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 fully participate in their communities.

As a Medicaid-connected program, it’s jointly funded by the federal and state government, but administered at the county level. Families typically work directly with a county agency (or their designated program administrator) to apply for and receive CLTS services.

Examples of what CLTS 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
    • In-home direct caregivers, called Respite Care Service – see Respite Services

Who is Eligible for the CLTS Program

To be eligible for CLTS, a child needs to be eligible for Medicaid. As part of program enrollment, your county will assist you in identifying the best fit Medicaid program. CLTS guidelines also state the child may be eligible if they have a significant disability and are living at home or foster care, and under the age 22.

Functional limitations may include physical, cognitive, mental health or emotional challenges that restrict a child’s ability to carry out daily living activities.

After a child is enrolled in the CLTS Program, an annual screen will be done by their Support and Service Coordinator to make sure they continue to be eligible for the program. Learn more: Who Is Eligible?

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 – dhs.wisconsin.gov/clts/apply.htm.  

How Eligibility is Determined

A tool called a Functional Screen is used to determine if a child meets the level of care needed to be eligible for CLTS. It collects information on a child’s health, need for support, and ability to play and interact with others.

As parents 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 may 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 days.

Waiting for Services to Begin

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 that will let you know if there is a delay. Eligibility determination may take time, so there may be a delay until all paperwork and enrollment requirements are completed. Families can get through this step as quickly as possible by being responsive to questions, sharing contact information for health professionals, and by prioritizing the initial appointments with agency staff.

The CLTS Dashboard gives an estimate of any anticipated delays in enrollment. 

Your Child is Found Not Eligible

If your child is found to be not eligible, think about the details that might have been overlooked or the limitations and care needs that may not have been explained to the screener. Most often, this forgotten information is the reason why children who should qualify may not. You can ask to review the functional screen with the screener and a second review by the agency. If you disagree with the result, you can also file an appeal to have a formal review – see CLTS factsheet on appealing denials.

Enrollment Process

If you receive a letter saying your child is eligible, it will include the anticipated date to be enrolled in CLTS. A Support and Service Coordinator will be assigned to your family and their first meeting with you will be to get to know your family and your child. They will partner with you to create an Individual Service Plan (ISP). This annual plan documents the goals you have for your child and outlines the services the Support and Service Coordinator can provide to support them in reaching these goals. Learn more – What to Expect After a Child is Determined Eligible.

Learn about ISPs in Fact Sheet #5, Developing Your Child’s Individual Service Plan.

CLTS Program Fees

There may be a Parental Payment fee for some families. The annual fee depends on your income, family size and the overall cost of your child’s plan. Your Service Coordinator will let you know if you have a payment due, and your family will be billed by the county.

When a Requested Item is Denied

There may be times when the CLTS Program does not approve a requested item or service, or they approve something you feel is less suitable than you requested. You have the right to appeal the denial. The best place to start is to work directly with your child’s Support and Service Coordinator and their supervisor. Families have told us they have found the best chance for success in navigating differences when they kept the conversation focused on the problem to be solved. For example, focusing the conversation on keeping your child from leaving the 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 from the ISP.

If working with your Support and Service Coordinator and agency supervisor fails, you can also complete the county’s grievance process or seek an appeal by requesting a Fair Hearing with the State Division of Hearings and Appeals. Learn more: Appealing a Denial.

Resources 

• The CLTS Program Participant and Family Handbook offers explanations for all topics related to the CLTS Program and where to learn more if your family has questions.

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.

Do you need a resource in another format or a printed copy? Contact Lynn@fvofwi.org.