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.

With your help, we have connected Coloradans who lost their jobs during this economic downturn to public health coverage, which is an important tool in the battle against health disparities and the most important contributor to maintaining the state’s uninsured rate at about 6.6%. Specific to Colorado children, together, Health First Colorado (Colorado’s Medicaid program) and Child Health Plan Plus (CHP+) now cover nearly one in two Colorado children. Contributing to this reality, the number of children and parents we cover is up by almost one-third since the start of the pandemic.

After health coverage, another top priority in battling health disparities for low-income children is vaccinating them against COVID-19. Across the nation and here in Colorado, we are experiencing a frightening vaccine uptake disparity for people with lower incomes. Our 5-19-year-old members' vaccination rate is almost 17 points below all Coloradans of the same ages, and our adult members’ vaccine disparity is about 26 points below all adult Coloradans.

In our quest to overcome this important health disparity, and to encourage more providers to be part of the solution, we have received approval from CMS to further increase the Health First Colorado and CHP+ reimbursement rate for COVID-19 vaccine administration to $61.77 for the first two doses, retroactive to Sept. 1, 2021. This rate is triple the typical Medicaid vaccine administration rate and 50% above the Medicare rate. With this change, we again ask our providers to please become a Health First Colorado vaccine distribution partner. That includes Health First Colorado primary care providers, dentists, pharmacists and specialists, too. We also ask that our provider partners leverage every opportunity, in every care setting to encourage vaccinating our kids as well as families, and to encourage boosters too, which is even more important given the Omicron variant surge. An outreach toolkit is available for your use.

We also want to thank you for your partnership in addressing the impact of COVID-19 on the mental health of children, youth and adults. The behavioral health workforce challenges and appropriate care site limitations are clearly frustrating for all of us, especially as the demand for behavioral health services continues to rise. Longer term, we are confident the 19 priorities of the Behavioral Health Task Force - including the Behavioral Health Administration - and the $450 million in American Rescue Plan Act funding to transform our behavioral health system, with committee recommendations forthcoming this month, will help address these significant challenges. In the shorter term, we are collaborating bi-weekly with hospitals to help them find placements here in Colorado and across the nation for children, youth and adults awaiting appropriate behavioral health services. Concurrently, we are improving community mental health center (CMHC) cost reporting methodologies and developing a new universal contract model to help address many of the CMHC safety net system opportunities. Look for further behavioral health safety net solutions in mid-January, and please read this statement reaffirming my shared commitment with Colorado Department of Human Services Executive Director Michelle Barnes on the importance of working together to transform the behavioral system to the betterment of all Coloradans seeking such services.

As we begin the new year, I want to thank you for your collaboration in navigating the COVID-19 pandemic. 2022 will be a year of dynamic transformation, to the betterment of the children, youth and adults who rely on our services each and every day.

Kim

Effective Dec. 23, 2021, the Department of Health Care Policy & Financing (Department) suspended new enrollments into InnovAge Colorado’s PACE program following numerous regulatory violations and non-compliance with the Department’s provider contract. The moratorium on new enrollments will remain in effect until InnovAge Colorado completes a Corrective Action Plan to the satisfaction of the Department and the Centers for Medicare and Medicaid Services (CMS).

For more information visit the PACE webpage.

Health First Colorado and CHP+ will cover any needed medication refills for members whose medications have been destroyed, damaged or lost due to the recent Boulder fires. Members should contact their pharmacy to request medication refills.

For more information, read the press release.

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

On Jan. 18, 2022, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced the availability of $13 million in funding to increase access to behavioral health care services and address health inequities in rural America, including through evidence-based, trauma-informed treatment for substance use disorder.

“The COVID-19 pandemic has caused behavioral health challenges for Americans of all ages and backgrounds,” said HHS Secretary Xavier Becerra. “This investment is part of the Biden-Harris Administration’s efforts to address the inequities that still exist surrounding behavioral health and advance care in rural America. It will support comprehensive behavioral health prevention, treatment, harm reduction and recovery interventions in rural communities—furthering the goals of our new overdose prevention strategy.”

HRSA’s Federal Office of Rural Health Policy will make awards through the Rural Communities Opioid Response Program (RCORP)—Behavioral Health Care Support. Eligible applicants include entities such as Rural Health Clinics, federally recognized tribes, tribal organizations, and community- and faith-based organizations.

“Our response to the COVID-19 pandemic must include meeting the behavioral health needs of individuals experiencing substance use disorder,” said HRSA Administrator Carole Johnson. “In rural areas, accessing the care and services to address these needs can be a particular challenge. The funding we are announcing today is directly targeted to the community needs of rural areas and will help expand access to behavioral health services to meet these needs.”

Since 2018, the Rural Communities Opioid Response Program—a multi-year initiative administered by HRSA—has provided over $400 million in direct grants and technical assistance to rural communities addressing behavioral health care challenges, including substance use disorder. To date, the initiative has expanded access to substance use disorder prevention, treatment, and recovery services in over 1,500 counties nationwide, with RCORP grant recipients serving over 2 million individuals in rural communities in fiscal year 2020.

Applicants can begin the RCORP-Behavioral Health Care Support application process on Grants.gov and must apply by Tuesday, April 19, 2022, at 11:59 p.m., ET. Visit the Notice of Funding Opportunity for more information.

For more information about efforts to address barriers to treatment for substance use disorder in rural areas, visit HRSA’s Federal Office of Rural Health Policy.

To learn about the HHS Overdose Prevention Strategy, visit https://www.hhs.gov/overdose-prevention/.

The Biden-Harris Administration is committed to improving health outcomes and promoting health equity in rural America. In 2021, thanks to the American Rescue Plan (ARP), the Department of Health and Human Services has invested over $16 billion to strengthen rural health. Read the Fact Sheet on HHS Investments to Strengthen Rural Health - PDF.

Sign up to get the Department's latest newsletter highlighting Maternal, Child and Reproductive Health Legislation. The new monthly publication will offer updates, information, and stakeholder engagement opportunities related to SB 21-194, SB 21-009, SB 21-025, SB 21-016 and SB 19-195, the Maternal Opioid Misuse Grant, and the Maternal Advisory Committee.

Don't miss out; register today by emailing HCPF_HPO_Comms@state.co.us and requesting placement of the distribution list. In the meantime, check out the Maternal, Child and Reproductive Health webpage for the latest information. 

On Jan. 5, 2021, the Centers for Disease Control and Prevention (CDC) approved the COVID-19 Pfizer booster for anyone 12 and older. The Colorado Department of Public Health & Environment encourages all Coloradans age 12 and up to get a booster dose as soon as possible if it has been at least six months since they got their second dose of Pfizer or Moderna, or at least two months since they got the Johnson & Johnson vaccine.

As a reminder, children ages 5-11 are eligible for the COVID-19 vaccine. Vaccines and boosters are common practice in routine childhood vaccination. Many vaccines require multiple doses at specific intervals to be most effective. Anyone with questions about boosters is encouraged to speak with their health care provider.

Learn more about COVID-19 vaccines and boosters and where to find them. Anyone who needs help making a vaccine appointment should call 1-877-268-2926. Health First Colorado members who need help finding a ride to get to a vaccine appointment can use the Non-Emergent Medical Transportation benefit.

The Department is implementing a multitude of projects to expand, enhance, and strengthen the Home and Community-Based Services (HCBS) system from fall 2021 through spring 2024 tied to federal funding in the American Rescue Plan Act (ARPA). This newsletter will serve as a source for key updates on all project planning and implementation, stakeholder engagement opportunities, and other topics of interest related to the funding.

For more information, please visit and bookmark the ARPA webpage for all the latest information and updates and sign up for the newsletter.  

HCPF submitted a budget request (R-8) for FY 2022-23 that attempts to address county and state concerns regarding funding and oversight. Please see this presentation

and the FY 2022-23 Budget Agenda Summary for more information.

All provider enrollments as a Case Management Agency must be revalidated every five years, even though they are non-billing providers. They will be notified by mail about the revalidation application.

County fact sheets provide an annual snapshot by fiscal year of Health First Colorado activity, including average annual caseload and top five claim types for each county.

Timeliness for all Medical Assistance applications was measured at 97.43%.

Timeliness for all Medical Assistance redeterminations was measured at 97.81%.