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County Incentives Program
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| Reporting Period 2 began January 1, 2016 |
New Reporting Period
Reporting Period 1 ended on December 31, 2015. Reporting Period 2 runs from January 1, 2016 through June 30, 2016.
Deliverables for Reporting Period 2 are due on
July 5, 2016. Requests for extensions will not be granted.
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MEQIP Quarter 2 Report
MEQIP Quarter 2 report, covering October, November, and December of 2015,
is due on February 1, 2016.
MEQIP reports must be submitted timely to count towards the FY 2015-16 County Incentives Program.
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County Incentives Program - Task Group
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In February 2016, the Department will convene the FY 2016-17 County Incentives Program Task Group. The Task Group will provide counties the opportunity to provide feedback on the FY 2015-16 County Incentives Program and inform next year's program.
We encourage county directors and/or upper-level managers to participate in this opportunity. If you would like to participate, contact either
Joshua Montoya or
Crestina Martinez.
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County Grant Programs - Task Group
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In February 2016, the Department will convene the FY 2016-17 County Grant Program Task Group. The Task Group will provide counties the opportunity to provide feedback on the FY 2015-16 County Grant Program and inform next year's program.
We encourage county directors and/or upper-level managers to participate in this opportunity. If you would like to participate, contact either
Joshua Montoya or
Crestina Martinez.
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| County Training Opportunities |
Staff Development Center:
Expanding Foundations Long Term Care - Denver Metro
January 28, 2016 - January 29, 2016
8:30am - 4:00pm
Expanding Foundations Medical Assistance - Denver Metro
February 23, 2016 - February 26, 2016
8:30am - 4:00pm
IRS 1095-B Health Coverage Form training
Online through
TrainColorado
Department of Health Care Policy and Financing:
1095-B Webinar
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Quick Links and Resources
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Medicaid and CHP+ Rules and Guidance
Volume 8 - Rules - direct link to Secretary of State
HCPF Forms and Rules
HCPF Agency and Directors Letters
HCPF FAQs and Training
HCPF County Relations
CBMS Enhancement Sheets - OIT
Staff Development Center
Training Calendar
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Welcome to the January 2016 edition of County Connections!
Welcome to the newest edition of the
County Connections newsletter. The content in this newsletter is designed to inform county directors, management, and staff in areas such as county performance, process improvement, collaboration, policy updates, upcoming due dates, and more.
The content will continue to evolve. We encourage our county partners to give us your content suggestions. Feedback can be sent to the
HCPF County Relations team.
Please feel free to share County Connections with your colleagues by selecting forward this email
at the bottom of this page.
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Breaking News - Policy and Process Updates |
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County Incentives Program - Preliminary Numbers for Reporting Period 1
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Department releases information on county performance in Reporting Period 1, FY 2015-16 County Incentives Program
In order to earn incentive funds, counties must meet the requirements in the
County Incentives contracts. Based on the Department's preliminary data, we estimated how many counties will earn funds, according to the incentive benchmarks, for Reporting Period 1 (RP1), which covered November 1, 2015 - December 31, 2015.
Timeliness -
is calculated by totaling up all timely determinations and redeterminations completed within
RP1 and dividing that by the total number of determinations and redeterminations completed within RP1. These calculated percentages
shall be rounded
to two (2) decimal places. The timeliness benchmark is 95% for counties who process more than 240 cases per month unless you meet the small county exemption.
Preliminary data indicates that 59 out of 64 counties met the timeliness benchmark.
Backlog - is determined for both applications and redeterminations at the end of RP1. Data for backlog is pulled the first business day after the end of the reporting period. Counties may earn an application backlog incentive payment if the application backlog benchmarks are met for
both new applications and redeterminations.
Preliminary data indicates that:
- New applications: 61 out of 64 counties met the backlog benchmark.
- Redeterminations: 31 out of 64 counties met the backlog benchmark.
- Both new applications and redeterminations: 30 out of 64 counties met the application backlog benchmark.
Potential reasons redeterminations are in backlog
MEQIP - counties met the MEQIP incentive if they submitted all the quarterly report timely. Reports must be submitted on the specified due date, and requests for extension do not meet the timely submission requirement.
Preliminary data indicates that 61 out of 64 counties met the MEQIP benchmark.
Collaboration - counties met the collaboration incentive by conducting quarterly meetings with approved collaboration partners, submitting supporting documentation and identifying 2-3 joint goals.
Preliminary data indicates that 46 out of 64 counties met the collaboration benchmark.
Training - the training incentive requires 75% county medical eligibility FTEs to complete 9 hours of Department-approved training and submit supporting training
documentation. For FY 2015-16, these 9 hours can be completed between November 1, 2015 and June 30, 2016.
Training documentation is not required to be submitted until July 5, 2016.
Note - if your county is completing a request for exemption for timeliness and/or backlog or reached out about your incentives documentation, this may not be reflected in the preliminary data above. The Department will release final numbers regarding Reporting Period 1 in the near future.
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1095B Press Release and County Resources
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New Federal Tax Document IRS Form 1095-B Mailings Began January 2016
As many of you know, IRS Form 1095-B is a federal tax document that the Department is required to send to members as proof that they had qualifying health coverage during the month(s) they were enrolled in Medicaid or Child Health Plan Plus (CHP+) in 2015. Under the Affordable Care Act, most individuals are required to have health coverage, or pay an IRS federal tax penalty, the
Individual Shared Responsibility Payment.
The Department began mailing out 1095-B forms earlier this week, and will continue sending them through the end of January. We expect that members will start seeing these forms in their mailboxes today. We have posted the cover letter in
English and
Spanish, and an
annotated 1095-B form, so you can see what members will receive.
Visit
COHealthInfo.com/IRSForm1095B for answers to frequently asked questions from members about Form 1095-B. This resource will be updated to reflect questions received from members.
If you have any questions regarding the 1095B, please direct them to Nina Schwartz, Eligibility Communications Specialist.
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Connect for Health Colorado Marketplace Open Enrollment Update
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C4 and HCPF Joint Press Release
Between November 1, 2015 and January 15, 2016, more than 190,000 Coloradans enrolled in health coverage for 2016, either in private health insurance purchased through Connect for Health Colorado, or in Medicaid, or Child Health Plan Plus (CHP+). Read Connect for Health and the Department's
joint news release on enrollment gains
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Open enrollment continues through January 31, 2016.
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Timeliness for December 2015
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Timeliness numbers for the month of December 2015 are in! Overall, timeliness for all Medical Assistance
applications for the month was measured at
98.69 percent. The Department is especially proud that, for the month,
27 individual counties registered timeliness at 100 percent!
Timeliness for all Medical Assistance redeterminations was measured at
96.90 percent for December 2015. This could not have been accomplished without the hard work of our county partners. Many thanks!
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Timeliness All-Stars - Large County
New Applications
Congratulations to December 2015 All-Stars Mesa County
at 99.15
percent
timely and Pueblo County
at 98.89
percent
timely!
Redeterminations
Congratulations to December 2015 All-Stars Boulder County
at
98.81 percent timely
and Mesa
County
at
98.63 percent timely!
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Timeliness All-Stars - Medium County
New Applications;
Congratulations to December 2015 All-Stars
Alamosa, Chaffee, Delta, Huerfano, and Logan Counties, all at
100 percent timely!
Redeterminations
Congratulations to December 2015 All-Stars
Logan County at 100
percent timely,
Moffat County at
99.60 percent timely and
Huerfano County at
99.54 percent timely!
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Timeliness All-Stars - Small County
New Applications
Congratulations to December 2015 All-Stars
Baca, Bent, Cheyenne, Clear Creek, Costilla, Crowley, Custer, Dolores, Grand, Gunnison, Hinsdale, Jackson, Kiowa, Kit Carson, Lake, Mineral, Ouray, Phillips, Rio Blanco, San Juan, Washington, and Yuma
Counties - all are at
100 percent timely!
Redeterminations
Congratulations to December 2015 All-Stars
Archuleta, Cheyenne, Dolores, Hinsdale, Jackson, San Juan, and Sedgwick Counties - all met
100 percent timely!
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Medicaid Eligibility Quality Improvement Plan (MEQIP)
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MEQIP FY 2014-15 Annual Report: Case File Documentation
Over the coming months, the Department will highlight various results from the FY 2014-15 MEQIP annual report. This month highlights whether the county's case file documentation corroborated the client's eligibility determination as made by the Colorado Benefits Management System (CBMS).
In the map above, if your county is shaded green, your case file documentation was found to have corroborated the eligibility determination 95% or above of the time.
If your county is shaded yellow, your case file documentation corroborated the eligibility determination between 75% to 94% of the cases reviewed. If your county is shaded orange, your case file documentation corroborated the eligibility determination between 0% to 74% of the cases reviewed.
Counties should utilize this data in order to determine training needs and areas for improvement.
In addition, the entirety of the MEQIP FY 2014-15 Annual Report - Statistics is now available. The Department will continue to highlight various areas throughout the coming months.
More information about MEQIP can be found on the website. For assistance on MEQIP reporting, contact Gina Martinez.
Note: if your county is shaded orange, you may have submitted an exemption; MEQIP reporting on County Connections represents a point-in-time. If you have made corrections and/or other arrangements with the MEQIP program manager, they may not be reflected in County Connections at the time of publication.
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Public Assistance Reporting Information System (PARIS)
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PARIS expenditures in FY 2015-16 - As of November 30, 2015
Each fiscal year, the ten counties with the most cases listed in the PARIS system are allotted additional funds in order to work these cases. This system is critical to determining if a beneficiary is receiving benefits in multiple states, and if so, whether the client's case in Colorado should be closed or remain open.
As of November 30, 2015, these counties have only spent 17% of the state-wide allotment. Breakdown by counties is listed below.
| County |
% of PARIS Allotment Spent |
| Adams |
33% |
| Arapahoe |
4% |
| Boulder |
0% |
| Denver |
6% |
| El Paso |
19% |
| Jefferson |
1% |
| Larimer |
46% |
| Mesa |
29% |
| Pueblo |
22% |
| Weld |
26% |
The Department encourages these counties to utilize the funding allotted to them to work those cases listed in the PARIS system.
For more information regarding PARIS, contact Jared Shaffer, PARIS Program Manager.
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FY 2015-16 County Grant Program: Proposals focused on Process Improvement
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Counties submit proposals focused on process improvement
As part of the FY 2015-16 County Grant Program, counties submitted various proposals focused on improving internal business processes. These proposals ranged from document scanning technology for electronic case files to the outstationing of technicians at different venues to increase enrollment.
Included in proposals received were various LEAN and training initiatives, as well as cutting-edge technology such as client engagement portals.
The Department has prepared a document that lists all proposals received for the FY 2015-16 County Grant Program. The document includes proposal descriptions and budgets, cost allocation information, and whether the project was funded and accepted by the county.
This document may be useful as counties continue to consider projects and proposals for the upcoming FY 2016-17 County Grant Program.
Questions regarding the County Grant Program can be directed to the HCPF County Relations team.
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Behavioral Health Organizations (BHO)
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Reminder: BHOs eligible for collaboration under the collaboration incentive
Through the County Incentives Program, counties are eligible to include BHOs as part of their collaboration incentive. The Department would like to encourage counties to consider collaborating with their BHO in 2016 to help meet their collaboration incentive.
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County
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Behavioral Health Organization |
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Denver
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Access Behavioral Care |
| Adams, Arapahoe, Douglas |
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Alamosa, Archuleta, Baca, Bent, Chaffee, Conejos, Costilla, Crowley, Custer, Delta, Dolores, Eagle, El Paso, Fremont, Garfield, Grand, Gunnison, Hinsdale, Huerfano, Jackson, Kiowa, Lake, La Plata, Las Animas, Mesa, Mineral, Moffat, Montezuma, Montrose, Ouray, Otero, Park, Pitkin, Prowers, Pueblo, Rio Blanco, Rio Grande, Routt, Saguache, San Juan, San Miguel, Summit, Teller
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Boulder, Broomfield, Clear Creek, Gilpin, Jefferson
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Cheyenne, Elbert, Kit Carson, Larimer, Lincoln, Logan, Morgan, Phillips, Sedgwick, Washington, Weld, Yuma
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Accountable Care Collaborative (ACC) Phase II
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Stakeholder Feedback & Meeting Summaries
The Department is looking to consult with stakeholders on the future of the Accountable Care Collaborative (ACC). The ACC is the Department's delivery system for health care services and supporting the health of our clients.
Learn more about the ACC
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Procurement Timeline & Stakeholder Engagement
The Department is currently reviewing the ACC Phase II procurement timeline and its stakeholder engagement plan and look forward to sharing more information in the coming month. We have been aware that our original proposed timeline was aggressive given the need for robust stakeholder feedback and discussions with the Centers for Medicare and Medicaid Services (CMS). The ACC Phase II Team has received significant feedback from our partners and want to ensure our steps forward reflect the needs of the Department, our members, the physical and behavioral health provider community, county and community partners and other stakeholders.
December Meeting Summaries Available
The Department has made available meeting summaries from the following ACC Phase II feedback opportunities. The summaries can be found at
Colorado.gov/HCPF/ACCPhase2
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Department introduces NEMT-related bill during legislative session
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HB16-1097 Stakeholder Feedback Opportunity
The Department and the Public Utilities Commission (PUC) have been working with Representatives Coram (R - Montrose) and Moreno (D - Commerce City) on a bill to increase Medicaid clients' access to non-emergency transportation. On January 19, 2016, HB16-1097 - Concerning Regulation of Medicaid Nonemergency Transportation Providers was introduced with the goal of reducing barriers for transportation companies interested in becoming enrolled Medicaid transportation providers. The bill does not impact the current regulations of common carriers. Any common carrier enrolled as a Medicaid provider would still be able to serve clients under their existing permit.
The sponsors are holding a stakeholder meeting Thursday, January 21st at 3:00 PM, Colorado State Capital, 200 East Colfax, Room 246 - Barney Ford Room, Denver, CO 80203, to explain the bill and collect feedback from interested stakeholders. Leadership from the PUC will be available to explain the details of the permitting process and answer questions.
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| Long Term Services and Supports (LTSS) Updates |
Adult Day Redesign Workgroup
The Department is creating a workgroup to make revisions to the Adult Day Home and Community Based Services rule. We welcome all clients, families, providers, case managers, and any other interested parties to join us in these efforts.
The first meeting will be in February. Please RSVP to
cassandra.keller@state.co.us if you are interested in joining this workgroup. A schedule and agenda will be provided upon RSVP.
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No Wrong Door (NWD) Update
The Department is preparing to launch a series of No Wrong Door (NWD) regional pilots in 2016. Funding for the pilots will be awarded through a request for applications (RFA) process instead of the request for proposals (RFP) that we originally planned to issue. The RFA provides the Department with more flexibility in how we can operate. Applicants will be allowed to define the geographic areas they will serve instead of the Department defining them. Also, through the RFA, the Department has the option of creating three, four or five pilots, instead of predetermining a set number.
The RFA will be issued in early 2016 and applications will be scored by a team of evaluators. While we are in the process of determining specifics of how to score applications, they will be based on the following criteria:
- Partnerships/collaboration: Applicants should build a network comprised of the following organizations conducting long-term services and supports (LTSS) entry point functions within a self-defined region:
- Area Agency on Aging
- Single Entry Point
- Community Centered Board
- Center for Independent Living
- County eligibility staff
One organization within the network will serve as the lead agency to ensure the pilot is carrying out the following six functions of an NWD system:
- Information, referral and community awareness
- Person-centered counseling
- Streamlined eligibility determination for public programs
- Person-centered transition support
- Consumer populations, partnerships and stakeholder involvement
- Quality assurance and continuous improvement
- Self-assessment: An explanation of what NWD functions applicant organizations are currently fulfilling along with an understanding of their ability to carry out the rest of the functions.
- Stakeholder input: A plan for how the applicant will solicit input from a wide range of stakeholders throughout the pilot period. This effort includes engaging consumers, families and referral sources to provide feedback and input to improve the customer experience with the NWD system.
- Leveraging funds: Funds awarded through the RFA are a supplement to existing funds and resources that are already being used by organizations carrying out LTSS entry point functions. Applications should include a budget narrative that demonstrates how funds will be used to help the community and entry point agencies better carry out the six functions in a more integrated or coordinated network.
- Person-centered approach: A demonstrated commitment to utilizing an approach in connecting individuals to LTSS that allows the consumer to make informed choices and direct the process.
- Coordinated eligibility determination: A clear plan to coordinate the financial and functional Medicaid LTSS eligibility determination.
If you are part of an organization that is interested in serving as a pilot, now is the time to begin your planning work. Discuss opportunities for collaboration with other LTSS entry point organizations near you and define the geographic region you propose to serve. Begin developing an operating budget that spans the length of the pilot phase - estimated start date is July 1, 2016; concluding date is September 30, 2018.
The Department will release the RFA for public comment in the near future.
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Provider revalidation information used for new Colorado interChange
The Colorado interChange is the Department's new claims payment system. The interChange is a flexible system that will be able to support cost-effective business processes and improve health outcomes.
Federal rules require providers to be revalidated/screened in order to continue providing services to Colorado Medicaid members. Revalidation/screening information will be used to enroll providers into the Colorado interChange.
If you are a county who bills Medicaid as a transportation (non-emergency medical transportation/NEMT) provider or Local Public Health Agency (LPHA), your county must revalidate through the Colorado interChange. Providers must revalidate by March 31, 2016.
The Department has a variety of resources available for providers including a Provider Revalidation & Enrollment Video and Step-by-Step Revalidation & Enrollment Instructions. This webpage and the Provider Bulletins will be the go-to location for instructions and updates.
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Connect for Health Colorado - Special Enrollment Period
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From Brenda LaCombe, Connect for Health Colorado
Connect for Health Colorado® announced on January 13, 2016 that thousands of
Coloradans would have additional time to pick new health insurance coverage for 2016 through a Special Enrollment Period.
Individuals and families who are shopping for new health insurance coverage because their health insurance company is no longer offering health plans in their area - or because they had a policy last year that no longer meets the minimum legal requirements - will be permitted to enroll in new coverage through Feb. 29. This includes individuals and families who purchased their 2015 health insurance on or off Connect for Health Colorado's site.
"We have worked with the state Division of Insurance and our carrier partners to give Coloradans in these particular circumstances a little more time to enroll in a health plan," said Kevin Patterson, CEO of Connect for Health Colorado®. "But I want to remind everyone who does not have health insurance provided through their employer to enroll now to provide financial security for their family and to avoid a penalty of $695 or more."
Those who do not qualify for a Special Enrollment Period must enroll in a health plan by the end of Open Enrollment on Jan. 31, 2016. That is the last chance for most people to buy health insurance this year and avoid a tax penalty that is expected to average nearly $1,000 per household this year.
The Special Enrollment Period, through February 29 is largely offered to individuals who lost certain types of coverage:
- Those whose 2015 coverage was with the Colorado HealthOP or Access Health Colorado.
- Those who were Rocky Mountain Health Plans but are no longer in the company's redrawn service area.
- Subscribers of "Transition" plans, which do not meet the standards of the Affordable Care Act.
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White House Health Communities Challenge
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From Andrea Albo, Denver County DHS
President Obama reached out to 20 key communities across the country to launch the "White House Healthy Communities Challenge" for year three of ACA open enrollment. The focus of the challenge is to engage 20 key communities with large numbers of uninsured through the marketplace, excluding Medical Assistance/Medicaid enrollments which can occur at any point during the year. Denver's Mayor Michael B. Hancock has accepted the challenge for Denver and has asked that communities help to draw awareness to this effort to increase enrollments. The White House is identifying participating areas by using the Denver media market map (see attached), so we're asking for county partners and elected officials to help spread the word in respective communities to reach the 170K uninsured in these surrounding areas!
Through this challenge, the White House is calling on community leadership to build outreach efforts to reach these remaining uninsured and help them gain coverage. Denver's Mayor's Office and County DHS is engaging with leadership from US Health & Human Services Region VIII, HCPF, Connect for Health CO, Denver Health & Hospitals Authority, CCI, and Boulder Outreach to initiate this effort in Denver. If you and your community are interested in participating in this challenge, please share the following information and encourage enrollments as we move toward the final stretch of open enrollment ending January 31, 2016!
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From Laurel Petralia, Delta Dental CHP+ Outreach
Did you Know?
Tooth decay is the most common chronic childhood disease. Children with toothaches typically miss more school than children with healthy mouths, and poor dental health can affect a child's overall health and well-being. Delta Dental of Colorado is dedicated to improving Colorado's dental health by working to eradicate childhood tooth decay and increasing access to dental care.
Delta Dental of Colorado administers the Child Health Plan Plus (CHP+) dental benefits for Colorado. CHP+ is a public low-cost health insurance for certain children and pregnant women. It is for people who earn too much to qualify for Medicaid, but find it difficult to afford private health insurance.
Children covered under CHP+ have $1,000 of allowable benefits per calendar year (January 1-December 31). There are no out-of-pocket costs or copayments for dental exams, cleanings, or sealants, but they do count against the annual benefit maximum. Unfortunately, many parents are not aware of the CHP+ benefits, and as a result, many benefits go unused each year.
The start of the new year is the ideal time to educate parents about CHP+ dental benefits. Providers and community-based organizations serving low income families can play an important role. It's as easy as...
- Select a CHP+ Dentist from the CHP+ Provider Directory at deltadentalco.com/chp.aspx or call 1-800-610-0201.
- Schedule an appointment for two dental exams and two cleanings each year.
- Encourage parents to talk to their dentist about sealants - a thin plastic coating that helps prevent cavities. They should be placed when both sets of molars first come in, usually around 2nd and 7th grade.
Delta Dental also offers a special fund up to $1,000 for CHP+ members who reach their annual benefit maximum. These funds are available to the practicing dentist through an application and treatment plan process. For more information, contact Monica Woods at
303-889-8607 or mwoods@ddpco.com.
The smile on a child's face is priceless. There is a lot parents and community-based organizations can do to help keep it that way. In fact, maintaining children's teeth, gums, and mouth is key to their overall health.
Delta Dental of Colorado offers an extensive oral health and wellness resource library
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The Colorado Department of Health Care Policy and Financing does not discriminate against any person on the basis of disability in its programs, services, and activities.
To meet the requirements of Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990 ("ADA"), the Department adopted operating procedure
ADA001 Disability Rights Policy and Grievance Procedure. More information including a copy of this policy is available on the Department's
website. Printable copies of the Disability Rights Notice in
English and
Spanish are also available on the website.
For further information or to file a discrimination complaint contact:
504/ADA Coordinator
Health Care Policy & Financing
1570 Grant Street
Denver, Colorado 80203
Telephone: 303-866-6010
FAX: 303-866-2828
State Relay: 711
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