Colorado Health Care 
Training and Consulting

July 24, 2018

"Nothing can stop the person with the right mental attitude from acheiving their goal; nothing on earth can help the person with the with the wrong mental attitude."

Thomas Jefferson

Healthcare Training
Each year CHC provides training and consulting to hundreds of agencies, their staff of nurses, therapists, personal care providers, and aides as well as to family and other caregivers who provide in-home services to the infirm, chronically ill and disabled  to improve care, quality and safety. 
CHC is the first Colorado company approved by CDPHE for Administrator CEUs.

Medicare Advantage & Open Enrollment 2018

Non-skilled in-home care services will be allowed as a supplemental benefit for Medicare Advantage (MA) plans 

For 2019 coverage, open enrollment will run from October 15, 2018, to December 7, 2018. 

During the annual enrollment period (AEP) Medicare beneficiaries can make changes to various aspects of their coverage. They can switch from Original Medicare to Medicare Advantage or vice versa.

The rule was initially proposed in February and continues to receive enthusiasm from the home health and private duty home care industries. Home health care providers have already made great strides as partners in MA contracts, and adding non-skilled services opens the door to the growing MA population even further.

The CMS estimated that more than one-third of all Medicare enrollees, or 34%, will be in a Medicare Advantage plan in 2018.

Breaking misconceptions about IHSS

IHSS program rules waive certain provisions of the Colorado Nurse Practice Act and Colorado Nurse Aide Practice Act to allow this service to be provided to people who otherwise would be living in a nursing home rather than independently, in their own residence.  A Registered Nurse provides oversight not actual care.

IHSS services will be allowed as a supplemental benefit for Medicare Advantage (MA) Plans in 2019 forward.

IHSS agencies are required to be licensed as home care agencies by CDPHE, and as licensed home care agencies, they must adhere to the standards of care established by
the Colorado State Board of Health, which is located in CDPHE.

The Medical Services Board, located in HCPF, is charged with adopting rules for the implementation and administration of IHSS for Medicaid reimbursement, which it has
done. HCPF has delegated the monitoring of the standards of care to CDPHE.

An IHSS agency is different from other Class B agencies since it must contract with or employ a licensed healthcare provider, such as a registered nurse, to verify the skills
and competencies of attendants. This is not necessary for other Class B agencies since they do not provide healthcare services.

This step is necessary because IHSS agencies are different from other Medicaid certified home care agencies.

For one, an IHSS agency is defined by statute as providing independent living core
services, which include:
 Information and referral services;
 Independent living skills training;
 Peer counseling, including cross-disability peer counseling; and
 Individual and systems advocacy.
These responsibilities are not required of other home care agencies

Another reason IHSS agencies are different from other home care agencies is because IHSS participants may select and train their own attendants, and certain provisions contained in the Nurse Practice Act and the Nurse Aide Practice Act are waived. This enables attendants, who may be lay persons, to provide some services (such as wound care, catheter irrigation, and medication administration) that might otherwise be considered the practice of nursing. 

For example, an attendant for someone with cerebral palsy may not be a licensed nurse, but he or she may be trained to provide gastronomy tube feedings in order to prevent malnourishment. RN is for oversight not actual care.  

By participating in IHSS, individuals with significant health care needs are able to keep the cost of care down by employing a lay person rather than a skilled nurse. Otherwise, the cost of care at home or in the community may exceed the limits set by Medicaid, and the individual would be required to move into a nursing home.

Unlike other Class B agencies, an IHSS agency is required to contract with or hire a licensed healthcare professional, who is in charge of, among other things, verifying the skills and competency of attendants, consulting with clients in case medical issues arise, and assuring attendants are following care plans.

For a home care agency to provide IHSS, it must have at least a Class B license and have basic HCBS certification. Although IHSS attendants may provide health-related services, they only provide assistance with specific health maintenance tasks that they are trained to do by the clients and verified by the IHSS agencies. IHSS attendants do not provide skilled nursing care to a general population as a nurse in a Class A agency does.

IHSS agencies must renew their home care agency licenses every year, and CDPHE conducts periodic surveys to ensure that IHSS agencies are in compliance with the home care standards and, per interagency agreement with HCPF, current HCBS and IHSS regulations.

Individual Participation in IHSS: In order to receive long-term care through Medicaid, individuals must go through a
regional case management agency. Colorado has 23 case management agencies, called Single Entry Point (SEP) agencies, which determine eligibility for long-term care
clients who may be eligible for IHSS. A case manager works with an applicant to determine the need for long-term care services and select a long-term care provider. The cost of IHSS cannot be more than the cost of placement in a long-term care facility.

For detailed information related to your own agency and IHSS, please contact Laura Neill.
CHC Consultant Laura Neill is the resident expert on IHSS:

CDPHE-approved Basic 8-hour Administrator Training for  A ll agency types 
with Connie McWilliams, MBA, CHC president with 20 years of experience as owner-operator of an accredited Medicare-certified agency.
LIVE PROGRAM offers 4 CEUs each day
September 11 & 12, 10:00 am to 3:00 pm

 This course provides compliance with both  Annual Training and Initial Training   required  of all Administrators, Managers & alternates.

HCBS or IHSS Home Care: The Standards & Ongoing Compliance 

8/9 HCBS
7/19 IHSS with NEW regs 

 Laura Neill, former CDPHE Surveyor and Case Manager (

Non-medical Management & Supervisor
Training Parts I & II 
Part 1:  8/23
Part 2:  8/30

Join Laura Neill (, former CDPHE Surveyor and Case Manager.

eLearn available 24/7 

24/7 - eLearn Care about Care coordination
24/7 - eLearn Care about Privacy, Confidentiality & HIPAA
24/7 - eLearn Behavior Management of the client with Dementias
LIVE and Online
7/31 The Provision of Skilled Care and Services
8/7 Agency Oversight & Operations
8/9 HCBS
8/14 Quality Management Program
8/16 IHSS
8/21 Emergency Preparedness
8/23 Non-medical Management/Supervision Part 1
8/28 Complaint & Incident Process Part 1
8/30  Non-medical Management/Supervision Part 2
9/11 & 12 LIVE Basic 8-hour Administrator Training

CEU Consulting at your offices by appointment & 4-hour minimum.

eLearn available 24/7 $100

Behavior Management of the Client with Dementia or Cognitive Disorders

Registrants will learn skills and tools necessary to provide care and services to clients with cognitive and memory impairments.

Home care not alone in search for workers
The U.S. Postal Service is sending volunteers dressed in sandwich boards to the streets of Denver to advertise its 200 job vacancies. A Colorado senior-living company is handing out one-time grants to help employees with financial hurdles, such as car repairs, to ensure they make it to work. And the state's largest grocery chain not only added a tuition reimbursement program to its benefit package in May, it upped its 401(k) match to boot. 

Faced with a tight labor pool, employers are making bold moves to attract and keep workers. (Denver Post)

eLearn Courses 
2 CEUs
available 24/7
( A ll agency types)
CDPHE-approved Care about Care Coordination
- 2 CEUs $100

CDPHE-approved Privacy & Confidentiality: C are about HIPAA-2 CEUs $100

These eLearn courses are available 24/7 and offer clear learner progress indicators and unlimited replays of course material. Resume learning exactly where you left off, on your mobile, tablet, laptop or any device.  

Consulting CEUs

Agency-centered Training
CEU Consulting 
4 CEUs and up

  • Quality Management Program
  • Complaint, Incident, Occurrence, Grievance Log
  • Provision of Skilled Care & Services
  • Annual Evaluation

eLearn Program: Why Home Care Should Care 
With $2.8 billion being spent on healthcare hacking breaches during 2016, and 81% of IT leaders citing data security as a top business goal, security in healthcare has never been more important.
OASIS C2 (& D) Classes *FREE* 
OASIS C2 Basics (One Session): Course ID 1066908
This beginning three-hour class is how to get started with OASIS C2.

OASIS C2 Item-by-Item (2 Sessions): Course ID 1066909
This practical application class reviews item-by-item data set completion. We will follow Mrs. Green's assessment, which will require two sessions to complete. Attendance at both sessions is required to complete this class.

OASIS C2 Quality Measures (One Session): Course ID 1066910
This course assumes familiarity with the OASIS C2 Item Set, covering more advanced content and application.

To see additional session details and register for on-site attendance for one of these offerings:
1. Go to
2. Log in to your existing TRAIN account, or new users click "Create an Account"
3. Once you've logged in, or created an account, Search (top right) for the appropriate Course ID. (See above for desired training)
4. Click link for desired course.
5. Click the "Registration" tab.
6. Click the "Register" button for the session you wish to attend.
7. Remember to register separately for each desired course.
Questions?:  Please email 

9 am - 11 am
2 CEUs
7/24 Understanding Surveys
7/31 Provision of Skilled Care
8/7 Agency Oversight & Operations
8/14 Quality Management Program
8/21 Emergency Preparedness
8/28 Complaint & Incidents Part 1
Join Jennifer Windram, RN, BSN and former CDPHE Surveyor.

The CHC mission is to provide practical education that improves care, quality, and safety of clients in the home and brings compliance to all involved in the organization. 

Colorado Experience.
Colorado Owned.
Colorado Operated.
START UP or MATURE agency assistance.
Non-Medical Home Care

Medicaid-waiver Personal Care & IHSS

Skilled Home Health Care

Directed plan  of correction

Directed in-service training

Billing and revenue management

Administrator mentoring

Corporate entity setup
 - Resources on corporations. 
Licensure application
 - Help with answering questions on your application.
Policies & Procedures
 - Specific to program type plus Administrator training for understanding and compliance.
Quality Management Program / QAPI
 - New survey process includes Core elements.
Consumer record
 - Includes Service Plan and documentation requirements.
Medical chart
 - Unique to your services, programs and policies.
Personnel record
 - Detailed and observed competency and written testing.
Complaint, Infection Logs
 - Administrative procedures to ensure consumers are protected.
Occurrence, Incident Reporting
 - Ensures Reporting requirements are met.
Written, step-by-step
competencies - 
Detailed and observed competency evaluation for direct care providers.
Consumer safety, Emergency Preparedness
 - Preserve the health, safety and security needs of care providers, their employees and their patients during a sudden emergency 
Privacy, confidentiality and HIPAA compliance 
- Ensure enforcement of your Privacy prolicies.
Mock surveys
 - Onsite review of survey-risk areas.
Agency-specific educational consulting
 - Combined lecture and interactive mini-mock survey using your agency data in real-time followed by staff training of findings.
Billing Services for Medicare, Medicaid, Commercial Insurance, Medicare Advantage, TriCare - Training or billing provided