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

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
F-20445H Individual Service Plan - Children’s Long-Term Support Programs, Hmong 09/2022 Word Hmong No
F-20445I Individual Service Plan - Children’s Long-Term Support Programs, Instructions 09/2022 PDF English No
F-20445S Individual Service Plan - Children’s Long-Term Support Programs, Spanish 09/2022 PDF Spanish No
F-20445S Individual Service Plan - Children’s Long-Term Support Programs, Spanish 09/2022 Word Spanish No
F-20445A Individual Service Plan - Outcomes - Children’s Long-Term Support Programs 05/2022 Word English No
F-20445A Individual Service Plan: Outcomes, Children’s Long-Term Support Programs 05/2022 PDF English No
F-20445AH Individual Service Plan: Outcomes, Children’s Long-Term Support Programs, Hmong 05/2022 Word Hmong No
F-20445AH Individual Service Plan: Outcomes, Children’s Long-Term Support Programs, Hmong 05/2022 PDF Hmong No
F-20445AS Individual Service Plan: Outcomes, Children’s Long-Term Support Programs, Spanish 05/2022 Word Spanish No
F-20445AS Individual Service Plan: Outcomes, Children’s Long-Term Support Programs, Spanish 05/2022 PDF Spanish No
P-02012 Information about Disability Determinations for County Waiver Agencies 10/2017 PDF English No
F-21076H Informed Consent - Children's Long-Term Support Functional Screen, Hmong 03/2021 Word Hmong No
F-21076S Informed Consent - Children's Long-Term Support Functional Screen, Spanish 03/2021 Word Spanish No
F-21076 Informed Consent – Children's Long-Term Support Functional Screen 03/2021 Word English No
F-21076KA Informed Consent – Children's Long-Term Support Functional Screen, Karen 03/2021 PDF Karen No
F-21076RY Informed Consent – Children's Long-Term Support Functional Screen, Rohingya 03/2021 Word Rohingya No
F-21076SO Informed Consent – Children's Long-Term Support Functional Screen, Somali 03/2021 Word Somali No
F-21076V Informed Consent – Children's Long-Term Support Functional Screen, Vietnamese 03/2021 Word Vietnamese No
P-02246I Instructions 09/2018 PDF English No
P-02616 Instructions and Requirements for the Use of Protective Equipment and Mechanical Restraints in Children's Long-Term Support Programs 02/2022 PDF English No
P-02573 Instructions for CWA Fiscal Staff to Access the CLTS Data Warehouse External CWA Templates Folder 01/2020 PDF English No
F-00539 Instructions for the County Waiver Agency Support and Service Coordination (SSC) Rates 09/2019 PDF English No
P-03106 Intake Call and After Inquiry Guidance Sheet 09/2021 PDF English No
N/A January 4, 2024, CLTS Program TPA Transition Financial Management Services Provider Forum 07/2024 PDF English No
N/A January 9 & 11, 2024, CLTS Program TPA Transition Financial Management Services Provider Forum 07/2024 PDF English No

Glossary

 
Last revised January 25, 2023