Oct. 6, 2023

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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High-Impact Updates

Message from the Executive Director

Partner to Keep Coloradans Covered



Our top priority continues to be partnering with stakeholders throughout the state to achieve our shared goal to Keep Coloradans Covered. With the end of the public health emergency, all states, including Colorado, resumed eligibility renewals after a three-year pause. In Colorado, this means renewing each of our 1.7M Health First Colorado (Colorado’s Medicaid Program) and Child Health Plan Plus (CHP+) members on their annual anniversary date. 


May-August 2023 Point-in-Time Reported Data

Based on point-in-time information, an average of 49.0% of members with renewal anniversaries between May-August were renewed, according to initial data pulls (see below on how this figure improves over time). Of those renewed, just under half were automatically renewed through advances in processing technology, while the other half were renewed after completing their renewal packet. An average of 48.5% of individuals up for renewal May-August were disenrolled (2.5% applications were pending on average). Of those disenrolled, an average of 17.2% no longer qualified due to exceeding the income levels for their household size or eligibility classification. An average of 33.4% lost eligibility for procedural reasons such as not completing the renewal paperwork submission process. That figure was 12% prior to the pandemic. More information is available on our website.


Improved Renewal Rates 90 Days Later

We expect the data to change as late renewal paperwork is received or individuals receiving termination notices complete and return their renewal packets. For members up for renewal in May, this was indeed true - after the 90-day reconsideration period, 60% have now been renewed, which is better than the pre-pandemic average of 57%. For the same set of members, losing eligibility for procedural reasons fell by 4% to 22%, an improvement. Members with renewal anniversaries in June and July are still within the 90-day timeframe, but we are already seeing some take late action on their renewals, tracking similarly to the May cohort. More information is available on our website.


Focus on Special Populations

We are closely monitoring more vulnerable populations. Regarding members with long-term care waiver supports, procedural denials are tracking with rates pre-pandemic at 17% then versus 18% now. Less than 1% of members with long-term care waiver supports have “whereabouts unknown,” meaning this population is receiving renewal notices. Renewal rates for children are better than for the general membership: For May, June and July renewals, 69% of children remained enrolled, better than the overall 58% of all Colorado individuals who renewed during the same period. Also, we are not finding racial disparities between people of color and white people: for example, children who identify as Hispanic are being renewed in Colorado at a higher rate than non-Hispanic white children (72% versus 68% from May renewals).


Employer Chamber Engagement

We also met with several employer organizations over the last 60 days (i.e., Denver Chamber, Pro15, Club20, Colorado Springs Chamber, and more), helping them understand the impact of the end of the public health emergency on coverage and providing tools to message employer affiliates about coverage renewals and transitions, including how to help employees covered by Health First Colorado understand how to enroll in available employer-sponsored programs should they be disenrolled from Health First Colorado or CHP+ coverage. This work, in conjunction with the outreaches from Connect for Health Colorado to disenrolling Health First Colorado members, is intended to help connect individuals to affordable coverage. 

 

Changes in Process to Keep Coloradans Covered

Keep Coloradans Covered is our top priority, which is why we – with our partners – are conducting multiple outreaches and following up to disenrolling members, refining renewal notices and improving PEAK access and efficiencies, among other strategies. HCPF is also leveraging additional flexibility from CMS to provide a 60 calendar day extension to complete the renewal process to those accessing Long-Term Care (LTC) waiver services and supports or Buy-In recipients who have not returned their renewal packet on time. This extension enables HCPF to conduct additional outreach and is in effect starting Sept. 5, 2023, through June 2024. Additional CMS guidance requires a change to our ex parte process for renewals. As we take a phased approach to the change, HCPF is implementing a temporary renewal extension for all members up for renewal in September and October. Thank you, Regional Accountable Entity partners, for additional outreach to affected members. For more information, please see our Special Edition Newsletter


Call to Action: Help Us Keep Coloradans Covered

Our ability to Keep Coloradans Covered depends on all of us engaging to do our part. Thank you to providers, educators, counties, community leaders, advocates and employers - you are our trusted messengers on the ground, seeing our members when they walk through your doors. Please leverage the HCPF resources in public areas and through email - flyers, posters, messaging, social media, and more - to achieve our shared goals. And thank you for all you’re doing to Keep Coloradans Covered.

Benefit Plans for Free Family Planning Services

Individuals not eligible for full Medicaid coverage may be able to receive free family planning services through Health First Colorado. Effective July 2022, the Family Planning Limited Benefit and the Reproductive Health Care Program now cover family planning and family planning-related services at no cost to the member. 

  • The Family Planning Limited Benefit Plan (FAMPL) is available for individuals who have a higher income than the Medicaid limit but meet all other eligibility requirements. 
  • The Reproductive Health Care Program (RHCP) is combined with the Emergency Medicaid Services Benefit Plan (EMS) and is available for individuals who do not meet Medicaid’s citizenship requirements, but meet all other eligibility requirements. 


Applicants should select that they want family planning services when completing the application. Here’s how counties can help members learn and enroll in these benefit plans so Health First Colorado can improve access to reproductive health services: 

  • Post and share flyers informing individuals about the benefit plans:
  • Family Planning Limited (FAMPL) Benefit Plan English I Spanish 
  • Reproductive Health Care Program (EMS/RHCP) Benefit Plan English I Spanish
  • Direct members to our Health First Colorado website to learn more:
  • FAMPL and RHCP Website
  • EMS Website
  • Member Handbook
  • Family Planning Benefits and Services
  • Ensure members understand the Public Charge rule so they can feel confident when applying for and using Health First Colorado Benefits:
  • Public Charge Information: English I Spanish 
  • Recommend this as an option for individuals who are concerned they will lose coverage with the end of the PHE.
  • Increase use of translated resources that ensure all individuals can access these benefit plans.


Members can learn more online, in-person or over the phone. 


If your county would like additional information on the new benefit plans, please reach out to Kim Tolchinsky.

Temporary Renewal Extension & Eligibility Site Initiated MA Terminations

HCPF is providing additional guidance on processing renewals during the temporary extension period for individual ex parte.


Renewals due in September and October have been temporarily extended for all Medical Assistance (MA) programs for members who have not submitted their Renewal Packets.

 

All MA renewals for September and October that have not been started have been updated to Data Entry Complete No to allow cases to remain open until a renewal is received or the short-term system fix is implemented in October. 


It has been identified that in some cases, the MA Case Complete indicator, Data Entry Complete, was set back to Yes, and EDBC was rerun by eligibility workers without any indication of the receipt of a Renewal Packet. This is causing temporarily extended cases to terminate before the short-term fix is implemented.


Action:


When a renewal is received within the extension period, eligibility workers should process the renewal and complete the eligibility determination according to program guidelines. If, while processing the renewal, the case requires additional verifications, please complete the Case Wrap-Up screen and update the MA Case Complete indicator Data Entry Complete to Yes.


When a renewal is not received within the extension period, eligibility workers should not update a case by switching the MA Case Complete indicator, Data Entry Complete, to Yes; it should remain as No.


When a renewal is received after the extension period, and the case is terminated, eligibility workers should utilize the 90-day reconsideration policy. 


Contact: HCPF Medicaid Eligibility

Recent Memo Series Issued to Counties

All memos and their attachments are on the Memo Series website.

Policy Memos

None

Operational Memos

HCPF OM 23-058

CBMS Limited Medicaid Benefits for Incarcerated Individuals

This operational memo explains HCPF’s policy on Limited Medicaid Benefits for Incarcerated Individuals to Medicaid-eligible individuals. The audience includes individuals who are involved in the Colorado criminal justice system; County Department of Human/Social Services; Medicaid Assistance Sites; state, county, and city corrections and law enforcement agencies. The guidance below will explain the process for all applications from incarcerated individuals should be completed, submitted and processed while the applicant is still incarcerated and should not be postponed until release.


HCPF OM 23-057

Second Round of Physical Security Improvements for County Departments of Human/Social Services

The purpose of this Operational Memo is to inform county departments of human/social services of a second chance to apply for funds made available through HCPF. These purchases must focus on enhancing services for Home and Community-Based Services (HCBS) population through improved county office physical and environmental security. This memo provides guidance on the process to access funding for these purposes through the American Rescue Plan Act (ARPA) and the County Targeted Grant Program.

Informational Memos

None

Informational Updates

Long-Term Care (LTC) and Buy-In Renewal Extension

A CBMS update will automatically extend the renewal period for 60 days for Long-Term Care (LTC), individuals on Waivered Services, and Buy-In recipients who have yet to return their renewal packet on time during COVID Unwind.  


HCPF is providing an additional 60-day extension to assist our vulnerable populations, including Long-Term Care (LTC), individuals on Waivered Services, and Buy-In recipients who have not returned their renewal packet on time during COVID Unwind.  


CBMS will add 60 days to September renewals for vulnerable populations, including Long-Term Care (LTC), individuals on Waivered Services, and Buy-In recipients who do not return their renewal packet on time. This does not include cases that have already closed.


Action: Below are resources for eligibility workers that provide additional information and data entry guidance.     


  • The Staff Development Division (SDD)
  • MA Renewal for LTC & Buy-in Population Desk Aid 
  • Navigate to the Document Library on the website and find the above titled desk aid in the Long-Term Care folder
  •  The COVID Resources for County and Eligibility Partners  
  • Aug. 24 HCPF/Eligibility Sites COVID Unwind Touch Base Meeting
  • Slide Deck (coming soon)
  • Recording 


Contact: Any questions regarding this communication may be directed to hcpf_medicaid.eligibility@state.co.us.

Temporary Extension for All Members Up for Renewal

HCPF will be temporarily extending members’ renewals due in September and October who have not yet submitted their renewal packet. This is to comply with recent federal guidance. This will be done this evening, Tuesday, Sept. 5.

 

HCPF received new guidance from the Centers for Medicare and Medicaid Services (CMS) on Aug. 30, 2023, that requires a change to the ex parte process for renewals. Instead of renewing members with ex parte at the household level (all members of a household receiving Health First Colorado or CHP+ benefits reviewed for eligibility at the same time), CMS is requiring states to perform ex parte reviews on an individual basis, meaning each person in the household is reviewed and approved separately. This new guidance will require significant changes to our eligibility system that will need to be done in a phased approach. As a result, HCPF is implementing a temporary renewal extension for all members up for renewal in September and October until we implement a short-term system change in mid-October to bring us into compliance with CMS guidance. The extension and short-term system change will not impact the member’s experience of the renewal process. Members are strongly encouraged to complete, sign, and return their renewal packet right away.

 

Action: New functionality is not being added. This means no additional action is needed from eligibility workers beyond normal processing of renewals. Similar to the Long-Term Care (LTC) and Buy-In Renewal Extension, the extension will be done systematically by setting the Data Entry Complete field in CBMS to No on the Case Wrap up screen. This is for September and October Medical Assistance renewals in which a renewal packet has not yet been started and will prevent a termination for failure to return the renewal packet. This will not affect renewals that have been started in CBMS and are already in progress.

 

Renewals that are received from members should be started in CBMS within 24-48 hours of receipt and processed accordingly. Once data entry is complete, eligibility workers must manually update the Data Entry Complete field to Yes and run eligibility.

 

Contact: hcpf_medicaid.eligibility@state.co.us

Processing Incarcerated Applications

As a reminder, Medicaid applications must be processed regardless of incarceration. Applications should be approved and placed into incarcerated status if the individual is otherwise eligible and incarcerated at the time of the determination. Please see below where this is referenced in rule: 


8.100.3.G.1.b.ii. Inmates who are incarcerated in a correctional institution such as a city, county, state or federal prison may be enrolled, if eligible, with benefits limited to an inpatient stay of 24 hours or longer in a medical institution.


Thank you for your support in ensuring Coloradans have timely access to their benefits.

Partner Webinars

HCPF will be hosting quarterly informational sessions about the end of the Continuous Coverage Requirement and the COVID-19 public health emergency. These webinars are geared toward community partners such as advocacy organizations, providers, and community organizations who may provide other assistance to Health First Colorado or CHP+ members (housing, social services, etc). 


The presentation and recording from the July 26, 2023, PHE Unwinding webinar are posted in the PHE Resource Center.


Next Webinar Information

When: Oct. 25, 2023, 1 to 2:30 p.m. Mountain Time

Register in advance for this webinar.


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


We would like your feedback on the format of future webinars to ensure they are productive for all. Please take a moment to take this survey to inform the structure of future webinars.

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 email us 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.
Supplemental Information

HCPF Contacts & Resources

Staff Development Center (SDC) Homepage


CO.Learn/Learning Management System Login


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