June 27, 2024

County Connections

This Department of Health Care Policy & Financing (HCPF) newsletter is designed to inform county directors, management and staff about high-impact updates, important changes, county performance, new guidance, and program changes.

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Message from The Executive Director

A Bit of Good News for County Partners

County Partners,


Thank you for the important dialogue at the CCI Conference. This COVID-19 chapter, the public health emergency (PHE) and the unwinding of the PHE has truly been challenging for all of us. Our partnership through challenging times like these is even more important as we bring forth meaningful changes in response to your requests for support and to the betterment of those who we jointly serve.


The data from our May 2024 renewal cohort, the first renewal month after the public health emergency, is a very positive indicator, reflecting the hard work that we have collectively invested to keep eligible Coloradans enrolled in Health First Colorado and CHP+. While this is only one month of data, we believe it is directionally an indicator of future, similar metrics. In that spirit, consider the below May 2024 renewals data: 


  • A 76% renewal approval rate, up from 54% during the PHE unwind and far above the 57% renewal approval rate before the PHE started.
  • A 50% decrease in our procedural termination rates, from 25% to 12%.
  • Ex parte renewal rates increased from 33% to 59% (67% MAGI). This is critical to reducing county workload while improving the member experience. We will continue to drive actions and efforts that increase automation in order to reduce county workload while better serving members.
  • Additional state and county data is on our unwind data reporting webpage.


We also appreciate the thoughtful ideas counties have put forward to partner with hospitals and other ideas to improve the renewal process. Our staff will be following up with you to move this important work forward. Thank you in advance for your ongoing engagement on this.


Although we are enormously proud of these metrics that truly demonstrate our commitment to Keep Coloradans Covered and to reduce county workload, please know that we have heard your continued concerns about the need to stabilize and improve CBMS to alleviate downtimes. We continue to do deep dives on that system downtime, and both HCPF and CDHS are committed to partnering with you to evolve CBMS to better support system users and improve the member experience. We are also evolving 55 standard eligibility correspondence by the end of the calendar year to improve clarity, improve process efficiencies, and reduce member questions to counties.


Longer term, we are collaborating with you across three major areas, all of which will improve the eligibility processes for counties:

  • Long Term SB22-235 Plan. The HCPF Leadership Team is fully committed to advancing the Year 1 recommendations from SB 22-235, as well as determining next steps from the Funding Model developed for Year 2. The county partners who sat on these workgroups with us deserve special recognition for all of the time they spent helping us drive to a better outcome for this critical work.
  • We are collaborating on the Joint Agency InterOperability work.
  • We are collaborating on the CBMS vision and strategy. 


To close, I will reiterate how truly appreciative I am for the work you do every day; for being committed public servants who support your communities; for your continued advocacy for those who need our safety net coverage supports and for your continued partnership with us to help Keep Coloradans Covered through the PHE unwind. Please pass on my sincere appreciation to your managers and staff for all they’ve done over the past year, and continue to do, to support all Coloradans.

HCPF Department Updates

UPDATE- 1902(e)(14)(A) Waivers

As many of you are aware, CMS is further extending these unwinding-related section 1902(e)(14)(A) waivers through June 30, 2025. These have still NOT been made permanent as states requested, rather this is a temporary extension. Moving forward, Colorado plans to continue with the 1902(e)(14)(A) waivers that CMS had previously granted approval for:


  • Renew Medicaid eligibility based on financial findings from Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), or other means-tested benefit programs
  • Renew Medicaid eligibility for individuals with no income and no data returned on an ex parte basis ($0 income strategy).
  • Extend the timeframe to take final administrative action on fair hearing requests within the maximum 90 days permitted under the regulations for fair hearing requests.
  • Delay procedural terminations for beneficiaries under long-term eligibility categories for up to two months.  
  • Permit acceptance of updated in-state enrollee contact information from the National Change of Address (NCOA) database and United States Postal Service (USPS) in-state forwarding address without additional confirmation from the individual to update beneficiary contact information.
  • Renew Medicaid eligibility for individuals with income at or below 100% FPL and no data returned on an ex parte basis (0% and 100% income strategy).
  • Permit designation of an authorized representative for the purposes of signing an application or renewal form via the telephone without a signed designation from the applicant or beneficiary.
  • Reinstate eligibility effective on individual’s prior termination date for individuals disenrolled based on a procedural reason that are redetermined eligible for Medicaid during 90-day reconsideration period (scheduled to implement in October 2024).


Although the waivers were extended temporarily, it is not our intent to apply for any of the waivers that we previously decided not to pursue. We will continue to push our federal partners to make the flexibilities permanent and will keep you updated as we learn more - some may require Congressional action.  


In addition to waivers, our staff are working with Code for America and US Digital Services to further explore ways to improve ex parte rates.


If you have any questions on the above, please contact hcpf_countyrelations@state.co.us, or use our County Relations webform to get assistance.

Accountable Care Collaborative (ACC) Phase III Request for Proposal (RFP) 

HCPF is pleased to announce that we have officially published the Accountable Care Collaborative (ACC) Phase III Request for Proposal (RFP) on the Colorado Vendor Self Service website as RFP-UHAA-2024000332-1. More information on how to access the RFP is available on this email announcement. The RFP will remain open through July 13, 2024. 

Non-Emergent Medical Transportation (NEMT)

HCPF is considering moving to a single statewide broker for Non-Emergent Medical Transportation (NEMT). 


Initial feedback will be gathered via an online form


If you would like to learn more and attend a dedicated meeting on the topic please reach out to patrick.potyondy@state.co.us

Upcoming Trainings for Behavioral Health Providers

Trainings for behavioral providers are underway! Trainings focus on expanding benefits and services, improving access to care, and elevating quality.


Upcoming live trainings and office hours:


Reminder! Pre-recorded trainings, as well as recordings of live trainings, are available under Training Library on the HCPF Safety Net Providers landing page. Newly added trainings include:

  • We Can't Do It Alone and We Don't Have To: Advancing Mental Wellbeing and Connecting CoReducing the Impact of Traumatic Events with Trauma-Focused CBT
  • Reducing the Impact of Traumatic Events with Trauma-Focused CBT
  • Medications Assisted Treatment in Jails/Prisons: Supporting Re-Entry and Recovery



Join the Behavioral Health Provider TTA newsletter to stay up to date!

Incentives Spotlight

We had our first Incentive Task Group (ITG) kick off meeting on June 14. During this meeting the ITG drafted the upcoming agenda topics. The future meetings are as follows:

  • Friday, June 28 (9 a.m., 1.5 hours) 
  • Performance Incentive 
  • MAP data discussion and what MAP performance measures are in operation 
  • Update on MAP Renewal EPG SQL 
  • Update on MAP Renewal SQL Timelines 
  • Introduction of EPG Performance Measure Targets and formula
  • New renewal target formula will be an example to initiate the discussion
  • Friday, July 12 (9 a.m., 1.5 hours) 
  • Performance Incentive 
  • Continued discussion around EPG Performance Measure Targets and formula
  • EPG 45 and EPG 90 targets and formula 
  • Renewal EPG targets and formula
  • Discuss Ongoing Case Maintenance (Changes) SQL and Targets 
  • Presentation of MAP Exemption Process 
  • Friday, July 26 (9 a.m., 1.5 hours) 
  • Customer Service Incentive 
  • Overview Member Experience Survey Data
  • Review Member Experience Survey Form 
  • Formula of calculation of customer calls in small and medium Counties
  • August 9 (9 a.m., 1.5 hours) 
  • Customer Service Incentive 
  • Overview of Call Center Benchmarks 
  • Balancing Customer Satisfaction with Call Center Benchmarks
  • Customer Satisfaction 
  • Completion rate% - First contact resolution 
  • August 23 (9 a.m., 1.5 hours) 
  • Accuracy Incentive 
  • Overview of Accuracy Data 
  • Discussion of Accuracy Target and Calculation 
  • Focus on Procedural Errors Rate “Errors That Did Not Impact Eligibility” 


If you would like to send a representative please email their name(s) to hcpf_countyrelations@state.co.us. You may send different representatives to each meeting.

Grants Spotlight!

HCPF is so excited to share the project highlights from the FY 23-24 County Grant Program recipients. This group of counties did extraordinary work improving member health, customer service, and through employee satisfaction. Whether that was establishing a large county call center or expanding a network of translation experts or supporting eligibility staff through trauma-informed care, these counties brought true innovation to their grants this year!


The FY 23-24 County Year End Report Out meeting is now posted on HCPF's website. You will find the meeting recording and presentations.



Grand County - Integration of EDI into the Workplace

Grand County received funding approval to support HCPF’s strategic pillar to empower staff and improve equity, diversity, inclusion and accessibility. 

  • Improved our employees’ professional development opportunities.
  • Conducted surveys to assess employee satisfaction that helped us identify ways to improve recruitment and retention.
  • Increased accessibility to our building and to the services we offer. 
  • Conducted EDI training and laid the groundwork for a departmental long-term EDI culture and commitment. 

Grant Program contacts: Deb Ruttenberg, Deputy Director (deb.ruttenberg@state.co.us) and Karen Asato-Chrysler, Deputy Director (karen.asato-chrysler@state.co.us)


Lake County - Language Access Policy Implementation & Development of the Interpreter Network

Expansion grant to build upon the FY 22-23 grant-funded program, with focus on community outreach, data collection and strategic planning for the Interpreter Network.

  • Community outreach, staff training and support on language access, Interpreter Network training and development.
  • Hiring a full-time Interpreter Network Coordinator position.
  • Translation of vital documents in Spanish, and strategic planning and sustainability initiatives with a Contractor.
  • Community data revealed: Most respondents have Moderate/High Confidence in receiving services in their language; most are aware of the right to language access and that services are available; and some reliance on family and friends for language needs remains. Most importantly, the county learned it needs work on: having more bilingual staff available and more professional interactions.
  • Strategic Planning & Sustainability initiatives: data revealed many organizations/counties are relying on bilingual staff.
  • Five training sessions for staff and interpreters; Bridging the Gap and Community Interpreter training for new Interpreters joining the Interpreter Network.
  • Three strategic goals for the Lake DHS Interpreter Network over the next 1-3 years:
  • Provide access to qualified interpreters throughout Colorado.
  • Catalyze the narrative about language access across Colorado.
  • Ensure long-term sustainability for the Interpreter Network and its expansion.
  • Key lessons learned: Spanish-speaking community is aware that language access is a right and bilingual staff are relied upon too heavily for client support.

Grant Program Contact: Christin Logan, Deputy Director of Funding and Program Development (christin.logan@state.co.us)


Lake County - Creation of Member Experience Advisory Council for Lake County

Gather feedback on the application process experience with Lake DHS. 

  • Required to pivot from a focus-group style feedback forum to virtual options, such as WhatsApp interviews and phone calls.
  • Feedback takeaways: faster processing times, better communication from staff (explanation of services, processes for Medical Assistance), improved language supports, and more professional interactions requested.
  • Key lesson learned: personal connections and health care providers are the main sources to learn about Medical Assistance.
  • Hired contractor who specializes in Spanish language/Latino communications, marketing, focus groups based out of Denver.
  • Number of Medical Assistance members who provided feedback (all Channels): lofty goal was 50+ Individuals and 38 individuals benefited from this grant.

Grant Program Contact: Christin Logan, Deputy Director of Funding and Program Development (christin.logan@state.co.us)


Lake County - Enhancing Trauma-Informed Work Culture Impacting Retention & Recruitment

Expansion grant from FY 22-23 program, with key deliverables of longitudinal study of public assistance staff, one-on-one coaching sessions, and a webinar to share with other Counties.

  • Longitudinal survey found that staff recognize own stress responses, identify resilient activities that benefit their well-being at work, staff feel supported by leadership. Learned that there were existing concerns about physical safety in the workplace, and lack of feeling in control of the work environment.
  • Two staff training sessions: Emotional Intelligence Training (January 2024), and Communication, Emotional Response & Stress Management Training (April 2024)
  • 21 one-on-one sessions with contractor: topics ranged from job satisfaction levels, help with resiliency tools/ideas, and support and guidance.
  • Key lessons learned: in-person trainings are best for this subject matter.

Grant Program Contact: Christin Logan, Deputy Director of Funding and Program Development (christin.logan@state.co.us)


Lake County - Outcomes for Vulnerable Medicaid Members

The goal was to improve member health outcomes for vulnerable Medicaid members in Lake County.

  • Well-rounded care team approach: wraparound and Adult Protective Services case management.
  • Eliminate obstacles to health services for Medical Assistance members.
  • Referral process with public assistance and community agencies.
  • Goal was to serve six vulnerable adult individuals and 27 clients were served by this grant.
  • The project has confirmed the need for this overlooked population, especially in mountainous, rural areas.
  • Key lesson learned: multiple ways to connect people to the Medical Assistance services they need, across-unit collaboration was an essential piece of the referral process.

Grant Program Contact: Christin Logan, Deputy Director of Funding and Program Development (christin.logan@state.co.us)


Mesa County - Economic Assistance Call Center

Mesa County received funding to implement an on-site call center, with the goal of creating a better experience for clients and increasing communication and trust within the community.

  • Developed and implemented a Call Center and team from the ground up. 
  • In order to reach the goal of helping community members in the best way possible, trained technicians in all intricacies of SNAP and Medical Assistance.
  • Improved staging times, processes, consistency, and effectiveness. 
  • Designed and implemented tools for the Call Center Team such as a processing queue, 100% time reporting production logs and data tracking. 
  • Key deliverables: increased client support and quality interactions, improved staff morale, increased number of Spanish speaking technicians on the team, and created efficient processes for staff and clients. 

Grant Program Contact: Melissa Schierland, Economic Assistance Director (melissa.schierland@mesacounty.us)


Pitkin County - Trauma Informed Management Practice

Pitkin County Human Services contracted with Alia Innovations (trauma-informed workplace) to facilitate peer-learning with human services staff to increase capacity, improve departmental processes, and improve staff and customer experiences.

  • Learned a lot through this process, particularly how this type of work can have significant impacts on staff and operations.
  • Due to the nature of the work, the project was modified to include more in-person work with the entire team.
  • Staff Survey Outcomes:
  • Staff Engagement: Expected (20% increase); Actual (6.25% decrease)
  • Institutional Trust: Expected (20% increase); Actual (1.62% decrease)
  • Overall Employee Satisfaction: Expected (15% increase); Actual (3.69% decrease)
  • Customer Survey Outcomes:
  • Customer Engagement: Expected (20% increase); Actual (52.38% decrease)
  • Customer Satisfaction: Expected (15% increase); Actual (4.71% increase)    
  • Suspect the reason staff experiences decreased in these areas is because of the nature of adopting this type of work, through clarifying roles/ responsibilities, and opening up staff feedback channels–the teams are ‘storming’ in further defining boundaries and expectations. 
  • Pitkin County will plan to do another year with expanded metrics to include the trauma competent workplace into the strategic plan as a central pillar to the work that’s done.

Grant Program Contact: Lindsay Maisch, Pitkin County Director (lindsay.maisch@pitkincounty.com)

How to Get Help!

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 & Eligibility teams.

  1. County Relations & Eligibility Site Request Form. This webform allows you to enter details to help us resolve your issues and is the best way to contact both the County and Eligibility teams at HCPF.
  2. Health First Colorado and Child Health Plan Plus Grievance Form. This webform allows anyone to enter details to help us resolve and be aware of any grievances.

July 2024

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