Contents12.1 Information Available on the Eligibility Results
Page 12.1 Information Available on the Eligibility Results PageOnce the screener has selected "Calculate Eligibility" a new screen will appear with important information. At the top of the page will be the following information that helps identify who produced this screen and when it was completed. Included is:
The page will then display the following chart:
For the Community Options Program, the following Eligibility Results are possible:
For the Family Support Program, the following Eligibility Results are possible:
For the Children's Waivers, the following Eligibility Results are possible:
Note: The Children's Waivers Functional Eligibility Results will list all the target groups for which the child meets the functional eligibility requirements. The decision of which specific target group to select for any particular child is the responsibility of the agency/county using the Children's Waivers. For the Katie Beckett Medicaid Program, the following Eligibility Results are possible:
For the MH Wrap Around, the following Eligibility Results are possible:
Pending Results may include:
If a CLTS FS indicates that there are Pending Results for a child's functional eligibility, then only when those issues are resolved can one determine that a child actually meets the functional eligibility requirement for that particular program. However, meeting the functional eligibility for a program does not automatically make the child eligible for that program because there may be additional criteria that must be met prior to program eligibility. At the bottom of the page is the reminder that "This does not
include FINANCIAL eligibility." This is important to keep in mind
because Financial Eligibility is of significant importance to certain
programs. 12.2 What Do These Results Mean?The results only indicate that the child meets (or does not meet) functional eligibility for certain programs. It does not mean that they meet program eligibility. Some programs have additional criteria including financial eligibility that need to be determined for program eligibility. The CLTS FS only determines functional eligibility. If the functional eligibility is pending anything, than the child is
not considered functionally eligible for that program until the pending
issues are addressed. The Level of Care (LOC) or Target Group that the
child will meet once the pending issues are addressed is listed so that
plans for their eventual functional eligibility can be made accordingly. 12.3 Functional Disability Indicator (FDI)The FDI is limited to disabilities where the Disability Determination Bureau (DDB) might in the future have the CLTS FS determine eligibility. It does not address multitude of other disabilities. If the result specify that the Functional Disability Indicator was met,
it simply means that the items selected on the CLTS FS suggests that this
child will be found eligible by the DDB. For programs that require a DDB
determination, the child's record will need to be reviewed at the DDB
regardless of the Functional Disability Indicator. It may be that in the
future this process will be streamlined but at this time the Functional
Disability Indicator is just that - an indicator that the child will meet
DDB eligibility determination. 12.4 Confirm the Functional Eligibility ResultsScreeners, as knowledgeable professionals in the field who have met the child and reviewed valuable information about the child, are responsible for confirming that the results of the CLTS FS meet with their professional judgment. If the outcome is not what the screener expected, the screener should contact State Clinical Staff to request a screen review. This is especially important if the screener expected the child to be functionally eligible and they were not and visa versa. The subtleties of meeting one Level of Care versus another are not as significant. Screeners should not attempt to change their answer choices on
the screen to get the results they anticipated. If the screener finds that
they unintentionally checked something incorrectly on the screen, they can
use the Edit button to make small changes to their answer choices and
recalculate eligibility. If the Calculate Eligibility button is selected
multiple times on a single child, the screener will be asked by State
Clinical Staff to provide an explanation for their repeated eligibility
calculations. 12.5 Sharing Functional Eligibility Results with OthersNaturally the functional eligibility results are to be kept confidential. This page is not to be shared in total with a family. If requested, the screener can share the results for the program the family requested a screen for, but do not share the results for other programs. If the screener sees from the results that the child has met the
functional eligibility for another program, the screener can refer the
family to that program. Screeners are not required to make such referrals.
The CLTS FS does not determine program eligibility so being found
functionally eligible for a program does not guarantee program
eligibility. Screeners should never tell a family that they are eligible
for any program other than the program the screener is offering. 12.6 Functional Eligibility Results Affecting Eligibility for Other ProgramsThe CLTS FS determines functional eligibility for multiple programs. Therefore, it may find children ineligible for multiple programs as well. When the functional eligibility results indicate that a child is no longer functionally eligible for a program that they are currently receiving services from, it is the screener's responsibility to inform that program of their results. For example, if a screener is completing a CLTS FS for the Family Support Program and the results indicate that the child is no longer eligible for the Katie Beckett Program, the Family Support Program has a responsibility to inform the Katie Beckett Program of this change immediately. As long as the CLTS FS is completed accurately, it does not matter who
completed it or which program it is being completed for. The functional
eligibility results are binding for all programs listed. It is important
that the CLTS FS be completed based on fact and not subjectively as the
results impact many programs for which the child may be functionally
eligible. 12.7 Results not as ExpectedWhenever a screener receives results that they did not expect, they should complete a thorough review of the screen. If the results are the same following this initial review, they should conduct an internal review with someone else from the same agency. If the results are still in question, the screener should contact the CLTS FS Clinical Advisor for assistance. If the result is that the child is Not Functionally Eligible, the
screener should always request an internal review by their agency/entity.
Each agency/entity is responsible for screen/screener quality assurance at
a local level. The CLTS FS Clinical Advisor may be consulted when specific
questions arise but cannot verify eligibility results for any child. 12.8 Completed CLTS Functional Screen Summary ReportsThere are summary report options available for a completed individual CLTS FS. These reports can be viewed at the web site and can also be printed. The reports have been developed based on feedback from screeners and managers who operate the programs for which the CLTS FS determines functional eligibility. There are four (4) report formats to choose from. The four reports are titled:
FS report w/eligibility Family FS report w/notes Family FS report Notes Summary |