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DDES Memo Series 2003-14
ACTION MEMO

December 19, 2003

STATE OF WISCONSIN
Department of Health and Family Services
Division of Children and Family Services
Division of Disability and Elder Services

To:
Area Administrators/Assistant Area Administrators
DDES Bureau Directors
County Departments of Developmental Disabilities Services Directors
County Departments of Human Services Directors
County Departments of Social Services Directors
County Long Term Care/Developmental Disabilities Coordinators
County COP Coordinators
County Waiver Coordinators
Tribal Chairpersons/Human Services Facilitators

From: 
Sinikka Santala, Administrator

Re: Long Term Care Functional Screen

Document Summary

The Department will require all counties currently operating COP and Home and Community-Based Waiver programs to begin using the Long Term Care Functional Screen (LTC FS) to determine eligibility and level of care for those programs by Calendar Year 2005. Counties must complete and submit Attachment 3 as soon as possible so that the Department can schedule sufficient training sessions for LTC FS implementation in 2004.

Since early 2002, the Department has been helping counties to implement the Long Term Care Functional Screen (LTC FS) in place of the Community Options/Waiver functional screen. This automated screening tool is available through the Internet and provides a consistent method of determining functional eligibility for adults with physical or developmental disabilities and for frail elders. 

The tool is currently being validated for use with the Brain Injury Waiver. This automated screening tool replaces the other tools currently in use to determine COP and waiver level of care and reduces the complexity of waiver management.

The LTC FS provides an immediate determination of functional eligibility and level of care upon entry of all required information. The results are reliable and objective because they are based on criteria that are applied in a consistent manner to the data entered into the system. In addition, the data collected in doing the LTC FS provides a source of important management information for long-term support programs.

The LTC FS also provides us with an opportunity to develop additional functionality. The Department is piloting a Children’s Long Term Support Functional Screen that uses the same technology as the adult screen. After the pilot phase, this will be available to all counties. 

A mental health version of the screen is also being piloted in paper form and is expected to be available in an automated form in 2004. In addition, the Department is beginning to develop the requirements for using the screen for prior authorization of personal care services. The LTC FS will provide the foundation for a comprehensive set of tools for care managers.

To date, close to 30 counties have volunteered to adapt their process and are or will soon be using the screen. The Department is now ready to move towards statewide implementation. 

In the future, the LTC FS will serve as an important source of data about the long-term support caseload, a management tool for determining the needs of people in our programs and as the foundation for quality assurance and quality improvement activities.

It is the Department’s intent that counties will begin using the automated LTC FS as soon as possible and that all counties must begin to use it by the end of Calendar Year 2004. In 2005, the LTC FS will become the required tool for functional eligibility determination for home and community-based waivers and COP.

To encourage counties to move forward as quickly as possible, the Department will provide each county with an incentive payment of $2,000 in general purpose revenue upon full implementation of the LTC FS before July 1, 2004. Full implementation means that the county is using the screen for all new waiver recipients and for all waiver recertifications for all target groups. 

The funds will be added to the county’s administrative allocation and may be used to match federal funds for a total increase in available funds of $5,000. Home and community-based waiver counties (i.e., counties without Family Care CMOs) that have already begun to use the LTC FS for functional eligibility for all target groups are eligible receive the $2,000. 

If the county is not using the screen for all target groups, the incentive will not be available unless the county begins to use the screen for other target groups by July 1, 2004.

Attachment 1, "Steps for Implementing the Long Term Care Functional Screen," describes the process for implementation. Briefly, they include:

• Staff become knowledgeable/competent in applying the screen tool clinical determinations via an on-line computer training course. Staff can complete this required training at their own pace. Social workers receive twelve continuing education hours for completion of this training.
• Screen users attend optional training that provides an orientation to navigating through the LTC FS program and a description of the changes to waiver approval requirements as a result of the new screen.
• The county agency integrates the LTC FS into its on-going assessment and care management activities.

To facilitate implementation, the Department has planned several sessions in sites around the state for the hands-on component of the screen training. Space is limited at these sites, so counties should respond promptly to schedule training in the preferred site and at the preferred time. 

Additional sessions will be added if needed to ensure timely implementation of the screen. While optional, county staff have found the sessions to be useful.

Attachment 2 provides a description of the computer hardware and software that is needed to use the automated LTC FS. We anticipate that most counties will have computer capacity that meets these requirements. 

If you think your agency will not meet these requirements or you are not certain, the Department will provide consultation to assist you. Although it is not necessary for each screener to have a computer at his/her desk, computers should be conveniently available when needed.

Attachment 3 is a form entitled "LTC FS Local Implementation Information" that should be completed and returned to DDES so that we can develop an implementation schedule. Please complete this form and return it to the Department as soon as possible. We would appreciate hearing from as many counties as possible by February 15, 2004.

This is a very exciting opportunity to streamline COP and waiver administration. I look forward to working with Wisconsin counties in making these programs as efficient as possible.

Action Summary:
Counties must send the attached "LTC FS Local Implementation Information" form to the following address as soon as possible (preferably by February 15, 2004):

Gail Propsom
DDES/BALTCR
P. O. Box 7851
Madison, WI 53707-7851
Fax: 608/267-3203
E-mail: propsgf@dhfs.state.wi.us

Regional Office Contact: 
Assistant Area Administrators – Adult Services

Central Office Contacts:

MEMO WEB SITE: http://www.dhfs.state.wi.us/partners/local.htm

Attachments:
Steps for Implementing the Long Term Care Functional Screen
LTC FS Computer Requirements
LTC FS Local Implementation Information

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