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Wisconsin Department of Health Services

Overview of the Long Term Care Functional Screen

The federal Centers for Medicare and Medicaid Services has approved the use of Wisconsinís Long Term Care Functional Screen (LTC FS) to determine functional eligibility for Wisconsinís Home and Community Based Waiver (HCBW) programs for children and adults. Wisconsinís LTC FS was developed to provide an automated and objective way to determine the long term care needs of elders and people with physical or intellectual/developmental disabilities and their functional eligibility for publically funded program assistance. These programs are the HCBW programs (CIP 1A, CIP 1B, CIP II, COP-W, Family Care, IRIS, PACE, and Partnership) and the Community Options Program (COP).

Use of the automated LTC FS began in October 2001 in five counties piloting the Family Care Program and in the Partnership Program. In 2002, use of the LTC FS expanded statewide to other LTC programs.

In addition to providing information key to determining functional eligibility, data collected on the LTC FS is used to inform rate setting for managed care program capitation payments and for research purposes. Screen data contains not only documentation of program applicantsí needs, but also identifies the degree of assistance required to address those needs.

The screen was developed with input from stakeholders, consumers and clinical practitioners. Several studies to test its validity and reliability were also completed. For more information, see Testing the Reliability and Validity of the Wisconsin LTC Functional Screen (PDF, 54 KB).

The LTC FS looks at a personís ability to complete both Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). ADLs include bathing, dressing, eating, mobility in home, toileting and transferring. IADLs include meal preparation, medication administration and medication management, money management, use of a telephone and transportation.

The LTC FS also looks at a personís cognition, behavior(s), diagnoses, medically-oriented tasks and employment; as well as indicators for mental health issues, substance use issues and other conditions that put a person at risk of institutionalization in a nursing home or Intermediate Care Facility for the Mentally Retarded (ICF-MR).

Upon completion of the LTC FS, the person who administered the screen may immediately view the applicantís level of care and functional eligibility result for Wisconsinís HCBW programs and COP.

Any information collected for completion of the LTC FS or during the screening process is confidential. Completion of the LTC FS is voluntary, but it is required to enroll in a HCBW program or COP. The LTC FS is a web-based application that must be entered online. In-depth instructions for how to complete the LTC FS are available online.

Only a qualified and experienced professional who has passed the online certification exam and who meets additional requirements can complete the LTC FS. An agency worker seeking to become a certified screener must work with their agency screen liaison to register for the online course.

Back to: Wisconsin's Functional Screen Home Page

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Last Revised:  October 11, 2012