Jan. 5, 2021
At a Glance is a Department of Health Care Policy & Financing (Department) publication that provides information on major initiatives, policy changes and program updates. Feel free to share At a Glance with your colleagues. Find previous editions of At a Glance on the Department website at colorado.gov/hcpf/publications. Thank you for your interest!
A Message from the Executive Director
Stakeholders, Advocates and Partners:

The staff and leadership of the Department of Health Care Policy & Financing is filled with hope for 2021! We invite you to stay aligned with many of the Department’s key initiatives intended to support the members we serve, our safety net programs, Colorado families and Colorado employers as well. Together, we can be the change in the world we wish to see and help Coloradans rise and shine through the end of this pandemic.

First, we are excited about the distribution of COVID-19 vaccines. If you need clarification as to where you and your community are placed in the distribution plan, the graphic below will provide helpful insights. Concurrent with this distribution, we will continue to collaborate with providers and our partners in public health to do our part in managing the COVID-19 pandemic while providing clear messaging to protect the health and well-being of our members and all Coloradans. So, please continue to help us message about the importance of “masking up,” social distancing and following public safety guidance until all Coloradans are vaccinated.
With the economic downturn, many Coloradans have lost their jobs and, with that, their employer-sponsored health coverage. Accordingly, the Department will continue to connect these individuals and families to affordable health insurance coverage through Health First Colorado (Colorado’s Medicaid program), Child Health Plan Plus (CHP+) and Connect for Health Colorado commercial insurance offerings. Thank you to all the stakeholders who are engaging with us to battle the rising uninsured rate and keep Coloradans covered through this pandemic.

On Jan. 7, the Department has its Joint Budget Committee (JBC) Hearing. In one aggregated review, we will address key issues and answer submitted JBC questions on HCPF’s Office of Community Living, Behavioral Health services and all other topics usually covered in the Executive Director hearing. Due to the economic impact of COVID-19, the Department is covering more Coloradans than ever -- more than 1.4 million, representing almost 1 in every 4 Coloradans. Given that, it is no surprise that the Governor’s budget for 2021-2022 indicates that the Department will consume 29% of the state’s general fund and 35% of total state funds.

Given our share of the state’s budget, the state’s fiscal challenges and the continued rising cost of health care, the Department will maintain its focus on health care affordability strategies and initiatives. Our goals are to help protect our programs, cover all Coloradans who need us, efficiently use state resources and lead collaborative efforts with the commercial industry to drive affordability innovations and strategies that also benefit Colorado employers and Colorado families -- we are all battling the same challenges and can produce better results through collaboration. Look for a new Department health care affordability website that includes a toolkit of resources available to help communities control costs to the benefit of Medicaid, CHP+, Colorado families and our employers. Also look for a new Prescription Drug report that outlines the cost drivers and possible solutions to control them. Both of these tools will be released and discussed during our Jan. 12 Health Policy Summit, brought to you by HCPF and the Governor’s Health Cabinet. You can review the event agenda and register online. We invite you to join the more than 1,300 individuals who have already registered for this important event.

The Department has been and will continue to be an active leader in the Behavioral Health Task Force blueprint and priorities implementation. Related and beginning Jan. 1, HCPF expanded the Medicaid substance use disorder (SUD) benefit to include inpatient and residential treatment. This addition will complete a full continuum of substance use disorder services offered to Medicaid members, enabling the Department to better respond to the increasing overall demand for behavioral health services.

COVID-19 has not just increased demands for substance use disorder and behavioral health services; it has also exacerbated pervasive health care disparities. We invite your partnership as the Department identifies and shines a light on opportunities to address and close these disparities with the goal of better serving all Coloradans.

Our Department experts will also be engaging with the current and incoming federal administration to manage through the Public Health Emergency, which is currently scheduled to end on Jan. 20. Based on emerging insights, we are confident the PHE will be extended; however, we do not have that in writing yet and are working to secure that assurance. We will also be sharing evolving federal policy priorities emerging from the new administration and their impact to the Department, our programs, our members and all Coloradans. Look for more communications on that opportunity in the coming months.

Through this unique chapter and this calendar year, Department staff and leadership will continue to leverage our strengths, health care expertise and insights to the benefit of those we serve and all Coloradans. There is a bright light on the horizon with the vaccine now in the distribution stage. We are grateful to have your partnership on all the above work toward a better, hope-filled tomorrow. Rise and shine, Colorado! Rise and shine!

Kim Bimestefer
Executive Director
Breaking News
Substance Use Disorder Benefit Expansion:
Beginning Jan. 1, 2021, Health First Colorado is adding coverage for residential treatment, inpatient treatment and medical withdrawal management services for substance use disorder (SUD). With this addition, the full continuum of SUD care will be covered for our members.
 
For more information about this benefit expansion, including an FAQ and SUD Provider Manual, visit our webpage, or email questions to hcpf_sudbenefits@state.co.us.  
Provider Interim Payments:
The Department is now offering a second round of Interim Payments to help stabilize Colorado’s small and medium primary care providers. The payments preserve access to care in communities across the state during COVID-19.

Through a unique public-private partnership with five local Colorado health foundations, eligible providers receive a lump sum interim payment that totals their 4th Quarter 2019 Health First Colorado revenue. Thanks to funding from Caring for Colorado, The Colorado Health Foundation, Delta Dental of Colorado Foundation, Rocky Mountain Health Foundation and Rose Community Foundation, half of the interim payment will not need to be repaid by providers. The other half of the interim payment is funded by the federal government and will need to be repaid. Providers will have close to a year to repay half of the interim payment, with a 0% interest rate.

The application is online. Application period: Dec. 28, 2020 through Jan. 18, 2021.

For more information, visit our website.
Mobile App Helps Fight COVID-19:
You can now download an app to help fight COVID-19, slow its spread, and protect yourself and your loved ones. CO Exposure Notifications will quickly notify you if you’ve likely been exposed to the virus, allowing you to seek timely medical attention and take action to protect others. 

The app is free and does not share your personal information. It can alert you if you have been exposed to COVID-19 in the last 14 days. Visit AddYourPhone.com to watch a short video about how it works and how to turn it on with Apple or Android devices.
Here for YOU, Colorado!
We have created educational materials and resources on our webpage, Here for YOU, Colorado! This page contains shareable content for websites, social media, emails and newsletters. The goal of our Here for YOU, Colorado! campaign is to spread the word about applying for Health First Colorado (Colorado’s Medicaid program) and Child Health Plan Plus (CHP+). 

We also have fresh content monthly featuring Coloradans who get their health care coverage through our programs, under “Ads” in the "For Coloradans Who Need Health Insurance" section of the webpage. December's ad features Colorado kids.

Thank you for helping us spread the word!
New Resource Limits:
Resource limits for Qualified Medicare Beneficiaries (QMB), Specified Low Income Medicare Beneficiaries (SLMB), Qualified Individuals (QI-1) and Low-Income Subsidy (LIS) resource limits have increased.

Cost of Living Adjustment Increase:
Monthly Social Security Administration (SSA) and Supplemental Security Income (SSI) benefits will increase due to a Cost Of Living Adjustment (COLA) in 2021.

For more information, please read the memo: 2021 Social Security Cost of Living Adjustments.
Member Video Toolkit:
Even Coloradans who never thought they'd need public health insurance are being served by Health First Colorado (Colorado's Medicaid program).

Following a traumatic brain injury, Mike received life-saving care at no cost thanks to Health First Colorado. Watch Mike’s story and listen to Health First Colorado members tell in their own words how Health First Colorado was there to help. Other Health First Colorado members want Coloradans to know that they may qualify for quality health care coverage. Most Coloradans who apply online learn immediately whether they qualify. 

Please help us spread our message by sharing videos where real members tell their stories about getting quality health care through Health First Colorado. It's easy to share! Just visit our member video toolkit to find copy-and-paste messaging and videos to upload to your social media channels.
ConnectToCareJobs.com Update:
The State of Colorado, led by the Department and in collaboration with Advancing States, is launching its latest update to ConnectToCareJobs.com

This release will open the site to home care and home health providers. The website is dedicated to matching long-term care providers with direct care workers and other medical professionals seeking jobs. Watch your news feeds for this exciting release in late October to early November!

For more information, visit the Connect to Care Jobs website.
Operational Excellence
Home and Community-Based Services (HCBS) Settings Final Rule Open Meeting Reminder:
As previously mentioned, Colorado continues to work toward statewide compliance with the federal HCBS settings final rule. To that end, the Department has been hosting a series of open, informal stakeholder meetings to discuss the draft rule that will codify within Colorado regulations the requirements of the federal rule, as well as other materials. In the last At a Glance issue, the Department noted that all are welcome at the next meeting, which will be held on a remote-only basis on Jan. 13, 2021, from noon to 1:30 p.m. 
 
New information about how to join this meeting: 
Click the link above to join the meeting. For audio, you may listen through your computer or dial 720-279-0026 or 1-877-820-7831 and enter participant code 982280.

To receive emails about this and possible future meetings, along with updated materials for discussion, and to submit comments, please email us at hcpf_STP.PublicComment@state.co.us
 
For more information, see HCPF IM 20-034 and the attachments on the Memo Series webpage.
Direct Care Workforce Collaborative Starts in January:
The Direct Care Workforce Collaborative is a stakeholder-led group with support from the interagency Direct Care Workforce Group. The Collaborative was formed to help identify and elevate priority issues affecting the workforce. The group will be run by non-state staff who will help develop agendas, lead discussions, form partnerships, and receive reports and recommendations based on the priorities of the workgroups.

The goal of the Collaborative is to implement strategies that support their priorities, raise awareness, and ultimately stabilize the direct care workforce. The first meeting is on Jan. 13, 2021, and it is open for everyone to attend. Attendees will have the opportunity to take a deeper dive into the challenges, priorities, and solutions that we discussed at the Direct Care Worker Summit this past October. We hope to see you there!

How to participate:
Wednesday, Jan. 13, 2021
10 - 11:30 a.m.
Local: 720-279-0026
Toll Free: 1-877-820-7831
Participant Code: 982280#

For more information, email us at HCPF_DCWorkforce@state.co.us or visit our webpage.
Prescriber Tool Project:
The Department is implementing the Prescriber Tool, a multifunctional platform that will be accessible to all prescribers through most electronic health record (EHR) systems. The Prescriber Tool will help improve health outcomes, reduce administrative burden for prescribers and better manage prescription drug costs by providing patient-specific information to prescribers at the point of care. 

The Prescriber Tool is being implemented in modules which will provide different types of patient information or functionalities. 

Opioid Risk Module
The opioid risk module will be implemented first and is anticipated to be operational in January 2021. OpiSafe has been contracted to administer this module which will help prescribers prevent the misuse and abuse of opioids and benzodiazepines. The module will provide:
  • Easy access to Prescription Drug Monitoring Program (PDMP) data 
  • Identification of Opioid Use Disorders (OUD)
  • Educational tools with access to evidence-based treatment
  • Tools for overdose prevention

Additional modules are expected to be implemented by summer 2021, including a module that will provide real-time, patient-specific pharmacy benefit information. 

Open Access License Program
In order to access the opioid risk module, each prescriber must have an individual license. To facilitate rapid adoption of the module, the Department will be awarding a limited number of user licenses free of charge to qualified Health First Colorado prescribers. The subsidized license will be valid for one year, thereafter prescribers will need to pay an annual license fee to OpiSafe. Please note, the Department is unable to assist with any EHR-related costs (if applicable) for accessing the opioid risk module.

The online application for the Open Access License Program will be available from Jan. 2 through March 1, 2021, or until all subsidized licenses have been awarded.
  
Once operational, the cost to prescribers for accessing the Prescriber Tool will vary depending on the specific module(s) and EHR utilized. Visit the Prescriber Tool Project webpage to apply for a user license, or for more information about the Prescriber Tool project.

For more information, email hcpf_Colorado.SMAC@state.co.us. 
Transitions Stakeholder Advisory Council Date Change:
The Department invites all interested stakeholders to become involved and provide input on the future of transition services by participating in meetings of the Transitions Stakeholder Advisory Council.
 
The council provides feedback and recommendations to the Department regarding operational policy and procedural changes to transition services, including identifying barriers to successful transitions and potential solutions. All council meetings are open to the public with dedicated time each meeting for public comment regarding transition services. The council meets on the first Thursday of every month, 2:30 p.m. - 4:30 p.m.

DATE CHANGE: For the January 2021 meeting, the Council will meet Jan. 14.
 
Transitions Stakeholders Advisory Council Virtual/Phone Meeting Only 
Thursday, Jan. 14
2:30 p.m. - 4:30 p.m. MT 
Join by Google Meets:
or by phone:
(470) 268-2030
PIN: 614 405 288 #
January Meeting Discussion Topic:
Housing: This month's meeting will focus on discussing barriers to housing during the transition process and will include brief presentations from Department staff, Division of Housing, and a contracted housing navigation provider.
 
Transitions Stakeholder Advisory Council Webpage:
Please check the Transitions Stakeholder Advisory Council webpage to access the agenda and presentation slides for the January meeting. Previous meeting minutes and agendas are also available.
Care and Case Management System Implementation Update:
The design, development and implementation of a new care and case management system is underway. This new system is intended to replace the BUS, Bridge and DDDWeb, and will include the new long-term services and supports level of care (LTSS LOC) eligibility determination, Home & Community-Based Services (HCBS) assessment and person-centered support plan. The new system is scheduled to go live in July 2021.

Gainwell Technologies (formerly DXC Technology) will be using MedCompass ®, a configurable care management platform product of AssureCare®, to customize the new Care and Case Management system to Colorado’s unique needs. The new system will help streamline processes and increase efficiency for case managers and members in Colorado.

Case managers and all interested stakeholders can sign up to join our mailing list for our Case Manager's Corner newsletter. We will use this newsletter to provide monthly updates about implementation of these systems and other developments. Visit our newsletter sign-up webpage, fill in your information and select the “Case Manager’s Corner” mailing list.
Health Care Affordability
Hospital Transformation Program (HTP) Update:
HTP Implementation Update
As a state and nation, we are witnessing the novel coronavirus disease (COVID-19) pandemic continue to worsen and hit unprecedented levels while having major impacts on our communities and hospitals. On Nov. 20, Executive Director Kim Bimestefer authorized the decision to move the start date for the HTP from Feb. 1, 2021 to April 1, 2021. This is part of the Department’s continued effort to support our hospitals during this crisis and our commitment to set the HTP up for success. Additional details and updated program timelines will be shared through the HTP listserv. To be added to this listserv, please contact Courtney Ronner.

Rural Support Payment Update
The Rural Support Payment is an integral part of the HTP that will aid in making the concepts of HTP operations a reality for many rural hospitals. Total funding available is $12,000,000 per year for five years, beginning with federal fiscal year (FFY) 2020-21. On Dec. 3, additional information was shared with program participants and stakeholders, including a list of qualified hospitals. 
  
Link to HTP Refresher Training
An HTP Refresher training took place on Tuesday, Nov. 10. The training was recorded and posted on the HTP website under “Tools & Resources.”
 
HTP Community Advisory Council
Community Advisory Council meetings continue to take place monthly, with the most recent meeting taking place on Monday, Nov. 16. The agenda, meeting materials and previous meeting notes are on the HTP Community Advisory Council website.

If you'd like to know more about the HTP, visit the HTP website and read past editions of the HTP Newsletter in our online archives.

For more information about HTP, contact Courtney Ronner.
Helpful Resources
Female provider, kneeling next to parents holding small child.
Enrollment
In November 2020, there were
1,384,219 Coloradans enrolled in Health First Colorado and
68,189 enrolled in Child Health Plan Plus.