This Department of Health Care Policy & Financing (the Department) 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
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County Partners,
Partnering to Address Health Disparities
Thank you to the 1,000 stakeholders who joined our Summer Health Cabinet Summit last month and to those who will watch the Summit sessions in the coming weeks. And thank you to the panelists who provided expert insights and thought-provoking dialogue to each of our topics: prescription drug and hospital affordability, behavioral health transformation, and health equity. The event recording and materials are posted on our Affordability website and the newly released reports – Hospital Cost, Price & Profit Review and COVID-19's Impact on Colorado Hospitals' Finances - are posted on our Hospital Reports Hub.
A top priority for HCPF remains getting our members vaccinated and therefore protected against the impact of COVID-19. Health First Colorado members (who, by definition, have low incomes) have a 25-point vaccination gap compared to the state vaccination rate. This gap is the same or smaller than the vast majority of states. Still, closing this disparity is of vital importance to reducing spread, hospitalizations, and deaths among low-income Coloradans.
Thanks to you, our partners, we know that targeted outreach works, as evidenced by the results of three strategic initiatives: (1) Medicaid members with disabilities are now vaccinated at more than twice the rate of their counterparts; (2) homebound members are now vaccinated at twice the rate of their counterparts; and (3) the gap between Medicaid members of color and white members has been narrowed to less than 3%. The issue remains closing the vaccination gap between low-income compared to medium- and high-income Coloradans.
Thank you, Regional Accountable Entities, community health centers, physicians, hospitals, pharmacists, and our many other valued partners. We appreciate the individual outreaches, education, and encouragement that resulted in Medicaid members getting vaccinated. Your trusted voices are critical to closing this 25-point health disparity and saving lives.
As leaders, we are important role models. Thank you to the many hospitals that led the way and implemented employee vaccine mandates. The State of Colorado is requiring all state employees to be fully vaccinated or to test twice-weekly for COVID-19 starting Sept. 20. Also, at the request of the Governor, the State Board of Health is requiring vaccination by Oct. 31 for personnel working with Colorado’s most vulnerable as well as in settings where people receive essential health care services in order to keep Coloradans protected and save lives.
On 9/14/2021, we released our Maternity Report that identifies related disparities and solutions to address them. Approximately 250 people attended the accompanying 9/15 presentation and panel discussion.
Kim
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Help Us Get the Word Out! Monthly Tax Credit Resources for Parents & Stakeholders
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This toolkit was created for anyone to use to spread the word that expanded tax credits can help lift up to 40% of Colorado families out of poverty. The toolkit contains English and Spanish language messages, a flyer for distribution in physical settings, and sample newsletter and text message content. Please share with your networks and families who could benefit from these new cash-back resources!
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Overflow Processing Center
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At the beginning of the COVID-19 pandemic, the federal government declared a Public Health Emergency (PHE). As a result, most Health First Colorado and Child Health Plan Plus (CHP+) members have remained enrolled (known as “locked-in”) and have been eligible to receive benefits during the PHE.
At the end of the PHE, these members will require an eligibility review within the timeframe given by our federal partners at the Centers for Medicare and Medicaid Services (CMS).The Department has approved funding for the Overflow Processing (OPC), which will assist counties with the end of PHE workload and then will continue to assist with backlogs of Health First Colorado and CHP+ applications, eligibility determinations, and redeterminations.
After a thorough application process, Prowers County has been selected as the vendor for the OPC. The OPC will be located in Granada, CO, and is a different entity from Prowers Department of Human Services (DHS).
We continue to engage with our eligibility site representatives to develop and finalize processes for the OPC around implementation and workflow to ensure quality, timeliness and customer experience. We are working towards an anticipated operational start date at the end of 2021/beginning of 2022. It is the Department’s goal to keep counties and eligibility sites informed about the OPC and to continue to partner with you through the challenges resulting from the pandemic.
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Recent Memo Series Issued to Counties
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PM 21-006
The purpose of this Policy Memo is to inform eligibility sites of the income and resource
eligibility rules for the Advance Child Tax Credit (CTC) for tax year 2021, expanded by
the American Rescue Plan Act (ARPA). This memo includes guidance for all Medical
Assistance eligibility categories. Please share this memo with all eligibility staff,
supervisors, and outside agencies as appropriate.
PM 21-005
The purpose of this policy memo is to inform eligibility partners that if a guardian, conservator, or lawyer holds assets on behalf of a Medicaid applicant or member, such assets may be countable as a resource in determining eligibility for Medical Assistance, subject to any applicable resource exemptions. Similarly, income attributable to these assets or other income received by an individual on behalf of a Medicaid applicant or member may be countable as income in determining eligibility for Medical Assistance, subject to any applicable disregards.
PM 21-004
The main purpose of this Memo is to inform stakeholders of changes to the disability
trust regulations that add a requirement for trustees to provide notice of certain trust
distributions. Additionally, this Memo sets policy and provides guidance with regard to
this change and revises the earlier guidance furnished in HCPF PM 20-005 issued on
July 16, 2020.
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OM 21-058
The purpose of this memo is to inform authorized individuals/entities, such as county
departments of social/human services, Medical Assistance (MA) sites, Eligibility
Application Partner (EAP) sites, and anyone who processes applications of the change
regarding Compact of Free Association (COFA) individuals being eligible for medical
coverage.
OM 21-057
The purpose of this Operational Memo is to provide amended guidance to the eligibility sites regarding their responsibilities when responding to documentation requests and findings from the Medical Assistance Eligibility Quality Assurance (EQA) unit.
OM 21-056
The purpose of this memo is to provide county department of human /social services and medical assistance sites with general information about Emergency Medicaid provided through health First Colorado. Additionally, this memo will outline the eligibility criteria for Emergency Medicaid, how people can submit their applications, as well as a brief explanation of covered emergency services. This guidance is intended for all teams who are working in-person, online or over the phone. Please share this memo with anyone who works with Health First Colorado applicants and members.
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IM 21-051
The purpose of this Informational Memo is to provide county Department of Human
Service (DHS) agencies an update from the Colorado Department of Health Care Policy
& Financing (Department) regarding a single county transferring from one CCB
catchment area to another and information regarding the new agency that will be
providing CCB services. Please see the accompanying chart for agency information.
IM 21-047
The purpose of this Informational Memo is to provide county departments of
social/human services (counties) and county child welfare staff with information on
children’s Home and Community-Based Services (HCBS) waivers, so that they might
increase referrals to Case Management Agencies (CMAs) for HCBS waivers assessments.
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County-Level Vaccine Dashboard
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The Colorado Department of Public Health & Environment (CDPHE) announced that as of Feb. 19 the vaccine data dashboard includes county-level vaccine administration data in beta.
The goal of the expanded data dashboard is part of the state's commitment to prioritize data transparency throughout the COVID-19 response, to inform an equitable vaccine distribution process, and ensure accountability.
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Manual Process To Establish Individuals Who Are Eligible for
Medicare Savings Programs During Public Health Emergency
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The Centers for Medicare and Medicaid Services (CMS) provided Medicare Savings Program (MSP) guidance in their April 13, 2020, Frequently Asked Questions for the Families First Coronavirus Response Act (FFCRA), Public Law No. 116-127 Coronavirus Aid, Relief, and Economic Security (CARES) Act, Public Law No. 116-136. They clarified that members who meet all criteria for the MSPs are to be enrolled into that program while also maintaining the coverage they were enrolled in at the time of the Public Health Emergency (PHE). If a member is currently showing active in a primary aid code of MAGI Adult, Qualified Disabled Widower (QDW), and Breast and Cervical Cancer Program (BCCP) and is Medicare eligible, and meets all criteria for a MSP, they cannot automatically transition to the MSP they are eligible for as a primary aid code due to COVID lock-in logic.
For members becoming and meeting the eligibility for MSP Qualified Medicare Beneficiary (QMB) and Specified Low Income Medicare Beneficiaries (SLMB) while maintaining coverage in MAGI Adult, BCCP, or QDW during the PHE, please refer to the instructions contained in the Staff Development Center Desk Aid for Project 14101 COVID-19 PHE-Changes-CHP+/Misc.
To ensure that the MSP QI-1 program is correctly added to a member’s case while they are showing active in a primary aid code of MAGI Adult, BCCP, or QDW, the Department will use a manual process to support these individuals. The Department will be running a monthly ad hoc report, based on the criteria for the program, to identify new individuals and manually add QI-1 for coverage of Medicare B premiums via the MA override functionality. In CBMS, this will be reflected as SLMB as a secondary aid code to cover the member’s Medicare Part B premium until the PHE ends and the member can transition to QI-1 appropriately. Additionally, members will receive a Notice of Action of the addition of the MSP QI-1 program.
No appeal is needed, and eligibility sites should follow the guidance referenced above to create Help Desk Ticket for MSP QMB and SLMB. No Help Desk Ticket is needed to add the QI -1 members. Eligibility sites should review the case to determine if the override for the MSP benefit has been added to the case. If the case is not reflecting the MSP or there are specific case issues with this MSP process, please email Beverly Hirsekorn.
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Samantha was diagnosed with multiple rare diseases and needed help. Health First Colorado found her top-notch doctors that treat her with dignity and respect. Now she looks forward to every day. Share Samantha's video with your social media network by using our Social Media Toolkit. If you have any questions about the materials in this toolkit, please email Sarah Eaton or Health First Colorado Feedback Inbox.
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County Grants & County Incentives Program
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FY 2020-2021 Incentives
- Final Status Reports have been sent and payments have been disbursed.
FY 2021-2022 Incentives
- Operational Memos to come
- Accuracy setting meeting to be scheduled
Please use the codes below for FY 2021-2022 Public Health Emergency BA-10 Budget Amendment Funds
eligible for non-enhanced vs. enhanced funding.
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Competitive Grants
FY 2021-22 Competitive Grants have been awarded. Thank you to all of our applicants!
Quarter 1 check ins will be scheduled for October.
Targeted Grants
More information on FY 2021-22 Targeted Grants will be available soon.
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Timeliness for August 2021
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Timeliness for all Medical Assistance applications was measured at 96.68%.
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Timeliness for all Medical Assistance redeterminations was measured at 99.28%.
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Department Contacts & Resources
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