Sept. 30 , 2022

County Connections

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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High-Impact Updates
Message from the Executive Director

Advancing Rural Health Care and Prescription Drug Affordability

The Department is collaborating to invest in rural health care to increase care access, improve member health, close disparities, save people money on health care and improve rural provider sustainability. 


In partnership with the Polis-Primavera Administration, the General Assembly, and our rural providers and stakeholders, the Department is taking multiple steps to achieve these shared goals:


• Rural Connectivity & Access to Virtual Care. To minimize the digital divide between rural and front-range providers, the state has connected 86% of rural safety net providers to the statewide health information exchange (HIE) and custom data analytics. This is important progress toward enabling all critical access hospitals and rural health clinics to connect to health information exchange services, supporting the Polis-Primavera Administration's health priorities. In partnership with the Office of eHealth Innovation (OeHI) and as supported by the General Assembly, a total of $17.4 million in federal matching funds will be invested over four years. This connectivity supports rural member access to virtual care, helps keep care local by supplying rural health care providers with access to critical data and technology, improves care coordination and enhances the efficiency of care delivery to rural patients.


• Stabilizing Rural Hospitals & Improving Affordability Capabilities. In partnership with our hospitals and the Colorado Hospital Association, the five-year Hospital Transformation Program (HTP) is designed to improve the affordability and quality of hospital care by tying provider fee funded hospital payments to quality- and affordability-based initiatives. A critical component of the HTP is the Rural Support Fund, which invests $12 million each year over five years ($60 million) to help 23 critical access and rural hospitals modernize, better serve their communities and prepare for value-based payments.


• Improving Rural Access & Affordability. In partnership with the Polis-Primavera Administration and the General Assembly, we are leveraging American Rescue Plan Act funding through Senate Bill 22-200, which created the Rural Provider Access and Affordability Stimulus Grant Program. Through this program, the Department will allocate about $10 million in grant payments to qualified rural hospitals. Grant payments will be equally allocated into two categories: affordability initiatives and care access initiatives. The Department will administer this program with the advice and recommendations of the Rural Provider Access and Affordability Stimulus Advisory Committee.


We are also investing in the health care workforce to expand access to care across the state, including in our rural communities. Together, we expanded our provider network by more than 25% over the past few years, with 95,000 providers now enrolled in Health First Colorado. That includes more than 10,000 active behavioral health providers. A very special thank you to the General Assembly and the Joint Budget Committee for their 2% across the board provider reimbursement rate increase effective July 1, 2022, for the specific rate increases propelled through our Medicaid Provider Rate Review Advisory Committee (MPRRAC) process, and for the wage increases for certain direct care and nursing home workers – all critical to supporting our providers in caring for our members, reducing disparities, improving quality and increasing care access. 


Additionally, we continue important work to Save People Money on Health Care, with a special focus on the leading contributor to rising health care costs – prescription drugs. Americans pay two to three times the prices available in other countries for the same drugs. Colorado’s Canadian Importation Program, an initiative managed by HCPF, is poised to save consumers and employers an average of more than 60% on prescription medications through this emerging program. Drug importation from Canada will allow Colorado consumers and employers to pay a fair price for their medications, safely and in compliance with all federal safety guidelines. In August, the Polis-Primavera Administration and the Department announced a major milestone in the development of this program – executed contracts with key supply chain partners that will help Colorado operationalize the importation of lower cost medications from Canada. The next steps include negotiations with drug manufacturers and the submission of a comprehensive Section 804 Importation Program (SIP) application to the Food and Drug Administration (FDA) for approval. 


Thank you again for your partnership in caring for our members while improving health care access, quality, equity and affordability across Colorado.

New HCPF Senior Executive Team Leaders

The Department of Health Care Policy & Financing is pleased to announce additions to our Senior Executive Leadership Team.


New State Medicaid Director

The Department is pleased to announce that Adela Flores-Brennan, MA, JD has been selected as our Medicaid Director, reporting to Executive Director Kim Bimestefer. In this role, Adela will also assume the role of Office Director, leading our newly titled Health Policy Office (formerly Health Programs Office), which designs, maintains and oversees Medicaid and CHP+ medical policies and contracts. Adela joined HCPF in May 2022 and had been serving as the Interim Benefits Division Director and the Deputy Chief Administrative Officer for HCPF. 


Adela brings over 20 years of experience in Colorado public policy and advocacy and a deep understanding of health issues including Medicaid, CHP+, private insurance, family economic self-sufficiency, state tax and budget policy, and federal oversight. More recently, Adela served as executive director of the Colorado Consumer Health Initiative (CCHI), which led numerous major health policy changes to benefit Colorado consumers during her tenure. She has successfully partnered with community members, policymakers and regulators at the state and federal levels to advance policies that expand access to quality and affordable health care while protecting consumers. Adela has also served on the boards of directors for Connect for Health Colorado, Center for Improving Value in Health Care (CIVHC) and Colorado Access. Please join us in congratulating Adela on her new role.


New Office of Medicaid and CHP+ Behavioral Health Initiatives and Coverage

We are pleased to announce the formation of a new office within HCPF - the Office of Medicaid and CHP+ Behavioral Health Initiatives and Coverage. Please join us in congratulating Cristen Bates, who has been promoted to Director of this new HCPF office. This office will govern HCPF’s specific behavioral health policies, benefits, special projects and strategies that were previously part of our Health Programs Office. Accordingly, Cristen and HCPF’s behavioral health managers and staff will remain in their same positions but within this new office, under Cristen’s leadership. 


The timing of this new office is very intentional. Given the unprecedented and historic changes both underway and forthcoming to transform the state’s behavioral health system, this new HCPF office under Cristen’s leadership will ensure that HCPF is fully aligned and engaged to support the Behavioral Health Administration (BHA) and its vision to achieve transformative goals while also improving HCPF’s focus and ability to meet the expectations of our advocates, legislators, providers, counties and other stakeholders in the provision of Medicaid and CHP+ behavioral health services. This includes implementing elements of the statewide behavioral health transformative initiatives attributed to HCPF while ensuring that HCPF continues to improve the behavioral health access, quality, equity and service provided to Medicaid and CHP+ members, who now number 1.67 million Coloradans. 


Cristen will also hold the role of Deputy Medicaid Director, ensuring close partnership with Adela as the Medicaid Director and Director of HCPF’s Health Policy Office. Cristen is a dedicated public health executive with 20 years of experience serving the community. Her behavioral health expertise and passion will serve her well in this important role. Cristen has been with HCPF for three years, and previously served as the Director of Strategy, Communications and Policy for the Office of Behavioral Health within the Department of Human Services. Cristen will now be a member of HCPF’s Senior Executive Leadership Team in this new role, reporting to Executive Director Kim Bimestefer, and joining other Department Office Directors (i.e., Tom Leahey, Pharmacy Office; Bonnie Silva, Office of Community Living; Adela Flores-Brennan, Health Policy Office; Charlotte Crist, Cost Control & Quality Improvement Office; Ralph Choate, Medicaid Operations Office; Bettina Schneider, Finance Office; Parrish Steinbrecher, Health Information Office; Tom Massey, Policy, Communications & Administration Office). 

Recent Memo Series Issued to Counties
All Memos and their attachments are on the Memo Series website.

Policy Memos

None

Operational Memos

None

Informational Memos

None

Informational Updates

The Caseload Dashboard - End User Dashboard Office Hours

Summary: The Caseload Dashboard - End User Dashboard Office Hours are scheduled for tomorrow, Sept. 14, 2022, from 1-2 p.m. The office hours are for all CBMS end users, to assist with navigation of and questions regarding the Caseload Dashboard - End User Dashboard.


Details: With project CPPM-1041 CBMS County Dashboard - End User, a Caseload Dashboard was implemented for Colorado Benefits Management System (CBMS) end users and supervisors. The dashboard equips end users with the ability to view and prioritize all pending work on their caseload in CBMS. Supervisors are able to view all pending work for all of the end users they supervise, as well as all pending work for their own caseload.


The CBMS team is excited to announce the following enhancements to the Caseload Dashboard, implemented in the September 2022 build, which will be discussed by Subject Matter Expert (SME) Brenda LaCombe during tomorrow's office hours:

  • Expanded Staff Access - Counties now have the ability to provide various staff with access to the Caseload Dashboard. A (Yes/No) radio button, Assign Supervisor Access, was added to the Security Information screen. If Yes is selected, the associated user (who is not a supervisor) can view all pending work for their assigned unit on the Caseload Dashboard.
  • RRR Status Column - An RRR Status column was added to the RRR section of the dashboard, to give end users the ability to sort RRRs by Status.
  • Default the Received Date (from oldest to newest) - Default the Received Date in the Apps Details, RRR Details - RRR Packet Received Date, PEAK Changes Details - Change Received Date, and the SNAP PR Details - PR Form Received Date from oldest to newest.
  • New Date Range Filter - A date range filter was added, which will benefit counties that have over 1,000 pending items.
  • VCL Due Date Information - A VCL Due Date column was added to the right of the VCL Due column and displays the most current VCL Due Date for the pending RRR.
  • The EXSNAP Column - The EXSNAP column displays next to the Program column so that the display of programs are next to each other, and therefore, easier to view and access.


The Caseload Dashboard - End User Dashboard Office Hours upcoming schedule:


  • Wednesday, Oct. 19, 1-2 p.m.
  • Wednesday, Nov. 16, 1-2 p.m.
  • Wednesday, Dec. 14, 1-2 p.m.


To join the the Caseload Dashboard - End User Dashboard Office Hours, please refer to the following connectivity information:


Phone: 1.813.498.2475

PIN: 423 818 458#

Join with Google Meet 


Add this event to your Google calendar


If you have any questions or concerns, please contact us at CBMS Liaison.

Request an Open Enrollment Kit from Connect for Health Colorado (C4HCO)

With less than two months until Open Enrollment (OE), C4HCO is getting OE Kick-Off Kits ready as a way for you to help spread the word about health insurance options! As a reminder, Coloradans who don’t qualify for Health First Colorado and don’t get health insurance through an employer can sign up for a health insurance plan and apply for financial help through Connect for Health Colorado from Nov. 1, 2022 - Jan. 15, 2023.

 

Please let us know if you would like an OE Kick-Off Kit mailed to you. The kits are free, and we’ll mail one right to your door in mid-October.


Open Enrollment Kits include:


  • Connect for Health Colorado overview brochures.
  • Posters highlighting key Open Enrollment deadlines.
  • A message board for you to hold up in a photograph and post to your social media platforms.
  • Brochure for OmniSalud, a new health insurance program for Coloradans who are undocumented.


Contact: To order your FREE kit, email madams@c4hco.com by Friday, Sept. 23, and include the following information:


  • Your name and your county’s name.
  • The address to which you would like us to mail the Open Enrollment Kick-Off Kit.

New Bookkeeper Training for County Human Services, October 2022

This is an announcement for New Bookkeeper Training for County Human Services (a repeat of previous classes) sponsored by Neal Christensen, retired CPA.

 

This training will be a live video conference format using software from Zoom. The Zoom video conference format will allow for interactions with training participants.

 

Where: Video feed to your personal computer at your desktop at work or at your home. The class materials will be emailed to you in an electronic format. You can print out these materials or use them in their electronic format.

 

When: There are 12 sessions of 50 minutes each with 4 sessions per day.

 

Oct. 12, 9:30 a.m. - 3 p.m., with a lunch break from 11:30 a.m. - 1 p.m.

Oct. 19, 9:30 a.m. - 3 p.m., with a lunch break from 11:30 a.m. - 1 p.m.

Oct. 26, 9:30 a.m. - 3 p.m., with a lunch break from 11:30 a.m. - 1 p.m.

 

Target Audience: County Human Services; Account Clerks, Bookkeepers, and Accountants with 0 to 2 years of experience.

 

Registration deadline: 5 p.m. on Oct. 5, 2022

 

Cost: $200 includes all three days and materials. The registration form is an attachment to this email in two formats, Word and PDF, and you can use either format. You can email the registration form to Neal.Christensen.CPA@gmail.com or you can send the form and payment to:

 

Neal Christensen

10152 Woodrose Lane

Highlands Ranch, CO 80129-5404

 

The detailed schedule is as follows:

 

Wednesday, Oct. 12

 

  • 9:30 - 10:20 Introduction to Human Services; explanation of the acronyms and the jargon; overview of the Colorado Department of Human Services (CDHS); descriptions of the different computer systems and more
  • 10:30 - 11:20 Random Moment Sample (RMS); detailed explanation of the RMS system
  • 11:30 - 1 lunch
  • 1 - 1:50 Coding of Transactions in the Colorado Financial Management System (CFMS); coding for direct costs and indirect cost (cost pools) plus specific examples
  • 2 - 2:50 County Financial Management System (CFMS); review of the basics of CFMS

 

Wednesday, Oct. 19

 

  • 9:30 - 10:20 Programs / Grants / Funding; detailed explanations and descriptions of the largest programs
  • 10:30 - 11:20 Monthly Settlement through CFMS; a walk-through of an actual county’s monthly settlement process; review of the flow of county warrant and Electronic Benefits Transfer (EBT) transactions
  • 11:30 - 1 lunch
  • 1 - 1:50 Allocations and Monthly Allocation Tracking; July 1 through June 30 State allocations
  • 2 - 2:50 Closeout of Allocations; a walk-through of the CDHS close-out process each June 30

 

Wednesday, Oct. 26

 

  • 9:30 - 10:20 State Financial Rules - Code of Colorado Regulations (CCR) - CDHS and HCPF; 11 CCR 2508-1 from the Colorado Department of Human Services (CDHS) and 10 CCR 2505-5 from the Colorado Department of Health Care Policy &  Financing (HCPF)
  • 10:30 - 11:20 Federal Financial Rules - Uniform Administrative Requirements; cost principles, administrative rules, and audit requirements for federal awards; formerly Office of Management and Budget (OMB) Circulars A-87, A-102, and A-133
  • 11:30 - 1 lunch
  • 1 - 1:50 Budgets; discussion of budget law, different types of budgets and exercises on how to create your own budget
  • 2 - 2:50 Internal Control; discussion of the five internal control modules and the 17 principles of internal control
County Relations Team Introduces
Customer Relationship Management System
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 hcpf_countyrelations@state.co.us. Your email to us will automatically create a service ticket with your email included. We cannot open encrypted messages within our ticketing system.
County Grants & County Incentives Program

County Incentives and Grants

County Incentives Programs 

Individual county contracts for County Incentives Program FY 2022-23 are in progress with Procurement. Both the Incentives Program Contract and FY 2022-23 Funding Table are posted on the County Administration Resources website: County Incentives Program.   

 

EQA results are paused while Eligibility Quality Assurance hires and onboards new staff. We will let you know as soon reviews will restart. As communicated by Melissa Vincent on July 5, 2022, EQA is still requesting cases files every month. While there is a pause in results, this might be a good time for you and your teams to reflect on your Accuracy Performance Incentive data and outcomes in FY2021-22. Have you integrated this work into your operations? Are there opportunities to re-train your teams based the most common errors made in FY 2021-22?   

 

MAP Dashboard Performance: Both Court Ordered Application and Renewal Timeliness dashboard calculations were updated in August for July data to exclude all system generated authorizations. This could potentially decrease or increase timeliness. As a result, no Management Decision Letters (MDLs) will be issued for non-compliance with both Court Ordered Application and Renewal Timeliness for the first five months of data (July – Nov 2022) as the baseline resets. The earliest an MDL will be issued for Timeliness is February 2023 based on December 2022 and January 2023 performance.   


It is critical for counties and eligibility sites to monitor Court Ordered Application Timeliness, taking steps to improve their performance if a decrease in timeliness performance is occurring.    

  • Is your county or eligibility site entering cases into CBMS timely? (Preferably the same day the application is received; best practice is within 1-2 business days.)  
  • Be certain you have assigned staff to monitor the MAP Dashboard data with special attention to pending - those coming due and those that are past due.  
  • Identify the root cause(s) of timeliness decreasing and implement a plan to improve your timeliness to meet or exceed the target before you are held accountable to timeliness performance.  


Counties and eligibility sites will continue to be held accountable for meeting targets for Pending EPG 45, Pending EPG 90. Pending Member Past Cert Period No EDBC and Pending Member Past Cert Period EDBC. MDLs will continue to be issued for these performance measures for non-compliance with Director-level performance targets.  

County Performance

Timeliness for all Medical Assistance applications was measured at 98.%.

Timeliness for all Medical Assistance redeterminations was measured at 98.44%.

Supplemental Information
Department Contacts & Resources