Behavioral Treatment and Other Support Services for Children with Autism

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Services Currently Provided Under the Children's Long-Term Support (CLTS) Waivers Program

The CLTS Waiver Program currently provides funding for specific autism treatment services not covered by BadgerCare Plus, Medicaid, or the Katie Beckett Program. For young children diagnosed with autism, this includes treatment using behavioral methods. The treatment is designed to teach new skills while reducing the challenging behaviors seen in some children with autism. A child who meets the waiver eligibility criteria can participate in this program for up to three years. After three years of treatment, the child may qualify for ongoing waiver services to address any additional needs he or she develops.

2016: A New Behavioral Treatment Benefit to be Provided Under Wisconsin Medicaid and Other FowardHealth Programs

In July 2014, the Centers for Medicare and Medicaid Services (CMS) directed states to provide coverage of autism treatment services as a regular statewide Medicaid benefit.  In response, the Department of Health Services (DHS) is transitioning coverage of autism treatment services from the CLTS Waiver Program to a new behavioral treatment benefit under ForwardHealth. ForwardHealth includes BadgerCare Plus, Medicaid, and the Katie Beckett Program.

The behavioral treatment benefit will be available beginning January 1, 2016, for the following groups:

  • Children currently receiving autism treatment services under the CLTS Waiver Program;
  • Children who have been diagnosed and are waiting for autism treatment services; and
  • Children who receive health care coverage through BadgerCare Plus, Medicaid, or the Katie Beckett Program and who have a need for behavioral treatment.

The new behavioral treatment benefit will be funded as a regular ForwardHealth benefit (like a physician service or a well-child screening) instead of through the CLTS Waiver Program. The CLTS Waiver Program will continue to provide support services to meet children's assessed needs.

What's Changing?

The ForwardHealth behavioral treatment benefit includes two different types of treatment: comprehensive and focused.

  • Comprehensive treatment is an early intervention treatment approach designed to address multiple aspects of development and behavior; typically, it involves higher weekly hours and longer duration.
  • Focused treatment is dedicated to addressing specific behaviors or developmental deficits; typically, it involves fewer weekly hours and shorter duration.

The ForwardHealth behavioral treatment benefit covers evidence-based treatments, including Applied Behavior Analysis and Early Start Denver Model.

In order to receive behavioral treatment, medical necessity must be determined first:

  • Medical necessity is determined by ForwardHealth through the prior authorization (PA) process.
  • The PA is requested by the behavioral treatment provider on behalf of the member.

A provider must be enrolled with ForwardHealth as a behavioral treatment provider in order to request prior authorization. Behavioral treatment providers will begin enrolling with ForwardHealth on and after November 16, 2015. To find an enrolled behavioral treatment provider, contact ForwardHealth Member Services after November 16, 2015, at 1-800-362-3002.

What Is Not Changing?

The CLTS Waiver Program will continue to provide an array of supports and services including support and service coordination to meet children's assessed needs.

The eligibility requirements for BadgerCare Plus, Medicaid, and the Katie Beckett Program and the eligibility criteria for the CLTS Waiver Program are not changing.

Who is Eligible?

See who is eligible for the new behavioral treatment benefit.

Previous Informational Meetings 

The Department of Health Services has scheduled six regional meetings to share information about the new behavioral treatment benefit available under ForwardHealth.

Letters announcing the meetings were sent to families of children with autism on October 19, 2015. Copies of the letters are linked below:

Regional Meeting Letters


Two of the regional meetings can be attended through a live webcast (Madison and Green Bay). Participants on the live webcast may submit their questions and comments. The webcasts will also be recorded for viewing at a later time by those unable to attend the live meeting. Registration is not required to attend any of the meetings or to view them online.

November 3, 2015

6:00 p.m. - 8:00 p.m.

Froedtert Hospital

Helfaer Auditorium

92nd Street

Milwaukee, WI 53226

November 9, 2015

6:00 p.m. - 8:00 p.m.

Alliant Energy Center

Mendota Room 1-2

1919 Alliant Energy Center Way

Madison, WI 53713

View the recorded webcast of the meeting.

November 10, 2015

6:00 p.m. - 8:00 p.m.

Western Technical College

Lunda Center, Conference Hall West

319 Seventh Street North

La Crosse, WI 54601

November 11, 2015

6:00 p.m. - 8:00 p.m.

Dunn County Human Services

3001 U.S. Highway 12 East, Suite 160

Menomonie, WI 54751

November 17, 2015

6:00 p.m. - 8:00 p.m.

Brown County Public Library


515 Pine Street

Green Bay, WI 54301

Join the live webcast of the meeting.

November 18, 2015

6:00 p.m. - 8:00 p.m.

Northcentral Technical College


1000 W. Campus Drive

Wausau, WI 54401

Meeting Materials

Autism Regional Meeting Presentation

English (PDF, 290 KB)
Spanish (PDF, 297 KB)
Hmong ((PDF, 280 KB)

Provider Training

The Department conducted provider training on the new behavioral treatment benefit on November 4, 2015, at the Mendota Mental Health Institute in Madison. Refer to the public notice for more information. Copies of the PowerPoint and additional handouts from the training are available on the ForwardHealth Portal. The training was recorded will also be available on the ForwardHealth Portal in the near future.

The Department will offer additional provider trainings throughout the state in early 2016. More information will be published on the ForwardHealth Portal as it is available.

Frequently Asked Questions

 The Department has developed responses to frequently asked questions (FAQs) from families. Click the link below to access the FAQ document:

Behavioral Treatment FAQs for Families

English (PDF, 186 KB) 
Spanish (PDF, 209 KB)
Hmong (PDF, 191 KB)

Families with additional questions may call Member Services at 800-362-3002.

Providers with questions should call Provider Services at 800-947-9627.

Waiver agencies with questions should contact their assigned children's services specialist.

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