-Term Support (CLTS) Waiver Program Treatment Foster Care Administrative Rates (P-00700), associated with the children’s foster care service documentation requirement for the CWA to maintain documentation that clearly describes the individual room and board, care, and supervision costs in the facility and shows that CLTS Waiver Program funds do not reimburse room and board costs.
- § 4.6.25.1: clarification that relocation services include supports and essential items needed to establish a community living arrangement for children or youth who are relocating from an institution or other provider-operated congregate living arrangement (examples include but are not limited to a foster home, group home, or homeless shelter), or who are moving out of the family home to a more independent setting.
- § 4.6.25.1: clarification that relocation services may include the purchase of allowable supports and essential items when necessary specifically for the participant, to prepare the selected living arrangement for their occupancy.
- § 4.6.25.1: clarification that relocation services covers only initial costs to prepare the living arrangement.
- § 4.6.25.3: added the following relocation services limitations:
- Coverage of security deposits is limited to relocations involving only the participant.
- Coverage is limited to supports and items other than those a participant’s natural supports (e.g. participant’s family) would typically cover for a relocation involving a minor child or youth who does not receive Medicaid home and community-based services.
- This service covers only supports and items needed specifically for the participant in order to prepare the selected living arrangement for their occupancy; supports and items needed or used by any other individuals are not covered.
- § 4.6.25.4: added the following relocation services exclusion:
- This service excludes any ongoing costs associated with covered supports and items.
Chapter 5–Use of Funding in Substitute Care
- § 5.2.2: edited to read “Administrative costs apply only to participants residing in a level 3, 4, or 5 treatment foster home. CWAs must comply with the standards outlined in Memo 2024-01 “Children’s Long-Term Support Program Funding Guidance for Children’s Foster Care Services” for coverage of administrative costs through the CLTS children’s foster care service.”
- § 5.5: removed
- Calculating Expenses for a CLTS Foster Home Using Actual Expenses (F-01715)
- Calculating Expenses for a CLTS Foster Home Using the Uniform Foster Care Brochure (F-01716)
- CLTS Program Approved 2023 CLTS Treatment Foster Care Administrative Rates (P-00700)
- Instructions—Calculating CLTS Foster Care Room and Board Expenses (F-01721)
Chapter 6–Enrollment and Recertification
§ 6.2: removed requirement for CWAs to notify the functional screen inbox of a late functional screen.
Chapter 7–Individual Service Plan
No changes
Chapter 8–Participant Rights and Appeal and Grievance Processes
No changes
Chapter 9–Health and Safety
No changes
Chapter 10–Transition
No changes
Appendix A
Updated