PAW TAW 2009 Fall Workshop

1. PAW TAW 2009 Fall Workshop Documenting Waiver Services in eWiSACWIS

2. CHILD WELFARE AND CHILDREN’S LONG TERM SUPPORTS CLAIMING REQUIREMENTS AND PROCESS

3. CHILDREN’S LONG TERM SUPPORT WAIVERS The CLTS Waivers support an eligible child with disabilities and his or her family with services in the child’s home and community. • Effective January 1, 2004; • Children may receive services up to age 22;

4. CHILDREN’S LONG TERM SUPPORT WAIVERS The CLTS Waivers support an eligible child with disabilities and his or her family with services in the child’s home and community. • Three CLTS Waivers serving children with a: • Developmental disability; • Physical disability; and or a • Mental health disability.

5. CHILDREN’S LONG TERM SUPPORT WAIVERS Determination of Exceptional Care Needs • Allowable services under the CLTS “Foster Care” service are “supplemental” supports for a child in a foster care setting. • Exceptional and supplemental foster care services costs may be claimed to the waiver if specific needs for a child are identified.

6. Policy Guidance on Serving Children in CLTS Waivers and Child Welfare Services DCFS Memo 2005-09 http://dcf.wisconsin.gov/memos/num_memos/2005/2005-09.htm DDES Memo 2005-19 http://dhs.wisconsin.gov/dsl_info/NumberedMemos/DDES/CY_2005/NMemo2005-19.htm

7. CHILDREN’S LONG TERM SUPPORT WAIVERS Determination of Exceptional Care Needs (cont.) • CMS approval allows these costs to be claimed directly to approved waiver. • Exceptional and supplemental foster care services costs must be documented in eWiSACWIS in order to offset DCF Title IV-E claim.

8. DOCUMENTATION PROCESS AND REQUIREMENTS

9. DOCUMENTATION • eWiSACWIS How Do I Guide • Open Discussion on Documentation of Waiver Revenue • To prevent double-billing, Medicaid reimbursement of CLTS Waiver supplemental/ exceptional placement costs must be documented in eWiSACWIS.

10. DOCUMENTATION (cont.) • Example of Waiver Documentation The following is an example of waiver and eWiSACWIS reporting.

11. DOCUMENTATION (cont.)

12. DOCUMENTATION (cont.) • Waiver Individual Service Plan (ISP) Foster Care Home (non-relative) (10/1/09) Basic Rate $ 452.00/mo Supplemental Rate 108.00/mo Exceptional Rate 7,416.50/mo

13. DOCUMENTATION (cont.) Foster Care Home (non-relative) as of 9/1/2009 Basic Rate $ 452.00/mo Supplemental Rate 108.00/mo Exceptional Rate 7,416.50/mo Client’s Income$682.00/mo Daily TFH Cost per plan: CLTS funds $7,524.50/mo. or a daily rate of $247.39

14. DOCUMENTATION (cont.) eWiSACWIS Trust Account Client Funds (Child Support/SSI, etc.) $682 AODA, CIP, Other $ 7,525 (Waiver Reimbursement of TFH Supplemental/Exceptional Costs)

15. How do we apply child’s income? • CHILD WELFARE • SSI and Child Support funds may be used to cover placement and services costs associated with children served in Child Welfare • Agency receipt of SSI and Child Support funds for children served in Child Welfare are documented in the child’s eWiSACWIS Trust Account page

16. How do we apply child’s income? • CLTS WAIVERS • SSI and Child Support funds are only used by CLTS to determine Medicaid eligibility • Client funds must be used to offset foster care basic rate; may not be used to offset supplemental/exceptional foster care costs.

17. eWiSACWIS Documentation • Placement • Basic • Admin • Costs > Spending Limit • Rate Setting • Supplemental • Exceptional • Contracted Maintenance Rate • Trust Account • Client Funds (Child Support/SSI, etc.) • CLTS Funds • Payment • System disbursed or Non-system disbursed

18. QUESTIONS/ ADDITIONAL CONSIDERATIONS