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When a CLTS waiver applicant or participant is determined to be ineligible for Medicaid, the IM agency sends notice of Medicaid ineligibility to the member. Additionally, IM must notify the CLTS case manager if an applicant or member is not eligible for a Medicaid source. When an applicant or participant is determined to be ineligible for the CLTS Waiver Program, the CWA sends notice regarding the waiver program to the family. The CWA must also inform the IM agency if an HCBW Medicaid member is no longer functionally eligible (that is, they no longer meet an institutional level of care). This page last updated in Release Number: 26-02 Release Date: 04/15/2026 Effective Date: 04/15/2026 37.3 HCBW Medicaid CARES Processing for the CLTS Waiver Program When a child who is functionally eligible for the CLTS program is referred to IM, he or she must first have eligibility determined using HCBW Medicaid rules. To be eligible for HCBW Medicaid, the child must be both Medicaid-eligible and functionally eligible. To determine eligibility for HCBW Medicaid, only the child’s income is counted. Assets are not counted for disabled or institutionalized children. Since assets are disregarded, there can be no divestment in a HCBW Medicaid case for a child. If an applicant or participant is ineligible for HCBW Medicaid, they must have eligibility determined for BadgerCare Plus. If the CLTS applicant is the only household member applying for healthcare, the packet provided by the CWA is all that is required to be submitted. If the CWA submits a signed F-10129 to the IM agency, the primary person is required to provide a second signature. The primary person can choose to call the IM agency to provide a telephonic signature or mail a signed Application Summary (see SECTION 2.2 APPLICATION METHODS). Individuals can be eligible for the CLTS Waiver Program and HCBW Medicaid through age 21. When a CLTS Waiver Program applicant or member reaches 18 years old and their source of Medicaid is HCBW, they must apply for HCBW Medicaid as the primary person. Federal and state privacy and confidentiality protections prevent the parents of adults from automatically having access to protected information; therefore, these young adults must apply separately from their parents. See Process Help Section 12.18.3 Home and Community-Based Waiver (HCBW) Medicaid for Children's Long-Term Support (CLTS) Program for processing instructions. This page last updated in Release Number: 26-02 Release Date: 04/15/2026 Effective Date: 04/15/2026 37.4 Cost Sharing 37.4.1 Group A Group A members are Medicaid eligible via SSI (including SSI-E Supplement and 1619a and 1619b) or a full-benefit Medicaid subprogram (see SECTION 21.2 FULL-BENEFIT MEDICAID) other than HCBW Medicaid.