We are now 9 months away from the ARPA Spending Deadline and since our last newsletter at the end of April, a whole new batch of projects have successfully closed. For the remainder of the summer and fall our team is excited to continue dedicating this newsletter as a space to highlight and celebrate the successes and changes that this rare funding opportunity has provided.

For anyone interested in digging even deeper into all of the projects, please feel free to use the quarterly reports that we create for our federal partners at CMS and our state partners at the JBC.

~ The ARPA Team

Project Completion Updates In This Edition

Strengthen the Workforce & Enhance Rural Sustainability

1.07 - Public Awareness Campaign

1.09 - Workforce Compensation Research

Improve Crisis & Acute Services

2.03 - Institute for Mental Disease (IMD) Exclusion, Risk Mitigation Policy

Support Post-COVID Recovery & HCBS Innovation

4.08 - Respite Grant Program

Invest in Tools & Technology

6.02 - Specialty Search in Provider Specialty Tool

6.05 - Member Tech Literacy

6.13 - Connect CMAs to ADT Data

Find all of the updates below, anytime, using the ARPA Project Directory page

✅ 1.07 - Public Awareness Campaign ✅

Completed

Key Project Achievements and/or Activities: 

The project set out to create a public awareness campaign to bring more awareness of the direct care workforce and what they do. The campaign began with research, content development, and message testing involving interested stakeholders. Using social media, TV, radio, and print ads, the campaign engaged in a broad attempt to reach a large audience across the state. After launching the campaign in November 2023, routine feedback and tweaks were made to ensure a robust campaign through its end in February 2024. Overall, the goal of this project was to help people see how important this workforce is to the state and to encourage more people to join this field. While the campaign has wrapped up, there remains a website with the materials to be used for recruitment efforts by HCPF and other interested stakeholders.

Summary / Project Outcome:

The 1.07 HCPF Public Awareness Campaign was launched to aid in addressing the critical shortage of direct care workers (DCWs) in Colorado and to raise awareness about their crucial role in providing care. Extensive planning and research were conducted to understand public perceptions and inform the campaign's strategies. The research revealed a lack of awareness and misconceptions about DCWs, prompting the need for targeted messaging.



Circuit Media, in collaboration with HCPF, developed a comprehensive campaign aimed at challenging stereotypes, promoting diversity within the direct care workforce, and showcasing the positive impact of DCWs on individuals' lives. The campaign utilized various media channels, both traditional and digital, to reach a wide audience across the state.

Continuous monitoring and optimization efforts were employed throughout the campaign, with regular reports providing real-time data for adjustments in messaging and media placements. Stakeholder engagement sessions and collaborative meetings further contributed valuable feedback and insights to refine campaign strategies.

Overall, the campaign sought to elevate the profile of DCWs and highlight their invaluable contributions to society, with the ultimate goal of addressing the workforce shortage and improving the quality of care in Colorado.

External Facing Reports/Websites: 

The campaign videos, infographics, flyers, and social media advertisements can be found on the Direct Care Spotlight webpage

✅ 1.09 - Workforce Compensation Research ✅

Completed

Key Project Achievements and/or Activities:

The project achieved the creation of a key Direct Care Workforce (DCW) Report. This report provides demographic information on DCW workers nationally and supplies essential details regarding the concerns of Direct Care Workers, such as turnover rates and the absence of paid time off. The report provides insights into various state policies, such as paid sick leave, with specific mentions of states like Connecticut, Rhode Island, Vermont, Virginia, and New Mexico, which offers home health aide training and free in-house child care. Noteworthy programs like Minnesota's transportation support for DCWs are highlighted.

The report incorporates stakeholder feedback gathered from over 100 individuals across multiple sessions, indicating a strong demand for increased pay rates, better health insurance, financial assistance for housing, utilities, transportation, child care, and improved working conditions. Based on this input, recommendations were proposed for tiered compensation linked to competency programs and peer mentoring initiatives. Additionally, the report outlines workforce innovations, including comprehensive compensation packages, recruitment and retention strategies, and initiatives for addressing burnout and turnover in the healthcare sector.

Various states and local entities, such as California, Colorado, and Idaho, are mentioned for their innovative approaches to workforce housing solutions. The report concludes by addressing the challenge of the benefits cliff, which poses a significant barrier to financial stability and job security nationwide. It emphasizes the need for collaborative efforts across agencies and programs to address this issue effectively, although there are currently no specific implementations underway to tackle this challenge.

Summary / Project Outcome:

The project resulted in the creation of a DCW Report.

The DCW Report delves into national demographics and critical aspects of Direct Care Workers (DCWs), emphasizing turnover rates and the absence of paid time off. It highlights various state policies, such as paid sick leave, and showcases innovative programs like New Mexico's child care plan and Minnesota's transportation support for DCWs. Stakeholder feedback from over 100 individuals emphasized the need for increased pay rates, improved benefits, and support for housing, transportation, and child care. Recommendations include tiered compensation linked to competency programs and peer mentoring, along with best practices for recruitment, retention, and workforce housing solutions.

This report underscores the need for comprehensive strategies to address workforce challenges, improve compensation and support systems, and enhance the quality of care provided to individuals across Colorado's healthcare sector.

External Facing Reports/Websites:

Direct Care Workforce: Innovative Compensation Recommendations Report 

✅ 2.03 - Institute for Mental Disease (IMD) Exclusion, Risk Mitigation Policy ✅

Completed

Key Project Achievements and/or Activities: 

Through this ARPA project, the team has set up a website specific to Institute of Mental Disease (IMD) policy work. To review many of the project outcomes and deliverables, including the Behavioral Health Campus Policy, please visit the IMD webpage.

Additionally, with support from this project, the State of Colorado has been able to pursue a multi-component amendment to its current 1115 Substance Use Disorder (SUD) Demonstration Waiver. Work from this project in support of that effort can be found on the 1115 SUD Demonstration web page.  

Summary / Project Outcome:

HCPF contracted with vendor Health Management Associates (HMA) to explore and develop opportunities to mitigate risks and barriers to psychiatric inpatient level of care on campuses and facilities designated as IMDs within the state of Colorado due to federally mandated restrictions on campuses and facilities deemed IMDs.

External Facing Reports/Websites:

IMD website

✅4.08 - Respite Grant Program✅

Completed

Key Project Activities and / or Achievements:  

The Department successfully developed a grant program increasing access to respite for caregivers/families of Members (state plan and waiver Members). Twelve grantees from across the state were awarded based on organizational capacity to achieve proposed outcomes, creativity of the project to address systemic or other identified barriers, and the proposed project meeting all grant requirements.

The Department utilized a contractor, Public Consulting Group, to study the landscape of respite availability across Colorado. This study included: conducting stakeholder engagement, researching best practices, conducting peer-state analysis regarding respite, researching current respite utilization and completing data analyses, and researching Home & Community Based Services waivers and identifying recommendations.

Summary / Project Outcome:  

A total of $1,138,547.50 was provided through grant awards to twelve organizations across Colorado, including urban and rural communities. They supported the unique respite needs of more than 1,200 Members, including children, older adults, Members with complex care needs, and Members with intellectual and developmental disabilities.  

Highlighted below is a few of the innovative ways the grant funds were used:

• An online/app Respite CareMatch program was developed
• A program designed for siblings to connect with other siblings was created
• Voucher Programs and other existing programs were expanded to allow for respite in the evenings and on weekends
• “Activities” for Members such boat rides and destination trips were offered
• A new respite program was started in Alamosa, Colorado
• Respite was offered for families seeking CNA Certification
• Additional respite was offered for Members who have exhausted their waiver benefit

The primary evaluation element of this project was used to identify gaps in respite and the final evaluations/lessons learned from the grant program will be the foundation for future programs, policies, and budget requests. The Respite Benefit will continue as this is a critical service for Members and their families but may be modified or expanded based on information gleaned from this ARPA project.  

Future plans include evaluating group respite availability across all children’s waivers and continuing to partner with our stakeholders and community partners to inform future decisions.  

External Facing Reports / Websites:  

Visit the Respite webpage, a landing page for respite within Home and Community Based Service waivers.  

✅6.02 - Specialty Search in Provider Specialty Tool✅

Completed

Key Project Activities and/or Achievements:

• Identified related service types  
• Web page to help guide prospective providers  
• Provider notification memo 

External Facing Reports / Websites:  



A web page has been deployed to help prospective HCBS providers select the right specialty in advance of enrolling with Gainwell or starting the licensure process with the Colorado Department for Public Health & Environment. This will save prospective providers time, reduce the amount of applications returned, and increase the number of available HCBS providers.

✅6.05 - Member Tech Literacy✅

Completed

Project Achievements and/or Activities:

Like HCBS providers, many HCBS-enrolled members could benefit from greater use of electronic systems. Every day we are all expected to adopt new technologies that improve our lives and help us to access the things we need, including our healthcare. This includes accessing doctor's portals, utilizing email and text messaging reminder systems for appointments, or receiving services through expanding telehealth and telemedicine options.  

Under this project, HCPF contracted with the Center for Inclusive Design and Engineering (CIDE) to understand the technology literacy landscape for members served through Long Term Services and Supports (LTSS) and identify best practices for effective instruction in achieving desired outcomes including increased digital literacy and use among LTSS members. The outcome of this work is the development of a Digital Literacy Pilot, which included 29 members and 18 coaches, aimed at improving the digital literacy skills of Colorado Medicaid recipients so they may better access online health information and services. During this project, the team is proud to have accomplished the following:  

• Conducted stakeholder engagement through a community survey, small group feedback sessions, and subject matter experts to inform the development of the digital literacy curriculum for people with disabilities. Report  
• Conducted a scholarly literature review of the technology literacy landscape for people with disabilities.  
• Developed a comprehensive Digital Literacy Coach Facilitation Guidebook.
• Developed two interactive digital literacy curriculums accessible via learning modules, one for coaches and another for learners.
• Conducted a pilot with 29 volunteer learners (HCBS recipients) and 18 coaches (service providers, family members, and friends) to evaluate the effectiveness of the curricula and learning modules.  
• Evaluated the learning experience and shared results in a final report.
• Published the full curriculum and modules online for anyone in the general public to access through Moodle.

Summary / Project Outcome:

This project developed a learning experience to aid members in developing digital literacy skills including how to access health information online utilizing a coach and learner structure. The learning plans include lessons on foundational skills, online healthcare, cybersecurity, and digital equity. The pilot participants shared their satisfaction with the learning experience in the evaluation process.

Moving forward, the developed content and learning management system will be available publicly for anyone to access, free of charge. Additionally, the team from the University of Colorado - Center for Inclusive Design & Engineering (CDIE), in partnership with the Colorado Office of Employment First (COEF), plans to continue to look for future funding opportunities to expand the curriculum.

External Facing Reports/Websites:  

• Learning opportunity in Moodle  
• Scholarly literature review
• Stakeholder Engagement Report
• Digital Literacy Coach Facilitation Guidebook
• Final Report 

✅6.13 - Connect CMAs to ADT Data✅

Completed

Key Project Achievements and/or Activities:

The following details the key achievements and activities resulting from the Connect Case Management Agencies (CMAs) to Admission, Discharge, Transfer (ADT) pilot project:

• HCPF was able to regularly deliver and distribute readable and user-friendly daily ADT data to each of the CMA participants.  
• Policy and process recommendations were submitted as Case and Care Management (CCM) system change requests to add event notifications and a work queue for ADT data.  
• The CMA pilot participants were able to learn how to use ADT data for identifying and following up on Critical Incidents Reports.
• The participants were able to identify potential areas of collaboration with their Regional Accountable Entities (RAEs) as a result of this project.  
• HCPF was able to successfully gather and implement stakeholder feedback through monthly meetings and surveys.  
• Connect Case Management Agencies (CMAs) to Admission, Discharge, and Transfer (ADT) Data Pilot Summary of Findings and Recommendations report was completed by the HCPF.

Summary / Project Outcome:

The 6.13 Case Management Agencies (CMAs) to Admission, Discharge, Transfer (ADT) Data pilot project began in January 2023 and concluded in December 2023. The pilot consisted of seven participating CMAs who received daily ADT hospital data files via a secure site from HCPF. The CMAs used the ADT data to identify members associated with their agency who had visited the hospital, alerting them to possible changes in functional needs and services and supports, as well as possible critical incidents. All of which made CMAs more effective at case management while enhancing member experience. The HCPF staff utilized feedback received from monthly participant meetings and monthly participant survey responses to determine the results and outcomes from the pilot project. Multiple positive outcomes were identified as a result. The feedback from participants resulted in the submission of a system change request to generate ADT notifications and a work queue in the Case and Care Management (CCM) system. As a result of having access to the ADT data, participants reported improved outreach and increased communication between case managers and their members thus enhancing member experience. Participants also stated feeling empowered to conduct more effective and comprehensive follow up with their members and identified increased opportunities for the coordination of discharge planning, in turn leading to a more seamless continuity of care. It was determined that both members and case managers benefited from connecting CMAs to ADT hospital data. Case managers were able to better coordinate care and participate in discharge planning with access to this vital information. Overall, this improved health outcomes and the quality of care for members.

Project Metrics:  

• Seven grants were issued to Case Management Agencies (CMAs) with a focus on diversity.
• 85.7% of grantees were designated with a diversity classification and were identified as small businesses.
• Pilot participants completed 12 monthly surveys which included an average of 10 questions across three different categories: Quality of Admission, Discharge, Transfer (ADT) data, Critical Incident Reporting, and Regional Accountable Entity (RAE) and CMA Coordination.
• The respondents were also asked to upload examples of ADT follow-up activities. Pilot participants engaged in 12 monthly meetings with HCPF staff to discuss and review outcomes related to the quality of ADT data, progress of Critical Incident Reporting, and communication with the RAEs.
• HCPF project leads spent 30+ hours gathering, documenting, and organizing stakeholder feedback for the ADT project.
• HCPF distributed 290 days of ADT data to pilot participants between January 26, 2023 and December 31, 2023, despite a brief interruption due to a nationwide data outage during the months of June and July 2023.
• An analysis demonstrated that the distribution of the ADT data impacted an average of 704 members per month.

External Facing Reports/Websites:  

Connect Case Management Agencies (CMAs) to Admission, Discharge, and Transfer (ADT) Data Pilot Summary of Findings and Recommendations Report 

What 6.13 Grant Recipients Are Saying

“We were able to follow individuals who are hospitalized more closely. Case Managers were able to check in with individuals as soon as they

received ADT notifications from our team. The pilot has given case managers the opportunity to provide better support to individuals and their

families after an admission or discharge. The data has also supported CIR submissions when we are not given dates in hospitals from providers.”

Reminder:

Training Fund Grants Open for Individual Direct Care Workers

HCPF is offering short-term grant funding to incentivize and expand training opportunities for the Home and Community-Based Services (HCBS) workforce. The grants will fund higher-level skills that will promote greater retention within the HCBS workforce. The maximum award amount per application for direct care workers is $500.

Eligible applicants include:

• Individual, age 18 or older, who is currently working in a direct care role within any of Colorado’s Home & Community-Based Service (HCBS) Waivers; or
• Individual, age 18 or older, who desires training to enter direct care within Colorado’s HCBS Waiver workforce; or
• Also included within this workforce, are Certified Nurse Aides and Home Health Aides within Long-Term Home Health; or

Interested in learning more about how this grant could support higher-level skills for the HCBS workforce?

Visit the grant program information page to get more details and apply.

Applications are only open until July 15!

Questions? Email us at hcpf_dcworkforce@state.co.us .

Direct Care Workforce Collaborative (DCWC) Training & Career Advancement Action Group

This Action Group works collaboratively with stakeholders to identify and move forward strategies to support the recruitment and retention of Colorado's direct care workforce. This group intends to meet every other month on the first Friday of the month from 9 to 10 a.m. MT. For more information, please see the Direct Care Workforce Collaborative webpage, or email HCPF_DCWorkforce@state.co.us.

The meeting will be held:

Friday, July 12, 2024

9 to 10 a.m. MT

Join via Zoom

Join via Phone:

(Toll-free) 1-877-853-5257

Meeting ID: 969 4053 6000, Passcode: 115140

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DCWC Compensation and Benefits Action Group

This Action Group works collaboratively with stakeholders to identify and move forward strategies to support the recruitment and retention of Colorado's direct care workforce. This group intends to meet every other month on the third Friday from 10 to 11 a.m. MT. For more information, please check out the DCWC webpage, or email HCPF_DCWorkforce@state.co.us.

The meeting will be held:

Friday, July 19, 2024

10 to 11 a.m. MT

Join via Zoom

Join via Phone:

(Toll-free) 1-877-853-5257

Meeting ID: 993 1700 7314, Passcode: 396389

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Criminal and Juvenile Justice Collaborative (Virtual and In-person) Meeting Series

The HCPF Criminal and Juvenile Justice Collaborative provides ongoing feedback to ensure robust stakeholder participation in the development of criminal justice projects including:

• ARPA 8.10 - Criminal Justice Partnerships
• Consolidated Appropriations Act (CAA) - Juvenile Justice
• 1115 Re-entry Waiver

The Collaborative meets on the fourth Wednesday of the month at 1 to 2 p.m. MT. The April 2024 meeting will be held at 303 E. 17th Ave., Conference Room 11AB, Denver, CO 80203. The location of future meetings - May 2024 and beyond - is to be determined.

The next meeting will be held:

Wednesday, July 24, 2024

1 to 2 p.m. MT

In-person meeting location for the May meeting:

303 E. 17th Ave., Denver, CO 80203

Virtual meeting access:

Join via Zoom

Join via Phone:

(Toll-free): 877-853-5257

Webinar ID: 895 8171 8788, Passcode: 011267

For more information about the Collaborative and its meetings, including location, please see the Criminal and Juvenile justice collaborative webpage. For any questions, please email Hannah Hall.



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Direct Care Workforce Collaborative (DCWC) Value and Awareness Action Group

This Action Group works collaboratively with stakeholders to identify and move forward strategies to support the recruitment and retention of Colorado's direct care workforce. This group intends to meet every other month on the fourth Friday of the month from 1 to 2 p.m. MT. For more information, please check out the Direct Care Workforce Collaborative webpage, or email HCPF_DCWorkforce@state.co.us.

The meeting will be held:

Friday, July 26, 2024

1 to 2 p.m. MT

Join via Zoom

Join via Phone:

(Toll-free) 1-877-853-5257

Meeting ID: 969 4053 6000, Passcode: 115140

Reasonable accommodations will be provided upon request for persons with disabilities. Auxiliary aids and services for individuals with disabilities and language services for individuals whose first language is not English may be provided upon request. Please notify John Barry at 303-866-3173 or John.R.Barry@state.co.us or the 504/ADA Coordinator at hcpf504ada@state.co.us at least one week prior to the meeting to make arrangements.