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. |
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Message from the Executive Director |
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Investing in Transformation
The Governor’s fiscal year 2022-23 Budget released Nov. 1 totals $40 billion with a $36.5 billion operating budget. HCPF’s operating budget represents $13.5 billion or 37% of that, while our $4 billion general fund budget request represents 30% of the state's general fund budget. The Governor’s balanced budget is prudent and fiscally responsible, doubles down on the Governor's commitment to saving Coloradans money, ensures workers can earn a living wage, and puts more money back in Coloradans’ paychecks. It combines fiscal responsibility with a historic opportunity to leverage one-time funding for health care and behavioral health system transformation thanks to federal COVID-19 relief funds and state investments in stimulating the economy.
HCPF’s leadership has been participating in the many discussions about what those historic, transformational investments could look like: more than $500 million in long-term American Rescue Plan Act (ARPA) transformational investments for people with disabilities through our home and community-based services (HCBS) spending plan
HCPF’s $4 billion general fund budget represents an increase of $343.4 million general fund over the baseline. The vast majority of this increase is to account for the expiration of the 6.2% federal match enhancement in the 2022-23 fiscal year at the same time we are increasing provider rates. HCPF’s other discretionary requests are, in aggregate, budget negative—reducing expenditure by $40.5 million total funds, $4.8 million general fund. While HCPF’s budget is comprehensive, we call out below some of the budget requests that enhance value-based payments, which pay Medicaid providers for value and performance versus just volume; increased county resources; and provider rate increases:
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R-6 Value Based Payments focuses on incentivizing affordable, higher quality and more equitable care. Currently, HCPF pays most providers for services delivered on a fee-for-service basis. The General Assembly has authorized HCPF - and CMS is strongly encouraging HCPF - to establish programs to pay for “care value” as opposed to just “care volume.” This budget request would support maternity bundled payments; primary care provider partial capitation models; model development to further improve outcomes and affordability across specialty care; and financial incentives to providers using the Prescriber Tool.
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R-8 County Administration, Oversight & Accountability provides increased support to our county partners for important administrative-related activities, including improved customer service, member eligibility and enrollment, quality improvement and meeting new administrative requirements. In addition, the request includes additional pay-for-performance funding through the County Incentives Program for counties to earn if they meet new and/or additional performance benchmarks and deliverables.
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R-11 Provider Rate Adjustments includes funding to address Medicaid Provider Rate Review Advisory Committee recommendations to increase and rebalance rates for specific providers while including a 0.5% across-the-board rate adjustment for all other providers. This request also furthers the Jan. 1, 2022, plan put forward by the Polis-Primavera administration and HCPF that creates a minimum $15/hour wage for direct care workers in home and community-based settings funded through Medicaid as part of our HCBS ARPA spending plan.
On Oct. 28, the Colorado Health Institute released the 2021 Colorado Health Access Survey report, which indicated that the state’s uninsured rate remained steady at 6.6% despite the historic economic downturn. Medicaid state and federal policies were significant contributors to that outstanding result. Conversely, this underscores the critical need for all of us to continue to work together through the end of the public health emergency (PHE) to help Coloradans stay covered as the continuous coverage provisions of the PHE come to an end.
Kim
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County fact sheets provide an annual snapshot by fiscal year of Health First Colorado (Colorado's Medicaid Program) activity including average annual caseload and top five claim types for each county.
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COVID-19 Vaccines for Children Ages 5-11 |
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This week the Centers for Disease Control and Prevention (CDC) announced the Pfizer vaccine is approved for emergency use for children ages 5-11.
As a partner, we encourage you to help connect Health First Colorado and CHP+ members and their families to information about the vaccine. A toolkit to assist partners with outreach has been developed. The Colorado Department of Public Health & Environment ( covid19.colorado.gov/kids-vaccines), Centers for Disease Control and Prevention ( www.cdc.gov) and the American Academy of Pediatrics’ Healthy Children ( www.healthychildren.org) have updated information about the vaccine.
Many medical offices will soon begin offering COVID-19 vaccines for children ages 5 to 11 years. Pediatric providers are encouraged to enroll as COVID-19 vaccine providers with CDPHE to help ensure access to the vaccine. Primary care providers can receive grant funding ranging from up to $60,000 to $120,000 (depending on practice size) to support the distribution of COVID-19 vaccines.
Additional resources are below:
Initial demand for the children’s vaccine has been very high, and although many slots already are full, Colorado will have ample supply of the vaccine. Updated information about the vaccine is available at covid19.colorado.gov/kids-vaccines.
Thank you for continuing to help keep Colorado safe during this pandemic.
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American Rescue Plan Act (ARPA) Update |
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The Department has started to implement a multitude of projects to expand, enhance, and strengthen the Home and Community-Based Services (HCBS) system tied to federal ARPA funding. The Department will be issuing quarterly reports on progress to both the Centers for Medicare and Medicaid Services (CMS) and the Colorado Joint Budget Committee (JBC), the first of which have been posted to the HCPF ARPA webpage.
Later this fall or early winter, a monthly newsletter dedicated to ARPA projects will launch and 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. Please take a moment to sign up for the ARPA Project Pulse Newsletter now!
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Recent Memo Series Issued to Counties |
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Reproductive Health Care Program Update |
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Senate Bill 21-009, Reproductive Health Care Program, requires the Department of Health Care Policy & Financing to cover access to family planning for people with undocumented status. The Department is working on implementing this bill, but there will be a short delay because of the Department’s COVID-19 public health emergency responsibilities.
The original timeline for full implementation was January 2022. Because of the delay, we expect the bill to be fully implemented by July 2022.
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Open Enrollment Toolkit Available! |
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Dear Community Partner,
The ninth Open Enrollment Period has begun and our online toolkit is complete! Our online toolkit provides you with the tools you need to easily inform your community about health insurance options and financial help through Connect for Health Colorado. It provides social media graphics and copy, newsletter copy, and brochures and flyers in English and Spanish. Open Enrollment ends Jan. 15, 2022.
Helpful Reminders
- Web and print versions of our resources are available to you free of charge through our Open Enrollment Online Toolkit and our Online Print Materials Store.
- For the Online Toolkit, we’ve made our materials web-friendly by making them easily readable on a screen and interactive with our website. Be sure to download the materials, they are not interactive from the basic preview mode.
- For the Online Store, simply create a login and shop away for materials such as posters, flyers, and brochures at no cost.
- Free, virtual, and in-person help 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 connectforhealthco.com/we-can-help/ to find assistance in your area.
- Connect for Health Colorado is sponsoring and attending virtual and in-person events and providing virtual and in-person presentations to those who will benefit from being informed about health insurance resources. Please contact me if you are interested!
Thank you for being a great partner and helping keep Colorado covered. I look forward to another successful Open Enrollment Period with you!
In Kindness,
Jess Smith, MSW
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Broadband Discount Program |
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Please help us spread the word about the Emergency Broadband Benefit Program (EBB). It gives a temporary discount on monthly broadband bills during the COVID-19 pandemic.
Anyone who gets cellular from the Lifeline program, free and reduced-priced school lunch or school breakfast program, SNAP, or Health First Colorado may qualify. People who have recently lost their job or had a large loss of income, or who receive Federal Pell Grants may also qualify.
People who qualify can get:
- Up to $50 per month discount on broadband service or up to $75 per month discount if their household is on Tribal lands
- A one-time discount of up to $100 for a laptop, tablet, or desktop computer.
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Help Us Get the Word Out! Higher Education Information for Health First Colorado and CHP+ Members |
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Did you know Health First Colorado and CHP+ members may qualify to get free money to complete their degree? Members can keep their coverage even if they receive grants, scholarships or work study placements. Money received for education does not count as income.
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Emergency Medicaid Eligibility Criteria and Updates |
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This memo outlines the eligibility criteria for Emergency Medicaid provided through Health First Colorado and new updates.
Applicants will no longer need to obtain and submit a written physician statement certifying the presence of an emergency medical condition in order for their application to be complete and processed. Due to the removal of this requirement, applicants are being encouraged to write “Emergency Medicaid” on the top of the application or indicate this in some other way. CBMS has been updated to no longer require a physician statement from applicants.
Resources
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County Grants & County Incentives Program |
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County Incentives and Grants |
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FY 2021-22 Incentives
- Incentives memos will be released in the next couple of weeks
FY 2021-22 Grants
- Q2 Grant check-ins have been scheduled for January
- Q2 Grant matrices are due Jan. 5, 2021
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Timeliness for October 2021 |
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Timeliness for all Medical Assistance applications was measured at 97.98%. |
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Timeliness for all Medical Assistance redeterminations was measured at 98.10%. |
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Department Contacts & Resources |
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