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DEPARTMENT OF HEALTH SERVICES Division of Medicaid Services F02365 (07/2018)STATE OF WISCONSIN 42 CFR 431.107WISCONSIN MEDICAIDCHILDRENS LONGER SUPPORT (CUTS) WAIVER PROGRAM PROVIDER AGREEMENT AND
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How to fill out childrens long-term support waiver
How to fill out childrens long-term support waiver
01
To fill out the Children's Long-Term Support (CLTS) waiver application, follow these steps:
02
Obtain the CLTS application form from your local county human services agency or download it from their website.
03
Read the instructions provided with the application form carefully to understand the eligibility criteria and required documentation.
04
Gather all necessary documents, such as proof of income, age verification, and medical documentation supporting the need for long-term support.
05
Fill out the application form accurately and provide all requested information. Be sure to answer each question thoroughly and truthfully.
06
Attach the required documentation along with the application form. Make sure all documents are legible and labeled properly.
07
Double-check the completed application form and attached documents to ensure they are complete and accurate.
08
Submit the application form and supporting documents to the designated address or office mentioned in the instructions.
09
Wait for a response from the county human services agency. They will review your application and notify you if any additional information is needed.
10
Keep a copy of the submitted application and all supporting documents for your records.
11
Follow up with the county human services agency if you have not received a response within the specified time frame.
Who needs childrens long-term support waiver?
01
Children who require long-term support due to a physical or developmental disability may be eligible for the Children's Long-Term Support (CLTS) waiver. This waiver is designed to provide services and supports to children and their families to enhance their quality of life and promote independence. Eligibility for the CLTS waiver may vary by state, but generally, children with significant functional limitations and a need for ongoing support and assistance will qualify. It is best to contact your local county human services agency or Medicaid office to determine specific eligibility criteria for the CLTS waiver in your area.
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What is childrens long-term support waiver?
The childrens long-term support waiver provides services to children with disabilities who would otherwise require institutional care.
Who is required to file childrens long-term support waiver?
Parents or legal guardians of children with disabilities are required to file childrens long-term support waiver.
How to fill out childrens long-term support waiver?
To fill out the childrens long-term support waiver, parents or legal guardians need to provide detailed information about the child's disability and care needs.
What is the purpose of childrens long-term support waiver?
The purpose of childrens long-term support waiver is to provide support services that enable children with disabilities to live at home and in the community.
What information must be reported on childrens long-term support waiver?
Information such as the child's medical history, diagnosis, care needs, and family situation must be reported on childrens long-term support waiver.
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