Wisconsin's Functional Screen

Wisconsin's Functional Screen 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. The screen is used to determine functional eligibility for certain mental health services, adult long-term care programs and children's long-term support programs. Experienced professionals, usually social workers or registered nurses, who have taken an on-line training course and passed a certification exam are able to access and administer the screen. 

Resources for certified screeners: Adult LTCFS, Children's LTS, MH/AODA, General Resources for all Screeners

General Information

• Overview: Background information on the history and use of the Long-Term Care (LTC) Functional Screen.
• Papers¹ on testing the validity and reliability of Wisconsin's functional screens:
  • Adult Long-Term Care Functional Screen Validity (PDF, 54 KB)
  • Children's Long-Term Support Functional Screen Validity (PDF, 268 KB)

Resources for Adult LTCFS Screeners

• Wisconsin Adult Long Term Care Functional Screen, F-00366 (PDF, 145 KB) Revised January 2017
• Wisconsin Long Term Care Functional Screen Instructions Revised January 2017
• Tools and decision trees:
  • Diagnoses Cue Sheet, P-00814 (Excel, 103 KB) Revised March 2017
  • No Active Treatment (NAT) Algorithm, P-00944 (PDF,  31 KB) Revised January 2017
• Basic Information for Screeners, P-01604 (PDF, 222 KB)
• Assessment/Supplement to the Long Term Care Functional Screen, F-20980 (PDF, 325 KB) (for Home and Community-Based Waiver Screeners only)
• 2012 Continuing Skills Testing Video (Adobe Connect, help; 50 minutes) This video portrays a functional screen interview in the home of an applicant for long-term care programs. The video is recommended for use for general training purposes.
• Listserv Sign Up

Webcast Trainings

• LTCFS Target Group Automation (Webcast, help) 48 minutes; 11/30/16
  • PowerPoint Slides (PDF, 526 KB)
• Requires Nursing Assessment and Intervention (Webcast, help) 1 hour, 11 minutes; 3/29/10
  • PowerPoint Slides (PDF, 58 KB)

Resources for Children's LTS Screeners

• Clinical Instructions (Revised 01/2015)
• Listserv Sign Up
• Diagnosis Cue Sheet, P-00920 (PDF, 449 KB; 01/2015)
• Norm-Referenced Assessment Tools for Communication and Learning, P-00933 (PDF, 33 KB; 01/2015)
• Paper Form, 00367 (PDF, 132 KB; 01/2015)
• Children's LTS Age-Specific ADL and IADL Questions: 
  • Birth to 6 Months, F-00367a (PDF, 20 KB; 02/2011)
  • 6 to 12 Months, F-00367b (PDF, 24 KB; 02/2011)
  • 12 to 18 Months, F-00367c (PDF, 25 KB; 02/2011)
  • 18 to 24 Months, F-00367d (PDF, 24 KB; 03/2012)
  • 24 to 36 Months, F-00367e (PDF, 24 KB; 12/2012)
  • 36 Months to 4 Years, F-00367f (PDF, 25 KB; 12/2012)
  • 4 to 6 Years, F-00367g (PDF, 25 KB; 12/2012)
  • 6 to 9 Years, F-00367h (PDF, 27 KB; 12/2012)
  • 9 to 12 Years, F-00367i (PDF, 26 KB; 12/2012)
  • 12 to 14 Years, F-00367j (PDF, 26 KB; 12/2012)
  • 14 to 18 Years, F-00367k (PDF, 26 KB; 12/2012)
  • 18 Years and up, F-00367l (PDF, 27 KB; 12/2012)

Introduction to the CLTS FS Quality Tool

• Presentation (Adobe Connect, help; 20 min, 38 sec; recorded July 2012)
• Six CLTS Functional Screen Basic Essentials (PDF, 21 KB)
• Five Attributes of CLTS Functional Screen Quality Notes (PDF, 22 KB)

CLTS FS Online Training for Certified Screeners

• Module 1: Overview (Adobe Connect, help) 10 min, 7 sec
• Module 2: Informational Pages (Adobe Connect, help) 14 min, 23 sec
• Module 3: Diagnoses  (Adobe Connect, help) 19 min, 11 sec
• Module 4: Mental Health (Adobe Connect, help) 16 min, 27 sec
• Module 5: Behaviors (Adobe Connect, help) 22 min, 0 sec
• Module 6-Part 1: Activities of Daily Living (ADLs) (Adobe Connect, help) 17 min, 11 sec
• Module 6-Part 2: Instrumental Activities of Daily Living (IADLs) (Adobe Connect, help) 15 min, 3 sec
• Module 7: School and Work (Adobe Connect, help) 3 min, 29 sec
• Module 8: Health-Related Services (Adobe Connect, help) 16 min, 24 sec
• Module 9: Screen Time and Notes (Adobe Connect, help) 3 min, 18 sec
• Module 10: Functional Eligibility Rights (Adobe Connect, help) 6 min, 23 sec
• Module 11: Resources for Certified Screeners (Adobe Connect, help) 9 min, 5 sec

Presentations on Institutional Levels of Care in Children's LTS Programs (Recorded September 2011)

1. Intermediate Care Facility (ICF/MR) Level of Care: Developmental Disabilities (DD LOC) (16 min, 40 sec)
2. Psychiatric Hospital Level of Care: Severe Emotional Disturbance (SED LOC) (38 min, 58 sec)
3. Nursing Home Level of Care: Physical Disabilities (NH LOC) (24 min, 44 sec)
4. Hospital Level of Care: Physical Disabilities (HOS LOC) (13 min, 26 sec)

Resources for Mental Health/AODA Screeners

• Clinical Instructions (Revised 5/22/09)
• Paper Form, F-00258 (PDF, 77 KB)
• Signup for MH/AODA Functional Screen Listserv

General Resources for All Screeners

• Functional Screen Information Access (FSIA) gateway page
• Adding a Trusted Site to Internet Explorer, P-01598 (PDF, 445 KB)
• FSIA System Requirements, P-01448 (PDF, 924 KB)
• Functional Screen Application Training 101