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Dane County Department of Human Services Provider Hub

Getting Started Providing Children's Long Term Support Services in Dane County


Thank you for your interest in providing assistance to children with long-term support needs and their families. A Medicaid program called the Children’s Long Term Support Waiver (or CLTS for short) pays for these services. The program helps children remain in their home and participate fully in their community. Since a combination of federal, state and local tax dollars fund the program, CLTS providers must complete some mandatory paperwork. The steps to becoming a Dane County CLTS provider are:

1.    Familiarize yourself with Children’s Long Term Support (CLTS) services. 

2.    Notify Dane County CLTS Network Coordinator Ross Hazlewood, CLTS Lead Angela Radloff, or Community Services Manager Monica Bear of interest in providing CLTS services. Please contact:

Ross:         hazlewood.ross@countyofdane.com / (608) 242-6301 or
Angela:      radloff.angela@countyofdane.com / (608) 242-6225 or
Monica:     bear@countyofdane.com / (608) 242-6438
 

Time: Approximately 30-60 minutes

3.    Register to do business in Wisconsin. (This costs between $100-130, depending on entity type.)

  • Most businesses are already registered to do business in Wisconsin. If not, you must become an LLC or some other type of legal business entity. If not already registered, go to Wisconsin Department of Financial Institutions (DFI) website: https://www.wdfi.org/apps/CorpFormation/

Time: Approximately: 30-60 minutes

4.    Register to provide CLTS services in Dane County on the Wisconsin DHS CLTS Provider registry. No cost. Time: Approximately 30 minutes.

5.    Obtain the right type of insurance to provide CLTS services. (There are varying costs associated with this, depending on the insurance provider. For contracts over $11,000 per year, there may be a small additional fee to list Dane County as an “additional insured”.)

If you plan to do more than $11,000 per year worth of CLTS business per year, your insurance agent will need to provide Dane County with a Certificate of Insurance (COI). This certificate must list Dane County as an “additional insured” (for more information: Additional Insured Requirements). Insurance companies typically charge $100 - $200 for this service. Businesses who have employees based in Wisconsin must provide workers’ comp at Wisconsin statutory limits. Please contact hazlewood.ross@countyofdane.com if you have questions.

Depending on the type of service your business provides, you must have at least one of the following:

  • Commercial General Liability at a limit of not less than $1,000,000 per occurrence. Coverage shall include, but not be limited to, Bodily Injury and Property Damage to Third Parties, Contractual Liability, Personal Injury and Advertising Injury Liability, Premises-Operations, Independent PROVIDERs and Subcontractors, and Fire Legal Liability. The policy shall not exclude Explosion, Collapse, and Underground Property Damage Liability Coverage. The policy shall list DANE COUNTY as an Additional Insured.
  • Commercial/Business Automobile Liability (If transport waiver recipients). PROVIDER agrees to maintain Commercial/Business Automobile Liability at a limit of not less than $1,000,000 Each Occurrence. PROVIDER further agrees coverage shall include liability for Owned, Non-Owned & Hired automobiles. In the event PROVIDER does not own automobiles, PROVIDER agrees to maintain coverage for Hired & Non-Owned Auto Liability, which may be satisfied by way of endorsement to the Commercial General Liability policy or separate Business Auto Liability policy.
  • Professional Liability at a limit of not less than $1,000,000 per claim with a $1,000,000 aggregate for all PROVIDER’s professional employees. The coverage shall include Unintentional Errors/Omissions Endorsement. There shall be an extended reporting period provision of not less than two years.
  • Umbrella or Excess Liability may satisfy the minimum liability limits required above for Commercial General Liability and Business Auto Liability under an Umbrella or Excess Liability policy. There is no minimum Per Occurrence limit of liability under the Umbrella or Excess Liability; however, the Annual Aggregate limit shall not be less than the highest “Each Occurrence” limit for the Commercial General Liability and Business Auto Liability. PROVIDER agrees to list DANE COUNTY as an “Additional Insured” on its Umbrella or Excess Liability policy.

Time: Varies, depending on insurance provider.

6.    Email completed County forms to hazlewood.ross@countyofdane.com

Forms include:

Please note: Completion of these forms starts the Dane County contracting process. A signed rate schedule is not a contract.

Time: Approximately 30 minutes.

7.    After review, Dane County will email your CLTS contract to you. Providers can usually expect their contract within 6-8 weeks of submitting the required paperwork.

After signing, please email legible, signed contracts in their entirety (not just the signature page) to dcdhscontracts@countyofdane.com

If you cannot email a legible document, you may send your agreement or contract to the following mailing address: Dane County Human Services, 1202 Northport Drive, Madison WI, 53704, Attn: Contract Coordination Assistant. Please note that Dane County cannot accept and will return illegible or incomplete documents.

Time: Approximately 5-15 minutes.

8.    Set up account with WPS Insurance, Wisconsin’s CLTS Third Party Administrator (TPA).

Dane County Program Specialist Eric Linn-Miller miller.eric@countyofdane.com / (608) 242-6447 will reach out to you shortly after your CLTS contract is finalized, and assist you with this step. After your business is added to our CLTS IT system, Eric will also email service authorizations to you via Excel spreadsheet, and discuss the process for submitting claims and receiving payments through WPS Insurance.

Time: Approximately 30 minutes.