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Children's Long-Term Support (CLTS) Waiver Forms and Publications - Resources for Counties

The CLTS Program Participant and Family Handbook is here!

This easy-to-use handbook was created to help families better understand the CLTS Program, so they can better access available supports and services and navigate the program with confidence.

Get the Children’s Long-Term Support Program Participant and Family Handbook, P-03689.

Below is a list of all Children's Long-Term Support (CLTS) Waiver forms and publications. If the document is available to order in a paper version, there will be a "Yes" with a link to ordering instructions.

When you are searching for a document, enter the number or a portion of the title in the search box below.

Assigned Number Title Release Date File Type Language Available to Order
P-02035 Children’s Long-Term Support (CLTS) Functional Screen Tips: Presenting Diagnoses 11/2017 PDF English No
P-02012 Information about Disability Determinations for County Waiver Agencies 10/2017 PDF English No
N/A Eligibility and Enrollment Streamlining Presentation 09/2017 PDF English No
N/A CLTS/WPS General Claim Submission Requirements 06/2017 PDF English No
N/A WPS CLTS County Waiver Agency Authorization File Tips 06/2017 PDF English No
F-20987 Authorized Representative Designation Medicaid Community Waiver Programs 03/2017 Word English No
F-21059 Variance Request for Institution Respite 03/2017 Word English No
F-20987S Representative Designation Medicaid Community Waiver Programs, Spanish 03/2017 PDF Spanish No
F-21059 Variance Request for Institution Respite 03/2017 PDF English No
F-20987 Authorized Representative Designation Medicaid Community Waiver Programs 03/2017 PDF English No
F-20987S Authorized Representative Designation Medicaid Community Waiver Programs, Spanish 03/2017 Word Spanish No
F-21072 Determination of Exceptional Care Needs for Children in Child Care or Foster Care Setting 03/2017 Word English No
F-00926A Request for Use of Medical Restraints - CLTSS 02/2017 Word English No
F-00926A Request for Use of Medical Restraints - CLTSS 02/2017 PDF English No
F-00412 Third Party Administration (TPA) Children's Medicaid Waivers Provider Billing and Service Information 02/2017 Word English No
N/A Sample Level of Care Termination Letter 09/2016 Word English No

Glossary

 
Last revised January 25, 2023