Payment Issues for Colorado Medicaid Providers

On March 1st, Colorado Medicaid billings changed from Xerox to Hewlett Packard Enterprises (HPE). This change has been fraught with issues, and most providers have been impacted financially, due to no payments, delayed or partial payments. Feel free to share this post with your providers or clients.  We are in this together and can help: we need short term solution to get provider paid and services restored AS WELL AS getting the HPE system fixed for long term. All medicaid billing is subject to this new HPE system from doctors, to respite providers, to day programs, residential agencies, therapies like speech, OT, PT, ABA and anyone billing for any medicaid services, including waiver services. 

The information below was targeted to providers of Division of Intellectual Developmental Disability (DIDD) PASA providers, but any agency or entity that bills medicaid could be impacted, especially smaller providers. Feel free to share this information, the goal is to help maintain providers and prevent them from dropping medicaid clients or closing their practices entirely. PLEASE SHARE.

Direct Service Agencies have shared that they are still due a lot of money and may be stretched to the limit. If you are needing payment and are suffering, the state has the money, and can get you paid. 
The lesson from all your stories is that PASAs who voice their need are the ones getting paid. Please share back your experience, to help others.

  • Many direct service agencies whose denials are challenging to resolve are requesting a “warrant” for services provided, (basically a check manually cut).  
  • Others have had success getting their error codes/billing issues resolved so their HPE claims are successfully processed.
  • Some suggest reaching out via a short email that is concise to targeted recipients.
  • Others have contacted HCPF or their legislators and even shown up person at the Capitol or HCPF to wait until their issue was resolved.
  • If one chooses to email, include your agency name, phone number and all addresses (especially if more than one location).
    Include a total balance of outstanding billable services.

 
To make this email easier,  the emails are listed below, to cut and paste (also add your state legislators from areas you serve, all emails are on the state legislature website).

Included emails below:
State Medicaid Agency Healthcare Policy and Financ
e- Sue Birch (HCPF), Jed Ziegenhagen (HCPF), Joanne Svenningsen (HCPF),

DIDD Specific - Jen Martinez (Director DIDD at HCPF), and Barb Ramsey (Director of Office of Community Living over DIDD at HCPF)
Also the 6 members of the Joint Budget committee- Senator Lambert (chair), Rep Hamner (co-chair), Senator Moreno, Rep Young, Rep Rankin, Senator Lundberg.
And Jennifer Brown, journalist covering this at the Denver Post. 
And Micki Hackenburger, Axiom lobbyist for Hewlett Packard Enterprises, the HPE of this software program.

Here are Emails for easy cut and paste:
Susan.birch@state.co.us,  jed.zeigenhagen@state.co.usjoanne.svenningsen@state.co.us,jennifer.martinez@state.co.usBarbara.Ramsey@state.co.us ,
senatorlambert@comcast.net,  rephamner@gmail.com,Dominick.moreno.senate@state.co.us,dave@repdaveyoung.com,  
bob.rankin.house@state.co.us,   kevin@kevinlundberg.com,jbrown@denverpost.commicki@axiompolitics.com

 

 

 

What is new on Denver's Capitol Hill? 


1. Family Support loan fund

http://www.denverpost.com/2017/01/31/disabled-families-loan-bill-house-vote/

link to house committee meeting audio and testimony, Maureen Welch Parent testimony toward end

http://coloradoga.granicus.com/MediaPlayer.php?view_id=20&clip_id=10191

link to bill and history http://leg.colorado.gov/bills/hb17-1078

2. Update on DD "comp" waiver waitlist

http://www.denverpost.com/2017/02/02/wait-list-adults-disabilities-months-years-long/

Presentation on waitlist starts at

Audio testimony starts at about 1:07 marker Maureen Welch, parent testimony about 1:40

http://coloradoga.granicus.com/MediaPlayer.php?view_id=46&clip_id=10243

3. Conflict Free Case Management Bill to be introduced this session, as a JBC bill. This is to come into compliance with the Federal Final Rule, Colorado is currently in non-compliance.  

4. The Audit of Developmental Pathways should be released soon, done jointly by Arapahoe and Douglas County Commissioners, on the local Mill Levy tax revenue uses at the Community Centered Board.

http://www.denverpost.com/2016/12/06/arapahoe-douglas-counties-disability-funding-audit/  

 

Denver Ordinance opens local property tax to wider proposals and federal matching funds

Denver sets bar for opening local mill levy funding 

Denver Auditor Tim O'Brien exposed the misuse of local property tax at the local Community Center Board in December 2015 report. 
“Because of our audit, we had a number of meetings last year with state legislators, Denver City Council members, and the families of the intellectually and developmentally disabled clients.  The need for new legislation emerged from those meetings,” O’Brien said.  “I’m proud that we were able to play a part in improving services for these residents not just in Denver, but throughout the state.”
https://www.denvergov.org/content/denvergov/en/denver-auditor/newsroom/2017/city-council-adopts-audit-recommendations-for-intellectually-and0.html

Approximately $14.5 million a year of property tax is now opened to proposals, more than the one historically designated monopoly.
*Contracts for purchasing services and supports for persons with intellectual and developmental disabilities through any other entity or organization that provides such services.
*Transfer of revenue to the Colorado Department of Health Care Policy and Financing in order to receive matching federal funds to provide Medicaid- approved waiver services to persons with intellectual and developmental disabilities.

January 11, 2017 Council meeting video link,
Bill 1071 starts about the 40 minute mark.
http://denver.granicus.com/MediaPlayer.php?view_id=180&clip_id=9887

Link to bill documents and the December  committee meeting discussion with video. 
https://denver.legistar.com/LegislationDetail.aspx?ID=2873695&GUID=FD0FA75F-7EE0-42A9-808B-3BFC0CD77DFF

 

Happy New Year- A reflection and look into 2017

2016 was a year of pressure to respond to the need for change in Colorado's Intellectual Disability services delivery system. Looking forward, 2017 will be setting the groundwork for years to come with the submitting of the 2019 drafts of the HCBS waivers (CES, SLS and DD) with new Federal Final rule compliance.  Also the next phase of the Affordable Care Collaborative (ACC). Of course, it is yet to be seen what will happen with medicaid programs and funding with a new Administration in the White House.
    We must be optimistic and continue the work to increase transparency, real consumer choice of both waiver targeted case management (only Community centered boards CCBS now) as well as direct services. We need to step forward to share our stories and strengthen our voices at at our county commission, local CCBs, State level at the Capitol, HCPF and other departments which are tasked with oversight at the regional centers, and investigations/enforcements (CDPHE and CDHS) and with our federal elected officials. 
CELEBRATIONS
*In December 2015
 the Denver Auditor's report of local county Mill levy funding exposed serious financial issues at Denver's CCB http://www.denverpost.com/2015/12/17/denver-audit-finds-shameful-misspending-for-intellectually-disabled/
*On December 31, 2015 The community united at a Press Conference to announce the need for accountability and transparency legislation.  http://www.denverpost.com/2015/12/31/parents-of-colorado-children-with-disabilities-fight-for-change/
*The legislative session was contentious, with SB16-038 Regarding transparency in Community Centered Boards being laid over four times in Senate committee but with strong community testimony, and lengthy negotiations,  it passed easliy through both chambers and was signed into law on June 1, 2016. State Audits will begin and transparency provisions will be put into Colorado Rules and Regulations in 2017. http://coloradofoic.org/governor-signs-ccb-transparency-bill-rocky-mountain-human-services/
*SB16-038 Details https://leg.colorado.gov/bills/sb16-038
*Employment First SB16-077 passed to address need for more employment opportunities for people with disabilities.  https://leg.colorado.gov/bills/sb16-077
*Late in 2016, responding to citizen concerns, Arapahoe and Douglas Counties set a precedent for local counties to proactively conduct an audit of their local mill levy money at Developmental Pathways, CCB. You too, can approach your county commission and request audits like families did in Douglas and Arapahoe Counties with audit as an outcome. Taxpayers deserve this accountability of voter approved local mill levy taxes.  http://www.denverpost.com/2016/12/06/arapahoe-douglas-counties-disability-funding-audit/

Somber Reality with Abuse Neglect Cases filed for Justice
There is so much work to be done to rid our system of abuse and neglect. There are many quality providers who are worthy of  recognition, respect and a real living wage. However it appears there is open season in Colorado for abusers and bad providers in the system to continue unpunished. 
*Passage of SB16-019 Concerning Mandatory Reporting of Mistreatment of an adult with a disability.  http://www.leg.state.co.us/clics/clics2015a/csl.nsf/fsbillcont2/E12A97A15F59EB1F87257DCC00575005/$FILE/109_enr.pdf
*Exposed abuse and neglect in the Colorado State Run Pueblo Regional center with Feds investigating http://www.denverpost.com/2016/09/27/pueblo-home-for-disabled-oversight-deficient/
*18 Pueblo Victims represented in a law suit against Colorado over violation of civil rights strip searches at Pueblo Regional Center in March 2015. http://www.westword.com/news/strip-searches-genital-manipulation-suit-accuses-state-of-abusing-mental-patients-8397208
*February 2017 Trial of Host Home Abuser Kelly Benz in Boulder County Courts http://www.dailycamera.com/erie-news/ci_30208773/erie-caregiver-accused-abusing-patients-set-trial-february
*December 2016 - 24 Felony Charges against school bus aide who abused students also in Boulder County Courts  http://www.dailycamera.com/boulder-county-schools/ci_30694431/st-vrain-valley-bus-assistant-charged-24-felony

Three HCBS Waivers (CES, SLS, DD) Drafts will be submitted by HCPF to Federal CMS in 2017 to begin back and forth for the 2019 final waiver renewals. These are renewed every 5 years, and will cover 2019-2024. These will expand to include Consumer directed Services (SLS only) and compliance with new Federal Final rule (encompassing Conflict Free Case Management, integrated Settings Rule, and person centeredness in services). Be sure to submit online public comment on waiver drafts, reminders will be sent from this newsletter.

Changes in the Affordable Care Collaborative in Colorado will affect our state- learn more at   https://www.colorado.gov/pacific/hcpf/accountable-care-collaborative-program-improvement-advisory-committee


As we close out this reflection, let's remember those receiving services who left this world in 2016. They left us too early, many died peacefully with good care, of natural causes. Sadly, some deaths could have been prevented if our reporting systems were functional. We must celebrate life, and work hard to move the system forward to treat our community with dignity, quality care with choice of all services.
Let's remember the Arvada host home fire victims on Robb Street:  Tanya Bell (adult client in host home, age 39), visiting granddaughter of provider Marielle Covington (age 5) and her mother Christina Covington (age 24). This tragic case in Jefferson county recently went to the Grand Jury. We pray for their families and friends, as well as all who have lost loved ones in the disability community. 

Let's make 2017 a year to work for justice, and make Colorado a place where people get what they need,  when and where they need it. 
Peace to you and yours,
Maureen Welch mpwelchco@gmail.com

 

 

Shameful situations in Colorado.

The Pueblo Regional Center abuse goes largely unpunished. Media links below.
Where is the respect for human dignity for residents at the Regional Centers? The system has structural issues safeguarding individuals with intellectual disabilities across settings. There are two important cases in courts currently in Jefferson County and Boulder County.

  1. Pueblo Regional Center abuse results in only one conviction.  Make sure to watch the embedded video, which has some additional information from the reporter Chris Osher.

http://www.denverpost.com/2016/12/09/pueblo-regional-center-disabled-neglect-abuse-complaints/

  1. Hoping for answers in the Tragic May 2016 Arvada Host Home Fire that killed three. The case recently went to a Grand Jury in Jefferson County.

http://arvadapress.com/stories/Grand-Jury-reviewing-investigation-into-Arvada-fire,240209

http://www.denverpost.com/2016/12/07/grand-jury-investigation-arvada-fatal-group-home-fire/

  1. Boulder County Erie Abuse by Host Home Provider Kelly Benz. The person who got action was a temporary respite worker, not the supposed safeguards in the system. Her pretrial hearing was on December 1, 2016. Her trial is set for February 2017. This case is believed to be the first prosecution in Colorado of a residential provider for abuse and neglect of those with intellectual disabilities.

http://www.dailycamera.com/erie-news/ci_30208773/erie-caregiver-accused-abusing-patients-set-trial-february

Media Article Links- Pueblo Regional Center

Watch Full Pad-Co CCDC Joint press conference from 10/7/16 at State Capitol http://bit.ly/2dBeHu7

Since the press conference, the Google trackers shows 58 mentions in media Nationwide, from San Francisco to Kansas. This is validation that this issue is one requiring attention and resolution. 

Pueblo Abuse

4.22.15 Denver Post PRC Abuse- 11 on leave   http://www.denverpost.com/2015/04/22/eleven-placed-on-leave-at-pueblo-regional-center-allegations-of-physical-sexual-abuse/

8.8.16 Channel 9 Why aren't strip searches in the news?  http://www.9news.com/entertainment/television/programs/next-with-kyle-clark/feds-probing-illegal-strip-searches-of-mentally-disabled-by-cdhs/291248144

9.27.16 Denver Post ORIGINAL FIRST ARTICLE POST CMS REPORT  http://www.denverpost.com/2016/09/27/pueblo-home-for-disabled-oversight-deficient/

9.28.16 Editorial PRC http://www.denverpost.com/2016/09/28/a-good-start-on-reforming-abuse-of-colorados-developmentally-disabled/

Press Conference Coverage on Friday October 7. 2016

10.7.16 Denver Post PRC http://www.denverpost.com/2016/10/07/abuse-disabled-pueblo-center-residents-inspector-general/

10.7.16 Channel 7 ABC PRC http://www.thedenverchannel.com/news/local-news/advocates-for-the-disabled-call-for-action-to-address-a-statewide-crisi

10.7.16 Channel 4 CBS PRC coverage http://denver.cbslocal.c om/2016/10/07/advocates-for-disabled-demand-action-after-abuse/

10.7.16 Pueblo Newsarticle http://www.chieftain.com/mobile/msearch/5220391-123/state-center-problems-disabled

Articles about Former Pueblo Director now working for a Grand Junction Case Management CCB

10/6/16 Denver Post Re: Speedie http://www.denverpost.com/2016/10/05/former-director-pueblo-center-disabled-abused-grand-junction/

10/8/16 Editorial http://www.denverpost.com/2016/10/07/are-bad-apples-being-passed-from-one-public-agency-to-another/

 

 

State Wide Crisis in Residential Care for Coloradans with Intellectual Disabilities

Read the full Federal report here:  http://www.ourwebs.info/HHServicesCMSPRCOnsiteReportPDF.pdf

and
http://www.denverpost.com/2016/09/27/pueblo-home-for-disabled-oversight-deficient/  

Excerpt: The federal report provides new details on the abuse, including that three residents had died, two from bowel obstructions and one who collapsed and was not given life-saving care because a staffer mistakenly thought there was a “do-not-resuscitate” order.


Concerns in the community extend beyond Pueblo Regional Center.

This is the tip of the iceberg and the community is united for justice and long overdue changes to safeguard our loved ones. Regional centers are components of a larger residential system in Colorado which is in need of attention statewide. Thousands of people with intellectual disabilities are in Colorado residential placements,  which are lacking effective and transparent supervision and oversight. 

  1. Erie Host Home provider Kelly Benz has her abuse neglect for her three host home clients, her husband was employed by the CCB Imagine, an agency with oversight responsibilities. http://www.dailycamera.com/erie-news/ci_29664481/indictment-erie-caregiver-physically-abused-failed-properly-feed
  2. Arvada Host home fire which killed three, one of whom was a client. The home met local code, which varies widely in true life safety.  http://www.denverpost.com/2016/05/16/woman-39-is-one-of-two-killed-in-arvada-fire-saturday-morning/ 
  3. Glenwood Springs where an overnight residential provider was sexually assaulting clients. http://denver.cbslocal.com/2016/05/25/jose-ignacio-echeverria-sexual-assault-colorado/
  4. When an agency investigator, employed at a CCB does try to do the right thing, he was terminated and had to sue. http://www.dailycamera.com/ci_20533666/ex-imagine-employee-says-he-was-fired-reporting

 
There are numerous reports, from all over Colorado, about a lack of comprehensive and transparent system for reporting and investigating abuse/ neglect cases for those with intellectual disabilities.  Now is the time for change.

Rise up!

Until lives of people with disabilities "matter" to the mainstream, and we get our issues to candidate/campaigns from county level, school district, to state and national offices, tragedies like this one in Japan (where 19 were murdered in their sleep at a center for people with disabilities) will continue with little to no media coverage.
This reflects to the Colorado level where the very agencies (CCBS and Co Dept of Health and Environment) who are supposed to investigate abuse and neglect are more interested in protecting the agencies who make money off the services of those with disabilities.
What can you do? Raise injustices you see, in solidarity. Take disability out of a silo and speak up at every opportunity. Yes, you will be told to be nice, to sit down, shut up and be grateful for what you have. But we must be vigilant and that means vocal and visible!
What will you do to contribute? This video is from Rooted in Rights- a great source- worth exploring their video stories...

http://bit.ly/2bhO7BY

August Update

Change- it is inevitable and uncomfortable. Soon the temps with drop, students will head back to school, the leaves will change colors and drop. And of course, it is a big political campaign season.

 I will be shifting the website around a bit, please be sure to check it out once in a while. 

Conflict Free Case Management Implementation Plan for CO is Online

A copy of the July 1, 2016 Conflict Free Case Management Implementation Plan is here

Conflict Free Case Management (CFCM) is a federal requirement, under the Final Rule,  from the Center for Medicaid and Medicare Services (CMS). Colorado is not in compliance and will be required to have an approved plan in place or risk approximately $250 Million in Federal monies (the Feds match the State contribution.)

Colorado's Healthcare Policy and Finance department (HCPF) has submitted the CFCM plan to the General Assembly (Colorado State Legislature) through the Joint Budget Committee. This CFCM implementation plan was funded using a consultant Navigant, via a contract funded through HB15-1318. This report is the first plan toward compliance with CMS's requirement to reduce the inherent conflict of interests when Colorado's 20 state Community Centered Boards (CCBs) are the sole provider for eligibility and targeted case management; another conflict is that most do also provide direct services. The federal Final Rule does has found this current Colorado arrangement in violation of the new Federal Final Rule for CFCM.

Rocky Mountain Human Services- Meetings upcoming & Seeking Applicants to Serve

1. Board of Director Meeting Wednesday, July 13, 2016 - 6:30pm to 8:30pm

All RMHS Board meetings are open to the public. Public comment period at every board meeting. (303) 636-5600 9900 E. Iliff Ave. Denver  Co80231

2. Mill Levy Community Forum  Wednesday, July 20, 2016 - 6:00pm 5600 9900 E. Iliff Ave  

Join us at the Mill Levy Community Forum to help determine community priorities for the Mill Levy, a fund RMHS receives from the City & County of Denver to increase and improve services for children and adults with intellectual/developmental disabilities. These funds come from property taxes collected by the City and are typically referred to as the Mill Levy. We want to hear from you! 

3. Mill Levy Advisory Committee Meeting    Friday July 22, 2016 2-4pm 9900 E. Illiff Ave Denver

RMHS enlists the assistance of community members with expertise in developmental disability services to advise the organization in its use of mill levy dollars from the City and County of Denver. These funds are used to serve children and adults with developmental delays and disabilities who live in the City and County of Denver. The Mill Levy Advisory Committee meets every other month. All meetings are open to the public, 

4. Apply to serve on one of the RMHS Bodies-

Board of Directors, Mill Levy Advisory Committee, Family Support Rocky Mountain Human Services is seeking  people with diverse life experiences to serve Rocky Mountain Human Services, the Denver Community Centered Board for Board of Directors (BOD) and Mill Levy Committee. Here is their website https://www.rmhumanservices.org/

     They have only had a few applications so far and there is an essential need to diversity their board and committees.  RMHS is in need of applicants from people with disabilities and also those with cultural experiences that are reflective of the community (cultural, linguistic, personal disability experiences, income and LGBT), even if the applicant ultimately decides against the opportunity, application is the first step. Currently the BOD is mainly male, Caucasian with white collar experiences and business community profiles. They desire a larger more diverse pool of applicants. The BOD can be up to 15 members, so plenty of room for additions.

The Board of Directors process and details are at https://www.rmhumanservices.org/board-councils

Mill Levy Advisory Committee advises the Board of Directors on uses for the county mill levy dollars, currently about $14 million a year but it fluctuates. It meets several times during the year. 

From the website:

In addition, the RMHS Mill Levy committee is recruiting new members. Please consider joining to provide your  input and advice on the efficient and impactful use of this funding.

The purpose of the Advisory Committee as outlined in the contract with the City and County of Denver is to have a forum in which members can provide advice to RMHS management and the Board of Directors. Committee members will have professional or personal knowledge of service for children and or adults with developmental disabilities, or have a keen awareness of the needs of the Denver community. The advisory committee will be convened for the primary purpose of receiving a briefing on the progress and direction of services that are supported by mill levy funds. Members will have an opportunity to provide feedback on current or proposed areas of mill levy expenditure.

Board of Directors information and nomination process:  https://www.rmhumanservices.org/sites/default/files/documents/bod_overview_nomination_policy2016_1.pdf

Nomination form for board and committee candidates (fillable pdf):  https://www.rmhumanservices.org/rmhs-council-committee-nomination-form

Information on the Mill Levy Committee:  https://www.rmhumanservices.org/mill-levy-advisory-committee

There are also  other bodies seeking members, Family Support Council and the Denver Providers Advisory Committee, information online https://www.rmhumanservices.org/board-councils

Public Event Governor Signs SB16-038

Wednesday June 1st at 10:30am at Rocky Mountain Human Services 9900 East Illiff Ave Denver

Come celebrate at this historic Event of stakeholders who worked diligently to craft a bill to Increase Transparency with Colorado's 20 Community Centered Boards. It will be a celebratory event.

See entire bill at http://www.leg.state.co.us/CLICS/CLICS2016A/csl.nsf/fsbillcont3/9A2752465B471D3C87257F2400644C65?Open&file=038_enr.pdf

Tragedy in Arvada- time to better regulate Residential Life safety

So tragic- Arvada fire in host home update. A 39 year old in services plus a 4 year old perished. Several news pieces in last days note that the dispatch reported residents were trapped in basement, and that the four year was the grandchild of the caregivers in the home. The dispatch said one was trapped, and lost contact with her on the phone. Her wheelchair rep was on camera saying he had a Monday appointment with her to repair her 2 wheelchairs. So many questions. Too much silence from systems who are supposed to advocate for the most vulnerable. 

http://kdvr.com/2016/05/16/young-child-adult-killed-in-arvada-fire/

http://arvadapress.com/stories/Fire-kills-child-and-disabled-woman,213566

SB16-038 is headed to the Governor to become law!

SB16-038 Transparency in Community Centered Boards is now going to be in state statutes- and be the law!
It was readopted this evening in the Senate with the amendments from the House! Next it heads to the Governor's Desk. 
Thanks to everyone who contributed and participated in the process. 
Transparency in CCBs is increased. Bravo to the stakeholder process. See full bill at http://www.leg.state.co.us/CLICS/CLICS2016A/csl.nsf/fsbillcont3/9A2752465B471D3C87257F2400644C65?Open&file=038_rer.pdf

SB16-038 moves forward as the 2016 Legislative Session comes to a close!

SB16-038 Transparency in CCBs is amended in the House and soon heading back to Senate. 

Thanks you all of you for your continued support and interest in this topic. Thanks to Representatives Sias and Young for getting it through the house with some excellent amendments and to Senator Aguilar for starting the bill way back in January in the Senate! Thanks to the CCBs for agreeing to these requirements.
It is historic that the community of stakeholders (parents, host home providers, advocacy groups) sat down with the CCBs/Alliance to work collaboratively to produce this bill. Although CORA open records provision was removed, the amendments will allow easy website access to financials and direct email access to each board of director (and many more amendments- see links below). These bill components are huge steps forward in transparency to the current status of CCBs and the State Auditor doing audits at least every 5 years lends some historical view of CCBs. 

1. The bill has third reading in the House Friday May 6 and then heads back to the Senate for approval with the House amendments. Session ends Wednesday May 11th at midnight. Things are moving fast with extra evening sessions and next week all rules are suspended to expedite and clear the bills in queue.
2. This is the link to the most current form of the bill  
http://www.leg.state.co.us/clics/clics2016a/csl.nsf/fsbillcont/9A2752465B471D3C87257F2400644C65?Open&file=038_rev.pdf
3. Here is a link to a well written article about the amendments
http://coloradofoic.org/amended-bill-requires-public-disclosures-nonprofits-serving-people-disabilities/
Team Transparency on the Road
So far 7 Board of Director meetings have been visited with public comment.
Attending and commenting is critical to community access for board members,
Please check the calendar as well as your local CCB website for other events. 
CCBs serve the community so getting involved is most welcomed!
We hope to see you at some board meetings on the road! 
http://changecoidd.com/calendar/?view=calendar&month=May-2016

SB16-038 in House Committee!

Transparency is in the House! SB 16-038 will be up in the Colorado House Health, Insurance and Environment on Tuesday April 26, upon adjournment. This bill mandates that at least every 5 years each Community Centered Board (CCB) shall be audited by the Colorado State Auditor's office.

Please express your support SB16-038 Regarding Transparency in CCBs  to the Committee Chair  Rep Beth McCann 303-866-2959 or beth.mccann.house@state.co.us the rest of  committee members with contacts, and House calendar links are at  http://1.usa.gov/22V4mWF 

Team Transparency is on the Road!

1. Forums to share plans for CFCM compliance in Community Centered Boards (CCBs), next week of 4/25
This is not a drill- now is the time to give feedback to the plan from subcontractor Navigant (paid for from the $500K allocation for CFCM in HC15-1318) Colorado is one of the states which is out of compliance with Conflict Free Case Management (CFCM) and must submit a plan.

The plan first goes to the Colorado General Assembly's Joint Budget Committee and then it will be reviewed at the Federal level at the Center for Medicaid/Medicare Services (CMS). If the plan is not acceptable, CMS can put the state into forcible Corrective Action, as they did in Ohio. Ohio had 4 days to come into full compliance with CFCM. Please read the plan and offer input, webinar is an option as well.Link to the CFCM forum schedule and webinar links for from home participation, is at http://1.usa.gov/1r5LatL


2. Attend one or more CCB meetings. Public comment is solicited and welcomed. Feel free to ask clarifying questions as a public attendee. Be assertive if public comment is not clearly offered; leadership among CCBs agreed this was a reasonable expectations as well as having hard copies of agendas and all meeting materials.  See calendar with details at http://bit.ly/1Nnb9ql 
Many, in public comment, are covering these points directly with board members:
*Encourage  CCB board of directors to stop paying their lobbyists and drop Alliance membership to utilize those resources for client services. This often can total $75,000 a year or more!
*Share that there is a myth to dispel: CCBs are not so special that they are above Federal Rule about separation to meet Conflict Free Case Management requirements. CMS has not allowed an exception for targeted case management and direct services by the same entity, even if for different people.
*Express dismay that 18/20 CCBs agreed (Denver's RMHS and Col Springs area TRE opted not to participate)  to use valuable monies to hire a fancy DC law firm, Squire, Patton, Boggs to lobby for an extension, to maintain the status quo. Other states have found this counterproductive, and resulted in extra reporting requirements to CMS.
*Encourage the board to reorient focus "back to the basics" of what the CCBs were designed to do in 1963: Targeted Case Management. Drop all other side businesses which offer direct services or serve other populations like veterans and brain injuries. (Many companies that are pushed by case managers are actually related to the CCB, thus the conflict).
*Reduce overhead and maintenance. It is a conflict for CCBs to run run host homes, day programs, vocational programs, and behavioral health services. Encourage locals to open businesses and operate independently. Open the free market for choice and to eliminate conflict. 

*Accept and Embrace the reality of Conflict Free Case Management Compliance. 
*Focus on quality targeted case management and choice of independent case managers. 

Participate webinar or in person CFCM Plan draft

Conflict Free Case Management (CFCM) Plan for Implementation

 Now is the time to participate with feedback. The system of targeted case management will change dramatically, and your input is critical. Share your vision of a new environment for case management in the waiver world. This report is in draft form now, and will be finalized and presented to the Colorado State Legislature Join Budget Committee on 7/1/2016. The new federal Rule from Center for Medicaid/Medicare Systems (CMS) states due to Colorado being out of compliance, an implementation plan must be written and submitted for Federal compliance.

This is a serious matter and we all must be involved.

Next week there are a series of forums across the state,  including a webinar Tuesday eve!

Link is here for the information https://www.colorado.gov/hcpf/conflict-free-case-management

Inquiries via email at cfcm.didd@state.co.us or call 303.866.5560

Please look at the calendar for this and other engagement opportunities like Board of Director Meetings at the CCBs around the state. http://bit.ly/1Nnb9ql