If you participate in the Wisconsin Children’s Waiver Program or are on a wait list, you have an opportunity to provide feedback! The Wisconsin Department of Health Services is looking for input on proposed Children’s Long-Term Services (CLTS) rates across the state and how they would impact children, the way the Department is ending children’s wait lists, and a proposed statewide provider directory. Families can provide public feedback on these issues at community forums across the state over the next few weeks. See the schedule here: https://www.dhs.wisconsin.gov/clts/forums.htm
For more background information:
The CLTS Waiver is going to set statewide provider rates for most CLTS services. Right now each county waiver agency decides how much their local providers are paid. The federal government is making Wisconsin do this so it is going to happen. The statewide rates are scheduled to start on January 1, 2019.
These rates will have a big impact on whether a child has access to a service. In some cases the rates may increase access because the new rates are higher than what counties are paying. In other cases the rates may be lower than what a county is paying, which then may make it harder to hire or retain workers. DHS will distribute a list of the proposed rates at the forums. If you go you should try to find out what the rates are for the services your child is receiving now. That way you can tell DHS if you think the new rates will help or hurt your child.
Two issues have not yet been addressed by the information DHS has provided. First, there are several rates for two services, supportive home care and respite. The rate is higher if the child has greater care needs. DHS has not explained exactly how it will decide which rate a child can use. You should ask DHS about that issue at the forum. Second, there needs to be a process that families can use to get a higher rate if the proposed rate isn’t high enough to secure qualified providers. You should ask DHS what that process will look like and how people will be able to use it.
You can register for the forums if you want to. We encourage registration so that DHS knows people are interested in this topic. https://www.surveymonkey.com/r/3QXVKS6
If you can’t attend any of the forums, but still want to submit written comments you can do that by email at the following email address: DHSCLTSStakeholder@dhs.wisconsin.gov
Here are some questions that you might consider asking if you go to one of the forums.
Questions People Can Ask at Community Forums on Rate-Setting for the CLTS Waiver
Questions related to the “tiers” for Supportive Home Care and Respite
What information from the long-term care functional screen will be used to decide which “tier” a child may be placed in?
What kind of needs would a child have if be placed in the middle tier? In the highest tier?
Will a family be able to appeal if they do not agree with the tier the child has been placed in?
Will DHS provide more information on how the tiers are determined before it starts using this new rate structure?
When will more information be available?
Questions related to an “Exceptions” process
Will DHS introduce an “exceptions” process by which providers or parents can ask for a rate that is higher than the rate generally available for a particular service?
When will we get more information about that process?
How will people or providers know about that system?
If a request for a higher rate is denied, will the parents or provider be able to appeal?
What types of situations does DHS think will be likely to be covered by this “exceptions” process?
Provider shortage is a real problem throughout the state. Low wages are a big reason for that. Will the inability to find a provider be a reason to exceed the normal rate for a service?
What will families have to show in order to qualify for an exception based on inability to find a provider?
Will DHS provide more information on the exceptions process before it starts using this new rate structure?
When will more information be available?