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:
Time: Approximately 30-60 minutes
3. Register to do business in Wisconsin. (This costs between $100-130, depending on entity type.)
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 email@example.com if you have questions.
Depending on the type of service your business provides, you must have at least one of the following:
Time: Varies, depending on insurance provider.
6. Email completed County forms to firstname.lastname@example.org
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 email@example.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 firstname.lastname@example.org / (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.