Today, the Wisconsin Medicaid Director Jim Jones issued the following memo regarding CLTS and CCOP. The purpose of the memo is to communicate changes to minimum contact standards and service coordination necessitated by the COVID-19 pandemic.
Background: COVID-19, Wisconsin’s Public Health Emergency, and “Safer at Home” Order
On March 12, 2020, Governor Tony Evers declared a public health emergency to direct all resources needed to respond to and contain COVID-19 in Wisconsin. Citing its commitment to reducing the risk of COVID-19 exposure to applicants, participants, and staff, the Bureau of Children’s Services (BCS) subsequently suspended the requirement for in-person face-to-face contacts for the Children’s Community Options Program (CCOP) and the CLTS Waiver Program.
On March 23, 2020, Governor Evers and the Wisconsin Department of Health Services (DHS) issued Wisconsin’s “Safer at Home” order. Among other things, it put in place requirements that Wisconsinites “Stay at Home” except for critical tasks, such as grocery shopping and medication pick-ups, and abide by “Social Distancing Requirements” – “the practice of keeping at least six feet apart from others and avoiding direct physical contact” as a primary tool in the effort to slow the rate of infection.
DHS BCS is committed to reducing the risk of COVID-19 exposure to protect participants, as well as coordinating with counties to directly support families during this critical time.
New Support and Service Coordination Requirements
To ensure health and safety needs of participants, families, and providers are adequately addressed during the global pandemic, DHS BCS has amended minimum contact standards for support and service coordination. To ensure operating entities are fully supporting participants and providing them with needed levels of support and service coordination in accordance with new requirements, county waiver agencies (CWAs) must carry out the following five activities:
(1) Make an initial contact
Even though face-to-face contacts are suspended, SSCs are the key link to families during this crisis. It is critical to maintain remote contact with families, focusing on high-risk situations and the most vulnerable children
(2) Carry out minimum direct contact with the family every month, unless the family specifically requests less frequent contact.
(3) Develop a child-specific SSC contact plan during the pandemic, taking into account capacity of the family and complexity of the child’s care needs. Child-specific plans should:
- Address applicable needs such as developing a backup/crisis plan and mental health and increased social isolation concerns.
- Be flexible, allowing for changes to an Individual Service Plan and needed supports and services.
- Delineate resources families can access remotely or with the least amount of contact possible with key service providers and partners in the community, such as food assistance, medical, and other needed services.
- Remind families of the importance of adhering to the fundamentals of the “Safer at Home” order by:- Washing hands often with soap and water.
– Staying at home.
– Limiting physical interactions to the same people.
– Keeping at least six feet apart from others and avoiding direct physical contact.
– Limiting the amount of time spent making essential trips to the grocery store or to pick up medication, and send just one adult (if possible) on such errands, avoiding turning essential activities into family outings.
– Making essential trips no more than once a week.
– Staying in touch remotely with phone, text, and email contacts to family and friends.
(4) Establish a rigorous plan for carrying out more frequent and in-depth contacts with vulnerable, high-risk participants.
Take action to protect vulnerable and high-risk children. Talk with families and youth about their health and safety needs, identify prevention strategies, changes in supports and services, and report any incidents that occur. A vulnerable child is defined as a child with a high level of life-sustaining needs (e.g., nutrition, fluids, or medical treatment) who has a limited informal support network and/or is dependent on caregivers or parents, has limited cognitive, emotional, and/or behavioral capacity to provide for these needs, and to whom at least one of the following applies:
– Is isolated with limited or no adult outside the home and is not available to be observed; o Is nonverbal and unable to communicate;
– Is medically complex and requires significant care from a caregiver or parent and is highly dependent on others to meet basic needs;
– Is the subject of current or historical child abuse and neglect reports; or – Has a primary caregiver with active substance abuse.
(5) Devise processes for tracking and substantiating the occurrence of these contacts within required timeframes and demonstrate qualitative elements of the plan put into place with families during the pandemic.
a. Both elements will be subject to record review.
BCS’ new minimum support and service coordination requirements are necessitated by the need to maintain quality services during the global pandemic, and the serious threat which the COVID-19 virus poses to the health of everyone, especially those with serious underlying medical issues.
The new minimum contact standard goes into effect immediately upon release of this memo and will remain in effect for the duration of the COVID-19 pandemic.
Questions on the new standard should be directed to BCS technical assistance (TA) staff.
Information on COVID-19
Since this is a rapidly evolving situation, we encourage CWAs to frequently monitor the DHS website for updates and to follow @DHSWI on Facebook and Twitter or dhs.wi on Instagram.