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Children's Long-Term Support Waiver

Everything You Need to Know About Updates to CLTS


What Has Changed for CLTS Participants?

In 2019, the Children's Long-Term Support Waiver program, administered by the Milwaukee County DHHS Disabilities Services Division, went to a digital-first records tracking system to better serve parents with children enrolled in CLTS and their providers.

This new system eliminates reams of paper records, and moves everything to digital recordkeeping, allowing parents, children, providers, and the County to maintain more accurate records more efficiently. This ensures parents get the services they need, and helps providers get paid more quickly.

However, in the process of transitioning to the new system, we encountered a set of unforeseen circumstances that have made things more difficult. We are working through these challenges as quickly as possible. This page is the information hub for CLTS participants using Fiscal Agent services.

FAQ for Fiscal Agent Program FAQ for CLTS Services Call ADRC (414) 289-6799

Fiscal Agent Frequently Asked Questions

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   What is the PPA Adjustment I see on my pay stub?

A PPA Adjustment is a reduction to a caregiver’s gross wages for employer’s payroll taxes and/or when the monthly authorized amount is exceeded. The participant enrolled in the CLTS program is given a monthly maximum authorization amount that is inclusive of employer payroll taxes. The monthly maximum authorized amount can not be exceeded. If the monthly authorized amount is exceeded a PPA Adjustment will appear on the caregiver’s payroll stub.

  I worked the hours I was told I could work. Why is my pay adjusted with a PPA Adjustment?

The monthly authorized amount that a participant enrolled in the CLTS program receives includes an amount for employer payroll taxes. This amount can not be paid out to caregivers’ in the form of gross wages as it is set-aside to pay the participant’s payroll taxes associated with employing a caregiver. 

  Why did my caseworker tell me I could pay my caregivers the hourly rate I offered them if it exceeded the monthly authorized amount my family receives from the CLTS program?

The maximum rate we had discussed is the rate prior to payroll taxes being deducted. That is the reason the rate realized by your care provider will be slightly less than the rate we discussed.

  I like paper time sheets. Can I turn in my hours using a paper time sheet?

For a limited time, caregivers may use a paper timesheet until they receive their log-in credentials for the automated Time & Attendance system. After the caregiver and the family receive their log-in credentials, the caregiver will only be paid when time is entered into the T&A system.

  I did not receive my paystub. What happened?

Employee pay stubs are posted to their portal on pay day. Pay stubs are not mailed out. Each employee was issued log-in credentials to the portal via email. Your pay stubs will remain in your portal indefinitely.

  Why didn't I get paid?

If you did not receive a paycheck on pay day it may be due to the following reasons:


The participant’s authorization to release your paycheck is still in process. Once the authorization is finalized your payroll check will be released.


If the gross wages you received on your first paycheck exhausted all of the funding available for the month you will not receive a paycheck. 

  When do I get paid?

Caregivers are paid semi-monthly on the 15th and 30th of each month. If pay day falls on a weekend day the caregiver will be paid the Friday before the weekend. 

  Will completing the new fiscal agent form create another delay in payment?

No. It will correct the pay rate for your direct care provider.

  Will there be opportunities to use a different fiscal agent in the future?

Yes. Premiere and UTS are currently being used. If you want to use a different fiscal agent, please talk to your service provider.

  Can my direct care worker be paid for more than what was authorized?

The fiscal agent will not pay out for more hours than was authorized. Please monitor the hours your direct care provider is working. If they are nearing the maximum hours authorized, please contact your Service Coordinator to discuss if more hours are needed.

CLTS Frequently Asked Questions

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  What is the Children's Long-Term Support (CLTS) Waiver Program?

The Children’s Long-Term Support (CLTS) Waiver Program is a Medicaid Home and Community-Based Waiver program that provides services for children with severe disabilities.

The waiver program allows Wisconsin to use Medicaid funding tor community-based services.

The program is administered in Milwaukee County by the Milwaukee County Department of Health & Human Services’ Disabilities Services Division.

  Who is eligible for the CLTS Waiver?

Children who have severe physical, developmental, or emotional disabilities may be eligible for the program. Children must meet the following criteria:

  • The child must have a Disability Determination from SSI Medicaid, Katie Beckett Medicaid, or State Waiver Medicaid.
  • The child must meet financial requirements in accordance with Medicaid guidelines.
  • The child must meet a Level of Care as determined through an assessment and functional screen.
  What services are provided through the CLTS Waiver?

Services funded through the CLTS waiver are based on the child’s assessed needs and the outcomes for the child that are developed with the family/caregiver.

Examples of services could include:

  • Home modifications for a child with a physical disability
  • Respite care
  • Therapeutic services
  • Adaptive aids
  How can families apply for the CLTS Waiver?

The CLTS waiver is currently a pilot program administered by the Disabilities Services Division of the Milwaukee County Department of Health & Human Services.

To make a referral, families should call the Disabilities Services Division for a brief telephone assessment.

Referrals can be made from 8 a.m. to 4:30 p.m. Monday through Friday by phone.

(414) 289-6799

Providers may not make a referral on behalf of someone or their family. 

  What happens after a family makes the referral?

The family will be contacted by a representative of Milwaukee County to schedule a home visit to further explain the program, complete an assessment of the child’s functioning, and complete the required paperwork.

The child must:

  • Be a U.S. Citizen
  • Live in Milwaukee County
  • Have a verified diagnosis
  • Meet functional eligibility
  • Meet financial eligibility
  What happens when a child is approved?

The family is assigned an ongoing Support & Service Coordinator who will work with the family to initiate services and continue to provide support to child and family.

CLTS Forms & Resources


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