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DLTC INFO MEMO 2008-05

STATE OF WISCONSIN
Department of Health and Family Services 
Division of Long Term Care
DLTC Info Memo Series 2008-5
Date: March 17, 2008

To: Listserv

For: County Departments of Human Services Departments
County Departments of Social Services Directors
County 51 Directors
County Fiscal Contacts
County COP and Waiver Coordinators
Children's Services Specialists

From: Sinikka Santala
Administrator

Subject: LTC Fiscal Update Memo #7

This memo clarifies the process by which funding will be determined and moved from the Community Integration Program (CIP) to the Children's Long-Term Support (CLTS) waivers to assure on-going support for children now served through the developmental disability waiver programs. Effective January 1, 2008, counties will no longer be permitted to submit new CIP I waiver applications for children under the age of 18. Effective the same date, counties will not be able to move children from locally-matched CIP I slots to state-matched slots. The CLTS waivers are available statewide, and counties must serve children through these waivers.

The Department of Health and Family Services (DHS ) developed a series of assumptions to guide the expansion of Family Care. These assumptions included the following:

  • All state-matched CIP I slot funding currently used to support adults will transition to Family Care. The funding for children being served in state-matched CIP slots was not included in the Family Care expansion budget, and this funding therefore remains in the children's service system.
  • The calculations used to establish a county's original contribution to the long-term care system did not include the local funds used to support children in locally-matched slots. Language in 2007 Act 20 changed the base year for the county contribution calculations from CY 2005 to CY 2006. When the county contribution was recalculated using the CY 2006 base, all local funds used to support children (persons under the age of 18 years old on December 31, 2006) were excluded from the calculation.
  • An adjustment was made to the formula to reflect the state-matched CIP slots that were used to serve children in CY 2006.
  • The funding associated with the children served in state-matched CIP slots in CY 2006 will be moved to each county's CLTS funding base.
  • The HSRS reported data and the state data system for assigning state-matched CIP slots will be used to determine the number of children who were in state-matched slots on December 31, 2006.
  • The actual funding that is moved to CLTS will be based on the value of the slot assigned to each child.

A HSRS report using CY 2007 data was generated to verify the current numbers of children being served in the state-matched CIP slots. Counties that show an increase over the CY 2006 base year will be expected to justify the change in order to retain additional funding (e.g., a child was next on the wait list when a slot opened up).

Contract adjustments will be made to the appropriate CLTS waiver contract(s) to reflect the transfer of CIP funding to the CLTS waivers. A corresponding contract reduction will be made to the appropriate CIP waiver program. Counties must use the children's functional screen to determine the appropriate CLTS waiver. If the value of the CIP slot identified as being used to serve a child is greater than the actual expenses for that child, the county may (i) designate the additional funding to serve other children or (ii) offset local match expenses. The Bureau of Long-Term Support's Children's Service Specialist (CSS) staff will work directly with each county to convert children to the CLTS waivers.

How to Move a Child from a CIP Waiver to CLTS Waiver for Counties Transitioning to Managed Care

Counties will be required to identify all children served through CIP state-matched and local match slots. The County will be asked to work directly with CSS to assure a smooth transition to the CLTS waivers for all children now served through the CIP waivers. A county must notify the Community Integration Specialist (CIS) of a pending transfer from CIP to CLTS waivers. This notification must include: child's name; slot number; type of slot (local match or state funded); the slot value; and the CLTS waiver type, confirmed by the CLTS functional screen. The HSRS-generated list of children served in CIP state matched slots will be shared with the CSS. All children must be transferred to the CLTS waivers by the end of the county's transition period to managed long-term care (i.e., the first six months when waiver clients are transferred to managed care).

A county must send written notification to the family assuring the child's continued participation in managed care after age 18, as long as the child remains eligible. See Attachment A for a sample notification letter.

The process outlined below describes the transition of a child from a CIP slot to a CLTS waiver slot:

  1. The Bureau of Long Term Support's Developmental Disabilities Section will close the child's CIP slot, assign a new CLTS slot number, and notify the county through e-mail of the child's CLTS waiver slot number and the appropriate HSRS LTS Code. The CSS staff will send the formal notification to the county.
  2. The county will then open the child in the new CLTS waiver slot.
  3. The CSS will send a formal CLTS approval letter to the county.
  4. For counties in the transition phase to managed long-term care, all children currently being served through the CIP I program must be converted to the CLTS waivers by the end of the transition phase.
  5. CSS staff will work with all other counties to transfer the children identified on the CIP programs to the CLTS waivers. The funding identified for transfer to the CLTS base will be based on the CY 2006 base, The CY 2007 base will be considered only in very limited instances and with strong justification.

Note: A CLTS waiver application is not required to transfer a child from the CIP waiver to a CLTS waiver. Please contact your CSS with all questions.

For questions regarding the process for transferring a child from the CIP waivers to the CLTS waivers please contact the Children's Services Section or the Developmental Disabilities Section. The Children's Service Section Regional contact information can be found at: http://www.dhs.wisconsin.gov/bdds/clts/documentation/index.htm. The Community Integration Specialists contact information can be found at: http://www.dhs.wisconsin.gov/bdds/cip/index.htm.

If you have questions regarding the fiscal impact of funding moves, please contact:

MEMO WEB SITE: http://www.dhs.wisconsin.gov/dsl_info/

Last Revised: September 13, 2010