CLTS FS Instructions Module #11: Resources for Certified Screeners

Contents

11.1 CLTS Functional Screen Online Course
11.2 Obtaining, Deleting or Changing Access for Certified Screeners
11.3 CLTS FS Listserv
11.4 DHS Website for the Functional Screen
11.5 CLTS FS Coordinator
11.6 DHS SOS Help Desk
11.7 Process for Transferring a Functional Screen
11.8 Incomplete Screens
11.9 Note Sections on the CLTS FS
11.10 Reports Available on the CLTS FS
11.11 Not Functionally Eligible LOC Results


11.1 CLTS Functional Screen Online Course

Instructions on how to register for the online Children’s Long-Term Support Functional Screen (CLTS FS) course, presented via the DHS Learning Center.

  1. Go to the DHS Functional Screener Learning Center: https://wss.ccdet.uwosh.edu/stc/dhsfunctscreen (Exit DHS).
  2. Select the Registration link
  3. Click on the Registration Account Form
  • Print out the form and fill in your information. On the last page, indicate the course you wish to take. Fax or mail the completed form to UW-Oshkosh as indicated on the form. Note: Signatures are mandatory for account registration.
  • Registration account requests are processed within 24-48 hours. UW-Oshkosh PTS Registration staff will notify you by email of your logon ID. Your logon ID becomes your unique personal identification for future functional screen courses hosted on the Learning Center. Retain it for future use.

Accessing the course:
After you receive your logon ID, go to the DHS Functional Screener Learning Center at https://wss.ccdet.uwosh.edu/stc/dhsfunctscreen (Exit DHS).

  1. Click on the My Curriculum link on the left navigation bar.
  2. Select the Children’s Long-Term Support Functional Screen Certification Course.
  3. Click on the first Module Code FUNCT_100 to begin the course.

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11.2 Obtaining, Deleting or Changing Access for Certified Screeners

https://fsia.wisconsin.gov/ 

Obtaining Access to the CLTS Functional Screen

To gain access to the CLTS Functional Screen as a Certified Screener, follow these steps:

  1. Go to https://fsia.wisconsin.gov/
  2. If you do not already have a WAMS ID, you will need to select the ‘WAMS’ link and create one.
  3. Select the ‘FSIA Request Access’ link
  4. Complete the Functional Screen Web Access Request Form
  5. Note, item #10 Profiles = “Children's LTS Functional Screen”
  6. Send the signed Functional Screen Web Access Request Form and the certificate of achievement from the School of Nursing to the state security officer.

Changing Access Information
Whenever a change needs to be made to a screener’s access to the functional screen, a formal request must be submitted. This form is available on the State of Wisconsin’s Human Service System Gateway page, see link above.

Click on the link to ‘FSIA – Request Access’ and update the necessary information on the form and then follow the instructions on that page.

Maintaining Access with a Change in Name of an Employee
When a screener changes their name for any reason, they will need to submit a Functional Screen Web Access Request form to update this information.

Restricting Access to the CLTS Functional Screen
When a screener leaves your agency and no longer has need to access the CLTS Functional Screen, the screen lead or supervisor is responsible for directing the DHS SOS Desk to delete the screener profile for that person. This is important to ensure the integrity and confidentiality of the personal data that is kept on the CLTS FS website. If a screener will be doing screens in a different county or agency, he/she should have his/her profile reactivated by the new employer.

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11.3 CLTS FS Listserv

http://dhs.wisconsin.gov/LTCare/FunctionalScreen/signup.htm 

Once certified, screeners are strongly encouraged to sign up for the CTLS FS Listserv. The Listserv is the principle way in which DHS will notify you about changes being made to the CLTS Functional Screen, clinical instructions and other screen-related resources. DHS manages the list to make certain screeners do not get unnecessary emails. This is a primary tool for all certified screeners to stay current on the CLTS FS. All certified screeners are accountable to know the information provided through the Listserv whether or not they sign up for the Listserv.

To join/unsubscribe the Listserv: Go to the Functional Screen Listserv website above. You will receive a confirmation email after your request is approved. You should either store this message on your computer or print a hard copy for future reference. You must have an individual email address to participate in the Listserv. Listserv owners may verify that new subscribers have a need to know the information shared by the Listserv. After your request is received, an email will be sent to the Listserv that you are a new subscriber. You will recognize emails that come from the Listserv because the subject line will always begin with the name of the Listserv (Example: [cltsfslist] Update Volume 7, Number 3).

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11.4 DHS Website for the Functional Screen

http://dhs.wisconsin.gov/ltcare/FunctionalScreen/#childrens 

Certified Screeners can find important information concerning the CLTS FS at this website. Information includes:

  • Current Clinical Instructions,
  • Diagnosis Cue Sheet,
  • Paper Form of the CLTS FS,
  • Age Specific Questions for ADL and IADLs,
  • Links to available webcasts.

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11.5 CLTS FS Coordinator

Becky.Burns@wisconsin.gov 

Becky Burns is the CLTS FS Coordinator. She can be contacted regarding specific clinical questions on the CLTS FS. Contact the CLTS FS Coordinator when the final functional eligibility result is not what the screener expected or anytime a screener has a question about the options available on the CLTS FS. Under no circumstance should the CLTS FS Coordinator’s name appear in any individual child’s functional screen. Her recommendations are to the certified screener, not to the screen itself as she has not had the opportunity to meet the child in question.

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11.6 DHS SOS Help Desk

DHSSOSHelp@wisconsin.gov 
Phone: 608-266-9198

Screeners can receive technical assistance on the CLTS FS by contacting the SOS Help Desk. Technical assistance includes, but is not limited to, issues such as not being able to access the screen, changes in Social Security Numbers, finding two files for the same child in the CLTS FS database, etc.

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11.7 Process for Transferring a Functional Screen

The CLTS FS improves access to long-term supports for families by reducing multiple applications and eligibility reviews in order to access long-term supports and services. In addition to the benefits of this simplification for families is the reduction of duplication of effort by professionals at the state and county level. Central to this process is the acceptance of another certified screener's results for a child. Each certified screener has specific security and access rights. Therefore, a transfer process is needed to provide access to a certified screener in a different agency with differing security access. 

The functional screen is a protected health record under HIPAA (the Federal Health Insurance Portability and Accountability Act). Transferring screens between agencies must be done in compliance with federal confidentiality and security rules and requirements. Sharing of confidential information without signed consent between county agencies and between county agencies and state staff is outlined in Wisconsin State Statutes 51.30(4)(b) and 51.42, DHS Administrative Rule 92.04(5), and Federal Medicaid laws on confidentiality.

1.)  When requesting a screen be transferred:

  1. Contact the transferring agency and request that they transfer the screen to your agency. Provide the transferring agency with the exact name of the child, the child’s date of birth and the exact name of your agency as it appears in the CLTS FS application. This is especially important if there is more than one agency in your county.
     
  2. All requests for transfers from the Katie Beckett Program can be e-mailed to the KBP Central Office at DHSKatieBeckett@wisconsin.gov. In the ‘Subject’ heading state: CLTS FS Transfer.

2.)   When transferring a screen:

  1. Transfer the screen to the requesting agency. Be sure to confirm that you have selected:
    -- The correct individual applicant;
    -- The correct screen type (such as the adult screen, children's screen, mental health screen); and
    -- The correct receiving agency from the drop-down list.

  2. Notify the requesting agency that you have transferred the screen.

Once a screen is transferred, it cannot be revoked. If a screener transfers a screen to the wrong agency, only the agency that received the screen can transfer it back to your agency. It is not acceptable to ask the agency that incorrectly received the transferred screen to forward or transfer the screen to the correct agency. The agency that incorrectly received the screen must transfer the screen back to the agency that originally transferred the screen.

For instructions on how to transfer a functional screen, refer to the technical assistance document on our website at: http://dhs.wisconsin.gov/LTCare/FunctionalScreen/training.htm. If you need help transferring a screen, contact the SOS Help Desk at:

SOS Help Desk
608/266-9198 
DHSSOSHelp@wisconsin.gov
 

3.)  What the person receiving the functional screen will do:

The person receiving the screen must check that the correct child's screen was transferred. Within a timely manner, the screener should meet the child and complete a screen.

  1. INITIAL SCREEN
    Complete an INITIAL SCREEN if the child is applying for a different program in the new county.

  2. RESCREEN
    Complete a RESCREEN if the child is continuing services within the same program in a different county.

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11.8 Incomplete Screens

Incomplete Screens create multiple problems on the CLTS FS. By definition, an incomplete screen is a screen where functional eligibility has not been calculated. This error happens most often when a screener has used EDIT to update information on an existing screen and has not recalculated eligibility. It may seem to the screener that the updated information was not pertinent to functional eligibility but the screen may still require recalculation. Any time a screener enters information in the CLTS FS they must save that information by advancing to a new page and checking to see if "Eligibility" in the left hand navigation column continues to have a green check mark next to it. If there is no green check mark, then functional eligibility must be calculated again.

There are two other ways to know if a screen is complete or not. The first is to look on the "My Recent Screens" page. If there is a clock image next to "CLTS" in the same row as the child's name, then that screen is incomplete. The other is to run the Screen Summary at Agency Level report to generate a list of all incomplete screens by a screener's name.

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11.9 Note Sections on the CLTS FS

Note sections are available on every page of the CLTS FS. This space is provided for the screener to enhance or support the items they have checked (or did not check) on each page. Some screeners may use the note section to complete necessary requirements for individual programs (e.g., narrative assessment for Waivers). However, this is NOT the primary purpose of the note sections as they relate to the CLTS FS. The PRIMARY purpose or expectation is that notes will be made to strengthen and corroborate items checked on the screen.

The following specific notes are expected on certain pages:

DIAGNOSIS
Note any specific diagnosis the child may have that was found on the Diagnosis Cue Sheet as well as the actual titles of a child’s Diagnosis.

Examples:

  • 09/07/10: Developmental Disability and Seizure Disorder have been checked per the Diagnosis Cue Sheet for a diagnosis of Cornelia De Lange Syndrome. BB

  • 09/07/10: Metabolic Disorder has been checked per the Diagnosis Cue Sheet for a diagnosis of Sanfilippo Syndrome. BB

MENTAL HEALTH
Note all details regarding any check marks for specific Symptoms (Violence, Suicidality, Psychosis, and Anorexia/Bulimia). Note all specifics regarding any selection of Rare and Extreme Conditions.

Examples:

  • 09/07/10: Violence has been checked because the child took a knife to school last week and threatened to use it. The police were involved. BB

  • 09/07/10: Psychosis was not checked although this child has many behaviors that resemble psychotic behaviors including reporting that they are hearing voices. The doctors are still determining the actual root of the problems. BB

  • 09/07/10: Although this child continues to have a diagnosis of Anorexia, the symptoms are well managed and therefore Anorexia/Bulimia was not checked on this page. BB

  • 09/07/10: Child attempted suicide 2 months ago. They have recently been released from the hospital. The discharge summary verifies this information. BB

BEHAVIOR
Note a detailed description of any check marks for specific Behaviors, especially those which occur at a frequency of "1-3 times/week" or "more than 4 times/week" and anytime "Other" is checked.

Examples:

  • 09/07/10: Child is going through a difficult transition and has run away every weekend often requiring police to help find her. She reports that she was going to a friend's house or walking off steam but was found miles away from home often walking along the side of a highway. Both her parents and the police reports support this. BB

  • 09/07/10: Child engages in head banging behavior on a daily basis. She wear a helmet to protect her head both at home and at school. She will strike her head on walls and floors. This accommodation is in her IEP and she was wearing her helmet at the home visit. BB

FIVE (5) ATTRIBUTES OF CLTS FUNCTIONAL SCREEN QUALITY NOTES

Notes contain the evidence/substantiation/verification to support what is selected (or not selected) on the CLTS Functional Screen. There is a reason certified screeners select certain items on the CLTS Functional Screen. Notes should provide the facts/details/specifics that led to those decisions.

Purpose of Quality Notes
If a screen is reviewed after a period of time (6 months, a year, etc.), anyone (the screener, the child’s parents, an administrative law judge, the CLTS FS Coordinator, an agency supervisor, etc.) should be able to stand behind the functional screen results with the evidence contained in the note sections on the screen. It must be clear that functional eligibility was determined based on all evidence available at the time of completion by a professional certified screener.

Five (5) Attributes of Quality Notes:

  1. PROPER FORMAT
  2. PROFESSIONAL APPEARANCE
  3. PREVIOUS NOTES ARE ACCURATE OR DELETED
  4. INCORPORATE MULTIPLE SOURCES
  5. CONTAIN DETAILED EVIDENCE

1. PROPER FORMAT
Dates and initials appear with notes, in desired format.

  1. Newest notes at the top of the note section; and
  2. b. Date (MM/DD/YY) - Notes - Initials

Notes appear on every page of the CLTS FS. Proper formatting is important because uniformity of the most up to date note at the top of the note section means anyone reviewing the screen knows where to look for the most relevant information. The format serves the purpose of locking (bookends) in a screener's notes so that no one else can accidentally add to the notes a screener has written.

2. PROFESSIONAL APPEARANCE
Notes must reflect a professional, legal, court ready document. This includes correct spelling and grammar. The CLTS FS represents the screener's best work. Acronyms and abbreviations should not be used. Additionally, a screen with notes that are grammatically correct and correctly spelled will be easier for a subsequent screener or someone reviewing the screen to understand. Writing notes in a Word document where spell check can be used is recommended. These notes can then be copied into the CLTS Functional Screen.

3. PREVIOUS NOTES ARE ACCURATE OR DELETED
Previous inaccurate, irrelevant, unprofessional or no longer applicable notes are deleted from the CLTS FS. Every note on a functional screen must support the child’s current functional abilities. Notes are always saved with screens in the ‘History’ of the CLTS FS. If previous notes remain entirely accurate, and pertinent to the current screen, screeners should indicate that this is the case in a newly dated entry.

4. INCORPORATE MULTIPLE SOURCES
Notes indicate that findings were corroborated from multiple sources of information and specific sources are identified. Sources must represent the child’s functional abilities in multiple locations throughout their day. Multiple sources are important throughout the screen but are essential on all selected categories on the Mental Health, Behavior and IADL pages. Sources include:

  1. Child – observations during the home visit
  2. Parent – information shared during the home visit and in written form (application, etc.)
  3. Others – verbal reports from others in the child’s life
  4. Reports – written documentation of the child’s functional abilities

5. CONTAIN DETAILED EVIDENCE
Notes provide details of the child’s functional ability that led to what was or was not selected on the CLTS Functional Screen. Notes present evidence to answer the question, “How would someone know the information selected on the CLTS FS is correct?” Notes:

  • Include objective descriptions of skills demonstrated at the home visit;
  • Provide evidence gathered from reports; and
  • Provide facts including the what, who, why, where, when with specific content.

When another person (e.g., another screener, hearing officer, parent or CLTS FS Coordinator) looks at a screen you have completed, it should be clear from reading the brief notes, why certain questionable items have been checked (or not checked) on the screen. This does not mean that there needs to be a note made every time a check mark is made. The critical notes are those that address items on the screen that might be questioned by someone else reviewing the screen.

Examples of items that do not require notes:

  • A child with Cerebral Palsy who has items checked on the ADL page.
  • A child with Down Syndrome who has items checked on the IADL page.
  • A child with Bipolar who has services checked on the Mental Health page.
  • A child with Spinal Muscular Atrophy who has items checked on the HRS page.

Examples of items requiring notes:

  • A child with Down Syndrome who has Running Away checked on the Behavior page.
  • A child with Depression who has Respiratory Treatments checked on the HRS page.
  • Any child who has Violence checked on the Mental Health page.
  • Any child who has Torture or Abuse of Animals "4 or more days each week" checked on the Behavior page.

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11.10 Reports Available on the CLTS FS

The reports available on the CLTS FS were designed for use by screeners and agencies. To access the reports from any page within the functional screen, select REPORTS from the upper right corner of the page:

Screenshot of CLTS FS

Select Children’s Long Term Supports Reports:

Screenshot of summary reports page

There are currently four reports available:

Screenshot Children's Summary Reports

1.) Screen Summary at Agency Level

This report helps agencies monitor screens that are incomplete, when screeners are completing screens, and the types of screens being completed among other factors.

View Screen Summary information by specifying any combination of criteria:

  • County;
  • Agency;
  • Screener;
  • Status (incomplete or complete); and/or
  • Screen Archive Status (active or archived)

Information can be collected within a specific date range. The report generated can be sorted as specified and created as a PDF document or EXCEL spreadsheet.

Screenshot of screen summary report criteria page

Once all criteria are selected, click SUBMIT.

The report will list:

  • Child's Name;
  • Child's Date of Birth;
  • Child's SSN;
  • Screener's Name;
  • Screen Completed Date;
  • County of Residence;
  • County of Responsibility;
  • Screen Type (Initial or ReScreen); and
  • Status (Complete or Incomplete)

Screenshot of a screen summary report
 

2.) Screen Time Report

This report helps agencies monitor the amount of time it takes for screeners to complete the tasks involved in meeting an applicant and completing a functional screen.

View Screen Time information by specifying any combination of criteria:

  • County;
  • Screener;
  • Agency; and/or
  • Screen Archive Status (active or archived)

Information can be collected within a specific date range. The report generated can be sorted as specified and created as a PDF document or EXCEL spreadsheet.

Screenshot of a screen time report criteria page

Once all criteria are selected, click SUBMIT.

This report will generate a list that includes all of the following information:

  • Screener's Name;
  • Child's Name;
  • Child's Date of Birth;
  • Child's SSN;
  • Screen Complete Date;
  • Screen Type (Initial or Annual);
  • Screen Time;
  • Referral Date;
  • Screen Begin Date;
  • Days from Referral Date to Screen Begin Date; and
  • Days from Screen Begin Date to Screen Completion

This report also computes total screen time for an agency and for each screener within an agency.

Screenshot of a screen time report


3.) Screener Summary at Agency Level

This report helps agencies monitor the status of their screeners. This is especially important when an employee leaves employment or assumes a different role in the functional screen process.

View Screener Summary information by specifying any combination of criteria:

  • County;
  • Agency;
  • Screener Status (Active or Inactive); and/or
  • Screener Profile (Child Screener, Child Screener - View Only)

Information can be collected within a specific date range. The report generated can be sorted as specified and created as a PDF document or EXCEL spreadsheet.

Screenshot screener summary report criteria page

Once all criteria are selected, click SUBMIT.

This report will generate a list that includes all of the following information:

  • Screener's Name;
  • Certification Begin Date;
  • Certification End Date;
  • Screener Profile (Child Screener, Child Screens - View Only); and
  • Status (Active, Inactive)

Screenshot of a screener summary report
 

4.) SSN Status Report

This report is available so that screeners can view applicants who do not have a verified SSN.

View SSN Status information by specifying any combination of criteria:

  • County;
  • Screener;
  • Agency; and/or
  • SSN Status

Information can be collected within a specific date range. The report generated can be sorted as specified and created as a PDF document or EXCEL spreadsheet.

Screenshot of SNN status report criteria page

Once all criteria are selected, click SUBMIT.

This report will generate a list that includes all of the following information:

  • Child’s Name;
  • Child’s Date of Birth;
  • Child’s Gender;
  • Screener’s Name;
  • Child’s SSN; and
  • SSN Status

Screenshot of a SNN screen time report

 

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11.11 Not Functionally Eligible LOC Results

Once functional eligibility is calculated an icon appears in the upper right corner of the Eligibility Results page for every child (see image below). By clicking on the “Print NFE Results” icon, a new pdf document will open which will outline Not Functionally Eligible (NFE) Results. Note that this option does not work on previous eligibility calculations, or history screens. Previously calculated screens will display the Child’s Results as “null.”

Image of the Eligibility Results page with the Print NFE Results icon
Screenshot: Print NFE icon

The new NFE Results document will outline the criteria for each of the four Institutional Levels of Care. Following the criteria, the specific Child’s Results will be outlined.

Image of the DD Level of Care NFE Results
Screenshot: DD LOC

Possible NFE Results for the Developmental Disability (DD) LOC:

  • This child does not have a diagnosis of a Cognitive Disability or a similar diagnosis as required to meet Criterion 1 of the DD Level of Care.
  • This child does not demonstrate substantial functional limitations as required to meet Criterion 2 of the DD Level of Care.
  • This child has a diagnosis of a Cognitive Disability or a similar diagnosis but does not demonstrate a substantial impairment in Learning as required to meet Criterion 1 of the DD Level of Care.

Image of the SED Level of Care NFE Results
Screenshot: SED LOC

Possible NFE Results for the Severe Emotional Disturbance (SED) LOC:

  • This child does not have a diagnosis of a mental health condition as required to meet Criterion 1 of the SED Level of Care Requirements.
  • This child’s mental health diagnosis has not existed for the required duration of time as required to meet Criterion 2 of the SED Level of Care Requirements.
  • This child’s mental health diagnosis is not expected to persist for the required duration of time as required to meet Criterion 2 of the SED Level of Care Requirements.
  • This child is not currently receiving or in need of involvement with the mental health service system as required to meet Criterion 3 of the SED Level of Care Requirements.
  • This child does not exhibit severe symptomology or dangerous behaviors at the intensity / frequency or required interventions to meet Criterion 4; Standards I-VI of the SED Level of Care Requirements.
  • This child does exhibit the rare or extreme circumstances or substantial social competency impairment required to meet Criterion 4; Standard VII of the SED Level of Care Requirements.

Image of the NH Level of Care NFE Results
Screenshot: NH LOC

Possible NFE Results for the Nursing Home (NH) LOC:

  • This child does not have a diagnosis of a medical or physical disability as required to meet Criterion 1 of the NH Level of Care Requirements.
  • This child does not require the skilled nursing interventions or does not have substantial functional limitations required to meet Criterion 2 of the NH Level of Care Requirements.

Image of the HOS Level of Care NFE Results
Screenshot: HOS LOC

Possible NFE Results for the Hospital (HOS) LOC:

  • This child does not meet the need for frequent and complex medical care that requires the use of equipment to prevent life-threatening situation for the required duration.

With the information provided in the NFE Results document, screeners can gather information from the CLTS Functional Screen, the Institutional Levels of Care and all additional documentation they have about the child to formulate a clear and concise explanation on why a child did not meet any one or all four levels of care. This pdf document cannot be shared with families as it is only a tool for certified screeners to use to guide their final eligibility decision. In addition, this information cannot be used to artificially change a child’s functional eligibility results without documented evidence specifically related to the child’s abilities, needs and limitations.

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Last Revised: April 29, 2014
Wisconsin Department of Health Services
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