New Case Management Related Memos | |
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Find all memos on the Memo Series web page.
OM 24-069 Updates to the Buy-In Program for Children with Disabilities
Information regarding CBwD application process changes, corresponding CBMS updates, and available training.
OM 24-068 Home Modification, Vehicle Modification, and Assistive Technology Benefits Form Requirements
Implements required Google Forms for Home Modification, Vehicle Modification, and Assistive Technology requests.
OM 24-067 Supports Intensity Scale (SIS) Complaint Process Updates
Overview of the SIS complaint process, Support Level Review (SLR) disputes, SIS Reassessment changes, SIS Family Friendly Reports CSRs requirements, and SIS Interview recording options for Members.
OM 24-066 Monitoring Contacts in the Home and Community-Based Services Program
Overview of HCBS Member Monitoring Contacts and corresponding documentation requirements.
OM 24-063 Case Manager Process for Requesting a Department of Local Affairs-Community Access Team Housing Voucher for Supported Living Services Waiver Members
Overview of HCBS-SLS CAT Housing Voucher request process and HCBS-DD waitlist expectations for Members receiving a CAT housing Voucher.
OM 24-062 Protected Rights and Rights Modifications in the Home and Community-Based Services Program
Overview of HCBS Settings Final Rule requirements, Rights Modification process, and monitoring of Member rights.
OM 24-061 New Learning Management System for Home and Community-Based Service Providers: required Training Materials for Licensure, Provider Enrollment, Revalidation, Bast Practices, and Setting Rule
Information on updated, expanded, and required HCBS Provider Enrollment and Revalidation Training in the state LMS for Provider Agencies.
IM 24-035 Update on Long-Term Care and Buy-In Eligibility Extension
Provides updated financial termination process for LTC, WAwB, and CBwD Members.
IM 24-034 Supports Intensity Scale (SIS) Complaint Process Overview
Overview of the SIS complaint process, Support Level Review (SLR) disputes, and SIS Reassessment changes.
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Newly Promulgated Rules for Case Managers | |
Targeted Case Management Training Resources | |
Upcoming Required Training for Case Managers | |
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Wellness Education Benefit (WEB)
This Virtual Instructor Led Training (VILT) is about the WEB benefit and its availability to all HCBS waivers in May 2025.
Case managers will learn what the WEB is and why it was created. After attending this training they will be able to explain the benefits of the WEB to members and the community and complete the enrollment process for the service.
Registration is required for 1 of the 3 available sessions:
- Tuesday, Jan. 28, 2025, 10 to 11:30 a.m.
- Wednesday, Jan. 29, 2025, 2 to 3:30 p.m.
- Thursday, Jan. 30, 2025, noon to 1:30 p.m.
Register on Zoom
Children with Complex Healthcare Needs (CwCHN) Waiver
This Virtual Instructor Led Training (VILT) covers the new Children with Complex Health Needs (CwCHN) Waiver. Case managers will learn about why the CwCHN waiver is being created, the sunsetting of CHCBS and CLLI waivers, eligibility requirements, available services, the enrollment process and service planning for this waiver.
Registration is required for 1 of the 3 available sessions:
- Tuesday, Feb. 18, 2025, 10 to 11:30 a.m.
- Wednesday, Feb. 19, 2025, 2 to 3:30 p.m.
- Thursday, Feb. 20, 2025, noon to 1:30 p.m.
Register on Zoom
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Case Management News: Questions and Answers | |
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Q. Are ICD codes required to be provided on the PMIP form?
A. No, regardless of the LTC program, the ICD codes are not required to be provided by the treating medical professional completing the form and verifying the diagnoses documented on the form being used to support the eligibility determination for LTC and, in some cases, target group criteria for specific programs.
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Related Benefits & Services News | |
Resources for Identifying Group Employment Settings | |
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Operational Memo 24-050 informs Home and Community-Based Services (HCBS) Medicaid- Supported Employment provider agencies, case management agencies (CMAs), and members of an operational update regarding the standards for determining when to utilize Supported Employment - Group services for members in the HCBS Developmental Disabilities (DD) Waiver, the Supported Living Services (SLS) Waiver, and the State SLS program.
OM 24-050 defines group employment settings and highlights Job Coaching - Group as the most appropriate service in those settings. It also specifies that Job Coaching - Individual services must not be authorized to support jobs that meet group employment criteria after February 1, 2025. Additionally, OM 24-050 indicates that Workplace Assistance may be used for members with elevated supervision needs in group settings if the member/situation meets the authorization criteria for Workplace Assistance. See OM 24-050 for specific definitions, dates, and authorization instructions.
Several tools are available to case managers, Supported Employment Providers, members, and others.
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Group Employment Setting Guide and Tool - includes group employment service and setting descriptions and a series of questions to help determine whether a site meets the group employment setting criteria.
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Workplace Assistance Service Guide - includes a service description and outlines what is needed prior to authorizing the service. The target audience for this tool is case management staff.
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Workplace Assistance Authorization Request Tool - is to be completed by the Supported Employment provider to describe the member's job and situation. The tool should be shared with the member and their case manager. The case manager will determine whether Workplace Assistance is justified and will update their Person-Centered Support Plan as appropriate.
Contact Jenny Jordan for technical assistance and support.
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Upcoming CDASS & IHSS Q&A Open Forums | |
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Consumer Direct for Colorado is hosting a Case Manager Open Forum webinar in January 2025 to answer questions about IHSS and CDASS. The Financial Management Services (FMS) providers, PPL and Palco, and HCPF will be participating.
Please join us to ask questions about CDASS or IHSS and to learn about upcoming changes to the programs. You can submit your questions in advance when you register online.
Case Manager Q&A Open Forum
When: Jan. 21, 2025, from 10 to 11:30 a.m.
Register here
Consumer Direct for Colorado will also host a member and Authorized Representative open forum event in February 2025. Please share this invite and information with the members or Authorized Representatives in your network.
Member and Authorized Representative Q&A Open Forum
When: Feb. 12, 2025, from 1 - 2:30 p.m.
Register here
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Operational Memo 25-002 informs Case Management Agencies (CMAs), Home and Community-Based Services (HCBS) members, their families, and other interested stakeholders of the forthcoming implementation of At-Risk Diversion, outreach to HCBS members who may be most at-risk of nursing facility admission and to provide CMAs the operational guidance necessary to implement At-Risk Diversion. This memo outlines CMA roles and responsibilities, clarification on outreach, and documentation requirements. The CMAs should be prepared to operationalize by Jan. 31, 2025, and the initial list will be provided soon after, and it will consist of approximately 250 members statewide. The target date for the initial list distribution is March 2025 (subject to change).
HCPF has developed a statistical model to prospectively identify HCBS members who may need nursing facility care in the near future. The HCPF LTSS website will provide further details on the methodology.
Office hours will be scheduled to provide case managers with an opportunity to ask questions, provide feedback, and seek out assistance. Case managers are encouraged but not required to attend office hours.
Starting in February 2025, office hours will occur on the third Tuesday of each month from 2 to 3 PM.
At Risk Diversion Office Hours
When: Feb. 18, 2025, March 18, 2025, and April 15, 2025, from 2 to 3 p.m.
Join with Google Meet
Or join by phone: (US) +1 256-567-4801
PIN: 600 066 368#
There will be a future training scheduled for additional information and documentation/deliverable compliance.
Please send any email via email to hcpf_clo_inreach@state.co.us.
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Working Adults with Disabilities Stakeholder Meeting Announcement & Invitation | |
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The Health First Colorado Buy-In Program for Working Adults with Disabilities allows adults with a qualifying disability to "buy into" Health First Colorado. Members who work and earn too much to qualify for Health First Colorado may qualify for the Buy-In Program. Interested stakeholders are invited to one of two virtual stakeholder meetings to learn about updates being made to the Working Adults with Disabilities Buy-In Program effective July 1, 2025.
Staff from HCPF will present an overview at these meetings of the changes being made to how Health First Colorado members enroll into the Working Adults with Disabilities Buy-In Program. These changes will specifically impact Health First Colorado members who also receive services through Home and Community-Based Services (HCBS) waivers. Attendees are invited to learn and ask questions about the upcoming changes. These two meetings are identical and therefore attendees only need to choose the meeting date and time that best fits their schedule.
Meeting date and time: Feb. 20, 11:00 a.m. to noon. and March 13, 1:00 to 2:00 p.m.
Registration and location: these meetings will be virtual via Zoom. Register in advance for the meetings.
Attendees will receive a confirmation email after registering with information about joining the webinar.
A recording of the meeting may be requested by sending an email.
Refer to the Health First Colorado Buy-In Program For Working Adults With Disabilities web page for more information about the Health First Colorado Buy-In Program for Working Adults with Disabilities.
Meeting Accommodation and Language Access Notice: Auxiliary aids and services for individuals with disabilities and language services for individuals whose first language is not English may be provided upon request. Contact Kyra Acuna at HCPF_stakeholders@state.co.us at least one week prior to the meeting to make arrangements.
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Adult and Pediatric Long-Term Home Health (LTHH) PAR Updates | |
Adult LTHH PAR Process Changes
Effective Oct.14, 2024, Acentra Health, the Utilization Management (UM) Vendor for HCPF, began processing Long-Term Home Health (LTHH) Prior Authorizations (PARs) for Health First Colorado adult members aged 21 and older. Operational Memo HCPF OM 24-049, distributed on Oct. 3, 2024, outlines the updated process and responsibilities for agencies. An updated FAQ addressing common questions from Case Management Agencies (CMAs) and Home Health Agencies (HHAs) is now available on the Home Health website.
Pediatric LTHH PAR Implementation
HCPF will reimplement PAR requirements for Pediatric LTHH therapy services beginning Feb. 3, 2025, with a Soft Launch, followed by a Go-Live phase for Physical Therapy (PT), Occupational Therapy (OT), and Speech Therapy/Speech-Language Pathology (ST/SLP). PAR submissions for Registered Nursing (RN) and Certified Nursing Assistant (CNA) services will Go-Live on July 1, 2025.
While no immediate action is required from CMAs, please note that members on the Children's Extensive Support (CES), Children with Life Limiting Illness (CLLI), Children’s Habilitation Residential Program (CHRP) and Children's Home and Community-Based Services (CHCBS) waivers may be affected. If supplemental documentation (485/Plan of Care, Home Exercise Program, or other requested items) is needed for members receiving LTHH services, CMs should contact the home health agency directly. If the agency does not respond or provide the necessary information, contact the Home Health Inbox for assistance. Further details will be available in Operational Memo HCPF-OM 24-060.
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