County Connections Newsletter
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This newsletter is designed for the Department to inform county directors, management and staff about county performance, policy changes, process updates, upcoming due dates, and more.
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High-Impact Policy and Process Updates
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Health Care Policy and Financing
PM 18-001 Implementation of the Memo Series
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Policy Memo 18-001 Implementation of the HCPF Memo Series
informs supervised agencies, contracted entities, and others of implementation of the Memo Series as the
official guidance communications method
issued by the Colorado Department of Health Care Policy and Financing (the Department) effective January 1, 2018.
Based on the authority of the Executive Director, the HCPF Memo Series shall be used as the Department’s official communication method relating to policy, operational guidance and information sharing.
Any Memos distributed after January 1, 2018 will be considered official guidance from the Department.
The intention of the Memo Series is to clarify protocols and ensure Department expectations are clear and actionable for the recipients of Department communications.
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CBMS Transformation Update
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The Road to Transformation
– CBMS Transformation Newsletter
The December Issue of the Road to Transformation
is available! The
Road to Transformation
is
a monthly one page overview that previews one key feature of CBMS Transformation and discusses current activities. The newsletter is published the first week of each month. To view all issues of the
Road to Transformation
, click
here
.
This month features a preview of Global Navigation for Phase 2.
The left-hand margin of the newsletter provides links that will help you to learn more about CBMS Transformation:
CBMS Transformation Address Tip Sheet Now Available
The CBMS Transformation Team has created a new
Address Tip Sheet
. This tip sheet will provide you with a quick walkthrough of the ‘address validation through the save button’ process, address quick tips/reminders, and an overview of the address error messages in the updated user interface.
Following Phase 1 Go-Live, the Transformation Team received helpful user feedback during our eligibility site visits. One of the main pieces of feedback highlighted confusion around address validation in the updated user interface.
With this response in mind, we’ve created an Address Tip Sheet that includes the ‘address validation through the save button’ process, address quick tips/reminders, and an overview of the address error messages.
The Resident Experts (REs) received access to this tip sheet earlier this week to help them prepare to assist with address validation questions. We encourage you to keep the REs in mind as key resources as you navigate through the updated user interface.
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System Error Generates Letter to Health First Colorado Members
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An Income Eligibility Verification System (IEVS) income discrepancy letter was sent in error to 2,200 Health First Colorado households between November 2 and November 3. This discrepancy was a system-generated error that added an incorrect employer and income record to members cases. The letter asked members to report income information to resolve a discrepancy in our system between what the member reported, and what our electronic records showed.
This system error has been resolved
. There was no interruption in benefits or other consequences for members who received the letter. Some members do not need to take action; others will need to respond to the income discrepancy record(s) based on accurate employer and income records.
We will contact affected members and assure them that the issue has been resolved. Members who do not need to respond, will receive a letter titled: “This letter is for your Information only. You do not need to take action.” Members who are required to respond will receive a letter with instructions.
If you receive any calls, questions or concerns about this issue, please direct members to their county department of human or social services.
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Children’s Habilitation Residential Program (CHRP): House Bill 18-1328, authorized the Department to:
- Remove the requirement that the child be involved in the child-welfare system.
- Transfer the administration of the CHRP waiver from the CDHS to the Department.
- Transfer the case management from child-welfare agencies to Case Management Agencies (specifically Community Centered Boards-CCBs).
- Add two services to the waiver to mitigate the need for an out of home placement and facilitate returns to the home once stabilized.
As of July 1
st
, 2018, selection into the CHRP waiver will include; children under the age of 21, who have a determination of developmental disability by a Community Centered Board who also have complex behavioral support needs which put the child or youth at-risk for, or in need of, out-of-home placement.
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The Department will engage stakeholders in a discussion about the assessment tool that will be used to determine the support need level for HCBS-CHRP waiver participants.
Meeting Details:
Date:
January 22, 2019
Time
: 10:00am - 12:00pm
Location:
The Department of Health Care Policy and Financing
303 E. 17th Ave, 7th floor, Conference Room 7B
Denver, CO 80203
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Healthy Communities Program New Toll-free Number
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The Healthy Communities Program serves children, young adults and pregnant women eligible for Health First Colorado or Colorado Child Health Plan
Plus
(CHP+) programs at no cost to families.
About 100 Family Health Coordinators throughout the state provide outreach, navigation and health education to newly eligible members and families wanting to apply for coverage.
Family Health Coordinators assist with:
- Completing Medical Assistance Program Applications
- Navigating Health Systems of Care
- Understanding coverage and benefits
- Providing referrals to community resources and providers
- Educating families on enrollment/re-enrollment issues, preventing gaps in coverage, the benefits of developing a relationship with their primary care medical provider to lead a "health neighborhood," appropriate use of medical services, and more!
To find a local Family Health Coordinator serving the zip code where you live, call
1-844-511-KIDS (5437)
. The call is free.
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HCPF Department Updates - Informational
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Affordable Care Act - Texas Ruling on December 14, 2018
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As many of you may be aware, on Friday, December 14, 2018, a district court judge in Texas rendered a judgement that the Affordable Care Act (ACA) is unconstitutional. This is a district court opinion and does not bind other courts. The decision is expected to be appealed. This judgement, if upheld, could have practical implications for our everyday work – from the populations that receive expansion coverage, to how our systems and administration are funded, from the quality of care members receive to the anti-fraud measures focused on program integrity. As we discussed at the Colorado Counties, Inc. conference in November 2018, Colorado has become a leader in the nation because of our collaborative approach to this work.
The Department thought it prudent to reach out and let you know that everything we’ve accomplished since the enactment of the ACA continues to stand as the case works its way through the appeals process
. In short, everything is business as usual and no action should be taken based on the district court’s ruling.
We continue to operate under our current federal authority and CMS has made clear to States that it will continue to enforce all provisions of the ACA until the appeals process is completed and a final decision has been rendered. As you may know from previous instances of the ACA in federal courts, this process can take up to several years.
If a final decision is rendered – at a future date – that impacts our work, the Department is committed to engaging our county partners on the implementation of whatever the final decision is. We will continue to rely on existing avenues – including PAC, Sub-PAC and the regional directors’ meetings – to share information as it becomes available. If policy and/or operational guidance changes, those updates will be communicated through the
HCPF Memo Series
.
Until we receive more information, please continue to:
- Support those who are not enrolled by working with them to submit applications in order to receive an eligibility determination
- Work with members to ensure they receive continued coverage by submitting their annual redeterminations and changes to their household circumstances
- Monitor and work towards performance benchmarks and measurements
- Follow existing guidance on funding streams, mechanisms and processes
- Encourage members to seek care by connecting them to their Regional Accountable Entity (RAE) or by using the Department’s Find a Provider tool
If you have any questions or concerns, I’d be happy to have conversations individually with you and/or your staff. Please feel free to reach out to me with anything you may need.
As always, we are extremely thankful for your hard work and dedication that has made Colorado a leader in the nation.
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Memos and Department Communications
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Policy Memos
–
PM 18-001
Implementation of the HCPF Memo Series
Operational Memos –
OM 18-021
Room and Board and Personal Needs Allowance Amounts
OM 18-022
Room and Board and Personal Needs Allowance Amounts (LTSS)
OM 18-023
CDASS Allocation Increase Process For Community Centered Board Case Management Agencies
OM 18-024
New Resources and Support for Participant Directed Programs Stakeholders
OM 18-025
Notification of Financial Ineligibility and Discontinuation of Advisement Letters
OM 18-026
2019 Social Security Cost of Living Adjustments
OM 18-027
Provider Choice for Individuals Enrolled in a Home and Community Based Services Waiver
Informational Memos –
IM 18-045
HCBS Settings Final rule - PTP Training Announcement #2
IM 18-046
No Wrong Door Quarterly Communication - November 2018
IM 18-047
Home Accessibility Adaptions Stakeholder Meeting
IM 18-048
Implementation of House Bill 18-1407, Stabilization of Direct Support Professional Workforce Stakeholder Engagement
IM 18-049
The Role of Psychological Testing in Accessing Medicaid Services FAQ
IM 18-050
Home and Community Based Services for Intellectual and Developmental Disabilities Wavier and Case Management
IM 18-052
Community Choice
Transition Services - Stakeholder Meetings Announcement
IM 18-053
House Bill 18-1407, Access to Services for Individuals with IDD Stakeholder Engagement Regarding New Criteria Based on Caregiver Capacity for Reserve Capacity Enrollments
IM 18-054
Children's Habilitation Residential Program (CHRP) Waiver Support Need Assessment Tool Stakeholder Engagement
IM 18-055
Case Management Redesign and Conflict-Free Stakeholder Engagement
IM 18-056
Changes to the County Allocation for the PARIS System
IM 18-057
Implementation of House Bill 18-1407, Stabilization of Direct Support Professional Workforce Stakeholder Engagement
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HCPF OM 18-026 2019 Social Security Cost of Living Adjustments (COLA)
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Monthly Social Security and Supplemental Security Income benefits will increase due to a COLA of 2.8% in 2019. The purpose of the COLA is to ensure that the purchasing power of Social Security and Supplemental Security Income (SSI) benefits is not eroded by inflation. It is based on the percentage increase in the Consumer Price Index for Urban Wage Earners and Clerical Workers from the third quarter of the last year a COLA was determined to the third quarter of the current year.
The 300% income limit, home equity maximum, minimum monthly maintenance needs allowance maximum, and the community spouse resource allowance will increase. The Medicare Part B premium will also increase.
Beginning January 1, 2019, the Medicare Nursing Facility Co-Insurance Rate and the Income Trust Gross Income Limits and Average Nursing Facility Private Pay Rates will change. Additionally, the Personal Needs Allowance (PNA) base amount for residents of Nursing and Intermediate Care Facilities will increase by 3%, setting the 2019 PNA Base Amount at $86.95.
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Public Rule Review Meeting
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Public Rule Review meetings
are an opportunity for stakeholders to have one on one conversation with the Department's rule author regarding draft rules.
Public Rule Review meetings happen on the second Monday after the second Friday of each month. Stakeholders can attend in person or can e-mail feedback to the rule author before the rule goes to the Medical Services Board.
This does not take the place of public testimony at the Medical Services Board meeting and anyone who wishes is invited to come to the MSB meeting to address the Board directly. The next scheduled meeting of the MSB is Friday, November 9 at 9:00 a.m. in the 11
th
floor conference room at 303 East 17
th
Avenue.
You can access information about the Public Rule Review Meeting by visiting our
web site
.
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Colorado WIC Online Referral Form
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The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides nutrition education, breastfeeding support, healthy food, health referrals and other services free of charge to Colorado families who
qualify
. WIC’s goal is to help keep pregnant and breastfeeding women and children under age 5 healthy, and improve long-term health outcomes and food security for families.
Referring to WIC just got easier! The Colorado WIC Referral Form,
www.coloradowicsignup.com
, is a short, online form health care providers and community programs can complete on behalf of a patient/client. The form, available at
www.coloradowic.com
, can also be submitted by families/individuals. We’ll take it from there! WIC staff will contact referrals to verify eligibility and schedule.
Help us spread the word! Please share via social media, newsletters, websites, etc.
Note:
The Department anticipates that Colorado's WIC clinics will remain open in the event of a short-term shutdown. If a shutdown does occur, the state relies on you provide accurate and timely messaging to help families and providers understand that WIC is not going away.
Please use the form above to continue to refer families
and make sure caseload numbers and services are not disrupted.
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Medical Assistance Supervisor and Manager Training Opportunity
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Did you know that if you are a Medical Assistance program manager or supervisor, you can help the Staff Development Center determine Program Area-specific training for supervisors and managers? Help us ensure that your team has the information you need to operate your programs and help members in the most accurate, timely, efficient and effective manner!
YOUR OPINION IS VALUABLE
. You know what supervisors and managers really need. What do you wish you would have known about your program area(s) before you became a supervisor/manager? What more do you want to know today?
Thank you for your contribution to this important initiative!
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Upcoming Training: Medicaid Trusts
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Did you know that the Staff Development Center and HCPF have collaborated on training and will deliver a Trust and Estate Recovery session on
January 23rd from 2-4 pm
?
This presentation will provide an overview of:
- Types of trusts that a Medicaid applicant or client may submit to an eligibility site
- Why individuals use trusts
- How Medicaid views trusts
- The County’s role in implementing the trust determination as it relates to an individual’s eligibility
- How to submit those trusts to the State for review
- Trust closures, estate recovery, overpayments, casualty cases, and cost avoidance
This presentation is designed around questions that eligibility sites have asked of HCPF concerning trusts and issues HCPF has encountered in analyzing, evaluating and determining the countability of trusts under federal and state law.
This will also include an overview on when and how to close trusts, who is impacted by estate recovery, what assets are typically collected by the Department at death, etc and may also cover other types of recoveries.
This instructor-led training will be developed into a WBT and will be available in February through CO.Learn
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County Grant & County Incentives Programs
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Deliverables are due to the County Team on
January 5, 2019.
Get ahead of the game before the holidays!
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Save the date!
The County Grant Program's Year End Report Out will take place on
May 29 and 30, 2019.
All grantees are required to attend, though other counties can visit and watch grantees' presentations.
Is your county considering applying for a grant in FY 2019-20?
Come to the Year End Report Out or take a look at previously funded grant projects on the
County Admin page
!
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Timeliness for November 2018
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Timeliness for all Medical Assistance
applications
was measured at
97.15 percent
. The Department and its county partners have registered 52 consecutive months above 95 percent timeliness.
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Timeliness for all Medical Assistance
redeterminations
was measured at
98.52 percent
. The Department and its county partners have registered 32 consecutive months above 95 percent timeliness.
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Connect for Health Colorado
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Applying for APTC via Paper Application
Clients who use a State paper application will still be evaluated for financial help from Connect for Health Colorado. If a client brings in a filled out paper application or fills it out in the county office, the county worker will enter the information from the paper application into PEAK/CBMS, like they do today. The customer will be evaluated and get a Health First Colorado or CHP+ approval OR CBMS will show the client’s preliminary APTC status as pass or fail.
If the client shows a preliminary pass for APTC, they will be referred to Connect for Health Colorado per current process.
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Open Enrollment Materials
Official Open Enrollment Dates for 2019 are November 1, 2018 - January 15, 2019.
Users will create an account and then can choose materials such as brochures, posters, and application checklists.
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Department Contacts & Resources
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The Colorado Department of Health Care Policy and Financing complies with applicable federal and state civil rights laws and does not discriminate on the basis of race, color, ethnic or national origin, ancestry, age, sex, gender, sexual orientation, gender identity and expression, religion, creed, political beliefs, or disability.
Learn more about our Nondiscrimination Policy
.
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-221-3943 (State Relay: 711).
CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-800-221-3943 (State Relay: 711).
For further information about this policy, to request free disability and/or language aids and services, or to file a discrimination complaint, contact:
504/ADA Coordinator
1570 Grant St
Denver, CO 80203
Phone: 303-866-6010, Fax: 303-866-2828, State Relay: 711
Civil rights complaints can also be filed with the U.S. Department of Health and Human Services Office for Civil Rights electronically through the
Office for Civil Rights Complaint Portal
or by mail, phone, or fax at:
1961 Stout Street Room 08-148
Denver, CO 80294
Telephone: 800-368-1019, Fax: 202-619-3818, TDD: 800-537-7697
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Colorado Dept. of Health Care Policy & Financing
(303) 866-2993 | 1570 Grant Street, Denver, CO 80203
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