In place of the Policy Advisory Council (PAC) update, the county team is using a newsletter in the style of County Connections to communicate critical information.
The content is designed for county human services directors and leadership.
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Letter from the Executive Director
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County Partners,
The ongoing COVID-19 pandemic has brought new focus to health, economic and racial disparities in our society. In Colorado, it is clear that people of color are facing higher COVID-19 hospitalization rates and all but the Asian community are experiencing significantly higher COVID-19 mortality rates. While the pandemic did not cause health inequities, the pandemic has shined a light on the disparities that exist. At the Department, we are facing these challenges head on through action we are taking in coordination with Governor Polis and other state agencies to effect real change. Our members are diverse, and we are dedicated to addressing health disparities among our members.
Our Department’s budget requests for the 2021-22 fiscal year reflect this dedication, with a focus on addressing the state’s current budget shortfall while still protecting member benefits and services and addressing health care disparities.
Budget request R24, Addressing Health Care Disparities, requests funding to address health disparities in the Medicaid program and Colorado by collecting data to identify health disparities by race and ethnicity and use the data to inform outcome-based value-based payments to Health First Colorado providers. The funding will support data transfer from community partners and provide data analytics to better target the efforts of community-based organizations, including outreach, training, and technical assistance.
Other budget proposals address enrollment and cost projections for Health First Colorado and CHP+ in support of physical and behavioral health services, prescription drug benefits, and services for people with intellectual and developmental disabilities. We will bring these budget requests to our Joint Budget Committee hearings in December. Budget proposals are not final until approved by the Colorado General Assembly and signed by Governor Polis in spring 2021.
Also in support of equity, diversity and inclusion, we are proud to introduce our new Health Disparities and Equity, Diversity and Inclusion Program Manager, Maileen Hamto. Maileen brings many years of experience in strategic communications, program development, and project management. Over the last decade, she has concentrated her professional efforts on leadership that serves people and a strategic approach to advancing equity and inclusion to provide opportunities and access for underserved and underrepresented communities. She has deep experience in health care, higher education, technology, and government. We are excited to explore new opportunities with Maileen for closing disparities to the benefit of our members while helping our own employees thrive.
Our Department has also created an Equity, Diversity and Inclusion Committee, which recently sponsored an interview with Cleo Parker Robinson, a tremendous leader in the African American community and in Arts-in-Education here in Colorado. I had the honor of meeting with her to discuss issues of equity, diversity and inclusion. Department staff were invited to attend and a recording of the interview will be available shortly.
On behalf of myself and everyone at the Department, please know we are dedicated to making Colorado a healthier and more equitable place for everyone. I appreciate each of you and your partnership as we work together toward this common purpose. And to the betterment to our members and all Coloradans during this holiday season, thank you for sharing this critical message with your networks to reduce spread of COVID-19 and protect health and well-being during this holiday season. Thank you!
Kim
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New Training from the Staff Development Center
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The Staff Development Center (SDC) is happy to announce that a new Med Incentive training has been released! This web-based training (WBT) titled CBMS Client Data Mismatch has been made mandatory as these changes are important for you to be familiar with so that you can quickly adapt with minimal effect on your processing.
This change will be implemented into CBMS on December 13th, 2020. We have released this training to you a week in advance so that you can be prepared for the change!
All CBMS workers must complete this training by June 30, 2021.
How To Get Credit:
In order to receive Med Incentive credit, you must sign in to CoLearn with your login credentials. After signing in, you will then be able to search for the CBMS Client Data Mismatch training.
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CBMS Client Data Mismatch
- This December 2020 build project will make several changes to SIDMOD Overrides to ensure that SIDMOD overrides do not modify existing case data without your awareness. These changes will give you, the CBMS User, more control over SIDMOD Overrides on your cases and will create a new screen where you can review the new information from a SIDMOD Override before it is updated in the case. This project will be implemented in the Dec. 13 build.
Total Credit Hours:
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Guidance for Residential and Inpatient Substance Use Disorder (SUD) Treatment: Provider Reimbursement for Medicaid effective on Jan. 1, 2021
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On Jan. 1, 2021, Health First Colorado, Colorado’s Medicaid program, will expand its substance use disorder (SUD) benefit. Residential and inpatient treatment and withdrawal management services will be added to the Department’s existing list of covered SUD services, giving members access to a full range of treatment options. The RAEs will be responsible for authorizing inpatient and residential substance use disorder treatments as part of administering Health First Colorado’s capitated behavioral health benefit.
To prepare members, providers, and stakeholders for the launch of these new SUD services, the Department will be sending out weekly communications with updated guidance and other information.
The Department has developed the following guidance for inpatient and residential SUD providers to facilitate a smooth transition to Health First Colorado reimbursement for Health First Colorado members already in residential or inpatient treatment when the new benefit begins on Jan. 1, 2021.
SUD residential treatment providers are asked to do the following:
- Enroll as a provider with Health First Colorado.
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Visit the Provider Enrollment webpage for more information about provider types.
- Discuss with each RAE opportunities for establishing a contracting arrangement.
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Generate a list of Health First Colorado members in treatment as of Dec. 11, 2020, using the Department's template. The list must contain the following information:
- Member Name.
- Health First Colorado ID.
- Treatment Provider (indicate whether Special Connections provider).
- Date of Admission.
- Anticipated Date of Discharge.
- Contact information for provider staff person.
- Submit the member information from the numbered list above to the Managed Service Organizations by Dec. 14, 2020.
- Coordinate with the individual RAEs as they reach out to discuss treatment plans, support transitions to community-based services for appropriate members, and arrange for stays that will extend beyond Jan. 1 to be reviewed for continued stay authorizations.
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Beginning Dec. 28, 2020, submit continued stay authorization requests to the RAEs for all Health First Colorado members who will remain in inpatient or residential SUD treatment after Dec. 31, 2020.
- All continued stay authorization requests must be received by the RAEs by Jan. 15, 2021, for members who began inpatient or residential SUD treatment prior to Jan. 1, 2021. Failure to submit continued stay authorization requests by Jan. 15, 2021, will jeopardize a provider’s ability to receive reimbursement back to Jan. 1, 2021, for eligible members.
Providers must be enrolled with Health First Colorado in order to be eligible for reimbursement for services provided to Health First Colorado members.
Additional information will be posted within the next week to better support providers during this transition.
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Children's Habilitation Residential Program (CHRP) changes:
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Effective Nov. 30, 2020, per 10 CCR 2505-8.508, the following changes to the CHRP rules will be in effect:
- Host Home Providers are now allowed to serve youth 18 to 20 years of age for CHRP Habilitation. The Host Home must meet all requirements of Host Homes as defined in Regulation Section 8.600 and be contracted with a Program Approved Service Agency (PASA) that is an approved CHRP provider.
- In-Home Support in Transition and Intensive Support Services was changed to Child and Youth Mentorship. There are no other changes to the service.
- Supported Community Connections was changed to Community Connector. This service can now be provided on a unit or hours per year basis. The overall maximum is the same. The service is limited to 1,040 units or 260 hours per year.
Effective January 1, 2020, there will be increases to the RCCF change. Please watch the Provider Rates and Fees for these updates.
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Hospital Transformation Program (HTP) Update
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HTP Implementation Update
As a state and nation, we are witnessing the novel coronavirus disease (COVID-19) pandemic continue to worsen and hit unprecedented levels while having major impacts on our communities and hospitals. On Nov. 20, Executive Director Kim Bimestefer authorized the decision to move the start date for the HTP from Feb. 1, 2021 to April 1, 2021. This is part of the Department’s continued effort to support our hospitals during this crisis and our commitment to set the HTP up for success. Additional details and updated program timelines will be shared through the HTP listserv. To be added to this listserv, please contact Courtney Ronner.
Rural Support Payment Update
The Rural Support Payment is an integral part of the HTP that will aid in making the concepts of HTP operations a reality for many rural hospitals. Total funding available is $12,000,000 per year for five years, beginning with federal fiscal year (FFY) 2020-21. On Dec. 3, additional information was shared with program participants and stakeholders, including a list of qualified hospitals.
Link to HTP Refresher Training
A HTP Refresher training took place on Tuesday, Nov. 10. The training was recorded and can be found on the HTP website under “Tools & Resources.”
HTP Community Advisory Council
Community Advisory Council meetings continue to take place on a monthly basis, with the most recent meeting taking place on Monday, Nov. 16. The agenda, meeting materials and previous meeting notes can be found on the HTP Community Advisory Council website.
Colorado Healthcare Affordability and Sustainability Enterprise (CHASE) Board meeting
The next CHASE Board meeting will take place via webinar on Tuesday, Dec. 15 at 3 p.m. Additional information about the board, as well as meeting materials, which will be posted before the meeting date, can be found on the CHASE Board website.
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Connect for Health Colorado: Open Enrollment
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Community Partners,
Unfortunately, the pandemic is continuing to grow and affect our communities. It is more important than ever to make sure all Coloradans have access to affordable health insurance and thankfully Open Enrollment has begun and is open to Coloradans until Jan. 15. 2021.
Here are some helpful reminders and virtual tools for you:
- Free, virtual help with enrollment is available from our certified Connect for Health Colorado enrollment experts located throughout the state. If anyone in the community you serve needs help, you can refer them to one of our experts to ensure they get the right health insurance coverage and financial help. Visit the Connect for Health Colorado website to find assistance in your area.
- Free virtual enrollment events are scheduled throughout the state. To view the calendar, visit their website.
- The auto renew date changed this year from Dec. 15 to Dec. 1. Current customers should shop and compare in next few weeks so they aren't auto renewed unless they choose to be!
Thank you for being a great partner and helping keep Colorado covered.
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Upcoming Change to Reasonable Opportunity Period (ROP)
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The Department is changing the timeframe in which we will verify a Health First Colorado or Child Health Plan Plus (CHP+) applicant's income.
Beginning in Spring 2021, the Department will be narrowing the window for a member to provide verification for an income discrepancy from 90 to 30 calendar days, when requested. This change is based on member feedback that this timeframe reduces confusion because it better aligns with other timelines in the eligibility process.
In addition, the Department is excited to upgrade to a more timely income verification process that pulls from multiple database sources. We hope doing so will help us verify income automatically without needing to request additional proof of income from applicants.
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Recent Memo Series Issued to Counties
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PM 20-010
The purpose of this Policy Memo is to inform eligibility sites of the income and resource
eligibility rules for all Medical Assistance categories, regarding the Colorado Emergency
Economic Stimulus payment. Executive Order D 2020 018 issued by Governor Jared
Polis on Oct. 28,2020, is a one-time direct stimulus payment to qualifying individuals
experiencing economic hardship caused by coronavirus disease (COVID-19). Please
share this memo with all eligibility staff, supervisors, and outside agencies, as
appropriate.
PM 20-009
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OM 20-098
The purpose of this operational memo is to inform members, stakeholders, and
eligibility sites of the addition of the Health First Colorado Medicaid Buy – In phone
number. Beginning, Oct.1, 2020, the Health First Colorado, Medicaid program for
children and working adults with disabilities (also known as the Medicaid buy-in
program), will have a direct number for members to use for questions about eligibility,
premiums, and status. Please advise members to use this dedicated, toll free number
for any Medicaid Buy-In questions or concerns, 1-800-711-6994. You can also continue
to use the Health First Colorado number as well. Please share this memo with all
eligibility staff, supervisors, and outside agencies, as appropriate.
OM 20-094
The purpose of this memo is to ensure eligibility sites provide complete contact information on all member correspondence issued from the CBMS.
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IM 20-051
The purpose of this Informational Memo is to inform Case Managers, participants, and providers of a change to the Personal Needs Allowance (PNA) in accordance with cost-of-living adjustments (COLA) for both Supplemental Security Income (SSI) and Old Age Pension (OAP).
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Department Contacts & Resources
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