Advocacy Guide: Children's Long Term Support (CLTS) Fair Hearings

Parents have the right to appeal CLTS decisions they believe are wrong. When parents appeal, a fair hearing is scheduled so an Administrative Law Judge (ALJ) can review the decision. This guide can help parents prepare for a fair hearing.

This is a general guide for people with disabilities and their families. It is not legal advice. For legal advice about your specific situation, please talk with a lawyer.

Step 1: Review The CLTS Participant and Family Handbook, Section 8

The Handbook summarizes:

• How and when you can file a CLTS appeal, including timelines

• CLTS decisions you cannot appeal

• When you should get a Notice explaining your right to appeal

• What the Notice should say

Please review the Handbook before using this guide.

Step 2: Ask for a Fair Hearing

There is no official form to appeal a CLTS decision. You can use the general Request for Hearing form on the Division of Hearings and Appeals (DHA) website. You can also write a letter to DHA saying what decision you want to appeal, and why you think the decision was wrong. If you got a notice from the County, include it with your form or letter. Find a sample appeal letter at the end of this guide.

Email or fax your appeal to DHA so you can prove when you sent it. If you mail the request, you may want to send it by certified mail.

Contact information for DHA:
Fax: (608) 264-9885
Email: DHAMail@wisconsin.gov
4822 Madison Yards Way
5th Floor North
Madison, WI 53705-9100
Phone: (608) 266-7709

Should you ask for continued benefits?

If your appeal is about a decision to terminate or reduce a CLTS service your child gets, you can ask to keep services the same until the hearing decision. To do this, you must file before the decision’s effective date. The notice should have an effective date, and you should get the notice at least 10 days before this date, so you have time to request continued benefits.

Step 3: DHA Acknowledgement & Notice of Hearing

You will get a written acknowledgement from DHA that it got your appeal request. It will have the case number for your hearing.

Next, you will get a “Notice of Hearing” with the date and time of your hearing. The hearing date is usually 3-6 weeks after you send the request. The Notice will have a name and phone number for the ALJ who will decide your case. The Notice will say how to send the ALJ documents at least two days before the hearing.

If the date or time of the hearing won’t work for you, call the ALJ and ask to reschedule, or ask by email. ALJs will usually grant at least one reschedule request.

Step 4: County Summary Letter

The county should send a letter explaining what action they took and why, although they don’t always do so. The letter should reference the CLTS policy used to make the decision. Read the summary letter, if you get one, and any policies carefully to help you prepare. County witnesses should reference the same policies at the hearing.

Step 5: Prepare Your Evidence

Written Evidence: Documents

These types of documents may be helpful in your hearing:

• Letters from your child’s treating providers or other experts explaining the child’s medical condition(s) and why they need the specific CLTS service the county denied, reduced, or terminated. Provider letters can also explain why options the County suggests are less effective or will not fully meet your child’s needs. Provider letters (or emails) will be more persuasive if they include professional credentials, describe their expertise, and how they know your child.

• Records verifying your child’s medical or behavioral conditions like assessments and evaluations, their Individualized Education Program (IEP), or the CLTS functional screen report may include details that help the ALJ understand your child and their need for a service.

• It is also helpful to find policies in the CLTS Waiver Manual that support your argument and include copies of them as evidence. Section 4.6 of the Manual, for example, has service definitions and coverage criteria for all CLTS services. You should prepare to explain how the coverage criteria apply to your child. 
  After you’ve gathered all this information, organize and email it to the ALJ at least two days before the hearing. Send a copy of everything to the County and keep copies for yourself.

Witnesses

You have the right to bring witnesses to the hearing to explain why the County’s decision was wrong and your child needs the CLTS service. You should either give the ALJ witness phone numbers or have witnesses on speaker phone with you during the hearing. You and the witness can talk before the hearing, so you know what they will say. Prepare questions to prompt your witness in their explanation. Witnesses are more persuasive if they describe their professional credentials, their expertise, how they know your child, and give specific examples.

Step 6: The Hearing

Have your phone turned on and charged to be ready for the ALJ’s call. Hearings are informal and usually take only 30-45 minutes. The ALJ will get everyone on the phone and give an overview of the process. The ALJ will “swear in” everyone who will testify.

During the hearing, you are called the Petitioner, and the County agency is called the Respondent.

ALJs usually name the documents in the record and give each document an exhibit number. It is important to listen carefully, and if possible, write the exhibit number on each document. Also, make sure the ALJ lists all documents you sent, and you have all documents from the county.  If not, you can ask for the hearing to be rescheduled so everyone has the same documents.

Hearings are recorded so it is important that only one person talks at a time.

The county witness goes first and explains how they made the decision and what CLTS policies they used. You can listen and take notes. County witness testimony should match what is in the notice, the summary letter, and other documents. They should not give new reasons or surprise you. If the county does this, you can object by saying: “I object. This is new information, and I disagree with including it in the record.” When county witnesses finish talking, you can ask questions if you want. The ALJ usually asks questions.  

Then it’s your turn. If you have witnesses, they can testify. ALJs usually have questions for you and for witnesses. The county can also question you and your witnesses.

Once all witnesses testify, you should summarize why the evidence supports your argument that the county decision was wrong. The County may also give a summary. The ALJ may call these closing arguments.

You won’t know if you won until you get the ALJ’s written decision. This usually takes several weeks.

Step 7: the Hearing Decision

Several weeks after the hearing, you will get a written decision in the mail. If you lose, the decision will tell explain how to request a rehearing or appeal.

Sample Appeal Hearing Request Letter

[Date]

Division of Hearings and Appeals
Via Fax at (608) 264-9885
Via email at DHAMail@wisconsin.gov

RE: [Child's Name] - Date of birth: [Child's date of birth]

Dear DHA,

I, [Your Name], on behalf of my child, [Child's Name] appeal the decision by [Child's County] County CLTS to [briefly describe the decision or denial you are appealing].

The county communicated the decision (in a notice / verbally) on this date: [date you got the decision].

I disagree with the county’s decision because [briefly describe why you disagree].

I attached a copy of the notice from the county.

Please send me all notices and documents related to this hearing. My contact information is below. Thank you.

Sincerely,

[Your Signature]
[Your Name]
Mailing address: [Your mailing address]
Phone: [Your phone number] Email: [Your email address]

Enc: (County Notice / Email Denial, etc.)