Summary of Revisions to the Children’s Functional Screen Clinical Instructions
The updates included in the most recent (May 2024) version of the Children's Long-Term Support Functional Screen (CLTS FS) Clinical Instructions. P-00936, are summarized below.
Module 1: Overview of the CLTS FS
1.4 Screening and Interview Process: Screeners are directed to review specific program manuals regarding screen visit requirements.
1.6 The NFE Process: Changed contacting the Wisconsin Department of Health Services (DHS) within 10 days after internal review to contacting DHS as soon as possible after an internal review.
Module 2: Informational Pages
2.3 Screen Type: Clarified the criteria for a child needing a new screen if they have not been found eligible for a program within the past 12 months.
2.3 Screen Begin Dates: Added that the screen begin date also establishes the age of the child at the time of the screening and generates the appropriate age cohort questions.
Module 3: Diagnosis
3 Diagnosis: Removed sentence stating that additional documentation is required to accept a reported mental health diagnosis.
3.2 Transplant Information: Removed information pertaining to the United Network for Organ Sharing (UNOS) list as this is not a list that is accessible to screeners.
3.3 Whose Diagnosis is Accepted: Clarified language to reflect that school records, Birth to 3 Program records, and the individualized education plan (IEP) can be used to identify some diagnoses. Clarified language that a suspicion of a diagnosis does not count for the screen and added autism spectrum disorder (ASD) as an example.
3.5 Mental Health Diagnoses: Updated this section to reflect DHS’s current guidelines surrounding how to verify a mental health diagnosis was made by a qualified provider using professional assessment and/or standardized testing, including that screeners can accept this detailed information from the parent.
3.6 Other Diagnostic Considerations: Added information regarding the need to identify what subtype of a diagnosis a child may have when selecting a diagnosis on the screen, using cerebral palsy as an example.
3.8 Is this a PRESENTING Diagnosis?: Added Example E, outlining a child with oppositional defiant disorder (ODD) and cognitive delay.
Module 4: Mental Health
4.3 Mental Health Symptoms/Minimum Frequency: Modified this section to provide better clarity and reduce redundancies. Clarified criteria for anorexia/bulimia as well as the definition of "violence."
4.4 Mental Health Services: Clarified the definition of “required” services.
4.5 Rare and extreme Conditions: Modified this section to provide better flow and clarity.
Module 5: Behaviors
5.1 Overview of Behaviors: Clarified meaning of internalizing self-regulation skills within the examples of Determining the Needs of the Child, not the Child in Services. "Substance abuse" has been changed to "substance use" here and throughout the document and screen. Added specificity regarding what to consider when reviewing some behaviors (headbanging, cutting, burning or strangulation, and destructive behaviors).
5.3 Frequency of Behaviors: Specified that changes due to medication should not be taken into account when reviewing frequency of behaviors.
Module 6: Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs)
Added examples to ADLs of: Bathing, grooming and dressing (sensory needs); eating (monitoring food intake); mobility.
Defined wording throughout IADLs for clarity.
Added examples of IADLs to: Communication (using language to share information). Defined wording throughout IADLs for clarity.
Module 7: School and Work
7.1 School: Added specificity to when to mark "Misses 50% of school due to Mental Health needs."
Module 8: Health-Related Services (HRS)
8.2 Medical or Skilled Nursing Needs
Recurrent cancer: Added language for primary/initial cancer diagnosis; "Stage IV Cancer" changed to "High Risk Cancer"; added criteria to mark high risk cancer.
Physical therapy (PT), occupational therapy (OT), or speech-language pathology (SLP) therapy: Aligned frequency of therapy to adult functional screen.
Wound, site care, or special skin care: Wound care language made more concise and include that parents have been trained.
8.3 Definitions for Particular Health-Related Services
IVs: Changed wording to reflect current medical language; added language to glucose monitoring.
Module 9: Screen Time and Notes
No changes made.
Module 10: Functional Eligibility Results
Updated information/name of "Eligibility Report."
Module 11: Resources for Certified Screeners
11.2 Obtaining, Deleting, or Changing Access for Certified Screeners: Edits for Wisconsin Web Access Management System (WAMS) access form update.
11.7 Process for Transferring a Functional Screen: Instructions updated for transferring screens. Links added to statute and administrative codes.