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Is My Child Eligible for the Children’s Long-Term Support Program?

(#2 of 8 in Series)

Reviewed June 2024

The Children’s Long-Term Support (CLTS) Program provides funding and support for families who have children with disabilities, under the age of 22, who are Medicaid eligible, so they can care for their children at home and participate in their communities. This article explains the eligibility process.

Get Started with Eligibility for the CLTS Program

A child may be eligible for CLTS if he or she has a significant disability that’s expected to last more than one year and is living at home or a foster care setting. A diagnosis from a health care provider may not be necessary. Eligibility is based on a child’s functional limitations which can be physical, developmental or emotional and restrict their ability to carry out daily-living activities like dressing or eating, or may impact their learning, communicating or mobility. 

To participate in CLTS, a child must:

      • be under the age of 22
      • be a United States citizen
      • be a Wisconsin resident
      • have significant care needs: A child must need a high level of care throughout his or her day. The CLTS Program defines this as an institutional level of care like the care typically provided in a hospital, nursing home or facility for people with developmental disabilities.

Wisconsin Medicaid Coverage and CLTS

Your child must be eligible and meet all the requirements for Medicaid to be eligible for CLTS. For families whose income is above the BadgerCare Plus limit, your children may qualify for Home and Community-Based Service (HCBS) Medicaid or the Katie Beckett Medicaid Program. Eligibility for these Medicaid programs is based on the child’s level of care needs or disability and the child’s (not the parent’s) income. If your child is not currently enrolled, signing up for Medicaid, either through BadgerCare Plus, the Katie Beckett Program or SSI–Medicaid will be part of the process of enrolling in the CLTS Program.

Eligibility Process for the CLTS Program

Step 1: Contact your county agency at dhs.wisconsin.gov/clts/contact.htm.                              

Step 2: Review the eligibility requirements (listed above) with agency staff.

 Step 3: Set up a call or visit to talk more about the long-term support programs, including CLTS and the Children’s Community Options Program. Someone at your child’s school, Birth to 3 Program staff, doctor’s office, or a grandparent or other relative can also contact the agency to start this process.

 Step 4: If your family decides to move forward with finding your child’s eligibility, you will be contacted to schedule a meeting. You will also get paperwork that includes Release of Information forms to allow your child’s doctors, school and other providers to discuss your child’s information with CLTS agency staff. 

 Step 5: CLTS staff will set up a home visit to get to know your child and family and make an eligibility determination. This must be done within 45 days of the initial application. During that visit, a screening tool, called a Functional Screen, will be used to assess your child’s level of care needs and functional limitations.

The Functional Screen is a tool that collects information on your child’s health, need for support and how they play and interact with others. The worker will rely heavily on your input to fully understand your child’s limitations, care needs and challenges. This is the time to be realistic about the things that your child can do and the areas where more support is needed than other children their age. 

Tip for Families

Imagine that you had to leave your child with a distant relative for a week, or a month. How would you explain everything that you do to keep your child safe, healthy and cared for? Your instructions would be pretty elaborate! It is this level of detail to mention during the functional screen. Tell the screener the issues that might happen only occasionally, as well as things that happen every day.

Step 6: County Agency staff will work with your family to complete all needed paperwork. Medical records, school reports and your child’s IEP may be requested as part of an eligibility determination. If your child isn’t covered by Medicaid yet, agency staff can help your family complete the application and enrollment process.

Step 7: Your family will receive a letter letting you know if your child is eligible for the CLTS Program. This process can take up to 45 days from the initial referral. If you have not heard back, call your county to ask for an update—It’s okay to call weekly while you are waiting.

 

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.

Family Voices of Wisconsin, 2024©  |  familyvoiceswi.org

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