The Children’s Long-Term Support Program (CLTS) provides funding and support for families who have children with disabilities so they can care for their children at home and participate in their communities. To qualify, a child must meet a hospital or institutional level of need and be eligible for Wisconsin Medicaid.

The program is funded by the federal and state government but administered at the county level, so families typically work directly with a county agency (or their program administrator) to apply for and receive CLTS services.

This information provides an overview of the CLTS Program. For more information on eligibility, enrollment, creating Individual Service Plans, appealing a denial and more, see additional Family Voices of Wisconsin CLTS Fact Sheets in this series.

CLTS is one of the long-term support programs for children. The Children’s Community Options Program (CCOP) is another program that can help children with special needs. Both programs can help pay for supplies, services and supports above and beyond what private health insurance or Medicaid, also known as the Forward card, covers.

Some Examples of What Long–Term Support Programs Can Pay for Include:

• • • Home modifications such as a fence or ramp
    • Adaptive aids and vehicle modifications such as computers, standing frames or ramps
    • Supplemental childcare costs above what a family would pay for a typically-developing child
    • Parent training and education such as attending a conference or seminar
    • Counseling and therapy such as music or hippotherapy
    • Respite such as in-home direct care providers (Read our fact sheet on  Respite Services to learn more.)

Who is Eligible for the CLTS Program?

To be eligible for CLTS, a child also needs to be eligible for Medicaid. CLTS guidelines also state that the child may be eligible if he or she has a significant disability and is living at home, or foster care, and is under age 22. A child’s eligibility is based on his or her functional limitations, so eligibility for the program can be considered without a formal medical diagnosis. 

Functional limitations include physical, mental or emotional challenges that restrict a child’s ability to carry out daily living activities. After a child is accepted into CLTS, an annual screen will be done by their Support and Service Coordinator (SSC) to make sure they are still eligible for the program. Learn more about eligibility for CLTS on the DHS webpage. 

Getting Started with Enrollment in the CLTS Program

The CLTS Program is administered by County Waiver Agencies, so families will work directly with agency staff. To start the enrollment process, contact your local agency using this link dhs.wisconsin.gov/clts/contact.htm. Their staff complete intake, application and eligibility determination.

How is My Child’s Eligibility Determined?

A tool called a functional screen will be used to determine your child’s eligibility for CLTS. The tool collects information on your child’s health, need for support and their ability play and interact with others.

As the parent or family member, your input and insights are an important part of the process. Try to be as realistic as possible about your child’s needs and abilities. This is not the time to overstate what they can or might be able to do. It’s a time to think about what you or other adults in their life do to support them, even on the most difficult or challenging day.

If your child is found to be not eligible for CLTS, think about the details that might have been missed or the limitations and care needs that may not have been explained to the screener. Most often, these are the reasons children who should qualify, might not. You can ask to review the functional screen with the screener and ask for a second review by the agency. If you disagree with the result, you can file an appeal to ask for a formal review.

What Happens After My Child is Enrolled?

You will receive a letter from your county saying your child is eligible and the anticipated date to be enrolled in CLTS. A SSC will be assigned to your child and he or she will then meet with your family to get to know your child’s needs and challenges. The SSC will partner with you to create an Individual Service Plan (ISP). This annual plan documents the services to be provided including those that CLTS will pay for each year. Learn more about this process in Fact Sheet #4 in this series, What to Expect After a Child is Determined Eligible.

As you talk with your child’s SSC, think about the goals, or outcomes, you want for your child. The ISP includes services to help your child and family meet these outcomes. Learn about ISPs in Fact Sheet #5, Developing Your Child’s Individual Service Plan.

What Does the CLTS Program Cost?

There may be a Parental Payment fee for participating, for families who have incomes above 330% of the Federal Poverty Level. The annual fee depends on your income and the overall cost of your child’s ISP. Your SSC will let you know if you have a Parental Payment due and your family will receive a bill from the county.

What if a Service or Item is Denied?

If you want to appeal a denial, the best place to start is to work directly with your child’s SSC and/or their supervisor. Families have told us they have the best chance for success in navigating differences when they keep the conversation focused on the problem to be solved (keeping your child from leaving your yard) and less on a specific requested item (a fence). Remember, every item that’s approved must support the stated goal or desired outcome for your child.

If working with your SSC and agency supervisor fails, you can also complete the county’s grievance process and/or seek an appeal by requesting a fair hearing with the State Division of Hearings and Appeals. Learn about Fair Hearings in Fact Sheet # 8, Appealing a Denial.

Will We Have to Wait for Services?

The time between your child being found eligible and beginning enrollment (using the program) can vary. You will get a determination letter following the evaluation for eligibility that will let you know if there will be a delay. Most families should not have to wait more than one year to be enrolled in the CLTS Program once their child is determined eligible. Keep in mind that eligibility determination may take time, so families may wait before all paperwork and enrollment requirements are completed.

The CLTS Dashboard gives an estimate on any anticipated delays in enrollment, dhs.wisconsin.gov/clts/enrollment-dashboard.htm. 

INFORMATION AND RESOURCES

Wisconsin Wayfinder: Children’s Resource Network, 877-WiscWay (877-947-2929):  Wisconsin Wayfinder offers families one name and phone number to find services for children with special health care needs. Wayfinder connects you to a resource guide at one of the five Children’s Resource Centers in your area.