Children’s Long-Term Support (CLTS) Waiver Program Support and Service Coordinator (SSC) Training: CLTS Waiver Basics

In accordance with the § 1915(c) home and community-based waiver application approved by the Centers for Medicare & Medicaid Services (CMS), all newly hired support and service coordinators (SSCs) are required to complete the CLTS Waiver Basics training.

Training Instructions

To complete the training, click on the series of links in each chapter. In most cases, you will be sent directly to the intended information; however, in a few instances you will be required to navigate to a specific section within a resource, for example, Ch. 2, section 2.02 a. (1).

The training is composed of resources citing the most up-to-date CLTS Waiver Program information. These resources include links to applicable sections of the CMS waiver application, Division of Medicaid Services (DMS) Information and Numbered Memos, guidance updates, relevant sections of the Medicaid Home and Community-Based Services (HCBS) Waiver Manual for the CLTS Waiver Program, and information on the Wisconsin Department of Health Services website. The training is based on the Waiver Manual and will be updated as revisions to the manual become available.

An Additional Resource list is also included with most chapters. This information is not required for the training and exam but can be used as needed.

The SSC training is a three-step process.

Step 1: Complete the Waiver Basics training and pass the exam to be certified to provide support and service coordination.

Step 2: Complete the Typical and Atypical Child Development Modules (four to six hours) and Think Possible! Employment Series trainings within the first six months of employment. These trainings can be found in the Waiver Basics training designated with an asterisk (*).

Step 3: After finishing each training in Step Two, print a copy of the completion certificate and keep in your file. If a certificate is not provided, complete an attestation stating that you have completed the training and the date this was achieved. The attestation must be signed by the employee and supervisor. The Support and Service Coordinator Waiver Basics Training Requirement Attestation form, F-02435 (Word), or your own form can be used to fulfill this requirement.

Note: The CLTS Functional Screen training is listed as an additional resource. This is not required for the Waiver Basics training, but any SSC who wants to be a functional screener must take the training and pass the exam to be certified.

Exam and Certification Requirements

Following completion of the Waiver Basics training, SSCs are required to take the Children's Long-Term Support (CLTS) Waiver Basics Exam, F-02008. A score of 80% or higher must be achieved to receive certification.

The final page of the exam includes notification of successful CLTS Waiver Certification if a passing score is achieved. This notification of certification must be maintained by the County Waiver Agency (CWA) and be available on request. The notification verifies that the SSC serving CLTS Waiver Program participants, and for whom the CWA receives reimbursement, is appropriately trained and qualified.

Keep copies of all completion certificates in your file. If a certificate is not provided, complete an attestation stating that you have completed the training and the date this was achieved. The attestation must be signed by the employee and supervisor. The Support and Service Coordinator Waiver Basics Training Requirement Attestation form, F-02435 (Word), or your own form can be used to fulfill this requirement. This documentation should be printed and kept in the employee's file.

CLTS Waiver Basics Training

Chapter 1: Overview and Administration

CLTS Waiver Program Description

The purpose of Wisconsin's CLTS Waiver Program is to support children who have substantial developmental, emotional, and/or physical disabilities and are living at home or in the community. The program aims to build on the capacity, resiliency, and unique abilities of children and their families to maximize inclusion in all facets of community and family life. (See About the Children’s Long-Term Support (CLTS) Waiver Program section.)

Wisconsin’s History With the Medicaid Home and Community-Based Waiver (HCBW) Program

Wisconsin began Medicaid HCBW programs in 1983. (See HCBS Waiver Manual for the CLTS Waiver Program​ Ch. 1, section 1.01 (PDF) , paragraphs 1-3.)

State Assurances to CMS

CMS requires states to meet certain requirements for receive HCBW funding. If these assurances are not met, a waiver will not be granted or may be terminated.

Chapter 1 Additional Resources

These resources are supplemental only. The material will not be included in the exam.

  • The Medicaid Home and Community-Based Services (HCBS) waiver program is authorized in § 1915(c) of the Social Security Act. The program permits a state to furnish an array of home and community-based services that assist Medicaid beneficiaries to live in the community and avoid institutionalization. (See Application for a 1915 (c) HCBS Waiver.)
  • The Fee-for-Service Selective Contracting Program operates concurrently with Wisconsin’s CLTS Waiver Program, a 1915(c) HCBS waiver program for children with developmental disabilities, physical disabilities, and severe emotional disturbances. (See the 1915(b)(4) Waiver application.)
  • In accordance with 42 C.F.R. § 441.302 (PDF), the state must provide assurances to CMS.
  • In accordance with 42 C.F.R. § 441.301(b)(1-6) (PDF), a person-centered written plan of care is completed for each participant.
  • CMS requires all states that operate HCBS waivers comply with a federal settings rule. The purpose of the settings rule is to ensure that people receiving services through home and community-based waiver programs have access to the benefits of community living and are able to receive services in the most integrated settings.

Chapter 2: Functional Eligibility

Eligibility Requirements
When a Participant Moves

When a participant moves from one county to another, both counties have the responsibility to ensure services continue. (See CLTS Waiver Manual, P-02256, Chapter 2 (PDF).)

Eligible Living Arrangements

The living arrangement of the child is reviewed when eligibility is being determined. (See CLTS Waiver Manual, P-02256, Chapter 2 (PDF).)

Services Assessment

SSCs assess the need for services to meet the child and family’s priorities and goals. (See CLTS Waiver Manual, P-02256, Chapter 7.(PDF))

Typical and Atypical Development Training*

Typical and Atypical Development training modules, created by the University of Wisconsin–Madison, explore the various stages of child development for both typically and atypically developing children. This training takes four to six hours to complete. Please keep a copy of the training completion certificate for your records.

* This training must be completed within the first six months of employment.

Chapter 2 Additional Resources

These resources are supplemental only. The material will not be included in the exam.

Functional Screen (FS) System

Wisconsin’s FS system is a web-based application used to collect information about an individual’s functional status, health, and need for assistance for various programs that serve the frail elderly and people with intellectual/developmental or physical disabilities. To become a screener, the SSC completes the FS training and passes the exam to achieve certification. A copy of the training completion certificate should be kept for your records.

Chapter 3: Medicaid Eligibility

Medicaid Enrollment Requirements
Parental Payment Limitations

Chapter 3 Additional Resources

These resources are supplemental only. The material will not be included in the exam.

CARES Process

The CLTS Waiver Program CARES process is used to assess whether the participant and family are eligible for BadgerCare Plus and the Group A Waiver or Group B or B Plus Waiver, based on the child’s income. (See Medicaid Eligibility Handbook, section 28.14.2.)

Katie Beckett Program (an alternative Medicaid source)

The Katie Beckett Program is a special eligibility process that allows certain children with long-term disabilities, mental illness, or complex medical needs, living at home with their families, to obtain a Wisconsin ForwardHealth Medicaid card.

Supplemental Security Income (SSI)
  • SSI is a monthly cash benefit paid by the federal Social Security Administration and Wisconsin Department of Health Services (DHS) to people in financial need who are 65 or older or Wisconsin residents of any age who are blind or disabled.
  • SSI disability benefits are for adults or children who have a disability and meet income, resource, and living arrangement requirements. Once someone qualifies for SSI, they are also eligible for Medicaid.

Chapter 4: Coordinating Supports and Services

Support and Service Coordination

This service (PDF) includes coordinating or facilitating access to all services and supports, both formal and informal, that are needed by the child and family to meet their identified outcomes.

Allowable Services
  • The CLTS Waiver Program offers a broad range of services to help families meet their identified outcomes.
  • The allowable service descriptions were updated to reflect the five-year renewal of the 1915(c) waiver application and concurrent 1915(b)(4) waiver application, approved by CMS. Some services are subject to rate-setting, while others are not.
Remote Services

Remote services are defined as waiver services delivered using multimedia that includes both video and audio components of communication technology permitting two-way, real-time, interactive communications between a provider and a participant and/or their parents, legal guardians, or unpaid caregivers. CLTS program services specified in the CLTS Benefit Code Crosswalk, P-02283 (PDF), can be delivered remotely in accordance with the standards outlined in the DMS Numbered Memo 2021-02 (PDF).

Service Codes and Provider Qualifications
Rate-Setting

In 2019, DHS began using a new uniform rate-setting methodology for service providers. DMS Numbered Memo 2019-03, Implementation of Children’s Long-Term Support Waiver Program Statewide Uniform Rates (PDF) provides information and resources for effectuating the CLTS Waiver Program statewide uniform rate schedule.

When Children's Community Options Program (CCOP) and CLTS Waiver Funds can be Used

CCOP funds can be used for supports and services that are not allowable under the CLTS Waiver Program. (See CCOP Procedures Guide, P-01780 (PDF), p. 6 under "CCOP and CLTS Waiver.")

Chapter 4 Additional Resources

These resources are supplemental only. The material will not be included in the exam.

HCBS Final Rule

Chapter 5: Substitute Care Funding

Allowable Costs
  • If a participant uses substitute care, the care and supervision costs are covered by the CLTS Waiver program, while room and board is not. (See Waiver Manual Ch. 4. (PDF))
  • Children’s foster care (PDF) services include supplementary intensive supports and supervision services beyond the maintenance payment made to foster parents to address a child’s or youth’s exceptional emotional or behavioral needs, or physical or personal care needs, in a family environment.

Chapter 5 Additional Resources

These resources are supplemental only. The material will not be included in the exam.

Foster Care Rates

DHS and the Department of Children and Families (DCF) collaborate each year to issue updated CLTS Waiver Program allowable treatment foster care administrative rates to be used by CWAs to calculate costs. (See Children’s Long-Term Support (CLTS) Waiver Program Approved CLTS Treatment Foster Care Administrative Rates, P-00700 (PDF).)

Foster Care Certification Requirements
Forms and Instructions

Chapter 6: Program Enrollment

Program Policy and Online Enrollment

To enroll a participant, the SSC enters enrollment data into the online EES system. This information can also be found in Chapter 2: Functional Eligibility. (See DMS Numbered Memo 2017-05 (PDF).)

State-Level Budget and Enrollment Administration 
  • Effective 8/1/21, children are funded at the point of functional eligibility determination. All children determined eligible for the CLTS Program are fully funded. CWAs must enroll the child in the CLTS Program and begin service planning immediately. (See DMS Numbered Memo 2021-03 (PDF).)
  • Children meeting the definition of a vulnerable child require immediate CWA attention and should be prioritized for enrollment. CWAs must enter the crisis criteria in PPS. (See Chapter 1, section 1.4 in P-02256.)
  • For more information, see the CWA State-Level Budget and Enrollment webpage and the State-Level Budget and Enrollment Dashboard.
Support and Service Coordination Timeline Requirements

Timeliness and access standards for eligibility and developing the individual’s person-centered service plan have been established to assist support and service coordinators.

Deciding Together Process

The Deciding Together Guide, P-02246 (PDF), and instructions, P-02246i (PDF), provide a clear, step-by-step team approach to facilitate dialogue between service coordinators and families using a family-centered, collaborative decision-making framework to develop comprehensive outcome-based support plans. This approach recognizes and maximizes the capacities, resiliency, and unique abilities of a child and their family and promotes self-determination and inclusion in all facets of family and community life. DMS Information Memo 2019-01, Release of Deciding Together Guidance describes the Deciding Together Guide and outlines the statewide implementation steps and timeline.

Individual Service Plan (ISP) Forms and Instructions

A person-centered approach is used when working with applicants, participants, and their families. An Individual Service Plan (ISP), F-02245 (PDF), is completed for each participant.

Chapter 6 Additional Resources

These resources are supplemental only. The material will not be included in the exam.

Written Plan of Care

In accordance with 42 C.F.R. § 441.301(b)(1-6) (PDF), a written plan of care must be completed for each participant.

Eligibility and Enrollment Streamlining (EES)
PPS
EPSDT

The Medicaid program benefit for children and adolescents is known as Early and Periodic Screening, Diagnostic and Treatment services, or EPSDT. In Wisconsin, EPSDT is known as HealthCheck Other Services. (See A Guide for States: Coverage in the Medicaid Benefit for Children and Adolescents (PDF).)

The HealthCheck Other Service Bulletin provides county waiver agencies with information on HealthCheck and HealthCheck “Other Services,” the prior authorization process, and how to help maximize HealthCheck and HealthCheck “Other Services” benefits for children.

Chapter 7: Recertification, Future Planning, Plan Review, and ISP Update

Requirements

For each participant, a recertification, ISP review, and update is completed by the SSC. (See Ch. 7 of the Waiver Manual (PDF).)

Think Possible! Employment Webinar Series*

Think Possible! is a four-part employment training series developed for service coordinators who work with the Birth to 3 Program, the Children’s Long-Term Support (CLTS) Waiver Program, and the Children’s Community Options Program (CCOP). Think Possible! was developed to help service coordinators support the children, youth, and parents they work with every day to develop and achieve the goal of working in the community. Please keep a copy of the completion certification for your records.

*This training must be completed within the first six months of employment.

Transitioning CLTS Participants to Adult Services

As young people near adulthood, a transition plan is created to help plan for the participant's life as an adult.

Chapter 7 Additional Resources

These resources are supplemental only. The material will not be included in the exam.

Transitioning Children to Adult Waiver Services

Chapter 8: Participant Rights and Appeal and Grievance Processes

Rights and Processes

CLTS Participants have rights and access to an appeal and grievance process.

Forms

Chapter 9: Participant Health and Safety

Health and Safety Assurance

Assuring the participant’s health, safety and welfare is an essential component of the CLTS Waiver Program. (See Chapter 9 of the CLTS Waiver Manual, P-02256 (PDF).)

Incident Reporting Overview, Instructions, and Form

If a reportable incident occurs, the Incident Report is completed. on how to complete the form.

Restrictive Measures

The restrictive measures policy is outlined in the Instructions and Requirements for the Use of Restrictive Measures in Long-Term Support Programs for Children, P-02616 (PDF).

Mandated Reporter Training

According to the CMS approved Application for a § 1915(c) HCBS waiver, DHS designated SSCs as mandated reporters for child abuse and neglect, and as a part of the county human/social/community service infrastructure, are required to issue referrals to county child protection and child welfare services, when warranted. As mandated reporters, SSCs must take relevant training. The Mandated Reporter Online Training was created by the Wisconsin Child Welfare Professional Development System and takes 30–60 minutes to complete. Please keep a copy of the training completion certificate for your records.

Chapter 9 Additional Resources

The Department of Children and Families: Preventing Abuse and Neglect brochure (PDF) provides information about the heightened risk for abuse and neglect for children with disabilities and how everyone can empower and support them.

Systems, Tools, and Additional Resources

These resources are supplemental only. The material will not be included in the exam.

Systems
Forms Library
Memos Library
  • DMS Information Memos communicate long-term care information that DHS wants or needs to share with its partners and providers.
  • DMS Numbered Memos detail actions that our partners and providers could or should take regarding long-term care programs.
DHS Communication Tools
  • CLTS teleconferences are held on the first and third Thursday of every month. To receive regular information about the CLTS Teleconference, please email us.
  • DHS communicates through email. Register to receive regular email communications.
Waiver Applications

External Resources

Last Revised: October 13, 2021