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.

• Learn more about service descriptions in Chapter 4 of the Wisconsin Department of Health Services’ (DHS) CLTS manual  
• Learn more about rates providers can charge by reviewing the CLTS Uniform Rate Schedule 

2. Notify and schedule meeting with Dane County CLTS Network Coordinator Ross Hazlewood and Community Services Manager Angela Radloff of interest in providing CLTS services. Contact:

Ross Hazlewood                   
Hazlewood.Ross@danecounty.gov 
(608) 242-6301

OR

Angela Radloff
Radloff.Angela@danecounty.gov
(608) 242-6225

• Please note: Even if your organization has completed the CLTS registry process, you will need to have services approved by Dane County before you can begin offering and billing for them.  To expedite that authorization process and reduce errors, Dane County needs to know what services you provide and what they cost.  Following this meeting, Dane County will send you the necessary forms to move forward in the approval process. 

3. Register to provide CLTS services in Dane County on the DHS CLTS Provider registry.

• Here is a link to the registration site  
• Here are tips on how to complete the registration
   
• Please note:  the business name or title you choose to register under will be what you use for the payment process, so please remember your DHS CLTS provider registration name.  Please contact us if you change your business name or title at any point.  

4. Please complete the following forms and return them to:  Hazlewood.Ross@danecounty.gov

• W-9
• New CLTS Provider Form
• Signed Rate Schedule

Please note:  Completion of these forms is needed before Dane County can approve a provider to begin offering CLTS services.  Unless otherwise arranged, provider services will be authorized to start the first of the month, after the provider’s meeting with Dane County CLTS staff to approve services, and all completed provider forms are received.

5. After all initial CLTS paperwork and registrations are successfully completed, Dane County will add services provided by your business to our CLTS IT system.  Dane County Program Specialist Eric Linn Miller Linn-Miller.Eric@danecounty.gov (608) 242-6447 will e-mail service authorizations to your business via Excel Spreadsheet. He will also discuss the process for submitting claims to and receiving payment from our third party administrator (TPA). 
    
6. If you need to make updates to your DHS/CLTS profile (i.e. address change, business title change, etc), you must do so through the DHS portal. You’ll need to sign in with your username and password, then click on “Reg ID.”  This should take you to your existing registration, where you can update/edit things as needed.  If you should encounter any issues with the state CLTS registry, please contact their representatives, at DHSCLTSProvider@dhs.wisconsin.gov

Thank you for completing this process!  We are excited to partner with you in providing services to Dane County children with disabilities and their families.