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Children’s Long-Term Support: Incident Management for Counties

County waiver agencies help kids in the Children’s Long-Term Support (CLTS) Program live their best lives. This means county waiver agency staff must report any incidents that could harm a child.

Report an incident

Incident information for county staff

You must know how to spot an incident and report it. Incident reporting also applies to the Children’s Community Options Program.

What is an incident?

An incident is:

  • Actual or alleged abuse, neglect, or exploitation involving the participant, including:
    • Physical, verbal, and emotional abuse.
    • Sexual abuse or exploitation.
    • Neglect constituted by failure to seek medical attention, lack of food or nutrition, dangerous living situation, or lack of supervision.
    • Financial exploitation constituted by misappropriation of the participant’s funds or property.
  • Hospitalization, including:
    • Hospitalization due to an error in medical or medication management that results in an adverse reaction.
    • Psychiatric hospitalization.
  • Law enforcement contact or investigation involving the participant.
    • Incident reports are required only for a participant’s contact with law enforcement that is associated with risk to the health and safety of a participant or others.
    • Incident reports are required for a participant’s law enforcement contacts that are part of the participant’s crisis or behavior intervention plan.
  • Unapproved use of a restrictive measure, including:
    • Misuse of mechanical restraint or protective equipment.
    • Use of manual restraint.
    • Use of isolation or seclusion.
  • Death of the participant.

What do I do after I learn about a possible incident?

You must:

  • Gather more facts and details. This helps you know if the event is an incident you need to report.
  • Work with the CLTS provider and family to reduce further risk.
  • Review the child’s service plan to find ways to help prevent more incidents.
  • Make changes you talked about with the family during the service plan review.
  • Refer claims of child abuse and neglect to county child protective services or local law enforcement, if needed.
  • Report incidents to us, Wisconsin Department of Health Services (DHS).

Why do I need to report an incident?

You need to report incidents to DHS because:

  • We value the safety and well-being of the kids in our programs.
  • When you notice, fix, and report incidents, it helps service planning.
  • The Centers for Medicare & Medicaid Services requires us to report incidents.

How do I report an incident?

You must report all incidents in the Children’s Incident Tracking and Reporting (CITR) System. Chapter 9, §9.3, of the Medicaid Home and Community-Based Services Waiver Manual for the CLTS Waiver Program, P-02256 (PDF) outlines incident reporting requirements. 

For emergencies, call 911. 

When reporting an incident, keep in mind these required timeframes:

  • Within three business days of knowing about the incident—Use the CITR system to notify DHS.
  • Within 30 calendar days of knowing about the incident—Submit a report to DHS, using the CITR system. 

You also can use the CITR system to track and manage incidents and view incident history.

For more, see the CITR User Guide, P-02617 (PDF).

What if I need help with CITR?

If you need help with CITR, contact the Help Desk:

The Help Desk can help you:

  • Register for a user ID.
  • Log in to CITR.
  • Fix problems with entering information or sending a report to DHS.

 Related topics


Last revised September 1, 2022