Department of Health Services Logo

 

Wisconsin Department of Health Services

 

Children's Home

Birth to 3 Program

Children's Long-Term Support Waivers

Compass
Wisconsin:
Threshold
Unified Intake for Families

Family Support Program

Katie Beckett Program

Resources for Families and Children

County and Provider Resources

Medicaid HCB Waivers Manual

Appendix E (CLTS Forms)

Contact Us

 

Children's Long-Term Support Waivers
Information for County Agencies: Who is Eligible?

All children or young adults must meet the basic requirements listed below for CLTS Waivers eligibility. To qualify for certain types of funding, there may be additional requirements.

Every CLTS Waivers participant must:

  • be under 22 years of age;
  • be eligible for Wisconsin Medicaid, including:
    • be a United States citizen or have acceptable immigration status;
    • be a Wisconsin resident;
    • not have income in their name in excess of the current Medicaid standards;
  • live at home or in a foster care setting;
  • have a level of care (PDF, 134 KB) need that is typically provided in an institutional setting such as a hospital, a nursing home, or an institution for people with developmental disabilities;
  • be able to receive safe and appropriate care at home and/or in the community; and
  • be able to receive safe and appropriate care at home and/or in the community that does not have a cost to the Wisconsin Medicaid Program that exceeds the cost Medicaid would pay if the child were in an institution

Additional Requirements

Disability Determination is Required for “State-Matched” Waiver Funding. Any CLTS Waiver participant receiving services that are funded by the county’s CLTS-Other contract, CLTS-Autism contract, or any other fully state-matched source of funding must have a current disability determination. The county waiver agency must refer the family to the local Economic Support Unit for processing a Medicaid Disability Application when needed. The county waiver agency may complete the Step One process and enroll the child with Presumptive Waiver Eligibility while the disability application is in progress. If state-matched funds are utilized during that process and the disability application is ultimately denied, the county will be required to utilize local funds for the match instead of their state contracted funds.

Intensive In-Home Treatment for Autism Spectrum Disorders. For a child to be eligible to have their name placed on the state waiting list for intensive in-home treatment, the child must meet all of the basic eligibility criteria listed above. In addition, the following criteria must be met:

  • be under age 8 when his or her name is placed on the state wait list for services; this means that all eligibility criteria must be in place prior to age 8,
  • be determined to meet a disability determination as defined by Social Security Administration rules,
  • must have been a Wisconsin resident for at least six months,
  • family must have identified a qualified treatment provider who has agreed to provide services to the child when their name comes off the waiting list

All of the wait-list criteria are listed on the Wait List Criteria Checklist (Word, 74 KB) that the county submits when referring a child for intensive in-home treatment services.

Last Revised: April 22, 2014