Agenda w/ Attachments

July 29, 2026 CHILDREN’S COMMUNITY OPTIONS PROGRAM ADVISORY COMMITTEE Douglas County Health and Human Services Department Wednesday, August 5, 2026, 2:00 p.m., Government Center, Boardroom 201, 1316 North 14th Street, Superior, Wisconsin www.microsoft.com/microsoft-teams/join-a-meeting | Meeting ID: 284 473 188 102 | Passcode: mBz7EE Or call-in: 1 872-242-8028 | ID: 566 234 854# If you are unable to attend, please call the County Clerk’s Office (715-395-1483) prior to meeting. MEM BERS: Lee Sandok Baker, Chair Paulette Alseth Shari Pioro Debora Carroll, Vice Chair June Finsland Corinne Nelson AGENDA Virtual attendance available to public; committee members must attend in-person to constitute a quorum and/or vote. Committee to maintain a two-hour meeting limit or take action to continue meeting beyond that time. All action items include attachments unless noted. 1. ROLL CALL 2. APPROVAL OF MINUTES a. March 11, 2026 * 3. INTRODUCTION OF NEW STAFF & COMMITTEE MEMBERS 4. ACTION ITEMS a. 2027 Children’s Community Options Program (CCOP) Plan Approval * 5. INFORMATIONAL ITEMS a. Bylaws b. CCOP Procedures Guide * c. Budget * d. Membership Update e. Program Update 6. FUTURE AGENDA ITEMS 7. ADJOURNMENT *Attachment included Not ice is hereby given that a majority of the members of the Douglas County Board of Supervisors may be present at the meeting, and although this may constitute a quorum of the County Board of Supervisors, the County Board will not take any action at this meeting. This meeting will be recorded. By attending, you acknowledge that your image, voice, or comments may be captured on a public recording and made available to the public. Allowing public comment at committee meetings and the length of time for comments is a t the discretion of the Committee Chair. (Resolution #38-24). cc: Cou nty Board Supervisors Other interested parties NO TE: Agenda and attachments available on www.douglascountywi.gov or in County Clerk's Office. Action may be taken on any item on the agenda. The County of Douglas complies with the Americans with Disabilities Act of 1990. If you are in need of accommodation to participate in the public meeting process, please contact the Douglas County Clerk's Office at (715) 395-1341 by 4:00 p.m. on the day prior to the scheduled meeting. Douglas County will attempt to accommodate any request. TDD (715) 395-7521. Post ed: Courthouse, Government Center, Superior Telegram, and Superior Public Library _______ ________________________________________ Name Date 07/29/2026 CHILDREN’S COMMUNITY OPTIONS PROGRAM ADVISORY COMMITTEE Douglas County Health and Human Services Department Wednesday, March 11, 2026, 2:00 p.m., Government Center, Boardroom 201, 1316 North 14th Street, Superior, Wisconsin 1. ROLL CALL Present – Susan Hendrickson, Debra Carroll, Paulette Alseth, Shari Pioro, June Finsland, Corinne Nelson. Others Present – Erika Johnson, Nicole Pierce, Lindsey Conley, Committee Clerk. 2. APPROVAL OF MINUTES Motion by Finsland, second Alseth, to approve minutes from January 14, 2026 meeting, with the following correction: update Shari Pioro as present in minutes. Motion carried. 3. ACTION ITEMS None. 4. INFORMATIONAL ITEMS a. Program Update: 1 vacant position of Community Long Term Support (CLTS) worker, with the position being in the interview process. N. Pierce is a new hire in the position of Support and Service Coordinator. Reports show through January 2026, not November. The number of children participating in the program have increased from 168 to 171. Department is within Department of Health Services (DHS) standards of establishing timelines. b. Bylaws discussion: Bylaws reviewed. Supervisor Erika Johnson has brought proposed bylaws to the Committee, after speaking with Douglas County’s Corporation Counsel with their recommendations. Summary of revisions or areas of review include: determining whether CCOP could be combined with any other committees, elaborate on the mission statement, include type of disabilities versus just including the term “disability,” clarify who makes the final appointment to the committee, determine whether terms have to be included, refer to the chair person as just “chair,” use more inclusive language (change his/her to they/their), determine whether we can have options to renew terms. c. Budget: Budget 2025 rollover funding reviewed. 2026 rollover should be awarded by next meeting. d. Membership Update: Recruitment efforts ongoing, renewed outreach with enrolled families. Difficulty getting people interested in attending meetings. 5. FUTURE AGENDA ITEMS Bylaws Program Updates 6. ADJOURNMENT Motion by Pioro, second Finsland, to adjourn meeting. Motion carried. Meeting adjourned at 2:22 p.m. Submitted by, Lindsey Conley, Committee Clerk RETURN TO AGENDA Children's Community Options Program (CCOP) Plan DHS has provided this downloadable resource that includes all the questions in this survey to aid in the development of the CCOP plan. Email submissions of this resource will not be accepted. CCOP Plans must be submitted through this online survey. 1) County Agency Contact Information* County Agency*: Douglas County Health and Human Services First Name*: Erika Last Name*: Johnson Email Address*: Erika.johnson@douglascountywi.gov Is this plan being submitted jointly with another county? * ( ) Yes (x) No Please enter the name of the county. * _________________________________________________ 2) Date the full CCOP Plan was reviewed and approved by the County CCOP Advisory Committee* _________________________________________________ RETURN TO AGENDA 3) Will the county use the annually allocated CCOP funds to pay for the Children's Long- Term Support (CLTS) Program Maintenance of Effort (MOE) requirement? * (X) Yes ( ) No If "Yes," approximate the amount of funds dedicated to CCOP goods and services. * $41,000 4) P rovide an estimated number of families that will be served utilizing CCOP funds in the upcoming calendar year. * 65 5) D oes the county plan to prioritize specific groups of individuals for CCOP funds? * ( ) Yes (x ) No If "Yes," provide a summary explaining the plans for prioritization. * 6) D oes the county have any local policies limiting available CCOP funds? * ( ) Yes (x) No If "Yes," provide a summary of identified limitations. * A ttach the local written policy, if applicable. 7) Does the CCOP program align with the CCOP policy timeframes related to referrals and eligibility as outlined in the CCOP Procedures Guide?* (x) Yes ( ) No If "No," share the plan and timeline for aligning with program policy. * 8) D oes the CCOP program align with the CCOP policy timeframes related to assessment and service plan development as outlined in the CCOP Procedures Guide?* (x) Yes ( ) No If "No," share the plan and timeline for aligning with program policy. * 9) D oes the CCOP program follow the Deciding Together process for Individualized Service Plan (ISP) development? * (x) Yes ( ) No If "No," describe the service planning process. * 10) D oes the CCOP program follow the CLTS policy timeframe for making decisions about participant-requested goods and services as outlined in the CLTS Waiver Manual Section 7.4.1?* (x) Yes ( ) No If "No," describe the local process. * 11) D oes the CCOP program have an identified method for promoting informal supports and advocacy systems as outlined in the CCOP Procedure Guide* (x) Yes ( ) No If "Yes," briefly summarize the methods. * Support and Service Coordinator’s inquire about informal supports while completing the case assessment. 12) D oes the county have any outreach materials used to educate the public on CCOP? * (x) Yes ( ) No If "Yes," provide a webpage where this information can be located or attach a copy to the submission. * DHS P-02991 (Children’s Services Programs: Cross Comparison) 13) D oes the CCOP program align with the CCOP policy timeframes for entering services expenses into the Health Engagement and Reporting Tool (HEART) as outlined in the CCOP Procedures Guide? * (x) Yes ( ) No If "No," share the plan and timeline for aligning with program policy. * 14) D oes the county have a protocol in place to ensure the full expenditure of the CCOP allocation as outlined in the CCOP Procedures Guide?* (x) Yes ( ) No If "No," share the plan and timeline for aligning with program policy.* 1 5) CCOP Advisory Committees are required to include the following individuals: • Parents of children with disabilities • Representatives from county departments/divisions of human/social services, community programs, developmental disabilities services, school districts, or local health departments • Individuals in the service area who provide other social or educational services to children who have disabilities Does the county’s CCOP Advisory Committee have representation from all three of the above groups of individuals? * (x) Yes ( ) No If "No," identify who is currently not represented in the committee and the plan for aligning with program policy regarding committee membership requirements.* 1 6) How often is the CCOP committee meeting, and where can the public meeting materials be accessed per Public Notice law found in Wis. Stat. § 19.84?* Quarterly – County website 17) I f another committee is designated as the CCOP Advisory Committee, identify which committee is serving that role. N/A 1 8) How will the county engage the CCOP committee throughout the year for ongoing monitoring and consultation? * Through quarterly meetings and agenda items. 1 9) Attestation* ( ) As the CCOP Coordinator, I attest that this plan has been reviewed and approved by our county’s local CCOP Advisory Committee and is in accordance with the program plan requirements listed in CCOP policy. 2 0) Attach a copy of the CCOP Advisory Committee's meeting minutes to attest that the CCOP Plan was developed, reviewed, and approved in collaboration with the CCOP Advisory Committee. * Children’s Community Options Program Procedures Guide for Administering Agencies Divis ion of Medicaid Services Bureau of Children’s Services P-01780 (04/2026) RETURN TO AGENDA CCOP Procedures Guide 2 Table of Contents PREFACE ........................................................................................................................................5 CCOP Purpose .....................................................................................................................5 Legal Framework of Wisconsin’s CCOP ............................................................................6 CCOP and CLTS Waiver .....................................................................................................6 When to Use the CCOP Procedures Guide ..........................................................................7 CHAPTER 1: PROGRAM ADMINISTRATION ...........................................................................8 Administering Agency Responsibilities ..............................................................................8 CCOP Advisory Committee 5 ...............................................................................................8 Committee Membership6 .........................................................................................8 Existing Committee .................................................................................................9 CCOP Plan ...........................................................................................................................9 Program Changes and Updates ..............................................................................10 Implementation and Monitoring ............................................................................10 Administering Agency’s Duties .........................................................................................10 Implementation and Monitoring ............................................................................10 Coordination of Programs ..................................................................................................11 CHAPTER 2: FUNDING ..............................................................................................................12 Fiscal Allocations...............................................................................................................12 CCOP Uses and Restrictions .............................................................................................12 Fiscal Responsibility ..........................................................................................................12 CCOP Waitlist and Children Waiting for CLTS Enrollment Who Have an Urgent Need .......................................................................................................................13 Administrative Costs ..........................................................................................................13 Funding Assessments, Plans, and Support and Service Coordination ...............................14 Procedures for Purchasing Goods and Services .................................................................14 Payment Methodologies for Goods and Services ..................................................14 Fiscal Agent .......................................................................................................................15 Parental Payments ..............................................................................................................15 Unspent Allocations ...........................................................................................................16 Risk Reserve ..........................................................................................................16 Carry Forward ........................................................................................................17 DHS-Established Exceptional Expense Funds ......................................................18 For More Information ........................................................................................................18 CHAPTER 3: INTAKE AND ELIGIBILITY ...............................................................................19 Outreach and Referral ........................................................................................................19 Intake ................................................................................................................................19 Rel ease of Information .......................................................................................................20 CCOP Eligibility Requirements .........................................................................................20 CCOP Procedures Guide 3 Age Limitations .................................................................................................................21 Parental Payments ..............................................................................................................21 Residency ...........................................................................................................................21 County Residency ..................................................................................................21 Residency in Two Homes ......................................................................................21 Change Reporting and Eligibility Redetermination ...........................................................21 Notifications .......................................................................................................................22 Limits of Available Funding ..............................................................................................22 CHAPTER 4: SUPPORT AND SERVICE COORDINATION ....................................................24 CCOP Staff ........................................................................................................................24 Community Connections Coordinator ...................................................................24 Support and Service Coordinator ...........................................................................24 Targeted Case Management (TCM) ......................................................................25 Assessment .........................................................................................................................25 Assessment Content ...............................................................................................26 Child and Family-Centered Individual Service Plan (ISP) ................................................27 Plan Notification and Signature .............................................................................28 ISP Review.............................................................................................................28 Serving Children Awaiting Enrollment in CLTS ..............................................................28 One-Time or Intermittent Need .........................................................................................29 Coordinating CCOP with Other Resources .......................................................................29 Transitioning to Adult Long-Term Care Services .............................................................30 CHAPTER 5: SUPPORTS AND SERVICES ...............................................................................31 Qualifications and Caregiver Background Checks ............................................................31 Service Categories .............................................................................................................31 CCOP Service Categories ..................................................................................................31 Consumer and Family-Directed Supports ..........................................................................34 Non-Allowable Goods or Services ....................................................................................34 High-Cost Expenditures .....................................................................................................35 CHAPTER 6: INCIDENT REPORTING AND RESTRICTIVE MEASURES ...........................36 Incident Reporting .............................................................................................................36 Restrictive Measures ..........................................................................................................37 CHAPTER 7: RIGHTS, GRIEVANCES, AND APPEALS .........................................................39 Notification of Rights ........................................................................................................39 County Grievances .............................................................................................................39 St ate Appeal for Fair Hearing ............................................................................................39 CHAPTER 8: REPORTING, CODING, RECORDS, AND CLOSURE ......................................41 Reporting Requirements ....................................................................................................41 CCOP Procedures Guide 4 Coding ...............................................................................................................................41 Billing for an Assessment and Plan .......................................................................41 Fiscal Records and Reporting ............................................................................................42 Children’s Records.............................................................................................................42 Closure of Participation .....................................................................................................43 Appendix A: Common Acronyms .................................................................................................44 Appendix B: Relevant Legal Authority .........................................................................................45 Wisconsin Statutes .............................................................................................................45 Wisconsin Administrative Code ........................................................................................46 Wisconsin Acts ..................................................................................................................46 Federal Code ......................................................................................................................46 Appendix C: Sample Notification of Denial Letter .......................................................................47 Appendix D: Rights and Responsibilities Notification Template ..................................................49 Appendix E: Assessment Criteria ..................................................................................................53 Abbreviated Assessment ....................................................................................................53 Comprehensive Assessment...............................................................................................53 CCOP Procedures Guide 5 PREFACE E ffective January 1, 2016, the Children’s Community Options Program (CCOP) was formed by merging the Family Support Program with the portion of the Community Options Program (COP) allocated to children. The statutory authority and program requirements for CCOP were established in 2015 Wis. Act 55, which created Wis. Stat. § 46.272. Th e intent of merging these two programs is to simplify the oversight of multiple program requirements and eliminate administrative redundancies while increasing the flexibility for administering agencies’ use of this funding. T he Bureau of Children’s Services (BCS) within the Wisconsin Department of Health Services (DHS), Division of Medicaid Services (DMS), is responsible for oversight and statewide administration of CCOP. T he Children’s Community Options Program Procedures Guide has been developed by DHS to clarify the purpose and requirements of the program and is operational effective January 1, 2017. A stakeholder workgroup, including parents, advocates, and representatives from county agencies and the Wisconsin Council on Children’s Long-Term Support, advised DHS on the development of this guide. C COP Purpose The purpose of CCOP is to provide a coordinated approach to supporting families who have a child with a disability.11 This approach recognizes and maximizes the family’s capacity, resiliency, and unique abilities with the intention of better supporting, nurturing, and facilitating self-determination, interdependence, and inclusion in all facets of community life for the child and family. T hrough a collaborative relationship with the family, supports and services aimed at achieving desired outcomes are identified, prioritized, and implemented. Strategies must be flexible, coordinated, and effective, and may include: • Information, education, and training on advocating on behalf of the child, leadership, and the full array of supports and services available in each community. • Methods for connecting families with other families (including parents, guardians, self- advocates, siblings, and grandparents) and support groups for mutual support and networking. • Goods and services that promote identified outcomes, benefit the child, and enhance the family’s long-term support roles. 11 Wis. Stat. § 46.272(1)(b) “Disability” means a severe physical, developmental, or emotional impairment which is diagnosed medically, behaviorally, or psychologically, which is characterized by the need for individually planned and coordinated care, treatment, vocational rehabilitation, or other services and which has resulted or is likely to result in substantial limitation on the ability to function in at least 2 of the following areas, equivalent to nursing home, hospital, or institution for mental disease level of care: 1. Self-care 2. Receptive and expressive language 3. Learning 4. Mobility 5. Self-direction CCOP Procedures Guide 6 The design of these strategies, supports, and services is intended to reflect the uniqueness of families in terms of their diversity, experiences, and community membership. C COP funds are designated for the purpose of purchasing goods and services that respond to assessed needs and desired outcomes, as identified in each participant’s child and family-centered individual service plan (ISP). L egal Framework of Wisconsin’s CCOP Wisconsin Stat. § 46.272 provides the legal framework for Wisconsin’s CCOP. Key policy factors used in the development of CCOP are: • CCOP is the funding of last resort. In order to maximize the use of federal funds, Home and Community-Based Services (HCBS) Medicaid Waiver Program funding must be used before CCOP for children who are functionally and financially eligible for Wisconsin’s Children’s Long-Term Support (CLTS) Waiver Program. This requirement is often referred to as the “waiver mandate.” • CCOP funding can be more flexible than CLTS waiver funding. Within limits, CCOP can be used to meet the long-term support needs of eligible children and their families to pay for goods and services that are not allowed under the waiver. • CCOP funding can be used as the nonfederal match for services provided via the CLTS Waiver Program. CCOP funding used this way is identified during the annual CCOP reconciliation and counts towards the CLTS maintenance of effort (MOE) requirement. • CCOP can be used when individuals are eligible for CCOP but are not eligible for the CLTS Waive r P rogram. • When CCOP funding is not used as the nonfederal match for CLTS waiver services, it is often referred to as “pure” or “straight” CCOP, and all CCOP guidelines and program rules apply. C COP and CLTS Waiver CCOP funds may not be used for long-term supports and services that can be funded under the CLTS Waiver Program. Waiver funds must be used when all three of the following exist: • The child is enrolled or can be enrolled in the waiver program. • The state has Medicaid waiver resources available. • The services to be provided are covered by the waiver.12 When a child is enrolled in the waiver program, all waiver-allowable supports and services must be paid through the CLTS Waiver Program, including support and service coordination. When a child meets the crisis criteria (see the Waiver Manual), they must be enrolled in the waiver and all waiver-allowable supports are billed to the CLTS Waiver Program. When a child is determined eligible for CLTS and the resources are available to serve them, they are enrolled in the waiver and all waiver-allowable supports must be billed to the CLTS Waiver Program; appropriate supports and services that are not allowable through the waiver can be paid with CCOP. F or eligible children waiting to be enrolled in CLTS and whose circumstances do not meet the crisis criteria, CCOP can be used to purchase interim supports and services to help families until they can be enrolled and fully served through the CLTS Waiver Program and/or CCOP. Administering agencies that choose to serve children waiting to be enrolled in CLTS must refer to the local CCOP plan for the list of 12 Wis. Stat. § 46.272(13)(a)(2) CCOP Procedures Guide 7 specific groups of children to be given priority, if any. Administering agencies must follow processes to ensure consistently fair and equitable use of CCOP funds. Whe n to Use the CCOP Procedures Guide CCOP can be accessed when any of the following applies: • A child is not eligible for Medicaid and will not receive services through the CLTS Waiver P rogram, but the child is eligible for CCOP and services can be provided with CCOP funding. • A child is eligible for Medicaid, but the administering agency decides their assessed need(s) can be fully met with one-time or intermittent services (i.e., three or fewer instances of receiving supports per year) through CCOP. • A child is determined eligible for the CLTS Waiver Program and receives interim services through CCOP until they are enrolled in CLTS. • A child is receiving services through the CLTS Waiver Program, and CCOP is being accessed to pay for supports and services that are not covered under the waiver. CCOP Procedures Guide 8 CHAPTER 1: PROGRAM ADMINISTRATION C COP is administered locally, as contracted by DHS.13 DHS has sole authority to approve or disapprove whether a county administers CCOP. Administering agencies may directly provide program services and/or subcontract with other service providers in the area. A dministering Agency Responsibilities At a minimum, the administering agency is required to: • Appoint members to a local CCOP advisory committee. • Cooperate with the CCOP advisory committee to develop a CCOP plan. • Submit the proposed CCOP plan to DHS for review. • Provide and/or subcontract with human service agencies in the area to provide program services within the limits of state and federal funds allocated for this purpose. • Coordinate the administration of CCOP along with other publicly funded programs in the area t hat serve children and young adults with disabilities. • Submit information and reports, as required by DHS.4 C COP Advisory Committee5 The primary purpose of the CCOP advisory committee is to monitor the program and provide consultation as necessary. The CCOP advisory committee informs and provides consultation to the administering agency. T he committee is encouraged to look at all of the local services and supports that are available to children with disabilities and their families, to identify gaps and needs, and to explore how these needs might be met through the public or private sector and existing community resources or parent-to-parent activities. The committee may be involved in activities to increase and improve access to community- based activities, resources, programs, and services. C ommittee Membership6 There is no set number of members for the committee; however, the majority of members must be parents of children with disabilities. State law further requires that, at a minimum, the CCOP advisory committee consist of: • Parents of children with disabilities, including, if possible, parents from families participating in CCOP. To the maximum extent possible, parents must be representative of the various disability, racial, and ethnic groups in the service area. • Representatives from (at least one person from this list must provide community social services to children who are eligible for CCOP): o County departments or divisions of human services, community programs, or developmental disabilities services o County departments of social services o School districts o Local health departments 3Wis. Stat. § 46.272(2)(a) 4Wis. Stat. § 46.272(4) 5Wis. Stat. § 46.272(4)(a) 6Wis. Stat. § 46.272 (4)(a)(1-3) CCOP Procedures Guide 9 • Individuals in the service area who provide other social or educational services to children who have disabilities. E xisting Committee The CCOP advisory committee can be newly appointed or an existing committee. If an existing committee or subcommittee of an existing group is designated as the CCOP advisory committee, the purpose, responsibilities, and membership requirements stated above must be maintained. For example, a local Birth to 3 interagency coordinating committee may serve as the CCOP advisory committee, if all of the other membership requirements are met. C COP Plan The administering agency and local CCOP advisory committee must work cooperatively to develop a CCOP plan as requested by DHS.7 A template for the CCOP Plan (F-01814) is available on the DHS website. The CCOP plan must include all of the following:8 • A description of the proposed program • The estimated number of families that will be assessed and served • A list of specific groups, if any, that will be given priority for available funding • A description of the outreach procedures that will be used to ensure that the program is made available to children with physical, emotional, and/or developmental disabilities • The procedures that will be used to determine family needs • A description of the methods that will be used to develop and monitor service plans and to coordinate the provision of services and goods to participating families • A description of the methods that will be used to promote the creation of informal support and advocacy systems for families • A description of the method that will be used to monitor the program O nce approved by the local CCOP advisory committee, the administering agency submits the CCOP plan to BCS for review and final approval. The proposed plan must be emailed to dhsccop@dhs.wisconsin.gov. Any questions about the CCOP plan can also be emailed to this address. BC S reviews all CCOP plans for programmatic compliance and issues one of the following responses in writing to the administering agency: • Approval • Conditional approval, in which case DHS will include a specific deadline by which the conditions placed on the plan are to be met and accepted prior to final approval • Denied approval with reasons for denial T he distribution of any funds is contingent upon prior DHS approval of a local CCOP plan.9 D HS will hold a copy of each county’s CCOP plan on file. Administering agencies must also maintain a copy of the plan locally. CCOP plans and the DHS Children’s Community Options Program Procedures Guide are available to all interested parties, including the general public, upon request. _____________________________________ 7Wis. Stat. § 46.272(4)(f) 8Wis. Stat. § 46.272(4)(b) 9Wis. Stat. § 46.272(13)(b)(2) CCOP Procedures Guide 10 Program Changes and Updates Significant program changes to an approved CCOP plan require prior approval by DHS. Administering agencies must complete and submit an amended plan through the same process outlined above. I mplementation and Monitoring The administering agency is responsible for ensuring the annual development of and compliance with the CCOP plan and/or update, and for involving the local CCOP advisory committee in these processes. D HS will monitor the implementation of CCOP through audits and/or other reviews of administering agency activities. Ad ministering Agency’s Duties Implementation and Monitoring The administering agency is responsible for ensuring the compliance with the most current CCOP plan and/or update, and for involving the local CCOP advisory committee in these processes. D HS will monitor the implementation of CCOP through audits and/or other reviews of administering agency activities. T he administering agency must appoint a staff person as the point-of-contact for CCOP, identified as the “CCOP Coordinator” in the CCOP plan, who performs administrative tasks for the program. A gencies are additionally required to: • Provide information about CCOP and other programs for children who have disabilities to families in the service area. 10 • I mplement CCOP in accordance with a DHS-approved program plan.11 • D esignate one of its employees to coordinate services for each participating family.12 • C onduct assessments, arrange contracts for long-term community support services, and provide ongoing care management for eligible children and their families, within the limits of available funding. 13 • E nsure that service providers who receive CCOP funding meet required qualifications and caregiver background checks in accordance with the CLTS Waiver Program. A dministering agencies may not have more restrictive policies or processes than state and federal governing policies, procedures, or guidelines. A dministering agencies are obligated to follow all state and federal laws and procedures governing confidentiality. ________________________________ 10 Wis. Stat. § 46.272(6)(b) 11 Wis. Stat. § 46.272(6)(c) 12 Wis. Stat. § 46.272(6)(d) 13 Wis. Stat. § 46.272(11) CCOP Procedures Guide 11 Coordination of Programs The administering agency is responsible for coordinating CCOP services for children and families under the guidance of the county’s CCOP advisory committee and the county structure. Service coordination requires considering and making decisions about which program will assume the role of central point of contact for the family and determining the appropriate extent and nature of involvement by other programs and their staff. Coordination requires familiarity with the eligibility requirements of other programs and knowledge of the roles of their staff and the limitations of resources. A s the funding of last resort, the following programs must be considered prior to using CCOP funding and, where applicable, be incorporated into a comprehensive service plan for children and families: • Medicaid (e.g., ForwardHealth, Comprehensive Community Services (CCS), and other Medicaid- funded programs) • Other county programs (e.g., developmental disabilities programs; social services; child welfare services; juvenile court, legal, and corrections-related services) • School-based and educational services • Prevocational or vocational programs through the Department of Workforce Development, Division of Vocational Rehabilitation • Birth to 3 Program • CLTS Waiver Program CCOP Procedures Guide 12 CHAPTER 2: FUNDING F iscal Allocations CCOP is funded with state General Purpose Revenue (GPR). CCOP funding for each county is determined based on a statewide formula and is distributed as an annual allocation. CCOP is reimbursed monthly, based on reported expenses up to the amount of the allocation, and actual expenditures are reconciled annually (see Chapter 8). The distribution of any funds is contingent upon prior DHS approval of a local CCOP plan. 14 DHS may release funds to counties acting jointly, if the counties sign a contract that explains the plans for joint program sponsorship and it is approved by the DHS Secretary.15 At a minimum, agencies administering CCOP are expected to do so up to the limits of funds provided for this purpose. Counties may provide additional funding to serve more families. C COP Uses and Restrictions CCOP is the funding of last resort. When other programs are also defined as the funding of last resort, they must be used before CCOP. When costs are not otherwise covered, CCOP is available to pay for program assessments, case plans, and the cost of providing long-term community support services for eligible children and their families. 16 Funds must be spent in accordance with each child’s ISP and service contract. C LTS waiver funds must be used when the participant is eligible or becomes eligible for the CLTS Waiver Program, the state has waiver funding available, and the services to be provided are waiver allowable. CCOP funds cannot be used when a child is eligible for and offered services through the CLTS Waiver Program, but the family chooses not to participate in the waiver program. Families who decline services through the CLTS Waiver Program remain eligible for CCOP-only supports and services (i.e., those services that do not exist under the waiver). C COP funds must not replace or supplant county, state, or federal funding under any program providing services to a family whose child is also eligible for CCOP.17 C COP cannot be used for room and board or to purchase land or construct buildings.18 Additionally, funds cannot be used to pay for support services provided to children residing in a nursing home or other residential facility, unless DHS waives this restriction as part of a child’s discharge plan.19 F iscal Responsibility20 It is the responsibility of the county where the child and parent/guardian physically reside and intend to remain to provide an assessment and develop and implement a child and family-centered ISP. For a child for whom admission is being sought, or who is about to be admitted to an institutional setting, the county in which the child has residence is the county of fiscal responsibility. 14 Wis. Stat. § 46.272(13)(b)(2) 15 Wis. Stat. § 46.272(13)(c) 16 Wis. Stat. § 46.272(13)(a)(1-2) 17 Wis. Stat. § 46.272(13)(h) 18 Wis. Stat. §§ 46.272(10)(a)(2) and 46.272(13)(b)(4) 19 Wis. Stat. § 46.272(13)(b)(3) 20 For information on programmatic residency requirements, see “Residency” in Chapter 3. CCOP Procedures Guide 13 F or a child residing in an institutional setting, except a state-operated long-term care facility, the county in which the institution is located is the county of fiscal responsibility. F or a child living in an institutional setting, except a state-operated long-term care facility, whose legal residence is established in another county, the county in which the legal residence is established is the county of fiscal responsibility. F or a child residing in a state-operated long-term care facility, or for a person protectively placed under Wis. Stat. chapters 48 or 55, the county in which the child has residence before entering the state- operated long-term care facility or being protectively placed is the county of fiscal responsibility.21 C COP Waitlist and Children Waiting for CLTS Enrollment Who Have an Urgent Need CCOP-eligible families are served on a county-level first-come, first-served basis within the limits of available CCOP funding in the county in which they reside. Because funding is limited, there may be a CCOP waitlist for an assessment, plan, or services. W hile a child is waiting to be enrolled in CLTS, CCOP funds may be used for interim needs, provided the child has a current CCOP assessment and plan, and CCOP funding is available. I n the event that a crisis situation emerges or is discovered, the child is moved immediately to enrollment in CLTS. Under these circumstances, the administering agency will determine CLTS Waiver Program eligibility and provide services through the waiver prior to using CCOP funding. The crisis criteria for CCOP are the same as the crisis criteria found in the Waiver Manual. Administrative Costs Administering agencies requesting CCOP administrative expense reimbursement must be in compliance with the Allowable Cost Policy Manual. CCOP administrative expenses must be supported by agency accounting records and cannot be included in any other program area. Agencies must have in place a methodology to uniformly and consistently identify only administrative expenses that are appropriately attributable to CCOP. Administering agencies may be reimbursed up to 7% of their base CCOP service allocation for ad ministrative expenses. During the contract year, agencies should report administrative expenses to the Grant Enrollment, Application and Reporting System (GEARS) for reimbursement on a monthly basis. Agencies report total contract year administrative expenses in HEART. If administrative expenses exceed 7% of the CCOP base service allocation, the administering agency may complete the variance request portion in HEART. Variances may be approved up to 10% of the base service allocation. 21 Wis. Stat. § 46.272(11) CCOP Procedures Guide 14 Funding Assessments, Plans, and Support and Service Coordination When a child has been determined to be eligible for CCOP, there are three ways an administering agency can pay for the cost of conducting an assessment, developing a child and family-centered ISP, and providing support and service coordination: • Bill the cost to CCOP. • When children are enrolled in the CLTS Waiver Program and accessing CCOP funds for services that are not covered by the waiver, the costs associated with assessments, ISPs, and support and service coordination are charged to the waiver, not CCOP. • For children who are enrolled in Wisconsin Medicaid, administering agencies may bill CCOP for t he cost and/or bill Medicaid for targeted case management (TCM) for comprehensive assessments, comprehensive plans, and support and service coordination conducted by staff who meets the Medicaid TCM qualifications. (For more information on TCM billing and reconciliation, see Chapter 8.) Abbreviated assessments and plans cannot be billed to TCM. Ta rgeted case management (TCM) services are a Medicaid reimbursable service for children eligible for Wisconsin Medicaid. Medicaid can be billed for the time a qualified case manager spends conducting comprehensive needs assessments, developing comprehensive child and family-centered ISPs, and providing ongoing case management. See the Wisconsin Medicaid Handbook for TCM requirements (including staff qualifications) and billing procedures. D HS requires each administering agency to annually submit a support and service coordination rate to DHS for approval. The rate must be developed using the DHS-approved methodology and must be applied consistently to all billable support and service coordination services. Community connections coordinator rates may not exceed the support and service coordination rate. A completed assessment and plan are required to bill CCOP for administering agency staff time. P rocedures for Purchasing Goods and Services Within the limits of funding, administering agencies are responsible for arranging service contracts and ensuring the provision of necessary long-term community support services for each child who is eligible for CCOP. 22 All purchases must be included in the approved child and family-centered ISP, connected to an assessed need and desired outcome, and not otherwise covered by another source. Administering agencies must maintain child-specific financial documentation of CCOP expenditures. P ayment Methodologies for Goods and Services Administering agencies’ payments for CCOP-funded services and supports must reflect actual costs incurred and may take a variety of forms, including: • A voucher • Direct payment to the vendor • Direct reimbursement to the family for completed goods and services • Advance payment to the family for approved goods and services (advance payments must be reconciled to actual costs prior to the end of the contract year) 22 Wis. Stat. § 46.272(7)(b) CCOP Procedures Guide 15 Fiscal Agent If a child or their parent or guardian receives direct funding for CCOP services, the administering agency may act as a fiscal agent or subcontract with a fiscal intermediary to serve as a fiscal agent for the purposes of performing the responsibilities and protecting the interests of the individual under unemployment insurance law. The fiscal agent is responsible for: • Remitting any federal unemployment compensation taxes or state unemployment insurance contributions owed by the child, including any interest and penalties. • Serving as the representative of the child in any investigation, meeting, hearing, or appeal i nvolving unemployment in which the child is a party. • Receiving, reviewing, completing, and returning all forms, reports, and other documents required under federal and state unemployment laws on behalf of the child. F amilies may waive the right to a fiscal agent, including all or any portion of a fiscal agent’s responsibilities. Families can rescind having waived this right in whole or in part at any time.23 Counties that act as a fiscal intermediary must also have a robust conflict of interest policy in place that has been approved by their CCOP advisory committee. The purpose of such a policy is to ensure protections for the child, family, and administering agency. A conflict of interest is present whenever a person or any other entity involved in operating any part of CCOP has an interest in or the potential to benefit from a particular decision, outcome, or expenditure. P arental Payments Parents of a child through age 22 enrolled in CCOP may be liable for a certain portion of the cost of CLTS services. After the child’s individual service plan (ISP) is finalized with their support and service coordinator (SSC), the county waiver agency (CWA) uses the Worksheet for Determination of Parental Payment Limit (F-01337) to estimate the amount of parental payment limit (PPL) that may apply. T he formula used in the worksheet is based on Wis. Admin. Code ch. DHS 1 and considers the size of the family, parental income, applicable federal poverty guidelines, and applicable ISP costs for calculating PPL. CWAs may bill PPL based on the cost of actual claimed services or use planned costs if reconciled with actual claimed costs. CWAs are prohibited from requesting tax documents, pay stubs, or W-2 documents to verify income or expenses. An income declaration form must be used to verify parental income. T able DHS 1.065, in Wis. Admin. Code ch. DHS 1, shows the maximum percentage of the costs of the participant’s ISP (also known as the “payment limit”) for which they may be liable. Parents whose income is below 330% of the federal poverty level are not liable for any portion of the costs of the participant’s CCOP services. The participant’s support and service coordination and administrative costs are exempt from PPL. C WAs may waive PPL if a family has a financial hardship. CWAs must provide parents verbal and written explanations of their PPL. CWAs must provide the Parental Payments for CLTS and CCOP (P-03342) to parents subject to PPL annually. 23 Wis. Stat. § 46.272(7)(e) CCOP Procedures Guide 16 The CWA must recalculate the PPL annually during recertification of eligibility and should recalculate more often if parental income decreases or the family size increases. If the CWA is using planned costs with actual cost reconciliation, the PPL should be recalculated if the ISP cost changes significantly. P er DHS ch. 1.06(6), a person aggrieved by an order to compel the parental payment may appeal the order as a contested case. CWAs must have a written grievance procedure for actions relating to liability determination, billing, and collections in accordance with DHS ch. 1.05(6)(c). Refer to Chapter 7: Rights, Grievances, and Appeals for additional information. T he CWA may not disenroll the participant from CCOP if their parent cannot or will not pay the PPL. R efer to the PPL FAQ for more information about PPL. U nspent Allocations Risk Reserve County Agencies may establish a CCOP risk reserve using unspent, unencumbered funds from their current CCOP allocation 24 per these criteria: 1) DHS must approve the terms of the risk reserve escrow account when it is first created. • Th e escrow account must be used exclusively as a CCOP risk reserve account and cannot include funding from other sources or programs. • T he county is responsible for creating the escrow account and sending a copy of the initial statement to DHSCLTSFiscal@dhs.wisconsin.gov for review and approval. • P lease include "[your county name] CCOP risk reserve start -up" in the subject line • C ounties will receive email notification that their CCOP risk reserve account has been approved • R isk reserve accounts should be established prior to the annual reconciliation to ensure there is adequate time for Department review and corresponding deposits 2) T he county shall maintain the risk reserve in an interest-bearing escrow account with a financial in stitution, and • A ll interest from the principal shall be reinvested in the escrow account. • A ll funding in the CCOP risk reserve must be used to defray costs of CCOP assessments and plans, services or, if approved by the department, for CCOP administrative or CCOP staff costs.25 3) A nnual risk reserve deposits may not exceed 10% of the county agency's base CCOP allocation • Th e total risk reserve balance, including interest, may not exceed 15% of the county agency's base CCOP allocation or $750,000, whichever is less.26 24 Wis. Stat. § 46.272(13)(f)1 25 Wis. Stat. § 69.30 (1) (b) 26 Wis. Stat. § 46.272(13)(f)2 CCOP Procedures Guide 17 4) The administering agency will notify DHS annually of any amount of unencumbered funds that will b e placed in the risk reserve. Prior DHS approval is not needed for annual risk reserve deposits; however • Th e deposit amount may not exceed the annual maximum deposit, may not exceed availabl e C COP funding, and may not cause the risk reserve account to exceed the maximum balance. • Th e county needs to account for interest before making risk reserve deposits. • E xceeding maximum deposit amounts may result in the department disallowing a portion of the deposit and recouping part of the previously reported expense. 5) T o deposit funding in a CCOP risk reserve the county must: • R eport the deposit as an expense to their Grant Enrollment, Application and Reporting System (GEARS) CCOP profile 377. This will cause GEARS to generate a payment to the county. • U sing the CCOP GEARS payment the county must deposit the funds into their CCOP risk reserve account. 6) T o expend funding from a CCOP risk reserve account the county must: • W ithdraw the appropriate funds from the bank account • R eport the expenditure during the annual CCOP reconciliation • T he reported withdrawal will be applied as an offset to the CCOP expenses for the year. The county will be responsible for covering those costs using the funds retrieved from the risk reserve instead of using that year's CCOP allocation. 7) C COP risk reserve funds may be used: • To defray the costs of CCOP assessments, plans, and services or, • For CCOP administrative/staffing costs, if approved by DHS.27 8) A gencies that maintain a risk reserve must: • Su bmit an annual report to DHS on the status of the risk reserve, including revenues and disbursements. • C omplete the risk reserve reporting section of the CCOP reconciliation form each year. • Pr ovide the corresponding bank statements. C arry Forward At the request of an administering agency, DHS will carry forward up to 5% of the county’s allocation (minus any amount being placed in a risk reserve) if the amount is unspent and unencumbered by December 31. Funds that are carried forward are available for the administering agency to use during the following calendar year and will not affect a county’s base allocation for CCOP. Carry forward funds that are not spent in the following calendar year will lapse back to the general fund. Carry forward funds cannot be used for administrative or staff costs, except as approved by DHS.28 27 Wis. Stat. § 46.272(13)(f)3 28 Wis. Stat. § 46.272(13)(e) CCOP Procedures Guide 18 DHS-Established Exceptional Expense Funds DHS may additionally carry forward to the next state fiscal year allocated funds that are unencumbered on December 31 and that local agencies have not requested to carry forward. This transfer will not affect a county’s base CCOP allocation. DHS may allocate these transferred funds during the next fiscal year for the improvement or expansion of long-term community support services for CCOP children and families whose cost of care significantly exceeds the average, including: • Specialized training for CCOP service providers. • Start-up costs for developing needed services. • Home modifications. • Purchase of medical equipment or other specially adapted equipment.29 For More Information Any fiscal questions can be directed to dhscltsfiscal@dhs.wisconsin.gov. 29 Wis. Stat. § 46.272(13)(g) CCOP Procedures Guide 19 CHAPTER 3: INTAKE AND ELIGIBILITY O utreach and Referral Administering agencies are required to specify outreach activities and procedures as part of each county’s CCOP plan. Administering agencies must engage in activities to ensure that the public is aware the program exists and is available to children with physical, emotional, and/or developmental disabilities and their families. Outreach strategies must reach diverse groups in the service area. I ntake The administering agency must establish procedures for receiving referrals and determining eligibility for families who request or are referred to CCOP. The administering agency must: • Receive referrals, provide information, and answer questions about CCOP; explain the intake process; and provide families with any forms that are needed to complete the eligibility determination process. o A referral is the act of making an initial inquiry or contact (which can include actions as informal as a phone call or email) to the administering agencies wherein the contact indicates that a child or youth has a disability or exceptional need.  Calls in which the caller inquires about supports, asks for help, or whose situation suggests the child or youth could reasonably be expected to benefit from services should be considered referrals.  The parent, legal guardian, or other person acting in the interest of the child o r y outh does not have to mention specific supports, services, or interest in a specific program for the contact to the administering agency to be considered a referral. Eligibility • Contact the family within 10 calendar days of the referral to schedule a home visit for the CLTS Functional Screen (CLTS FS). Provide written information to families on the: o Purpose of the in-home visit for eligibility determination and the need to include the child with disabilities in the visit. o Purpose of completing the CLTS FS. o Role of the family in identifying the strengths and functional needs of the child. o Right of the family to have other people of their own choosing involved in the eligibility process. o Right of the family, at any point, to accept or decline services that are offered. • Determine eligibility by gathering sufficient information about the family and child to comprehensively address the CCOP eligibility criteria and complete the CLTS FS. • Screen for crisis or urgent need situations during the intake process and, if identified, follow established agency procedures. • Notify the family verbally and in writing of the eligibility determination within 45 calendar days of receiving the referral or request for services. • Inform the family verbally and in writing of their rights and responsibilities, and one of the following: o Notify families who are eligible for CCOP. that:  The process will continue with an assessment and the development of a correspondin g c hild and family-centered ISP, or CCOP Procedures Guide 20  Due to limited resources, their name has been added to the CCOP waitlist; additionally inform these families regarding how and when to notify the administering agency of any significant changes with the child’s condition or the family’s circumstances. o Notify families who are not eligible why an assessment is not being done, inform them of t heir appeal rights (see Appendices C and D), and offer information about and/or assistance connecting with other programs that may be useful to them. Release of Information At the time of the initial eligibility determination or reassessment, administering agencies must request that parents/guardians sign a release of information (ROI) form. The ROI includes agencies whose reports and information are necessary to determine eligibility, complete a program assessment, or whose input is needed for service planning. The signed ROI is maintained in the child’s file. C COP Eligibility Requirements Children and their families who meet all of the following requirements are eligible to receive goods and services on a first-come, first-served basis within the limits of CCOP funding: • The child has a disability. • The child is under age 22 (see “Age Limitations” below). • The child meets an eligible level of care based on the CLTS Functional Screen. • The child lives in an eligible setting, as defined by the CLTS Waiver Program. C hildren do not need to have a disability determination or be currently enrolled in Medicaid to be eligible for CCOP, but they must meet the functional level of care criteria as determined by the CLTS FS. Administering agencies are required to use the CLTS FS to determine the child’s functional eligibility for CCOP, and the child’s CLTS FS must have been completed within 12 months prior to starting in the program. I f the functional screen for a child who is applying for services through CCOP finds that the child is not functionally eligible (NFE) for the program, the administering agency must choose to have a second screener review the screen. If the child continues to be NFE, then the agency will request that DHS review the screen as soon as possible, within 10 calendar days to confirm the NFE calculation, by emailing dhscltsfs@dhs.wisconsin.gov with “NFE Review” as the subject line. Administering agencies must work with DHS and follow the state’s guidance to resolve any CLTS FS issues or errors. T o be eligible for CCOP, all eligibility criteria must be met at the time services are provided. If changes in the child’s status result in eligibility criteria not being met for a period of time or on an ongoing basis, the family may become ineligible for CCOP during that timeframe. D HS may disallow reimbursement to administering agencies for services provided to children who do not meet the eligibility requirements.30 A child residing in foster care is living in an eligible setting and may be eligible for supports and services through CCOP. 30 Wis. Stat. § 46.272(12) CCOP Procedures Guide 21 A child living in the community who has been determined to be an adjudicated delinquent through the juvenile court system may still be eligible for CCOP. The CLTS FS will indicate CCOP eligibility on the results page. C COP funds cannot be used when a child is eligible for and offered services through the CLTS Waiver Program, but the family chooses not to participate in the waiver program. If a child is eligible for waiver- allowable services and funding is available, CLTS waiver funding must be used. Families who decline services through the waiver program remain eligible for CCOP-only supports and services (i.e., those services that do not exist under the waiver). Age Limitations Youth from the ages of 18 up to 22 years are only eligible for CCOP services when the youth does not meet the eligibility requirements for adult long-term care. W hen a child reaches 17 years and 6 months of age, they must be referred to the local aging and disability resource center (ADRC), and if appropriate, receive options counseling and an adult long-term care eligibility determination. Youth who are eligible but choose not to enroll in an adult long-term care program are not eligible for CCOP. P arental Payments At the time of application and again at annual review, administering agencies must require children or their parents/guardians to provide a declaration of income and a declaration of costs paid annually for disability-related care and services. 31 Please refer to Chapter 2 for a detailed layout of requirements and resources relating to parental payments. R esidency32 County Residency The county where the child and parent/guardian physically reside and intend to remain is responsible for establishing eligibility, conducting an assessment, and developing and implementing a child and family-centered ISP. I f a family moves from one county (the sending county) to another (the receiving county) within the state, the family needs to apply for CCOP in the receiving county. The sending county may continue to provide necessary services during this time, but it is not required. Residency in Two Homes Regardless of whether an eligible child resides in one or two homes, the child receives services in accordance with a single child and family-centered ISP. A child who lives in two homes is eligible to receive services in each home while the child is present. If the homes are in two different counties, the administering agencies must coordinate a single care plan to address the child and family’s needs. C hange Reporting and Eligibility Redetermination Administering agencies must inform parents/guardians that they are required to report any changes that might affect CCOP eligibility (e.g., residential, functional) within 10 calendar days of their 31 Wis. Stat. § 46.272(9)(b) 32 For information on administering agencies’ fiscal responsibility with regard to residency, see “Fiscal Responsibility” in Chapter 2. CCOP Procedures Guide 22 occurrence. Agencies will explain the importance of reporting changes in a timely manner so that staff can determine whether families are receiving the correct levels of supports and services to meet their and their child’s needs. A gency staff are to re-determine CCOP eligibility every twelve months. CCOP services can continue as long as the child remains eligible and has a current child and family-centered ISP. W hen the annual rescreen indicates that a CCOP participant is not functionally eligible, it is the administering agency’s responsibility to ensure the accuracy of the determination prior to taking action that will result in termination of services. The agency must have a second screener review the screen and alert DHS (with “NFE Review” as the subject line) as soon as possible, but within 10 calendar days when it appears the participant no longer meets functional eligibility. Administering agencies must work with DHS and follow the state’s guidance to resolve any functional screen issues or errors. The support and service coordinator (SSC) will delay ending services through CCOP until the NFE determination is confirmed by both the second screener and DHS. W hen a certified screener for any program (e.g., CCOP, CLTS waiver, Katie Beckett, Comprehensive Community Services, and Community Recovery Services) completes a screen that affects eligibility for another program, the screener must immediately notify the other program. No tifications The administering agency is responsible for notifying families verbally and in writing of the child’s eligibility or ineligibility for CCOP services within 45 calendar days of identifying a referral or request for services. T he administering agency must notify parents/guardians in writing at least 10 days in advance of a reduction or termination of services. A child who is denied eligibility for services or whose services are reduced or terminated may request a hearing from DHS through the Department of Administration, Division of Hearings and Appeals. The administering agency is responsible for sending the family written information regarding the family’s right to appeal and the necessary information regarding how to file an appeal. This written notification requirement applies at any time a child is denied eligibility or has a reduction or termination of services through CCOP. A lack of adequate funding may not serve as the basis for a request for fair hearing. 33 (See Chapter 7 for more information on appeals, Appendix C for a sample denial letter, and Appendix D for a notification of rights template.) L imits of Available Funding Eligible families are served on a first-come, first-served basis within the limits of available CCOP funding in the county in which they reside. Because funding is limited, there may be a CCOP waitlist for an assessment, plan, or services. Administering agencies may use CCOP funds to provide interim services while a child is on the CCOP waitlist. I n the event that a crisis situation emerges or is discovered, the child is removed from the CCOP waitlist to receive services. Under these circumstances, the administering agency will determine CLTS Waiver 33 Wis. Stat. § 46.272(15) CCOP Procedures Guide 23 Program eligibility and provide services through the waiver prior to using CCOP funding. The crisis criteria for CCOP are the same as the crisis criteria found in the CLTS Waiver Manual. CCOP Procedures Guide 24 CHAPTER 4: SUPPORT AND SERVICE COORDINATION S upport and service coordination is central to children’s long-term support programs, including CCOP. Service coordination entails viewing the child and family holistically; developing a collaborative working relationship with the family; and identifying each child and family’s unique strengths, goals, and needs. From this foundation, CCOP staff then leverage their knowledge of available programs, resources, and services to create an individualized plan that best supports the family in their pursuit of their desired outcomes. S ervice coordination requires working with the family to identify a broad range of resources that will promote the child’s inclusion in family activities and the community, including natural and funded supports, community services, other public programs, the CLTS Waiver Program, and/or CCOP. Th e Deciding Together Guide (P-02246) provides a clear, step-by-step team approach to facilitate dialogue between service coordinators and families using a family-centered, collaborative decision- making framework to develop comprehensive outcome-based support plans. This approach recognizes and maximizes a child’s and their family’s capacities, resiliency, and unique abilities, and promotes self- determination and inclusion in all facets of family and community life. C COP Staff Because families have varying capacities, strengths, and service needs, not every family will require the same level of engagement with CCOP staff. As a result, administering agencies may assign different types of staff to develop community networks and relationships, connect families to local resources, work with families to determine CCOP eligibility, conduct assessments, identify and coordinate local supports and services, and/or develop child and family-centered ISPs. C ommunity Connections Coordinator Administering agencies may employ a community connections coordinator (CCC) to provide families with information and connect families to benefits, programs, and other available community resources. CCCs are responsible for developing community relationships, connections, and circles of support for children with disabilities and their families and promoting a deeper understanding throughout the community of the contributions and gifts of children with long-term support needs. C CCs may conduct an abbreviated CCOP assessment (see Appendix E) and develop an abbreviated child and family-centered ISP to provide interim services to children and families awaiting enrollment into CLTS. I ndividuals who are qualified to work as a CCC will have knowledge of the wide-ranging strengths and needs of children with disabilities and their families. They will also be familiar with the Wisconsin Medicaid Program and local resources for families who have children with disabilities. They must possess any combination of four years of post-secondary education and/or experience working directly with children and families who have long-term support needs. Being bilingual and/or bicultural can count toward some of an individual’s experience, as long as they are also well-qualified with relevant disability experience and/or knowledge. S upport and Service Coordinator The support and service coordinator (SSC) facilitates access to all services and supports, both formal and informal, which are needed by the participant and family to meet their identified outcomes. CCOP Procedures Guide 25 Support and service coordination assists a participant and their family to achieve an inclusive, Interdependent, and self-empowered life. The participant’s SSC uses their knowledge of available programs, resources, and services to create an individualized service plan that best supports the participant and family in pursuit of their desired outcomes. This includes connecting families to supports throughout the community and promotes the participant’s self-determination and involvement in all facets of community life. I n addition to the CCC responsibilities outlined above, SSCs conduct comprehensive assessments to determine each child and family’s unique capacities, strengths, and service needs. SSCs coordinate a full array of services and assist CCOP-eligible children and their families in gaining access to medical, social, educational, vocational, and other services. SSCs often provide complex service coordination, are involved in planning and arranging services (i.e., authorization and procurement), and provide ongoing monitoring and case management. An individual SSC need not perform all of these functions, as long as the duties and responsibilities are fully covered by a combination of staff. I ndividuals who are qualified to work as an SSC must have knowledge of the diverse strengths and needs of children with disabilities and their families, the Wisconsin Medicaid Program, and local resources for children with disabilities and their families. Additionally, an SSC must have the skills and knowledge typically acquired through one of the following: • The skills and knowledge typically acquired through a course of study and practice experience that meets requirements for state certification or licensure as a social worker and also one year of experience with the target group(s) for which they are employed. • A course of study leading to a Bachelor of Arts or Bachelor of Science degree in a health o r h uman services-related field and one year of experience working with persons of the specific target group(s) for which they are employed. • An associate’s degree in a human services-related field and two years of experience working with persons of the specific target group(s) for which they are employed. • Any combination of training in a health or human services-related field and experience in long- term care case management and/or case management for individuals with disabilities or special needs that totals four years. Examples include but are not limited to: One year of coursework or training in a human services-related field and three years of experience in long-term care case management, or four years of experience in long-term support case management. • The completion of a course of study leading to a degree as a registered nurse and one year o f em ployment working with the target group. T argeted Case Management (TCM) When Medicaid is used as a funding source for TCM, staff must also meet the qualifications defined in the Wisconsin Medicaid Handbook. As long as all the criteria are met, TCM can be billed for conducting assessments, developing ISPs, and providing ongoing case management. See the Wisconsin Medicaid Handbook for more information. Asse ssment Administering agencies are required, within the limits of available funds, to provide an assessment for any eligible child and family seeking services through CCOP. Assessments must be conducted by an individual who is qualified to determine the needs of the child and who knows the availability of local services and supports. To collect the necessary information for an assessment, staff must coordinate CCOP Procedures Guide 26 with members of the child’s family; county community programs, developmental disabilities services, and/or social services; local schools; and health service providers.34 A dministering agencies must develop an assessment process to guide the collection of essential information. Assessment procedures are to ensure: • The assessment is conducted by a representative of the administering agency who is knowledgeable about the child’s condition and the related needs of the family. • The family participates in the assessment to the greatest extent possible. • At the family’s request, other people are present who are knowledgeable about the child’s c ondition and can identify and assist the family in assessing the social, psychological, and medical needs of the child and other family members. • The child is present and observed by those conducting the assessment. • The assessment takes place in the family home with the child present, unless the family chooses another setting. A ssessments must include a face-to-face meeting with the child and family, and will ideally implement the five steps of Deciding Together (P-02246): Step 1: Issues and Goals • Strengths, problems, needs • Goals and outcomes being sought Step 2: Creative Thinking Step 3: Weighing Options Step 4: Developing the Plan Step 5: Evaluating the Plan A ssessments must be conducted in each family’s primary method of communication, which may include providing communication aids such as taped or Braille materials; sign language interpreters; and/or language interpreters for families who have limited English proficiency. Communication and translation services are provided at no cost to the family. If an agency is unable to initiate or complete an assessment, the agency will provide the family with written notification that includes the reason(s) the assessment did not occur. Assessment Content Families are critical partners in identifying desired goals for the child and providing input on the supports and services that will help their child achieve these outcomes in the home and in community settings. During an assessment, the family and others present identify the family’s strengths, challenges, and priorities, along with the types of supports that will promote the child’s inclusion in family and community activities. A ssessments are child and family-centered, and focus on identifying the child’s capacities, strengths, needs, and desired outcomes, as defined by the child and family. Outcomes must be specific to each child and based on the child and family’s unique circumstances, goals, values, and priorities. The 34 Wis. Stat. §§ 46.272(8) and 46.272(7)(a) CCOP Procedures Guide 27 assessment also explores preferences for service delivery, living arrangement, medical care, and community participation. T he assessment provides the foundation for developing a child and family-centered ISP. It is essential to discuss the following factors during the assessment process: • The child’s functional abilities, including self-care, mobility, communication, intellectual c apacity, emotional/behavioral status, cultural and age-appropriate behaviors, health and physical status, and, for older children, the ability to work. • Daily family life, including variations in family routine and needs over the day/week/month/year, any concerns of siblings or extended family members, and any risk factors such as age or health of the child or other family members. • The physical environment, including physical accessibility, safety, transportation, and the effects of the physical environment on the family and child. • Identification and potential for enhancement of natural resources, such as extended family, friends, and neighbors. • Current services provided to the child and family by third-party payers (both public and private), as well as other public or voluntary programs in which the child or family participates, including educational services and programming. • Medical information, such as primary physician, current evaluations, and specialized medic al s ervices. • Discussion and identification of strengths, challenges, resources, desired outcomes, and priorities of the caregivers, child, and siblings. Th e criteria outlined in Appendix E provide a guide for gathering important information and ensuring that all of the necessary assessment topics are explored. C hild and Family-Centered Individual Service Plan (ISP) For eligible children, the administering agency must complete an assessment and develop a written child and family-centered ISP within 60 calendar days of an identified referral to the program. The CCC or SSC and family are to agree on the supports and services listed on the plan within this timeframe. From the date the coordinator and family agree to the plan, the coordinator has an additional 60 days to obtain all required signatures. Services are not to be delayed while a coordinator works to obtain signatures on the ISP. A dministering agencies may use the CLTS ISP template provided by DHS or their DHS-approved CLTS Waiver Program ISP for the CCOP child and family-centered ISP. When a child also receives services and supports through other county-administered programs (such as the CLTS Waiver Program or Birth to 3 Program), the coordinator can use the service plan from those programs to document goods or services purchased with “pure” CCOP. Staff can incorporate CCOP supports into already-existing service plans instead of creating a separate or additional ISP solely for CCOP. I SP content includes: • A statement of the child and family’s desired outcomes and priorities. • A description of the supports and services to be used, including frequency, intensity, annual cost, provider information, and any unique restrictions or specifications. • Any methods for maximizing the utilization of private health insurance and/or Wisconsin Medicaid (i.e., ForwardHealth). CCOP Procedures Guide 28 • If applicable, any reason(s) a family’s preferences for goods or services were not able to be a ccommodated. Th e resources and strategies included in a child and family-centered ISP need to be flexible, coordinated, and effective, and may include: • Information, education, and training on advocating on behalf of the child, leadership, and the full array of supports and services available in each community. • Methods for connecting families with other families (including parents, guardians, self- advocates, siblings, grandparents) and support groups for mutual support and networking. • Goods and services that address assessed needs, promote identified outcomes, benefit the child with the disability, and enhance the family’s long-term support roles. P lan Notification and Signature The administering agency must notify the family in writing of one of the following: • Approval for goods and/or services and the start date for CCOP funding. • Denial or modification of services with the reason(s) • If the family is placed on the CCOP waitlist for services, an estimated timeframe for receiving services. S ervices can begin as soon as the coordinator and family agree to the ISP. A parent/guardian and a representative of the administering agency must sign the ISP within 60 days of its completion to indicate mutual agreement with the child and family-centered ISP. One copy is given to the family, and another is maintained in the child’s file. I SP Review The ISP will be reviewed as needed. A review can be conducted at any point that needs arise or upon request by the family. Changes to the ISP are noted in the child’s file and documented in the ISP at the six-month review. T he ISP must be reviewed and updated during a face-to-face visit with the child and family at least every six months to monitor the implementation of the plan and discuss ongoing or changing child and family needs, future planning, and any anticipated changes or transitions. One review per year must be a home visit with a face-to-face meeting with the child and family; this review may coincide with the required annual eligibility redetermination. S erving Children Awaiting Enrollment in CLTS While a child is awaiting enrollment in CLTS, administering agencies can choose to use CCOP funds to provide interim services. In these instances, a CCC or SSC verifies that the functional screen is accurate, has been completed within the last 12 months, and demonstrates functional eligibility. Staff then conduct an abbreviated assessment and develop an abbreviated ISP. I f a child awaiting enrollment in CLTS who has received services through CCOP becomes eligible to receive services through the CLTS Waiver Program, a comprehensive assessment and plan must be completed. The SSC can use the abbreviated CCOP assessment and plan as a basis for completing a comprehensive assessment and plan. CCOP Procedures Guide 29 One-Time or Intermittent Need When an SSC’s comprehensive assessment determines that one-time or intermittent services (i.e., three or fewer instances per year) fully meet a child’s support and service needs and the family does not require monthly service coordination, the administering agency can choose between enrolling the child in the CLTS Waiver Program or fully serving the child through CCOP. A ny time a child/family requires more than three instances of services per year, or there is a need or request for service coordination, eligible children must be enrolled in the waiver program. Children who are enrolled in the waiver program can simultaneously receive supports and services through CCOP that are not waiver-allowable. C oordinating CCOP with Other Resources CCOP funds may not be used to replace or supplant any local, state, federal, or third-party payer (e.g., insurance) funds currently being provided to a family under any program. As appropriate, the service coordinator helps the family access additional supports and resources, such as: • Medicaid (i.e., BadgerCare, Katie Beckett) • Medicaid Home and Community-Based Services Waiver Program (i.e., CLTS waiver) • Birth to 3 Program • Comprehensive Community Services (CCS) • Other county programs (e.g., developmental disabilities programs; social services; child welfare services; juvenile court, legal, and corrections-related services) • School-based and educational services • Prevocational or vocational programs through the Department of Workforce Development, Division of Vocational Rehabilitation • Other community-based and local service organizations, including family support groups, faith- based, advocacy, or disability-related organizations, etc. A s the funding of last resort, a key aspect of CCOP and responsibility of the administering agency is to utilize CCOP in coordination with other available funding, services, and supports (both paid and unpaid). When other programs are also defined as the funding of last resort, they must be used before CCOP. The administering agency is responsible for coordinating funds and determining which programs, services, and funding sources can be leveraged to maximize the use of available resources. A family may be eligible for CCOP but receive all or a portion of services through one or more of these other programs. Service coordinators must explore the possibility of accessing the following programs in order to maximize the resources available to serve children with disabilities and their families: • Wisconsin Medicaid/ForwardHealth: Most children who are eligible for CCOP are also eligible for Medicaid. If a child is enrolled in ForwardHealth, medically necessary services are billed to Medicaid and cannot be funded through CCOP. Further, for children with Medicaid coverage, any supports or services that are covered by Medicaid cannot be funded through CCOP. • Birth to 3 Program: CCOP funds may not be used for any of the early intervention entitlemen t s ervices provided under the Birth to 3 Program, including evaluations, assessments, service coordination, procedural safeguards, or any other core early intervention service. CCOP may be used to purchase additional supports to supplement entitlement services for eligible children and their families, such as items in the “other services” section of the individual family service plan (IFSP). CCOP Procedures Guide 30 • Schools and Educational Services: Children who are eligible for CCOP may be entitled to early intervention, special education, or related services through the Individuals with Disabilities Education Act (IDEA). Students are also ensured adequate and appropriate services through Section 504 of the Rehabilitation Act of 1973. CCOP funds may not be used to supplant any o f t hese services. It is important for administering agency staff to work with local schools to coordinate services. • Child Welfare Services: If a child/family is under a court order or voluntarily involved with the c hild welfare services system and meets CCOP eligibility requirements, CCOP funds may be used to provide needed supports and services. However, CCOP cannot be used to pay for any support or service that is the responsibility of child protective services. • Juvenile Justice: If a child who resides in the community is involved with the juvenile court system, even as an adjudicated delinquent, they may still be eligible to receive supports and services through CCOP. However, CCOP funds cannot be used to pay for any support or service that is the responsibility of juvenile corrections. T ransitioning to Adult Long-Term Care Services Administering agencies are responsible for assisting children and families receiving CCOP through the transition from children’s long-term support to adult services. When a child reaches 17 years and 6 months of age, they must be referred to the local aging and disability resource center (ADRC), and if appropriate, receive options counseling and an adult long-term care eligibility determination. Individuals who are eligible for adult long-term care programs are no longer eligible for services through CCOP and must be enrolled in the program of their choice without delay. Youth who are eligible, but choose not to enroll in adult long-term care programs, are not eligible for CCOP. T he DHS Youth in Transition website contains information and resources to assist with transition planning. CCOP Procedures Guide 31 CHAPTER 5: SUPPORTS AND SERVICES CCOP’s approach of holistically assessing each child and family’s unique strengths, goals, and needs is the foundation for making individualized service decisions. CCOP funds are used for a variety of services and/or goods that benefit and support the child in their home and community and are typically used to purchase services or goods that help the family in its caregiving role. A dministering agencies are encouraged to think broadly about the ways in which CCOP can be used to supplement other family supports and services and are discouraged from either restricting funds to purchase a predetermined set of services or categorically excluding any particular service prior to completing an individualized assessment and plan. S upports purchased with CCOP funds often compliment a larger service picture, which may include medical or therapeutic services that are funded by insurance, Medicaid, Birth to 3 Program, CLTS Waiver Program, special education, and other community services (see Chapter 4). Any service or portion of a service that is documented in the child and family-centered ISP, that fits into one of the categories below, and that is approved by the administering agency, may be funded by CCOP. Q ualifications and Caregiver Background Checks All service providers who receive CCOP funding must maintain current state licensure or certification in their field of professional practice. Administering agencies are responsible for: 1) ensuring that providers meet the minimum standard training requirements and 2) completing any necessary background checks prior to beginning services. This includes assessing provider qualifications and conducting caregiver background checks, as needed, on any provider who has been chosen by the family. Agencies may use CCOP administrative funds to verify qualifications and conduct background checks for CCOP providers. Ongoing qualifications and background checks must be conducted in accordance with CLTS Waiver Program requirements. S ervice Categories The majority of the goods and services covered by CCOP are the same as those in the CLTS Waiver Program’s benefit package. If a child is eligible for services through the waiver program, they must first access CLTS waiver funding and reserve the use of CCOP funds for purchasing disability-related goods and services that are not waiver-allowable. The full benefit package is available to children who are eligible for CCOP but experience a delay enrollment into CLTS and/or are not eligible for services through the waiver. Services that are available through CCOP are defined broadly to create flexibility to identify the supports that best address the unique needs of each child and their family. Below is a list service categories for CCOP-allowable services, most of which are also allowable under the CLTS Waiver Program. Service categories provide valuable information about how funds are being utilized to assist families. C COP Service Categories Assessment and Plans Assessment and Plans cover a comprehensive assessment and ISP plan creation, both of which must be completed by individuals with the credentials of a Support and Service Coordinator (SSC). The ISP is a formal document that builds upon the assessment to identify supports and their intended outcomes. It lists the supports and services that will be used, including frequency, intensity, annual cost, and provider information. This service category can also be utilized for CCOP Procedures Guide 32 abbreviated assessments and plan creation for children and families waiting for CLTS services. An abbreviated assessment and ISP plan creation can be completed by a Community Connections Coordinator or Support and Service Coordinators. (For more information on child and family-centered ISPs, see Chapter 4 and Appendix E.) C hild Care Child care services are to supplement typical child care costs, such as 1:1 attention for additional support in a child care setting. This service ensures the child’s exceptional physical, emotional, behavioral, or personal care needs are met during times when their family members are working, pursuing education and employment goals, or participating in training to strengthen the family’s capacity to care for the child. Qualifying education activities for the participant’s family members include education related to the family members’ employment, as well as education activities related to the child’s disability, which equip the family to build on the child’s strengths, support their unique needs, and increase the family’s knowledge and resources. C ommunity and Safety Supports Community and Safety Supports are designed to increase the child’s safety and community involvement, including personal emergency response systems (PERS). It can be used for intensive case coordination and individualized community-based services to assist, empower and build upon the strengths of the child and family so the child can be fully integrated into the community with their family. Includes items or services that reduce risk or danger to help keep the child safe in their home and communities. These services and supports assist children who, without such supports, are experiencing or are likely to experience safety-related challenges at home or in the community as a result of their disability, trauma, behavioral, social, or emotional issues. E mployment Supports Employment Supports provide learning and work experiences to develop non-job specific strengths and skills, as well as support in attaining sustained employment that is at or above minimum wage in an integrated setting in the general workforce for the child. F inancial Management Services Costs for an FMS provider in the case of a county declining to operate as the FMS for a family. For more information on FMS, reference the CLTS manual. H abilitative Services Habilitative services are any tools, services, activities, and items that help the child learn, keep, and/or improve skills and functional abilities. This can be used to assist the child with daily living activities and personal needs, as well as education and skill development for the child to independently perform daily routine activities and use community resources. It can be used to provide education and training for caregivers to support the child and better understand their disability. This includes services or supports that improve the health, wellbeing, socialization or inclusion of the child. H ealth Care and Other Therapies Therapies and counseling to assist the child and their family with coping with grief, as well as maintaining or improving the health, welfare, and functioning of the child in the community. Special dietary needs would typically be determined by a qualified medical professional, CCOP Procedures Guide 33 registered dietitian, or other professional who is qualified to assess a child’s nutritional needs, monitor health and growth, and make recommendations for achieving desired outcomes in the individual service plan (ISP). This also covers dental and health screening services for non-MA eligible children. H ome Modifications and Housing Supports For supports to assist the child in moving and relocating to a safe, less restrictive, and more independent living environment. Provides comprehensive guidance to the child’s family on gaining and/or retaining safe and accessible housing. It can be used for home modifications that maximize a child’s independent functioning in their home, as well as utility costs incurred as a result of the child’s disability. Funding can be used to assist with placement in and supplementary costs for participants in a foster home, as well as those in an adult family home, excluding room and board. I ndependence Support Tools Supplies, equipment, technology, and other participant and family directed services to support the health, independence, and other long-term goals of the child. Can fund virtual equipment and supports that the child needs to access remote CCOP services. O ffsets Counties are to use this category for entering Cost Share, Refunds, and Parental Fees into HEART when monies are received. R ecreation The primary purpose of recreation and alternative activities is to support the child’s inclusion with their family and peers (with or without disabilities) in social and recreational programs in the community. Funds may be utilized for child/family-specific, outcome-based goods and services. CCOP funding can pay for recreational fees and other goods and services that promote community inclusion. It can cover fees for the whole family (e.g., to join a recreation club, for family recreation, camping, etc.) or when a child needs the assistance of an attendant in order to participate in family or community activities. CCOP funding can also be used to pay for attendant support during a family vacation, specialized transportation, and the rental of adaptive equipment. R espite Respite care services maintain and strengthen the child’s natural supports by easing the daily stress and care demands for their family, or other primary caregiver(s), on a short-term basis. These services provide a level of care and supervision appropriate to the child’s needs while their family or other primary caregiver(s) are temporarily relieved from daily caregiving demands. It can also be used to cover respite for siblings of the child. Respite care may take place in a residential setting, institutional setting, (CCOP funding for institutional respite settings must be prior approved by DHS), the home of the child, the home of a caregiver, or in other community settings. S ervice and Community Resource Coordination This service includes the responsibilities of the SSC and the CCC • Support and Service Coordinators (SSC) are responsible for coordinating or facilitating access to all services and supports, both formal and informal, which are needed by the CCOP Procedures Guide 34 participant and family to meet their identified outcomes. Support and service coordination assists a participant and their family to achieve an inclusive, interdependent, and self-empowered life. The participant’s support and service coordinator (SSC) uses their knowledge of available programs, resources, and services to create an individualized service plan that best supports the participant and family in pursuit of their desired outcomes. This includes connecting families to supports throughout the community and promotes the participant’s self-determination and involvement in all facets of community life. • Community Connections Coordinators engage in community outreach and provide families with information about benefits, programs, and other available community resources. CCCs may also conduct abbreviated CCOP assessments and develop abbreviated child and family-centered ISPs to provide interim services while families are waiting for CLTS services. (See Chapter 4 for more information on duties and required qualifications.) Transportation and Vehicle Modifications It can be used for transportation, mileage, food and/or lodging for parents/guardians, siblings, and/or someone accompanying the family when the travel is related to the child’s health but is not otherwise covered by Medicaid. This service includes the purchase of vehicle modifications that allow the vehicle to be used by the child to access the community, or those costs associated with the maintenance or repair of these items. C onsumer and Family-Directed Supports Families are able to direct supports in CCOP. The service category for any consumer and family-directed support will be the service category applicable to the service that is being directed as well as financial management services. Administering agencies are responsible for: 1) ensuring that all providers meet the minimum standard training requirements and 2) completing any necessary background checks prior to beginning services. N on-Allowable Goods or Services CCOP funds may only be used to support children living at home and to promote their inclusion in family activities and community settings. Funds may not be used to start new programs, increase or supplant the funding of an existing program, pay for room and board, or purchase land or buildings. Additionally, CCOP is the funding of last resort. C COP is not a source of funding for any service that would otherwise be the responsibility of another public or private entity, including: • Public benefits, energy assistance, or other poverty-related services. • Court-ordered, juvenile justice, or child protective services, including protective placement/guardianship or legal services. • Mental health services that are available through CCS. • Autism treatment services for children who qualify for the behavioral therapy benefit through Wisconsin Medicaid (i.e., ForwardHealth). • Any goods or services covered by a third party, including private insurance or Medicaid. • Services that are available through the education system, including those provided by IDEA or the Birth to 3 Program. CCOP Procedures Guide 35 • Pre-vocational or other services offered through the Department of Vocational Rehabilitation, Department of Workforce Development, or Department of Public Instruction. C COP funding may not be used for: • Basic living expenses or household goods, including rent or the purchase of a home. • Increases to a home’s square footage, except when necessary to complete an adaptation (e.g., in order to improve entrance/egress to a residence or to configure a bathroom to accommodate a wheelchair). • Goods or services that are harmful or are not effective. • Insurance copayments, insurance deductibles, or co-insurance fees. • Legal services, such as guardianships or estate planning. • Goods or services for children living in ineligible residential settings, as defined by the CLTS Waiver Program. H igh-Cost Expenditures Administering agencies determine the goods and services that best meet the needs and identified outcomes of each child and family. Agencies must implement processes to ensure that CCOP is utilized as the funding of last resort. Administering agencies must follow processes to ensure consistently fair and equitable use of CCOP funds. I n the event that the child/family requires a high-cost expenditure (i.e., $2,000 or more), the SSC must complete a thorough assessment to determine whether CCOP is the appropriate funding source. Agency staff must document the justification for the high-cost expenditure and the other sources of funding that were considered. Hi gh-cost expenditures may be subject to DHS review. CCOP Procedures Guide 36 CHAPTER 6: INCIDENT REPORTING AND RESTRICTIVE MEASURES I ncident reporting and restrictive measures policies apply to any child receiving ongoing or intermittent services through CCOP. I ncident Reporting Incidents of physical, verbal, and sexual abuse; maltreatment; neglect; death; and financial exploitation of children receiving ongoing or intermittent services through CCOP (including service coordination) are subject to the same incident reporting requirements as found under the CLTS Waiver Program. W henever a service coordinator becomes aware of an incident, they must file an incident report. A dministering agencies must give parents and guardians a copy of the Family Guide to Incident Reporting to inform them about incident reporting. Service coordinators are to discuss the importance, rationale, timeframes, and methods for reporting incidents with families at least annually. A dministering agency staff must report to DHS any actual or alleged event, situation, or condition that poses a significant, immediate, and/or ongoing threat or risk to the physical or mental health, safety, well-being, or continued community presence of a CCOP participant. Incident reporting definitions and timeframes for the CLTS Waiver Program apply to CCOP. Agencies are to refer to the CLTS Waiver Manual for additional information. I ncidents CWAs must report to DHS are any of the following events or situations:  Actual or alleged abuse, neglect, or exploitation involving the participant including: o Physical, verbal, and emotional abuse. o Sexual abuse or exploitation. o Neglect constituted by failure to seek medical attention, lack of food or nutrition, dangerous living situation, or lack of supervision. o Financial exploitation constituted by misappropriation of the participant’s funds or property. o Hospitalization.  Hospitalization due to an error in medical or medication management that results in an adverse reaction.  Psychiatric hospitalization.  Law enforcement contact or investigation involving the participant. o Incident reports are required only for a participant’s contact with law enforcement that is associated with risk to the health and safety of a participant or others. o Incident reports are required for a participant’s law enforcement contacts that are part o f t he participant’s crisis or behavior intervention plan.  Unapproved use of a restrictive measure including: o Misuse of mechanical restraint or protective equipment. o Use of manual restraint. o Use of isolation or seclusion.  Death of the participant. CCOP Procedures Guide 37 The administering agency’s incident management protocol must define who is responsible for reporting incidents and the procedure for reporting. A child’s or youth’s family and/or legal guardian(s), caregivers, and providers are all responsible for reporting threats to the child’s or youth’s safety or wellbeing to the CWA. In turn, the CWA must notify DHS of any incident or critical incident by completing the Incident Report in the online Children’s Incident Tracking and Reporting (CITR) System R estrictive Measures DHS maintains that all children and youth are entitled to live their best life and must be treated with respect regardless of complex behavioral needs. A foundational assumption is that every behavior has a purpose or meaning for the child or youth. Techniques involving coercion, including restrictive measures, are the least desirable way of addressing such behavior. Restrictive measures should be considered the method of last resort and only after less intrusive, alternate strategies to address the participant’s dangerous behavior have been determined ineffective. Restrictive measures encompass any type of manual restraint, isolation, seclusion, protective equipment, or mechanical restraint for behavioral purposes or medical purposes. C hildren and youth who are receiving services for mental illness, developmental disabilities, alcoholism, or drug dependency and enrolled in CCOP are covered by the provisions in Wis. Stat. § 51.61 and have the right to be free of restraints, including the intentional and unreasonable confinement of an individual in a locked room, involuntary separation of a child from their living area, use of physical restraining devices on a child, or the provision of unnecessary or excessive medication to a child. It does not include the use of these methods or devices in entities regulated by DHS if the methods or devices are used in conformance with state and federal standards governing confinement and restraint. Scope of Requirements These requirements apply to items, services, and supports using CCOP funds, regardless of who administers the restrictive measure, including unpaid caregivers who request to purchase items or fund services or supports through CCOP where there is a restrictive component. The process, definitions, and timeframes for restrictive measures are the same for CCOP as for CLTS Waiver Program participants. See Section 9.4.1 of the CLTS Manual for detailed definitions and authority. R estrictive Measures Eligible for DHS Approval for Planned Use Restrictive measures are used rarely as part of CCOP, and CWAs must have written policy and protocol barring the use of restrictive measures unless such measures are approved by DHS. Mechanical restraints and protective equipment are the only types of restrictive measures that are eligible for DHS approval for planned use. See the Instructions and Requirements for the Use of Protective Equipment and Mechanical Restraints in Children’s Long-Term Support Programs (P-02616) for all definitions and requirements for DHS approval. E mergency Use of Manual Restraints If an emergency occurs, provider staff should first follow emergency or crisis procedures and employ de- escalation strategies to the extent possible. De-escalation strategies are a series of steps including techniques such as offering choices, respecting personal space, allowing time for decisions, response blocking, providing redirection, graduated physical guidance, and modifying demands. T he use of manual restraint is prohibited except in very limited, emergency circumstances in which: CCOP Procedures Guide 38 • The participant’s behavior places the participant or any other person at imminent, significant risk of physical injury; • The measure used is the least restrictive approach possible, and; • The manual restraint is used for the shortest time possible A manual restraint includes physical holds and escorts and involves one or more people holding the limbs or other parts of the body of the child or youth to restrict or prevent their movement. S ee Section 9.4.3 Emergency Use of Manual Restraints of the CLTS Manual for detailed requirements for the use of emergency manual restraint. See Section 9.4.2 of the CLTS Manual for prohibited practices in the CCOP program. I ncident Reporting and Remediation for an Unapproved Use of a Restrictive Measure The use of an unapproved restrictive measure by a service provider is a reportable incident, including the emergency use of a manual restraint. A child’s or youth’s family and/or legal guardian(s), caregivers, and providers are all responsible for reporting threats to the child’s or youth’s safety or wellbeing to the CWA. In turn, the CWA must notify DHS of any incident according to the requirements listed in the earlier part of this chapter under the heading “Incident Reporting,” and in Section 9.4.4 of the CLTS Waiver Manual. DHS staff review each incident of an unapproved restrictive measure. Use of protective equipment or mechanical restraint in the manner approved by DHS does not need to be submitted as an incident report. Th e unapproved use of a restrictive measure is remediated by the county waiver agency at the individual incident level. When an unapproved restrictive measure is used, the SSC should discuss the incident with the provider, the family, and the participant (as appropriate) as soon as possible or no longer than five business days from the use of an unapproved restrictive measure. See Section 9.4.4 of the CLTS Manual for full incident reporting requirements related to unapproved use of restrictive measures. CCOP Procedures Guide 39 CHAPTER 7: RIGHTS, GRIEVANCES, AND APPEALS No tification of Rights It is the responsibility of the administering agency to inform all CCOP applicants and participants of their rights, including the right to file a grievance or appeal agency decisions with which they disagree.35 Notification must be given both verbally and in writing. A gencies are required to inform applicants/participants of their rights at the first point of contact and not less than annually thereafter. Whenever an administering agency denies CCOP eligibility or reduces or terminates services, the agency is required to notify the applicant or participant of the action being proposed, the reason(s) the action is being taken, and of their right to file a grievance or appeal contesting the agency’s decision prior to the decision being implemented. The administering agency must provide applicants and participants with all relevant information, including county grievance and state appeal procedures, appeal time limits, and contact information for the Division of Hearings and Appeals. T his information must be provided to each family in their primary method of communication and at no cost to the family. Alternative methods of communication may include, but are not limited to, taped or Braille materials, or translated materials for families for whom English is a second language. C ounty Grievances Administering agencies may have a county grievance procedure as an avenue for children and families to pursue resolving issues that arise. Local grievance procedures must not interfere with the right to file an appeal for a state hearing with the State of Wisconsin Division of Hearings and Appeals (DHA). Administering agencies cannot require children or families to file a local grievance prior to or in lieu of filing a state appeal for a fair hearing. I f a family files a grievance against reducing or terminating services, the administering agency must continue to provide supports and services according to the terms of the most recently approved ISP until a decision on the grievance is given. S tate Appeal for Fair Hearing Wisconsin Stat. § 46.272(15) authorizes program applicants and participants of the right to an appeal through a state fair hearing process under Wis. Stat. § 227.44. T he DHS Secretary has designated the Department of Administration, Division of Hearings and Appeals (DHA), as responsible for conducting the fair hearing process. A child who is denied eligibility for CCOP services or whose CCOP services are reduced or terminated has the right to request a hearing from DHA. A lack of adequate program funding may not serve as the basis for a hearing request.36 A request for a hearing may be made by the applicant, recipient or former recipient, by an immediate family member, or someone with legal authority to act on their behalf. 35 Wis. Stat. §§ 46.272(15), 227.44, 51.61, Wis. Admin. Code ch. DHS 94 36 Wis. Stat. § 46.272(15) CCOP Procedures Guide 40 (a) A request for a hearing may be made in writing or orally and may be made to the C COP administering agency or DHA. ( b) CCOP administering agencies must assist families who request or need help filing a fair h earing request. (c) A n oral request to the CCOP administering agency shall be put in writing by the agency and signed by the petitioner. ( d) Th e hearing request shall include a short statement of the matter to be reviewed. ( e) A n agency receiving a hearing request shall immediately date-stamp the request and forward it to: Wisconsin Division of Hearings and Appeals P.O. Box 7875 Madison, WI 53707-7875 (f) A ppeals may also be delivered in person to DHA at 5005 University Avenue, Room 201, Madison, Wisconsin.37 F amilies who request an appeal also have the right to access records and obtain copies of documents they would like to introduce as an exhibit at a fair hearing. Administering agencies must provide one copy of these records at no cost and within a timely manner before the hearing. W hen a request for a fair hearing is made, DHA will contact the administering agency for required information. A pplicants and participants must be informed that a request for a fair hearing must be filed within 45 days of the effective date of the denial or termination of services, or of the date of a written decision under the county grievance process, whichever date is later.38 Therefore, timeliness is important and the administering agency must inform the family in writing at the time of denial or reduction/termination of services regarding their right to seek a fair hearing under Wis. Stat. § 227.44, as well as the procedures to be followed and the time limitations for filing the request. I f a hearing request is received within 10 calendar days of the effective date of a reduction/termination of services (or of a written decision under the county grievance process, whichever is later), families have the right to request that CCOP-funded services continue to be provided throughout the appeal process according to the terms of the most recently approved ISP. The administering agency must inform families that costs could be recouped if the family were to lose the appeal. Th e petitioner may withdraw a request for a fair hearing or grievance at any time in writing.39 37 Wis. Admin. Code § HA 3.05(2-3) 38 Wis. Admin. Code § HA 3.05(3) 39 Wis. Admin. Code § HA 3.05(4) CCOP Procedures Guide 41 CHAPTER 8: REPORTING, CODING, RECORDS, AND CLOSURE A dministering agencies are responsible for monitoring to ensure that all CCOP payments align with supports and services identified in each child and family-centered ISP. The agency must have a process in place to ensure the funds claimed are accurate within the calendar year. Inaccuracies are subject to recoupment by DHS. Further, DHS may disallow reimbursement for services provided to children who do not meet the eligibility requirements.40 R eporting Requirements CCOP administering agencies are required to report both programmatic and fiscal information to DHS. Reporting for CCOP is required by Wis. Stat. § 46.272(4)(f). D ata and information submitted to DHS are used for the annual CCOP report. This report is submitted to the Governor and each house of the state legislature. In addition, reported data and information are used for the purposes of planning for this and other programs serving children with disabilities, at both the state and local levels. The data is used to develop county and state budget proposals and is made available to other units of state and county government, community programs, advocacy groups, and the general public, upon request. D ata from the HEART CCOP County Portal provides specific information about the children served, and the reporting tracks the use of CCOP funding. Agencies have access to the HEART Total Participants Served report which shows cumulative calendar year expenditures and provides participant-specific expenditure data by county. A dministering agencies are required to report CCOP costs as follows: • Expenses must be reported on a monthly basis for each child by the last day of the month following the month in which the services are provided. • Expenses must be reported as they are incurred based on date of service, not date of payment. A gencies may refer to the State and County Grant Award Contract for more detailed CCOP reporting requirements. C oding Agencies reporting CCOP expenses will use the CCOP County Portal within HEART. F or assistance accessing and using the CCOP County Portal in HEART, see the User Guide for the HEART CCOP County Portal. B illing for an Assessment and Plan Prior to receiving CCOP-funded services, a child must have a completed assessment and plan. If the participant already has a current CLTS assessment, an additional assessment is not needed and should not be billed to CCOP. Administering agencies should pay for the cost of an assessment and plan for CCOP-eligible children by billing the cost to CCOP. 40 Wis. Stat. § 46.272(12) CCOP Procedures Guide 42 Fiscal Records and Reporting The administering agency shall maintain records and submit reports prescribed by DHS. H EART is for local agencies to track and monitor actual expenditures for each family on a monthly basis. Program expenditures should be tracked throughout the year to allow updates, revise child and family- centered ISPs, and accurately plan for the expenditure of any unspent CCOP funds in the last quarter of the fiscal year. T he administering agency shall retain all fiscal records per county ordinance in accordance with Wis. Stat. § 19.21(5). At a minimum, financial records shall be retained for seven years from the date of reconciliation. The administering agency shall specify persons who are responsible for maintaining financial records. U se of CCOP funds must be reported monthly using GEARS Profile 377 and in HEART according to the schedule outlined in the State and County Contract. C hildren’s Records The administering agency maintains an individual child record for all participants who receive an assessment, a child and family-centered ISP, and/or services. The agency will dedicate specific persons to be responsible for maintaining these records. A t a minimum, each child’s confidential CCOP record must include the following information and documentation, when applicable: • Dated documentation of the initial referral or request for services • Documentation demonstrating functional eligibility (e.g., a copy of the CLTS FS eligibility page) • Demographic information, including a Master Client Index (MCI) number, if the child has one • Copies of all confidential release of information form(s) • Documentation that required rights, appeal, and grievance procedures were given to the p arent(s) • A copy of the child’s assessment • A copy of the CLTS Parental Fee Declaration form (F-01338) and worksheet for Determination of Parental Payment Limit for CLTS (F-01337) • Signed copies of the participant’s current and previous child and family-centered ISP(s) • Documentation of support and service coordination (e.g., case notes) • A copy of any appeal or grievance filed or pending T he administering agency is to retain all child/case records per county ordinance, in accordance with Wis. Stat. § 19.21(5). A child’s CCOP record must be confidential and ensure that personally identifiable information (PII) and personal health information (PHI) are secure and meet compliance with the federal Health Insurance Portability and Accountability Act of 1996, as well as confidentiality assurances for protection from unauthorized examination in accordance with Wis. Admin. Code ch. DHS 92 and Wis. Stat. §§ 51.30 and 146.82. CCOP Procedures Guide 43 Closure of Participation For the purpose of accurately reporting active CCOP participation, if a participant no longer receives CCOP funding for services other than service coordination provided directly by the administering agency, the participant is closed on the HSRS CCOP Module (or other equivalent system as approved by DHS). F amilies who receive service coordination or other county services but are not receiving CCOP-funded services can remain enrolled but are not reported on the HSRS CCOP Module. The administering agency may keep the family on their own records as continuing with CCOP, if they are planning to continue services to the family in the future and want to retain the family’s place within the program. I f a family receives services funded through CCOP at any time during the calendar year, the administering agency must report child and family information in HEART before the close of that reporting year. CCOP Procedures Guide 44 Appendix A: Common Acronyms Acronyms ADRC Aging and Disability Resource Center BCS Bureau of Children’s Services CCC Community Connections Coordinator CCOP Children’s Community Options Program CCS Comprehensive Community Services CLTS Children’s Long-Term Support CLTS FS Children’s Long-Term Support Functional Screen CPS Child Protective Services DHA Division of Hearings and Appeals DHS Department of Health Services DMS Division of Medicaid Services DVR Division of Vocational Rehabilitation EPSDT Early and Periodic Screening, Diagnostic, and Treatment GPR General Purpose Revenue HCBS Home and Community-Based Services (MA Waiver Program) HEART Health Engagement and Reporting Tool IDEA Individuals with Disabilities Education Act IFSP Individual Family Service Plan (Birth to 3 Program) ISP Individual Service Plan LTS Long-Term Support MA Medicaid NFE Not Functionally Eligible PHI Protected Health Information PII Personally Identifiable Information ROI Release of Information SSC Support and Service Coordinator TCM Targeted Case Management TPA Third Party Administrator CCOP Procedures Guide 45 Appendix B: Relevant Legal Authority Wi sconsin Statutes General Duties of Public Officials Custody and delivery of official property and records Wis. Stat. § 19.21(5): https://docs.legis.wisconsin.gov/statutes/statutes/19/II/21 S ocial Services Wis. Stat. ch. 46: https://docs.legis.wisconsin.gov/statutes/statutes/46/ C hildren’s community options program Wis. Stat. § 46.272: https://docs.legis.wisconsin.gov/statutes/statutes/46/272 C hildren’s Code Wis. Stat. ch. 48: https://docs.legis.wisconsin.gov/statutes/statutes/48/ P ublic Assistance and Children and Family Services Wis. Stat. ch. 49: http://docs.legis.wisconsin.gov/statutes/statutes/49/ S tate Alcohol, Drug Abuse, Developmental Disabilities, and Mental Health Act Wis. Stat. ch. 51: http://docs.legis.wisconsin.gov/statutes/statutes/51/ R ecords Wis. Stat. § 51.30: https://docs.legis.wisconsin.gov/statutes/statutes/51/30 P atient rights Wis. Stat. § 51.61: https://docs.legis.wisconsin.gov/statutes/statutes/51/61 P rotective Service System Wis. Stat. ch. 55: https://docs.legis.wisconsin.gov/statutes/statutes/55 M iscellaneous Health Provisions Confidentiality of patient health care records Wis. Stat. § 146.82: https://docs.legis.wisconsin.gov/statutes/statutes/146/82 Adm inistrative Procedure and Review Contested cases, notice, parties, hearing, records Wis. Stat. § 227.44: https://docs.legis.wisconsin.gov/statutes/statutes/227/III/44 Act ions Affecting the Family Wis. Stat. ch. 767: https://docs.legis.wisconsin.gov/statutes/statutes/767 J uvenile Justice Code Wis. Stat. ch. 938: https://docs.legis.wisconsin.gov/statutes/statutes/938 CCOP Procedures Guide 46 Wisconsin Administrative Code Management and Technology and Strategic Finance Uniform Fee System Wis. Admin. Code ch. DHS 1: https://docs.legis.wisconsin.gov/code/admin_code/dhs/001/1 C ommunity Services Early Intervention Services for Children from Birth to Age 3 with Developmental Needs Wis. Admin. Code ch. DHS 90: https://docs.legis.wisconsin.gov/code/admin_code/dhs/030/90 C onfidentiality of Treatment Records Wis. Admin. Code ch. DHS 92: https://docs.legis.wisconsin.gov/code/admin_code/dhs/030/92 P atient Rights and Resolution of Patient Grievances Wis. Admin. Code ch. DHS 94: https://docs.legis.wisconsin.gov/code/admin_code/dhs/030/94 M edical Assistance Covered Services Wis. Admin. Code ch. DHS 107: https://docs.legis.wisconsin.gov/code/admin_code/dhs/101/107 Wi sconsin Acts 2015 Wis. Act 55 h ttps://docs.legis.wisconsin.gov/2015/related/acts/55 F ederal Code Rehabilitation Act of 1973 34 C.F.R. § 104: https://www.gpo.gov/fdsys/pkg/CFR-2016-title34-vol1/pdf/CFR-2016-title34-vol1- part104.pdf I ndividuals with Disabilities Education Act, Part C 34 C.F.R. § 303: https://www.gpo.gov/fdsys/pkg/CFR-2016-title34-vol2/pdf/CFR-2016-title34-vol2- part303-subpartC.pdf CCOP Procedures Guide 47 Appendix C: Sample Notification of Denial Letter A dministering Agency Letterhead [D ate] F amily of [XXXXXX] Street Address City, WI Zip Code D ear [XX]: T his letter is to inform you that your application for the Children’s Community Options Program has been denied due to the following reason. [Insert reason.] T he following reports were reviewed in considering this decision: [Enter documents reviewed.] Y ou have the right to appeal this decision within 45 days from the date of this letter. A request for a hearing may be made by the applicant, recipient or former recipient, by an immediate family member, or someone with legal authority to act on their behalf. ( a) A request for a hearing may be made in writing or orally and may be made to the local agency or the State of Wisconsin Division of Hearings and Appeals (DHA). (b) the local agency must assist families who request or need help filing a fair hearing request. ( c) A n oral request to the local agency shall be put in writing by the agency and signed by you. ( d) Th e hearing request shall include a short statement of the matter to be reviewed. (e) Y ou can request a hearing using the form at doa.wi.gov/Pages/LicensesHearings/DHAWFSRequestingaHearing.aspx or by letter. Mail your signed form or letter to: W isconsin Division of Hearings and Appeals P.O. Box 7875 Madison, WI 53707-7875 A ppeals may also be delivered in person to DHA at 5005 University Avenue, Room 201, Madison, Wisconsin. CCOP Procedures Guide 48 Sincerely, cc: Department of Health Services, Bureau of Children’s Services CCOP Procedures Guide 49 Appendix D: Rights and Responsibilities Notification Template Y our Rights Under the Children’s Community Options Program A . Applying for the Children’s Community Options Program As an applicant / participant for CCOP, you have specific rights and responsibilities. 1. Y ou have the right to be told about the Children’s Community Options Program and other programs that can help you care for your child with disabilities at home. You have a right to be t old about services and other types of assistance that the Children’s Community Options Program can provide for you. 2. Y ou have the right to apply for the Children’s Community Options Program, and you have a right to decide not to participate in the Children’s Community Options Program. Authorization of s ervices through CCOP must be coordinated with other funding sources. 3. Y ou have the right to a written decision about your eligibility for the Children’s Community Options Program. The Agency must respond to your referral or request for services within 45 days. The written notice must state one of the following three decisions: a. Yes, your child is eligible (approval); b. No, your child is not eligible (denial) and why; or c. More information is needed (pending) and what information is needed. 4. I f you are put on a CCOP waitlist, you must be told why and given an estimate of how long the wait will be. 5. I f your application is denied, you have the right to file a county grievance and/or file a state appeal. You have the right to be told how to file a grievance or an appeal. B . Determining Children’s Community Options Program Services 1. I f your application is approved and funds are available, you have the right to a meeting to help decide what services will help you care for your child at home. This meeting will include a service assessment. A qualified person must do the assessment. This means someone who knows about your child’s particular disability and needs, and who knows about services to help your child remain at home. 2. Y ou have the right to share your opinions and preferences during the assessment and in developing an individual service plan (ISP) for your family. You have the right to have friends, relatives, or anyone you want with you in these meetings. 3. Y ou have a right to any help you need for you to understand and take part in the meetings. This includes interpreters, taped or Braille materials, or other communication aids. 4. Y ou have a right to have someone explain what choices you have to help your child remain at home. You have a right to a written copy of your assessment if you ask for it. CCOP Procedures Guide 50 5. A service coordinator will work with you to develop an ISP within 60 days of the agency receiving your referral or request for services. You have a right to have someone explain your ISP. The ISP must say what services are provided and for what purpose. The ISP must reflect y our child and family’s preferences. You have a right to a written copy of your ISP. 6. Y ou have a right to name the provider(s) from whom you would like to receive services. The person or provider agency you choose must be qualified. The Children’s Community Options Program must respect your preferences. 7. Yo u have the right to disagree with what is written in your ISP. You have a right to ask the county to change things with which you disagree. If you disagree, you have the right to file a county grievance or state appeal. 8. Y ou have a right to decide whether to accept the services offered in your ISP. C . Obtaining Children’s Community Options Program Services 1. Y our family has a right to services listed on the ISP if CCOP money is available and your child is eligible. 2. I f money is not available, your family has a right to be on a waitlist for services. If you are told that you have to wait for CCOP services, you have right to know how the waitlist works, how many others are waiting before you, and when the county thinks you will get services. 3. Y ou have a right to know the amount, if any, that you will have to pay for services. 4. Y ou have a right to request assistance from a service coordinator (for example, community connections coordinator or support and service coordinator) after you receive services. These s ervice coordinators can help make sure that you are getting the services in your ISP and that th e services work well together. You may meet with this person as necessary. 5. Y ou have a right to review your child and family-centered individual service plan with CCOP staff at least every six months. You have the right to have anyone you want with you at this meeting. 6. Y ou have a right to a written notice, at least 10 days in advance, whenever your child/family’s services are going to be reduced or ended, or your child is dis-enrolled from the program. You h ave a right to file a county grievance or state appeal if you disagree. D . Other Statutory Rights You and your child may also have a number of other rights specified in Wisconsin Stat. §§ 46.272, 49.001, 50.08, and 55.07. These include: 1. Th e right to be treated with dignity and respect. 2. A right to control their life and control the services received, as much as your child is able. 3. A right not to be hurt or threatened, and not to be tied, locked up, or forced to take drugs. CCOP Procedures Guide 51 4. A right to privacy, including the right to talk, to telephone, or to write anyone. 5. T he right to see your child’s file. 6. T he right to receive information about the Children’s Community Options Program in your fam ily’s primary method of communication. E. R ight to Appeal 1. Y ou have a right to be told how to file a county grievance or an appeal to the State of Wisconsin Division of Hearings and Appeals (DHA). This includes being told, whom to contact, what the steps are, and if there are time limits for filing the grievance or appeal. 2. Y ou can appeal to the state within 45 days of an action if your child is denied eligibility, if a request for service is denied, or your CCOP-funded services are reduced or terminated, however the lack of adequate funding may not serve as the basis for a hearing request reviewed by the s tate41. If you file an appeal within 10 days of the notice of the action, you have a right to request that the types and amounts of services you had been receiving continue until the appeal is decided. However, you may be required to pay those costs if the appeal is lost. A request for a hearing may be made by the applicant, recipient or former recipient, by an immediate family member, or someone with legal authority to act on their behalf. ( a) A request for a hearing may be made in writing or orally and may be made to the local agency or DHA. (b) Th e local agency must assist families who request or need help filing a fair hearing request. ( c) A n oral request to the local agency shall be put in writing by the agency and signed by you. ( d) Th e hearing request shall include a short statement of the matter to be reviewed. ( e) You can request a hearing using the form (available in different languages) at doa.wi.gov/Pages/LicensesHearings/DHAWFSRequestingaHearing.aspx or by letter. Mail your signed form or letter to: Wisconsin Division of Hearings and Appeals P.O. Box 7875 Madison, WI 53707-7875 A ppeals may also be delivered in person to DHA at 5005 University Avenue, Room 201, Madison, Wisconsin. You may withdraw a request for a fair hearing or grievance at any time in writing. 41 Wis. Stat. § 46.272(15) CCOP Procedures Guide 52 3. Y ou may get help with a county grievance or a state appeal from your Children’s Community Options Program service coordinator or from the following legal services resources (find the name and telephone number of resources in your area that can provide legal help): a. Legal Action of Wisconsin: legalaction.org b. Wisconsin Judicare, Inc.: judicare.org c. Disability Rights Wisconsin: disabilityrightswi.org F . Applicant / Participant Responsibilities There are specific responsibilities you must meet when you apply for or participate in the Children’s Community Options Program. If you do not meet these responsibilities, you may become ineligible for the program. Reporting changes in your circumstances is very important to maintain your eligibility. Changes should be reported promptly to your support and service coordinator, generally within 10 calendar days of when the change occurs. This includes: a. Maintaining contact with your support and service coordinator and participate in service planning and recertification activities. b. Contact updates, including address and phone number changes c. Report incidents, as outlined in the Family Guide to Incident Reporting ____ _______________________________ ___________________________________ Signature - Participant/guardian* Signature - Support and service coordinator D ate ____________________ Date ____________________ * M y signature indicates that I have been informed of and understand my rights and responsibilities under the Children’s Community Options Program. CCOP Procedures Guide 53 Appendix E: Assessment Criteria Th e assessment process involves the community connections coordinator or support and service coordinator gathering information about the child and the family as one comprehensive unit. Children are often able to communicate their answers, thoughts, and ideas, which must be taken into consideration when completing an assessment. While supports and services may meet an identified need or a deficit in a skill, the assessment must focus on the individual strengths, positive attributes, and desired outcomes of the child/family. A bbreviated Assessment The abbreviated assessment is designed to identify interim supports, services, or items for children and families on the waitlist. An abbreviated assessment can be completed by either a community connections coordinator or a support and service coordinator. I t is essential to discuss the following factors while conducting an abbreviated assessment: a. The child’s functional abilities, including self-care, mobility, communication, intellectual c apacity, emotional/behavioral status, cultural and age-appropriate behaviors, health and physical status, and, for older children, the ability to work b. Daily family life, including variations in family routine and needs over the day/week/month/year, any concerns of siblings or extended family members, and any risk factors such as age or health of the child or other family members c. Identification and potential for enhancement of natural resources, such as extended family, friends, and neighbors d. Current services provided to the child and family by third-party payers (both public and private), as well as other public or voluntary programs in which the child or family participates, including educational services and programming e. The physical environment, including physical accessibility, safety (both inside the home and on the property), and transportation f. Medical information, such as primary physician, current evaluations, and specialized medical s ervices g. Individual outcomes that are important to the child/family h. Any other information pertinent to the area of identified need C omprehensive Assessment A comprehensive assessment is more detailed than an abbreviated assessment and provides the basis for developing a child and family-centered individual service plan for children who will receive ongoing or intermittent services through CCOP. The comprehensive assessment must be completed by someone with the qualifications of a support and service coordinator (see Chapter 4). P rovided for reference, the following list includes the major topics that must be explored and documented in a thorough assessment: a. The child’s ability to perform/manage activities of daily living, ability to perform/manage instrumental activities of daily living, emotional and cognitive function, and mobility b. Background and social history c. Physical and medical health history d. Medications the child is currently using, their purpose, and what is needed to ensure their safe and effective management and administration e. Individual outcomes that are important to the child/family CCOP Procedures Guide 54 f. Behaviors that positively or negatively affect lifestyle or relationships g. The current use of or need for restrictive measures and associated risks, if any h. Social participation, friendships, existing social supports i. Cultural, ethnic, and spiritual influences j. Community participation and involvement k. Child and family preferences as to how, where, and with whom the youth wishes to live, their preferred environment, daily activities, and routines l. Available economic resources and how they are managed (i.e., ensure that those resources are u sed for the child’s benefit) m. A determination of whether there are any conflicts of interest present in the management and use of the child’s funds or in the selection or provision of services, and plans to resolve or ad dress identified conflicts n. Formal and informal supports and services that are present or available to the child/family o. Participant rights and responsibilities, including appeal rights p. School day, modifications to classes, and/or individualized education program (IEP) q. For youth age 14 and older, options and opportunities for transitions planning and resources r. For youth age 16 and older, options and opportunities for paid employment CCOP Revenues Taxes Intergovernmental Revenues Fines, Forfeits & Penalties Public Charges for Services lntergovt. Charges for Services Miscellaneous Revenues Other Financing Sources Revenues Expenses Personnel Contractual Services Supplies & Expense Fixed Charges Grants & Contributions Capital Outlay Department Allocation Expenses Net Cost Douglas County Wisconsin Department of Health and Human Services Through June 2026 2025 2025 2026 6/30/2026 Budget Actual Budget Actual (153,778) (141,255) (153,778} (75,280) (153,778) {141,255) {153,778) (75,280) 3,583 1,745 3,464 1,295 159,668 139,511 150,314 74,003 163,251 141,256 153,778 75,298 9,473 1 18 7/29/2026 Actual 48.95% {75,280) 48 .95% (75,280) 37.40% 1,386 49.23% 75,711 48.97% 77,097 1,817 RETURN TO AGENDA