28.14 Home and Community-Based Waivers Long-Term Care Children's Long-Term SUPPORT

28.14.1 Children's Long-term Support Introduction

28.14.2 Children's Long-term Support CARES Processing

28.14.2.1 Processing a Children's Long-term Support Application When No Funding Is Available

28.14.1 Children's Long-term Support Introduction

The CLTS waivers include the following three programs, differentiated by the population they serve:

Developmental Disabilities
Physical Disabilities
Mental Health Disabilities

The CLTS is entered in CWW as a Children's Waiver type. All the Medicaid eligibility criteria for the CLTS are identical to the Community Integration Program IB Waiver except not all children will need a disability determination in order to qualify. See County Funded Slot below. The care manager will inform the IM worker of the type of slot in which the child will be placed.

Not all children will require a disability determination to enroll in CLTS. It is the responsibility of the CLTS Support and Service Coordinator to identify to the IM workers which cases do not require a disability determination. If no disability determination is required, the “Is Disability Determination Required?” question on the Community Waivers page should be answered "No."

28.14.2 Children's Long-term Support CARES Processing

The child should first be tested with his or her family to see if there is eligibility for BadgerCare Plus and the Group A Waiver.

If the child is eligible for a type of non-CARES Medicaid such as Foster Care Medicaid, Adoption Assistance Medicaid, SSI Medicaid, or Katie Beckett Medicaid, the child will be eligible as a Group A Waiver (see Section 28.8 Home and Community-Based Waivers Long Term Care Instructions for waiver processing instructions).

If the child is not eligible for other categories of Medicaid or BadgerCare Plus, CARES will test the child for a Group B or B Plus Waiver, based on the child’s income.

Since a disability determination is not always required for these members, it is the responsibility of the CLTS Support and Service Coordinator to identify to the IM workers which cases do not require a disability determination. Income Maintenance workers should update the Community Waivers page based on the information received from the CLTS case manager.

28.14.2.1 Processing a Children's Long-term Support Application When No Funding Is Available

In order to be put on the waiting list for a CLTS waiver slot, the child must be determined otherwise eligible.

Income Maintenance workers who receive Medicaid applications for one of the CLTS waiver programs should process those applications even if there is no funding available (no waiver slot). Complete the normal process as follows:

Determine Medicaid eligibility using community waiver methodology.
Assist in the completion of the MADA .
Forward the MADA to the DDB .

If DDB determines that the child is disabled and meets LOC criteria, the child will be put on a waiting list for a CLTS slot.

The IM worker should determine if the child is eligible with his or her family for BadgerCare Plus or Elderly, Blind, Disabled Medicaid. If the child and/or family do not meet any other Medicaid or BadgerCare Plus eligibility requirements, then the application should be denied and confirmed in CARES accordingly.

Note: Do not keep the CLTS waivers case in pending status in CARES until funding becomes available.

If a CLTS waiver slot becomes available more than 30 days after the denial of the original application, a new application must be submitted and processed.

This page last updated in Release Number: 15-02

Release Date: 07/30/2015

Effective Date: 07/30/2015