October 30, 2020
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 Other Partners:

As we move into the fall season, I want to remind you of the important role you all play in helping us address the pandemic for the betterment of all Coloradans. I appreciate all you do to help set the right example in your community. Wearing a mask and practicing social distancing are proven actions we can all take to reduce COVID-19 spread and save lives – protecting both our care givers and the Coloradans we serve. 

November and December will bring additional challenges. Thanksgiving and the coming year end holidays traditionally bring friends and families together. This year will be different as we continue to make intention plans that protect one another. I invite you, as leaders in your community, to join in the Step Up campaign by sharing on social media the ways we are stepping up together to battle the pandemic. The website has examples of posts you can share to help. Thank you for your resilience, and thank you for your leadership and partnership during this truly historic and challenging chapter.

Concurrent with our efforts to battle the COVID-19 spread, we are actively monitoring the election results, emerging and related health policies, and the Supreme Court hearing on the Affordable Care Act. Through all this uncertainty, our goal is to stand firm to protect the healthcare gains we have made and continue to address persistent and emerging challenges. 

The ACA’s Medicaid expansion provision – and Colorado’s decision to maximize that opportunity – brought needed and affordable coverage to hundreds of thousands of Coloradans. With the economic downturn, even more Coloradans are turning to Medicaid. We are welcoming new members and outreaching to others to help connect them to our coverage programs, which is critical during the COVID-19 pandemic. The ACA also brought subsidies to improve the affordability of private insurance for those with incomes below 400% of the poverty level. It provided accessible coverage for young adults up to age 26 and created nondiscrimination provisions. As importantly, it created new protections for those with preexisting conditions, enabling many to gain access to coverage that was impossible before the ACA. Overall, the ACA has transformed our health care system and significantly reduced our uninsured rate here in Colorado and across the country.

While we have made gains together, we know work remains to improve affordability through new solutions and policies, especially in the area of rising prescription drug costs. We also have a host of work to do to close health care disparities, which have been further exacerbated by the pandemic. In this spirit, we invite you to join us in our quest to make a Colorado that Works for All of Us – A Colorado for All

Through these uncertain times, a global pandemic, and an economic downturn, our Department and our passionate staff will continue to work hard to protect and serve our growing members – soon to exceed 1.4 million. Our members are an inspiration, and it is our honor to serve them each day. (Watch Mike’s story.)

Thank you for your leadership and partnership through these uncertain times.
Breaking News
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. October's featured member is Samantha.

Thank you for helping us spread the word!
New Phone Number for Health First Colorado Working Adults and Children with Disabilities Buy-In Program Members:
The Health First Colorado Working Adults and Children with Disabilities Buy-In Programs now have a direct number for member questions about eligibility, premiums, and status: 1-800-711-6994. Please use this number for any Buy-In questions or concerns.
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.
Resources for Coloradans Impacted by COVID-19:
Onwardco.org can help connect Coloradans with services, funds and jobs during the COVID-19 pandemic. This resource is the result of collaboration with the Governor's Office, state agencies, community partners and Bitwise Industries. Please visit the website and share with anyone who is struggling, or may need the help: Onwardco.org.  
Voting in Residential Care Settings: 
Voting is an important issue for all Americans, and residents in residential care settings are no different. With the November presidential election on the horizon, the Residential Care Strike Team is working with key stakeholders, including members of the Clerk of Courts, to ensure that residents have access to education and voting assistance. The Clerk of Courts report that they will work with residential care facilities to ensure voting access and that COVID-19 precautions will not restrict their ability to provide outreach to residents. Please check the Residential Care Strike Team Website for resources, including those listed in this communication.
Disability Law Colorado: Voting Rights 
Voting Rights in Long-Term Care Facilities
Conducting Elections During a Public Health Emergency https://www.sos.state.co.us/pubs/rule_making/CurrentRules/8CCR1505-1/Rule27.pdf
Health and Safety Guidance for the November 3, 2020 General Election
Full Listing of All County Clerks in Colorado 
Income Verification Time Frame Changing in Spring 2021:
The Department is changing the time frame in which we will verify a Health First Colorado or CHP+ applicant's income, also known as the Reasonable Opportunity Period, or ROP. Beginning in Spring 2021, we are narrowing the ROP from 90 to 30 calendar days for a member to provide verification for an income discrepancy, when requested.

This change is based on member feedback that this time frame reduces confusion because it better aligns with other timelines in the eligibility process. In addition, we are excited to upgrade to a more timely income verification process that pulls from multiple database sources. We hope this will help us verify income automatically without needing to request additional proof of income from applicants.

For more information, email hcpf_medicaid.eligibility@state.co.us.
Member Health
Bundled Payment Program Focuses on Maternal Care:
Rising perinatal mortality rates in the U.S. concern health care providers, public health officials and policymakers. In Colorado specifically, the mortality rate was 47.4 per 100,000 live births during 2016. Since more than 45% of babies born in Colorado during 2018 were born to mothers enrolled in Medicaid, the state is keen on identifying innovative solutions to reduce maternal mortality rates. One approach is the Department’s Maternity Bundled Payment Program launching Nov. 1.  
The Department partnered with a diverse group of stakeholders to design a bundled payment focused on perinatal care. Bundled payments involve giving obstetric care providers a single, comprehensive payment covering services within an episode of care such as a pregnancy and birth. The program promotes collaboration between providers to improve the quality and coordination of care for the patient and their baby. Participating providers get shared savings when an episode stays in the designated threshold and quality goals are met.

For more information, read the program overview or contact Trevor Abeyta, program lead, to participate.  
Operational Excellence
Home & Community Based Services (HCBS) Settings Final Rule Update:
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
  • An informed consent template with built-in guidance for providers and case managers
For more information, see HCPF IM 20-034 and the attachments on the Memo Series site

All are welcome at the next meeting, which will be held on a remote-only basis:
November 18, 2020, 1 – 2:30 p.m.
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 about the statewide implementation schedule, including how Colorado is working with providers affected by the COVID-19 pandemic, please see HCPF IM 20-040 and the attached milestone schedule on the Memo Series site.
The Return Mail Project:
Member correspondence that is returned must be processed in the Colorado Benefits Management System (CBMS) eligibility system. This process is to ensure cases are updated with the correct contact information to ensure members receive important correspondence in a timely manner. Each county was responsible to process each piece of returned mail, which led to an unmanageable level of work and cases not being updated. When returned mail is not prioritized and processed, it causes an increase of cost and incorrect case information.
The Department has decided to consolidate the return mail processing under one central location, rather than by individual counties. The Return Mail contractor will streamline the existing process by increasing the accuracy of member contact information, decreasing the volume and costs of returned mail, decreasing county workload, and improving timely processing of returned mail, as well as county accountability and performance.  
The Department has a contract with Prowers County. This contract will allow Prowers County to create a Consolidated Return Mail Center; Prowers county will be responsible for all returned mail for the State of Colorado.
The Return Mail project will go out in two phases. Phase 1 will only include Medical Assistance cases. Phase 1 will begin with a pilot to include Prowers, Montrose and El Paso counties starting in November 2020. A full implementation of Medical Assistance only cases will begin early 2021.
Phase 2 will include CDHS programs and combo cases. Phase 2 is scheduled for spring 2021.
For more information, contact Monie Mangus via email or at 303-866-4221.
Transitions Stakeholder Advisory Council:
Transition Services support Health First Colorado members who qualify to live effectively in their communities, including people who want to move out of a long-term care facility.
This month's meeting will focus on education, training, and public awareness of the Transition Services program as well as barriers to transportation and its effect on Health First Colorado members successfully transitioning to and living in the community.
Transitions Stakeholder Advisory Council October Meeting 
November 5, 2020 from 2:30 - 4:30 p.m.
Join by phone: 470-268-2030‬ PIN: ‪614 405 288‬#
Home and Community-Based Services Person-Centered Budget Algorithm:
The Department is working to develop a Person-Centered Budget Algorithm (PCBA) for Health First Colorado Home and Community-Based Services (HCBS) waiver programs.

In collaboration with stakeholders, the Department has developed new processes for eligibility determinations, needs assessments, and support planning for all individuals seeking or receiving HCBS. As part of the new assessment and person-centered support planning process, the PCBA will help identify the right amount of support for members based on assessed need, and together with strengths and preferences identified during the assessment, contribute to a person-centered support plan. The PCBA is an important component of the assessment and support planning process to ensure a consistent method for assigning budgets for all members receiving HCBS.
The Department recognizes that transparency and stakeholder feedback are essential components of the process to develop a PCBA. The second series of statewide meetings is on November 16. Morning and afternoon sessions will be held to accommodate as many stakeholders as possible. Both sessions will contain identical content. 
Date and Times: Monday, November 16, 2020 at 9:30 - 11 a.m. AND 5 - 6:30 p.m.
Call-In: Local 720-279-0026 / Toll Free 1-877-820-7831; Participant Code: 982280#
Helpful Resources
Female provider, kneeling next to parents holding small child.
In September 2020, there were
1,340,803 Coloradans enrolled in Health First Colorado and
71,174 enrolled in Child Health Plan Plus.