Free CLTS Waivers, Intensive In-Home Autism Treatment Services - Wisconsin

DEPARTMENT OF HEALTH SERVICES Division of Long Term Care F-20911H (08/2008)

STATE OF WISCONSIN

ME NYUAM QHOV KEV PAB CUAM MUS NTEV, KEV MUAB SIAB KHO TUS MOB AUTISM NYOB RAU HAUV TSEV: COV CAI, COV LUAG DEJ NUM THIAB COV HAUJ LWM KOM UA
CHILDREN'S LONG-TERM SUPPORT (CLTS) WAIVERS, INTENSIVE IN-HOME AUTISM TREATMENT SERVICES: RIGHTS, RESPONSIBILITIES AND REQUIREMENTS
1. Cov Kev Muab Siab Kho Nyob Rau Hauv Tsev (The Intensive In-Home Treatment Services) yog tau los ntawm xeev Wisconsin Me Nyuam Qhov Kev Pab Cuam Mus Ntev (Wisconsin CLTS Waivers) uas yog pab rau cov me nyuam muaj tus mob autism, Asperger Disorder, los yog Pervasive Developmental Disorder, not otherwise specified (PDD-NOS). Niam thiab txiv yuav tsum qhia rau tus neeg ua hauj lwm pab (Support and Service Coordinator) kom nws paub tas nrho cov kev tshuaj pom tus mob ntawm tus me nyuam. Qhov tsis kam qhia cov kev tshuaj pom tus mob yuav ua rau daim ntawv thov Cov Kev Muab Siab Kho Nyob Rau Hauv Tsev (Intensive In-Home Treatment Services) tu mus. Wisconsin Me Nyuam Qhov Kev Pab Cuam Mus Ntev (Wisconsin CLTS Waivers) yuav pub txhua tus me nyuam uas tsim nyog tau txais kev pab kom lawv tau txais qhov kev muab siab kho nyob rau hauv tsev (intensive in-house treatment) mus txog peb lub xyoos tsis hais leej twg yuav yog tus them rau qhov kev kho no. Cov pab them yuav muaj xws li, tab sis kuj yuav tsis yog tas rau cov no xwb: ntawv tuav pov hwm mob nkeeg (private insurance), ntawv kho mob ntawm tsoom fwv (Medical Assistance), them los ntawm lwm tus neeg (private pay), los yog los ntawm tsoom fwv hauv xeev cov kev pab cuam. Qhov chaw ua hauj lwm (the Waiver Agency) yuav tau xyuas nraim seb tus me nyuam tau txais ntau npaum cas rau Cov Kev Muab Siab Kho Nyob Rau Hauv Tsev (Intensive In-Home Treatment Services) yav tas los thiab tseem tab tom tau txais tam sim no. Cov niam thiab txiv yuav tsum muab kom tau tej ntaub ntawv hais txog tej nuj nqis kev pab muab siab kho tus me nyuam yav tas los thiab tam sim no. Tej ntaub ntawv no yuav pab txiav txim seb tus me nyuam puas yuav tsim nyog tau txais kev pab los ntawm Me Nyuam Qhov Kev Pab Cuam Mus Ntev (CLTS Waivers) thiab pab qhov muab los xam seb hnub twg thiaj yog lub sij hawm tsim nyog muab cov kev pab txiav kom tu. Ib tus neeg twg uas muab lus tsis yog los yog muab tsis tau ntaub ntawv tawm los kom thiaj li tau txais ntawv kho mob Medicaid, nrog rau cov kev pab los ntawm Me Nyuam Qhov Kev Pab Cuam Mus Ntev (Children's Long-Term Support (CLTS) Waiver benefits) yuav raug nyob txim mus txog rau (6)lub xyoo, raug nplua nyiaj txog $25,000 los yog raug ob qho tib si raws li txoj cai Wis. Stat. 49.49(1). Tsis hais leej twg yuav yog tus them, cov kev pab tas nrho hauv cov lis piam (all weeks) los ntawm ib tus pab them twg nyob rau theem muab siab kho (intensive level) yuav muab xam tias yog qhov kev pab tau txais thiab yuav muab nrho tawm ntawm qhov kev pab 3 xyoos. Ib tus me nyuam yuav tsum tau txais yam tsawg kawg 12 lub hlis rau cov lis piam uas pab them los ntawm Me Nyuam Qhov Kev Pab Cuam Mus Ntev (CLTS Waivers) xwv thiaj tau txais cov kev pab mus tsis tu (ongoing waiver services). Tsev neeg muaj lub luag dej num los xaiv lawv qhov chaw pab kho los yog kws pab kho. Qhov chaw pab kho uas xaiv tau yuav tsum nrog pom zoo muab kev pab kho tus me nyuam. Qhov chaw ua hauj lwm (Waiver Agency) yuav tsum tau lees paub tseeb tias qhov chaw pab kho (provider) yeej txaus siab kho tiag. Cov xuab moos (hours) ntawm Cov Kev Muab Siab Kho Nyob Rau Hauv Tsev (The Intensive In-Home Treatment Services) uas tau muab teev tseg los pab kho ib tug me nyuam twg, raws li Centers for Medicare and Medicaid Services (CMS) tus Service Code tau pom zoo, yog "tau muab teev tseg thaum sib tham nrog qhov chaw pab kho, tus me nyuam tsev neeg, thiab qhov chaw ua hauj lwm waiver agency." Tsis pub dhau 90 hnub tom qab Me Nyuam Cov Kev Pab Cuam Mus Ntev (CLTS Waiver) pib ua hauj lwm, tus me nyuam yuav tsum tau txais kev pab nyob rau theem muab siab kho (intensive level) tsis li qhov kev pab kho yuav raug muab txiav tu. Qhov kev pab nyob rau theem muab siab kho (intensive level) yog txhais tau hais tias tus me nyuam tau txais kev kho tim ntsej tim muag yam tsawg kawg yog 20 teev hauv ib lub lis piam. Qhov sij hawm 90 hnub uas ib qhov chaw pab kho muab suav rau cov sij hawm nyob rau theem muab siab kho ntawd yuav muab suav tsis tau ua cov lis piam ntsib tsis tau kom tau qhov muab ncua mus tshaj 3 xyoos (extension beyond three years). Tsev neeg muaj lub luag dej num muab kev koom tes lauj num zias nrog tus me nyuam mus cuag cov kev pab kho tus me nyuam kom tau. Yog tus me nyuam cov kev pab kho poob qis dua theem muab siab kho (intensive level) mus li 90 hnub sib law liag, qhov chaw ua hauj lwm (Waiver Agency) yuav tsum hais qhia rau Department of Health Services kom muab los xyuas dua. Qhov tau txais kev kho qis dua theem muab siab kho (intensive level) yuav ua rau raug tshem tawm ntawm Me Nyuam Qhov Kev Pab Cuam Mus Ntev (CLTS Waivers) mus los kuj muaj. Tsev neeg xav hloov cov chaw pab kho los tau. Yog tsev neeg hloov cov chaw pab kho, tus me nyuam yuav tsum rov qab mus txais Cov Kev Muab Siab Kho Nyob Rau Hauv Tsev (Intensive In-Home Treatment Services) nyob rau theem muab siab kho (intensive level) tsis pub dhau 90 hnub. Qhov sij hawm 90 hnub uas ib qhov chaw pab kho muab suav rau cov sij hawm nyob rau theem muab siab kho ntawd yuav muab suav tsis tau ua cov lis piam ntsib tsis tau kom tau qhov muab ncua mus tshaj 3 xyoos.

2.

3.

4.

5.

6.

7.

8.

9.

10. Yog tus me nyuam ntsib tsis tau cov chaw pab kho raws li cov sij hawm tau teem tseg, cov sij hawm uas tsis tau siv no yuav tau muab siv kom tas rau lub hlis ntawd tsuav yog qhov chaw pab kho xyeej sij hawm pab kho, tiam sis yuav muab siv tsis tau rau lub hlis tom ntej.

F-20911H Page 2 11. Cov Kev Muab Siab Kho Nyob Rau Hauv Tsev (Intensive In-Home Treatment Services) tsuas yog muab kev pab kho nyob rau hauv tsev nkaus xwb. Nws muaj tsawg zaus uas yog thaum ho muaj tej cov hom phiaj tsim nyog uas yuav tsum tau kho tus me nyuam nyob rau sab nraud xwb thiaj li yuav tau no ces kuj yuav muab kev zam rau thiab. Yuav tau ua hauj lwm koom tes nrog tus neeg ua hauj lwm pab (Support and Service Coordinator) los tsim kom tau cov hom phiaj rau qhov no. Tus neeg ua hauj lwm pab (Support and Service Coordinator) yuav tsum yog tus tso cai pom zoo rau cov xuab moos twg uas yog siv rau cov kev pab kho nyob sab nraud. 12. Tsoom fwv cov cai tswj kev pab kho mob Federal Medicaid thiab Community-Based Services Waiver Regulations txwv tsis pub kom tau txais ib qhov kev pab uas zoo tib yam los ntawm ntau qhov chaw raws li tsab cai hauv Individuals with Disabilities Education Act (IDEA). Nws muaj ib txog cai qhia seb thaum twg tsev kawm ntawv cov kev pab thiab cov kev pab los ntawm Cov Kev Muab Siab Kho Nyob Rau Hauv Tsev (Intensive In-Home Treatment Services) yuav tau ua hauj lwm ua ke. Txoj cai no kuj siv rau qhov qhia ntawv rau me nyuam hauv tsev thiab. Yog ib tug me nyuam twg kawm ntawv hauv tsev, cov kev pab ntawm Cov Kev Muab Siab Kho Nyob Rau Hauv Tsev (Intensive In-Home Treatment Services) yuav siv tsis tau los pab txhawb ntxiv rau qhov kawm ntawv hauv tsev. Tus me nyuam cov kev muab siab kho nyob rau hauv tsev (intensive in-home services) cov caij nyoog teem kho nws yuav tau muab qhia paub es muab kuaj xyuas kom zoo thaum muaj cov kev pab tshwm sim. 13. Tsev neeg yuav thov kom muab cov xuab moos uas tau pom zoo lawm txo kom qis los tau. Tsev neeg yuav tsum nrog lawv qhov chaw pab kho thiab lawv tus neeg ua hauj lwm pab (Support and Service Coordinator) tham txog qhov muab txo no, qhov thov kom muab txo no yuav tsis pub qis tshaj 20 teev hauv ib lub lis piam rau cov kev kho tim ntsej tim muag. 14. Kev ncua mus ntxiv thaum txwm 3 xyoos lawm kuj yuav muab coj los xyuas yog tus me nyuam muaj tas nrho yam tsawg kawg 12 lub lis piam mus ntsib tsis tau kev kho raws li tau teem cia nyob rau thaum twg los xij tsuav tsis txhob yog thaum thawj peb lub hlis los yog vim los ntawm kev pauv qhov chaw pab kho raws li tau hais nyob rau nqe 9 tas los. Qhov yuav ncua ntxiv ntev li cas yog nyob ntawm seb cov lis piam uas ntsib tsis tau ntawd muaj ntau npaum li cas, tiam sis yuav tsis pub ntau tshaj 52 lub lis piam. Ib tug me nyuam yuav tsum ua txhua yam raws li Tsab Cai CLTS Ncua Mus Ntxiv Peb Xyoos (CLTS Three-Year Extension Policy) thiaj li yuav raug muab rov qab los xyuas dua rau qhov kev ncua mus ntxiv. 15. Yuav kom muab coj los txiav txim xyuas seb puas tsim nyog tau txais qhov kev hlav mus ua qhov kev pab cuam tsis tu ncua (transition to ongoing services) hauv Me Nyuam Qhov Kev Pab Cuam Mus Ntev (CLTS Waiver) mas yam tsawg kawg ib lub xyoos ntawm Cov Kev Muab Siab Kho Nyob Rau Hauv Tsev (Intensive In-Home Treatment Services ) uas them los ntawm Me Nyuam Qhov Kev Pab Cuam Mus Ntev (CLTS Waivers) nyob rau ntawm ib theem muab siab kho (intensive level) yuav tau muab los kuaj xyuas kom yog.

Kuv to taub tias kuv yuav mus muab tau cov cai hais los saum no ntawm kuv tus neeg ua hauj lwm pab (Support and Service Coordinator), los yog muaj lus nug dab tsi los nug tau kuv tus neeg ua hauj lwm pab (Support and Service Coordinator) txhua lub sij hawm. Qhov kos npe hauv qab no yuav siv tau ua lus ceeb toom sau tseg tias kuv tau txais thiab nyeem daim ntawv hais txog Cov Kev Muab Siab Kho Nyob Rau Hauv Tsev (Intensive In-Home Treatment Services) Cov Cai thiab Cov Luag Dej Num. Cov lus no tau muab tham rau kuv ua lus hais thiab sau ua ntaub ntawv. Kuv to taub tias txhua yam lus kuv hais rau hauv no yuav muab siv coj mus txiav txim kuv tus me nyuam cov cai tau txais Medicaid cov kev pab. Qhov kuv kos npe no kuv lees tias tas nrho tej lus kuv hais muaj tseeb thiab yog tas tib si. Kuv to taub tias yog cov lus kuv muab no tsis muaj tseeb, kuv yuav raug nplua, nrog rau raug nyob txim mus txog rau (6)lub xyoo, raug nplua nyiaj txog $25,000, los yog ob qho tib si. Wis. Stat. 49.49(1). KOS NPE - Niam Txiv/Tus Saib Xyuas KOS NPE ­ Tus Neeg Ua Hauj Lwm Pab (Support and Service Coordinator) Hnub Kos Npe Hnub Kos Npe