Understanding HCPF Resource Needs & Protecting Our Children 

HCPF’s budget hearing is scheduled for Dec. 21, all day. Thank you in advance for your support of our $14.9B total funds and $4.43B General Fund request, 96% of which goes to our valued providers to help provide care to the one in four Coloradans we are honored to serve. Four percent of these funds are allocated to administration expenses, such as our incredible, dedicated staff and our valued, contracted partners to help us meet the needs of our members. You can find more information on HCPF’s budget at CO.gov/HCPF/legislator-resource-center.  

Together, Health First Colorado (Colorado’s Medicaid program) and Child Health Plan Plus (CHP+) cover more than 40% of children and more than 40% of births in the state. The number of children we cover in Health First Colorado is up by almost one-third since the start of the pandemic. Thank you to our hospitals and all medical providers, who are simultaneously responding to an especially challenging RSV season, the flu and COVID-19. Vaccination is the best way to protect children from these and other preventable infections. Consider the below actions you can take to help us achieve shared goals. 

1. Please promote flu and COVID-19 vaccines, with specific focus on the omicron booster as well as all routine childhood and adolescent immunizations. You can use the resources in these CDPHE toolkits on flu, COVID-19 and RSV and childhood and adolescent immunizations. Everyone 5 and older who has completed a COVID-19 primary vaccine series should get an omicron vaccine to increase their protection against the variants circulating in Colorado right now. And please leverage every opportunity when a patient is in front of you to discuss the importance of vaccination; even if someone said “no” before, they may say “yes” this time or be more open to the conversation. They may also not know they are due for a vaccine or booster. 
2. Provider leadership, please encourage your providers and staff to get their flu and COVID-19 shots.  

Health First Colorado & CHP+ cover the full cost of all vaccines for members. Additional information on flu vaccines is at fluvaxcolorado.org. Learn more about COVID-19 vaccines and boosters and where to find them. Those who need help making a vaccine appointment should call 1-877-268-2926. Health First Colorado members who need help finding a ride to a vaccine appointment can use the Non-Emergent Medical Transportation benefit. Also, as you know, HB22-1401, which was effective Sept. 1, 2022, requires health facilities and their owned PCPs to meet patient needs, including for vaccination and testing.  

This influx of patients with RSV, flu and COVID-19 is also adding to the already strained health care workforce, especially for the hospitals and pediatricians who treat children. Thank you in advance for your assistance on the above initiatives, which not only protect Colorado children, but also support our health care delivery system. In complement, we ask for your partnership in growing our health care workforce as well as the child care workforce (which helps women get back into the workforce), by printing and displaying these time-limited training opportunity communications in patient waiting rooms, exam rooms, and areas of your business operations frequented by Coloradans: hfcgo.com/assistance. Additionally, CDPHE's Healthcare Workers Recruitment and Re-engagement Fund supports the re-entry of health care professionals back into the workforce. Please visit the website for more information.  

Thank you for your continued partnership in helping us cover and care for low-income Coloradans and people with disabilities, and best wishes to you and yours for a healthy, safe, and inspiring holiday season!  

Pending Supervisory Authorization 

The purpose of this communication is to advise eligibility sites of the Pending Supervisory Authorization Memo being released. 

The Department is notifying eligibility site (county departments of human/social services, medical assistance, and eligibility application partner sites) staff that when a case is put into a pending status for “Supervisory Authorization Required,” the Colorado Benefits Management System (CBMS) will set a calendar day count to clear the Supervisory Authorization status when the case is pending for 90 days unless there are additional exception reasons preventing authorization.

Effective Dec. 12, 2022, if a medical assistance (MA) program is pending for “Supervisory Authorization Required” for 90 calendar days, the Colorado Benefits Management System (CBMS) will automatically run Eligibility Determination Benefit Calculation (EDBC) and authorize the MA program. The new batch process will run daily, which will minimize the number of cases that have historically pended indefinitely for Supervisory Authorization.

View the memo: Pending Supervisory Authorization 

Contact: If you need additional information or have questions regarding the memo, please contact HCPF Medicaid Eligibility. 

2023 Social Security Cost of Living Adjustments (COLA) 

The purpose of this memo is to advise eligibility sites of the 2023 Social Security Cost of Living Adjustments (COLA). Please share this memo with all affected adult and long-term care Medicaid eligibility staff, supervisors, and outside agencies, as appropriate. 

Monthly Social Security and Supplemental Security Income benefits will increase due to a COLA of 8.7% in 2023. The purpose of the COLA is to ensure that the purchasing power of Social Security and Supplemental Security Income (SSI) benefits is not eroded by inflation. It is based on the percentage increase in the Consumer Price Index for urban wage earners and clerical workers from the third quarter of the last year's COLA to the current year's third quarter. 

The 300% income limit, home equity maximum, minimum monthly maintenance needs allowance maximum, and community spouse resource allowance will increase. The Medicare Part B premium will also increase. 

Beginning Jan. 1, 2023, the Medicare Nursing Facility Co-Insurance rate and the Income Trust Gross Income Limits and Average Nursing Facility Private Pay rates will change. Additionally, the Personal Needs Allowance (PNA) base amount for residents of nursing and intermediate care facilities will increase by 3%, setting the 2023 PNA base amount at $95.97.

Read the 2023 Social Security Cost of Living Adjustment Cola Memo. Please share this memo with all affected medical assistance eligibility staff, supervisors, and outside agencies, as appropriate. 

Questions regarding this communication may be directed to [email protected].

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Department Annual Report

The Department's Annual Report to the Community is now available. This report illustrates the many ways we serve Coloradans every day. We invite you to review it and celebrate all that we accomplished together this past year.

Translations of Member Outreach Posters Now Available!

The Spanish version of the Member Assistance Opportunities posters and screensavers are now in our Toolkits for Partners Google folder.

ACC Phase III Stakeholder Engagement

The Department created the Accountable Care Collaborative (ACC) in 2011 to deliver cost-effective, quality health care services to its Health First Colorado members and to improve the health of Coloradans. The ACC features Regional Accountable Entities (RAEs) operating in seven regions.

Current contracts between the Department and the RAEs will end on June 30, 2025. The Department has developed goals and priority areas for improvement and innovation intended to better align with our modernized mission, advances made by our sister agencies, and stakeholder input received over the past several years. Additional information is available on the ACC Phase III webpage and in a fact sheet available on the webpage.

The Department, in partnership with the Colorado Health Institute (CHI), is pleased to be collaborating with stakeholders to discuss the vision for this next phase, referred to as Phase III. We are committed to receiving input from diverse perspectives through accessible, equitable, and productive engagement.

Dates are set for the first two Listening Sessions. We invite you to join us! Both sessions will feature the same agenda, so choose the meeting that is most convenient for your schedule. These sessions will take place virtually and will feature interpretation services.

• Dec. 20: ACC Listening Session #1 (12-1:30 p.m.)
• Jan. 10: ACC Listening Session #2 (6-7:30 p.m.)

An agenda and registration link for the Listening Sessions will be available in the coming days. Look for additional opportunities to engage over the next three months, including a public survey and other avenues to provide written feedback. Details will be available on the ACC Phase III webpage and shared in future newsletters.

Behavioral Health Secure Transportation Stakeholder Engagement

The Department of Health Care Policy & Financing (HCPF) is hosting the next virtual stakeholder meeting to specifically address behavioral health secure transportation on Tuesday, Jan. 17, from 4-5 p.m. (zoom registration link below). We will collaborate with the Behavioral Health Administration (BHA) and Colorado Department of Public Health & Environment (CDPHE) to present updates to this new benefit and solicit feedback on implementation concerns. This meeting will focus on the topic of CDPHE data collection requirements.

Behavioral health secure transportation is legislatively mandated by HB 21-1085 and the Colorado Department of Public Health & Environmental (CDPHE) has written standards in 6 CCR 1011-4. This meeting continues the stakeholder process for Medicaid reimbursement for behavioral health secure transportation. Behavioral health secure transportation will be paid as a benefit no later than July 1, 2023.  

Zoom webinar.

When: Jan. 17, 2023, 4-5 p.m. Mountain Time (US and Canada)

Register in advance for this webinar

After registering, you will receive a confirmation email containing information about joining the webinar.

HCPF is collating a list of county contacts who are responsible for licensing and permitting of BHST for their respective jurisdiction, so feel free to email Meghan Morrissey to contribute that information.

Thank you for your continued engagement.

_______________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. Please notify the Meghan Morrissey, Kelly O'Brien, or the 504/ADA Coordinator at [email protected], at least one week prior to the meeting to make arrangements.

Open Enrollment Has Begun

Open Enrollment for health insurance has begun! This year’s Open Enrollment

period began on Nov. 1, 2022, and ends on Jan. 15, 2023. Thanks to the

Inflation Reduction Act, there continue to be more savings for more people. See how much financial help you qualify for and review plans before enrolling by using our Quick Cost Plan Finder Tool.

Exciting New Health Insurance Option for Coloradans Who Are Undocumented

OmniSalud is a new health insurance program that provides Coloradans who are

undocumented with a safe way to compare affordable health insurance plans and sign

up on a secure online platform. Thanks to a new Colorado law passed in 2021, every

company that sells health insurance in the state has to offer plans with a specific set of

lower, fixed costs and make them available to everyone – no matter their

documentation status. We strongly encourage folks to sign up with the help a certified

expert who can walk them through the application and help them understand

how to use their health insurance, all free of charge. To learn more about OmniSalud

visit our website. You can also find an OmniSalud expert and make an appointment.

Web and print versions of our resources on Connect for Health Colorado and

OmniSalud are available to you free of charge through our Open Enrollment

Online Toolkit and our Online Print Materials Store.

Family Planning Limited Benefit Plan FAQ

The Department of Health Care Policy & Financing (HCPF) is releasing this communication to notify eligibility sites that the Family Planning Limited Benefit Plan FAQ has been released. 

The Family Planning Limited Benefit Plan FAQ includes guidance for all medical assistance eligibility sites and workers. The FAQ discusses scenarios that have come to the Department from different avenues regarding the Family Limited Benefit Plan. The scenarios include, but are not limited to, who is eligible, opt-in and out options, and secondary benefits such as MSP.

View the Family Planning Limited Benefit Plan

Questions regarding this communication may be directed to: HCPF Medicaid Eligibility.

Community-Based Organization Ambassador Program

The Department is working with Colorado communities to start an Ambassador Program. The goal of the Ambassador Program is to work with Health First Colorado members and people who might be eligible for services to improve the letters and other written information the Department uses to communicate with Coloradans about Health First Colorado. The Department is focusing first on Spanish- and Vietnamese-speaking communities.

Ambassadors are people who will help us understand the needs of the communities they live in. They will partner with community organizations that work with Health First Colorado members to help make the information members and people who may be eligible get easy to understand in their native languages and in culturally responsive ways. 

Ambassadors will help Health First Colorado with: 

• Leading interviews, focus groups, and listening sessions 
• Getting feedback about the best ways to communicate with members and potential members
• Sharing guidance for policies and programs
• Providing important information to Health First Colorado members and potential members

Ambassadors will be paid an hourly wage and get training and support from the Department.

We are asking for trusted community organizations to contact our subcontractor, Health Management Associates (HMA), if they are interested in supporting the Ambassador Program. This could include hosting an ambassador or providing information about potential ambassadors in their community. The program will be run by the Department’s Member Experience team.

Please contact Lee Repasch or Kelsey Moore for more information about the program and how to participate.

Overflow Processing Center

The Overflow Processing Center (OPC) will accept requests for assistance from Eligibility Sites beginning Nov. 1. The OPC is located in Prowers County and was created to benefit eligibility sites, and therefore benefits applicants and members, by providing support processing cases when needed, including: 



• Partnering with the eligibility site when a disaster strikes, or a scenario exists where the site cannot process applications, renewals and case changes due to extenuating circumstances. 
• Processing applications, renewals and changes from eligibility sites to maintain statewide timeliness targets according to state and federal eligibility guidelines.
• Assisting the site when staffing or vacancies are impacting performance measures and the ability of the site to process cases timely. 
• Helping the eligibility site to reduce eligibility determination wait times for applicants and members, helping to ensure quicker access to care for Coloradans. 

Types of OPC Assistance 

The OPC is currently accepting MAGI and Non-MAGI cases including the processing of: 

• Applications 
• Redeterminations 
• Case Changes 
• Combination cases with other high-level program groups, where the OPC would process the MA portion of the case only 

How to request Assistance

When an eligibility site is facing circumstances that will impact its ability to keep up with and manage their MA workload, the eligibility site will have the ability to request support from the OPC. To request assistance from the OPC, all sites are required to submit the OPC Request Form located on the HCPF website. Once submitted the Department will review the request and prioritize it according to the amount of work and type of work the OPC is already assisting with. Sites that are mandated to work with OPC or other scenarios the Department deems as an emergency may be prioritized higher than a standard request. 

OPC Memo & FAQ: HCPF OM 22-048

OPC Request Form: OPC Request Form

OPC Webpage: www.colorado.gov/overflow-processing-center

OPC HCPF Contact: Jesse Trujillo

COLearn Access - Capacity Limit for User Accounts

Did you know COLearn has a capacity limit for user accounts?

There are only so many active accounts that we are able to carry. Because of this, if an account shows no activity for a year, we deactivate the profile. Removing inactive accounts helps make room for new workers to register for a COLearn account. This may impact workers who are still active CBMS users. If they have not logged in to COLearn for a year to take training, their account may be deactivated. Effective Nov. 1, 2022, the Staff Development Division will deactivate accounts that have not been active for one year.

If an account does get deactivated due inactivity for more than 30 days but the user should still be active, there is no need to create a new account. Reach out to the SDD, we can reactivate the account and no transcript data will be affected.

Questions: If you need additional information or have questions regarding this email, please email the SDD Team at SOC Staff Development.

Do you need help? Do you have a question? Does a case need to be escalated? There are two ways you can contact the HCPF County Relations team.

1. County Relations Web Form—try this method first. It allows you to enter details to help us resolve your issues.
2. County Relations Email—You can still contact us by email. at [email protected]. Your email to us will automatically create a service ticket with your email included. We cannot open encrypted messages within our ticketing system.

County Incentives Programs 

Individual county contracts for County Incentives Program FY 2022-23 are in process with procurement and should be out for signatures soon! Remember, per HCPF OM 20-041, contract signatures are required to be provided through the Department’s DocuSign contract signature process. 

Customer Service Incentive 

Thank you for submitting your opt-in for which Customer Service Tier for the FY 2022-23 County Incentives Program. As a reminder: 

Tier 1 requirements are for the Big 10 + Douglas, who manage call center operations. To comply with contract requirements, Tier 1 counties will begin, in January 2023, to complete the following: 

• Submission of call center performance data on the 10th of each month 
• Scheduling of a 1:1 technical assistance session with the HCPF Member Contact Center (MCC) Operations team 
• Data requirements for call center performance data are detailed in the HCPF Operational Memo for the Customer Service Incentive. 
• HCPF will reach out directly to schedule the TA sessions. 

Tier 2A requirements are for all counties who opted into the Department-run Customer Service Survey. To comply with contract requirements, Tier 2A counties will have from January 2023 to June 2023 to document a plan to encourage member participation in the Department’s Customer Service Survey for the following contract cycle. 

• The survey is administered by the Member Experience Advisory Council (MEAC) and is distributed quarterly to all members who have an active email address on file. 
• The only action the county is required to take is to document their plan to encourage participation. 

Tier 2B requirements are for all other counties who did not opt into Tier 2A, allowing them to create their own Customer Service Improvement Plan. To comply with contract requirements, Tier 2B counties will have from January 2023 to June 2023 to document a Customer Service Improvement Plan (CSIP).  

• This allows the county to use existing member engagement methodologies, grounded in data collection, to collect member feedback. 
• The CSIP must meet the minimum requirements outlined in the HCPF Operational Memo for Customer Service Incentive. 

MAP Dashboards: Pending Workload 

Over the last few months, HCPF has monitored an increase in pending workload at the state-level, specifically in applications. Additional analysis has found that the increase is concentrated in a few counties and is not a statewide issue.  

We are asking all counties to please review their Applications MAP Dashboard. Then, go to the performance measure for “Case Status Pending.” (This is under the Manager Level header.) 

If your county, based on size, is above the below pending targets, we may schedule a meeting with you to discuss what your plan is for reducing these pending numbers prior to April 2023: 

• Large Counties - Case Status Pending is above 400 
• Medium Counties - Case Status Pending is at or above 50 
• Small Counties - Case Status Pending is at or above 10   

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