Children’s Long-Term Support: Eligibility and Enrollment Streamlining Disenrollment and End Dates

Support and service coordinators (SSCs) at county waiver agencies use eligibility and enrollment streamlining (EES) to manage enrollment in the Children’s Long-Term Support (CLTS) Program. This includes kids joining and leaving the CLTS Program. When a child leaves the program, we call it disenrollment. There are two types of disenrollment that happen in EES:

Automated—EES removes the child from the CLTS Program. Does not require an SSC.
Manual—SSCs use EES to remove the child from the CLTS Program. SSCs must include an end date.

Automated disenrollment

There are two reasons EES automatically disenrolls a child from the CLTS Program:

Age—If the child gets too old. EES disenrolls them on the last day of the month when they turn 22. They receive a disenrollment notice.
Death—If the child dies and their Medicaid enrollment ends, their CLTS enrollment will automatically end. SSCs can also manually disenroll children who have died if needed. The family does not receive a disenrollment notice.

EES does not automatically disenroll kids if any of these apply:

They aren’t enrolled in Medicaid. Learn how SSCs confirm Medicaid coverage.
They are not functionally eligible.
They are late with level of care re-evaluations they must do each year.

This function is off to prevent kids from losing CLTS services by mistake. SSCs must manually monitor kids who are enrolled. They can help fix eligibility issues or end enrollment in EES.

Manual disenrollment

There are two reasons SSCs might disenroll a child from the CTLS Program:

The SSC verifies that the child doesn’t meet CLTS eligibility requirements.
The family says they don’t want to get CLTS services.

To complete disenrollment, SSCs must enter an end date and one of the listed EES stop reasons:

DOD
Moved out of state
Not functionally eligible
No longer accepting services
No Medicaid eligibility
Residing in a non-eligible setting
Transition to Adult Long-Term Care Program

Note: Stop reasons last updated Jan. 24, 2018.

Disenrollment notices

When an SSC enters an EES stop reason, the system sends a disenrollment notice to the family. The system sends the notice on Tuesday, the week after the SSC enters the end date. The actual end date doesn’t affect when the notice goes out.

The system does not send a disenrollment notice for these EES stop reasons:

Date of death—When a child dies while in the CLTS Program.
Waiver agency transfer—When a child moves to a new county in Wisconsin. The sending county waiver agency ends the enrollment with their agency in EES. Then the receiving agency enrolls the child. Since the child is not disenrolling from the CLTS Program, they do not get a disenrollment notice. They get an enrollment confirmation letter after they’re enrolled with their new county.

How to choose an end date

When a child leaves the CLTS Program, the SSC must add the right end date in EES.

Reasons that require a 10-day notice

When SSCs enter an end date, most of the time, the EES system sends families a disenrollment notice. In some cases, it’s important that families get the notice at least 10 days before the effective date. We want to give them enough warning. Below are EES stop reasons that require a 10-day notice:

Moved out of state
No longer accepting services
No Medicaid (MA) eligibility
Not functionally eligible (NFE)
Transition to an Adult Long-Term Care Program

End date to enter in EES—Date must be at least two weeks away from Friday of the current week. This ensures the family get enough notice.

If the EES stop reason will happen after two weeks from Friday, enter the effective date as the end date.

Ineligible setting reason

If a child is living in a space that disqualifies them from the CLTS Program, SSCs can suspend enrollment in the EES system. SSCs must send a notice when they’ve suspended CLTS services. However, they do not have to send this notice 10 days in advance.

End date to enter in EES—Date can be as early as Tuesday of the next week. This is the day the notice sends.

If the reason will happen after Tuesday of the next week, enter the actual date as the end date in EES.

Date of death reason

If a child dies, we do not send a disenrollment notice.

End date to enter in EES—Date of death.