Care and Case Management System News

The Department of Health Care Policy & Financing (the Department) is nearing the implementation of Colorado’s new Care and Case Management (CCM) system, Colorado Single Assessment (CSA) and Person-Centered Support Plan (PCSP).

As a reminder, the new CCM system will replace the Benefits Utilization System (BUS), DDD Web, and in the future, the Bridge for member record management and Case Management Activities and documentation. 

The CSA and PCSP will replace the ULTC 100.2 and BUS Service Plan, as well as introduce a new comprehensive Needs Assessment which will eventually replace the Supports Intensity Scale (SIS) assessment for the IDD waivers and will be the first such assessment for non-IDD waivers.

The Needs Assessment will pave the way for the future implementation of a Person-Centered Budget Algorithm (PCBA), or resource allocation methodology that will allow for more person-centered resource planning and management by members and their teams.

All these changes will have spanned over a decade from the planning to implementation. They will be implemented in the phases below: 

 Phase I: CCM Statewide Implementation

• Without CSA & PCSP 
• Without Streamlined Eligibility Interface with CBMS
• With Legacy ULTC 100.2 SP in the CCM

Phase II: Introduction of CSA & PCSP

• Gradual implementation across all CMAs throughout Phase II

Phase III: Streamlined Eligibility Interface with CBMS

Phase IV: PCBA Implementation

Projected Implementation Schedule 

• Phase I 
• Training - Jan. 17 - March 10, 2023
• System Freeze - March 3 - March 12, 2023
• Go Live - March 13, 2023

• Phase II July 2023

• Phase III October 2023

• Phase IV- 2025

Find more information by reading the Care and Case Management FAQ. Please send additional questions to the CCM inbox.

Training 

Phase I training will familiarize case management agency users with system navigation, identifying key screens and features, and performing their job duties using the CCM system.

Training will be focused on topics such as searching for or adding a client; assessing an individual; creating and maintaining support plans; logging notes; reporting a critical incident, and more.

The training sessions will be comprised of three, two-hour virtual instructor-led training (VILTs) on the Zoom platform, which will be recorded. Supervisors will take a fourth VILT training. Additional learning materials will also be made available, including desk aids, a product manual, and FAQs. Office hours will also be held following the completion of the VILT training. 

Case management agencies will receive instructions from the Department on how to access the Learning Management System to register for training sessions.

Phase II training is expected to begin for the first cohort of users in mid-May 2023. The training plan is still being developed and more information will be provided as it is finalized.

Please send questions to the CCM inbox.

Home Care Allowance Update

Home Care Allowance (HCA) activities will not be moving into the CCM when we go live. Instead, the Department of Human Services (DHS) is moving them into CBMS. This action is anticipated to be completed on April 15, 2023. DHS will work directly with SEPs on the record retention and transition plan. If needed, HCPF expects that the BUS can continue to be used from March 13 - April 15 for HCA activities.

Please send questions to the CCM inbox.

News for Case Managers

CMRD Stakeholder Engagement Opportunities: We Need Your Help!

The Department's Office of Community Living & Case Management Redesign (CMRD) teams have upcoming meetings and opportunities for Stakeholder Engagement. Please share this information with members and clients for all programs, including State SLS and FSSP.

The Department wants to hear from stakeholders about each of the rule revision topics listed below to ask questions and receive feedback based on your knowledge and experience with navigating HCBS rules. The goal is to make these rule revisions work for all HCBS stakeholders. The Department will post the section of rule or waiver to be discussed on the CMRD webpage one week prior to each meeting. Stakeholder engagement, feedback and Department responses will be tracked through listening logs posted on the CMRD webpage.

Case Management Redesign (CMRD) Rule Revision Stakeholder Feedback Meeting Series Topics:

• Client Rights and Responsibilities       
• Case Management Agency Requirements
• Case Manager Requirements 
• HCBS Benefits and Services Rules, Part 1
• HCBS Benefits and Services Rules, Part 2
• HCBS Benefits and Services Rules, Part 3
• HCBS Provider Requirement Rules
• Wrap-Up, Follow-Up and Next Steps

The meeting access information for all the CMRD meetings is the same:

Join via Zoom

Meeting ID: 873 9014 4539, Passcode: 597847

Join via Phone: 877 853 5257 (Toll-free)

Note: The 2022 meetings are posted on the OCL Stakeholder Engagement Calendar. You can copy them from the calendar to your individual calendar from there. The 2023 meetings below will be posted on the OCL calendar before the end of December 2022.

New CMRD Memos

The Department has recently issued two memos regarding CMRD.

Case Management Retention Payment for Case Management Redesign Informational Memo

It is crucial to keep the local expertise and knowledge of Colorado Case Management (CM) staff throughout the CMRD transition process. To facilitate this, the Department of Health Care Policy & Financing (the Department) has created a retention payment grant to encourage staff to remain employed with current Case Management Agencies (CMA) throughout their companies’ transition phases. 

Organized Health Care Delivery System (OHCDS) Changes for Case Management

The purpose of this Informational Memo is to notify case managers, service providers, members, families and other interested stakeholders of: 

• Proposed changes to the Organized Health Care Delivery System (OHCDS), and 
• The responsibility of case managers for the Developmental Disabilities (DD), Supported Living Services (SLS), and Children’s Extensive Services (CES) waivers as it relates to changes in Case Management Agencies (CMAs) and Community Centered Board (CCB) structures due to Case Management Redesign (CMRD). 

Telligen Office Hours

Telligen is hosting office hours for case managers to answer questions regarding Utilization Review Utilization Management (URUM) reviews for:

• Health Maintenance Activities
• Over Cost Containment
• Supported Living Services (SLS) Exception
• Children's Home and Community-Based Services (CHCBS)
• Children's Extensive Services (CES)

Please submit any office hours topic requests by using the Telligen Support Request form no later than Friday, Jan. 6, 2023. 

Meeting Details

Jan. 12, 2023 

9 - 10:30 a.m. 

Please register to join. Each attendee should register individually.

New 3rd Party Access Request Form Processing for the BUS and the Bridge

Effectively immediately, all case management agency staff requesting new, modification, or revocation of existing user access to the Benefits Utilization System (BUS) and to the Bridge are required to use the newly issued 3rd Party Access Request form. Please immediately discontinue the use of older forms.

The new 3rd Party Access Request Form is located on the BUS Stop, in the first paragraph, in the Forms section, and on the landing page of the BUS.

All 3rd Party Access Request forms must be submitted to hcpf_oclsystemapplications@state.co.us. Do not send 3rd Party Access forms to individual Department staff; doing so will delay your application processing.

Please note that the new 3rd Party Access Request form includes roles for the still-in-development CCM system. Do not request roles for the CCM system, because this will delay application processing.

BUS Member Record Search and Duplicate Record Creation

Before creating new member records in the Benefits Utilization System (BUS), case managers must verify that there are no existing member records by searching for members using each of the criteria below:

• Last Name
• Date of Birth
• Medicaid ID
• SSN

Why is this so important?

If a member record is flagged as a duplicate, that member’s record will not migrate to the new CCM system. The CCM system will accept the most recently created record and its associated data (Log notes, Critical Incidents, Assessments and Service Plans). The original record will not migrate, and all the data contained in that record will not be available in the CCM.

How to ensure all data is migrated from the BUS to the CCM

If a case manager realizes they have created a duplicate, they must submit a BUS Tracker so the records can be merged. Labeling the record as “DO NOT USE” will cause issues with the member's record.

Each week until the CCM System Go Live, Rhonda Johnson will be emailing each case management agency to advise the agency of their duplicates. 

Case managers may contact Rhonda at Rhondab.Johnson@state.co.us with questions about this process.

Learning Collaborative Series for Colorado HCBS Case Managers

As a new year full of change and opportunity begins in the Colorado Home and Community-Based Services (HCBS) system, including Case Management Redesign, this monthly series of 50-minute discussions will provide individual Colorado HCBS case managers the opportunity to consider new strategies, gain knowledge and enhance strengths – especially during times of transition. Each webinar session will offer a live presentation, attendee activities, group discussions and time for questions and answers regarding the monthly topic.

Please register for the first Learning Collaborative session of 2023

Resilience in the Face of Change

Tuesday, Jan. 10, 2023

11 - 11:50 a.m.

Register and join through Zoom

Or join by phone: 1-877-853-5257; Webinar ID 947 1321 0978, Passcode 40771

Additional monthly sessions are planned including the following topics:

• Growth Mindset (TBD)
• Best Practices for Staff Supervision (TBD)
• Supporting Members and Families Through Active Listening (TBD)

To incorporate feedback from sessions this past year, these future sessions will be shorter (under an hour) and cover a new series of topics that allow participants to attend one, several, or all webinars depending upon their preferences.

This series will be recorded and made available on the HCPF CMRD website. Check the website for dates and times for future collaboratives.

Please send any questions to cthompson@healthmanagement.com.

Long-Term Services and Supports (LTSS) Over Cost Containment Threshold Changes for 2023

The Department informs Case Management Agencies (CMAs) that, effective Jan. 1, 2023, the average-daily-cost threshold for Over Cost Containment (OCC) requests for certain Home and Community-Based Services (HCBS) waivers will increase. The following HCBS waivers are affected:

• Elderly Blind and Disabled (EBD)
• Brain Injury (BI)
• Community Mental Health Supports (CMHS)
• Complementary and Integrative Health (CIH)

As of Jan. 1, 2023, the OCC request threshold will increase from $284.99 to $314.99 per day. Any average daily costs over the threshold amount will require a review. The average daily cost that requires CMA supervisor approval will not change. Any OCC requests submitted to Telligen before Jan. 1, 2023, will be reviewed utilizing the previous threshold amounts. For more details, see Informational Memo 22-037.

Upcoming Changes for Post Eligibility Treatment of Income (PETI)

There are several changes for the Alternative Care Facility (ACF) benefit that will be effective January 1, 2023.

Per Informational Memo 22-036, there are changes to the Personal Needs Allowance (PNA) and room and board amount in accordance with cost-of-living adjustments (COLA) for both Supplemental Security Income (SSI) and Old Age Pension (OAP). Additionally, the maximum PNA amount is increasing as a result of an increased appropriation from the Joint Budget Committee (JBC). 

Because the updated income information is not yet available in the Colorado Benefits Management System (CBMS), the Department is not requiring case managers to complete PETI revisions for 1/1/23. In February, this new income information may be available. Until then, case managers are not required but may revise the PETI at any time. This is true even when new income is not reflected. 

Once the income information is available in CBMS and the Bridge, case managers need to begin recalculating the PETI to determine the new Personal Needs Amount (PNA) and provider rate. Even if the PETI is not updated, the provider may charge the new room and board amount. As the member begins receiving the new SSI or OAP amount, they can pay the new room and board increase. Please note this does not require the PETI to be revised.