A CLTS eligibility screening is a functional screen, a structured set of questions about how a child's disability affects daily life. It is not a test the child can pass or fail, and it is not a review of family income. The process generally takes up to 45 days from first contact, and a screen result can pend for up to 31 calendar days before it affects enrollment.

Table of Contents

  • [What is a CLTS eligibility screening, and what is it not?](#what-is-a-clts-eligibility-screening-and-what-is-it-not)
  • [Who can apply for CLTS, and what happens before the screening?](#who-can-apply-for-clts-and-what-happens-before-the-screening)
  • [What questions does the CLTS Functional Screen ask?](#what-questions-does-the-clts-functional-screen-ask)
  • [What do the possible screening results mean?](#what-do-the-possible-screening-results-mean)
  • [How long does the screening and eligibility process take?](#how-long-does-the-screening-and-eligibility-process-take)
  • [What happens after a child is found eligible for CLTS?](#what-happens-after-a-child-is-found-eligible-for-clts)
  • [Where can families get skill-building and respite support while navigating CLTS?](#where-can-families-get-skill-building-and-respite-support-while-navigating-clts)
  • [Key Takeaways](#key-takeaways)
  • [References](#references)

What is a CLTS eligibility screening, and what is it not?

A CLTS eligibility screening uses the Children's Long-Term Support (CLTS) Functional Screen, the tool Wisconsin uses to determine functional eligibility for children from birth through age 21. The screen is deficit-based by design, according to the Wisconsin Department of Health Services. That means it captures a child's limitations and is not an assessment of the child or the family.

!A happy couple engages with an advisor during a consultation in a cozy living room.

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The screen determines functional eligibility only. It does not include financial eligibility, according to the Wisconsin Department of Health Services. Financial eligibility is handled separately through Medicaid or related programs.

The same screen is used for several programs. Those programs include CLTS, Katie Beckett Medicaid, the Children's Community Options Program, Comprehensive Community Service, and Community Recovery Services, according to the Wisconsin Department of Health Services. Families should understand that one screen can support multiple eligibility decisions.

Who can apply for CLTS, and what happens before the screening?

CLTS is for children and youth under age 22 with an intellectual and/or developmental disability, physical disability, and/or mental health disability who are eligible for Medicaid, according to Dane County Human Services. A child must need a level of care typically provided in a hospital, nursing home, or institution for people with developmental disabilities. The functional screen measures that level of care.

!Picturesque stone house surrounded by lush greenery in Oconomowoc, Wisconsin, during a sunny summer day.

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The referral step varies by county. In Milwaukee County, referrals are made by phone Monday through Friday, 8 a.m. to 3:30 p.m., according to Milwaukee County. Providers may not make a referral on behalf of a family. A parent or guardian must make that first call.

Families then meet with an Options Counselor to determine eligibility. A child with an autism diagnosis, including Autism, Pervasive Developmental Delays, or Asperger's, must provide additional information to the Options Counselor. That information helps determine mental health diagnosis and eligibility, according to Milwaukee County.

What questions does the CLTS Functional Screen ask?

The CLTS Functional Screen adjusts its questions as children develop, from birth through young adulthood until age 22, according to the Wisconsin Department of Health Services. A screen for a toddler looks different from a screen for a teenager. The tool follows the child's developmental stage.

The screen covers specific behavior categories. Those categories include High Risk, Self-Injurious, Aggressive/Offensive, and Lack of Behavioral Controls, according to the Wisconsin Department of Health Services. The screener asks about behaviors that affect safety and daily functioning.

A health-related services section covers medical and skilled nursing information. That section includes terminal conditions, tracheostomy, ventilator, dialysis, IV, oxygen, respiratory treatments, TPN, tube feedings, therapies, colostomy, catheter, and wound or site care, according to the Wisconsin Department of Health Services.

The screen is built for high inter-rater reliability. That means two trained screeners should answer the same way for the same child, according to the Wisconsin Department of Health Services. Families can expect a consistent, structured process.

What do the possible screening results mean?

The CLTS Functional Screen produces several possible outcomes. Those outcomes include Mental Health Target Group (Psych Hospital LOC), Physical Disability Target Group (Nursing Home LOC), Physical Disability Target Group (Hospital LOC), DD Target Group (ICF-IID/DD1 LOC), and DD Target Group (ICF-IID/DD2 LOC), according to the Wisconsin Department of Health Services.

Other possible results include Not eligible due to living situation, This screen should not be used for an individual of this age, and Not functionally eligible, according to the Wisconsin Department of Health Services. Each result points to a specific target group and level of care designation.

A "Not functionally eligible" result is not necessarily the end. The screener should always request an internal review by their agency when a child is found not functionally eligible, according to the Wisconsin Department of Health Services. Families can ask about that review process.

If a result reads "Requires a disability determination" for Katie Beckett but the child is applying for CLTS, the application can still move forward, according to the Wisconsin Department of Health Services. The pending Katie Beckett determination does not block the CLTS path.

How long does the screening and eligibility process take?

The eligibility process can take up to 45 days from initial contact, after which the family receives a letter about CLTS Program eligibility, according to Family Voices of Wisconsin. Families should plan for that full window.

A functional screen result can pend for up to 31 calendar days before it affects enrollment, according to the Wisconsin Department of Health Services. That pending period allows time to review the screen and resolve any issues.

When a child is enrolled from the CLTS wait list, the screen establishing functional eligibility must have been calculated by a certified screener within the last 12 months, according to the Wisconsin Department of Health Services. An older screen may need to be updated.

What happens after a child is found eligible for CLTS?

In Milwaukee County, after approval the family is assigned an ongoing Support & Service Coordinator (SSC), according to Milwaukee County. The SSC becomes the family's main point of contact for service planning and coordination.

Families may be placed on a waitlist to begin services depending on capacity at the time of enrollment, according to Milwaukee County. Eligibility does not always mean immediate service access.

Children can be dually enrolled in CLTS and Comprehensive Community Services (CCS) in Milwaukee County, according to Milwaukee County. Dual enrollment can expand the range of supports available to a child and family.

Where can families get skill-building and respite support while navigating CLTS?

Abide Supportive Living provides CLTS Non-Medical Respite for children on the Children's Long-Term Support waiver in Milwaukee, Waukesha, Ozaukee, and Washington counties. Respite gives families a planned break while their child stays engaged and supported.

Abide provides skill instruction and respite, not housekeeping, personal care, or nursing. The focus is on teaching skills alongside the people served rather than doing tasks for them.

For adults building independence, Abide also offers Daily Living Skills Instruction, Life Skills Training and Education funded through IRIS, Money and Planning Skills, and Community Access Skills. Families and care coordinators can ask about a referral or current availability without any pressure.

Key Takeaways

  • A CLTS eligibility screening is a functional screen, not a test of parenting or a financial review.
  • The CLTS Functional Screen determines functional eligibility only; financial eligibility is handled separately.
  • The screen covers children from birth through age 21 and adjusts its questions as a child develops.
  • Possible results include several target group and level-of-care designations, plus "Not functionally eligible."
  • A "Not functionally eligible" result should always trigger an internal review request by the screener.
  • The eligibility process can take up to 45 days from first contact, and screen results can pend for up to 31 calendar days.
  • In Milwaukee County, families are assigned a Support & Service Coordinator after approval and may be placed on a waitlist depending on capacity.

References

  1. CLTS FS Instructions Module 1 - Overview of the Children's Long-Term Support Functional Screen, Wisconsin Department of Health Services
  2. Eligibility Details and Steps, Family Voices of Wisconsin
  3. Children's Long-Term Support, Dane County Human Services
  4. Children's Long Term Support Program, Milwaukee County
  5. CLTS FS Instructions Module 10 - Functional Eligibility Results, Wisconsin Department of Health Services