Joint Budget Committee Office of Community Living Kim Bimestefer, - - PowerPoint PPT Presentation
Joint Budget Committee Office of Community Living Kim Bimestefer, Executive Director; Josh Block, Budget Director; Bonnie Silva, Interim Office of Community Living Director December 19, 2018
https://www.colorado.gov/hcpf/legislator-resource-center
Kim Bimestefer, Executive Director; Josh Block, Budget Director; Bonnie Silva, Interim Office of Community Living Director
December 19, 2018
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Redesign all aspects of long-term services and supports delivery system to support Coloradans with disabilities and older Coloradans to be able to live in the home of their choosing with the supports they need and participate in communities that value their contributions
dignity
NOTE: Goal and guiding principles were set by Executive Order D 2012-027, which established the Office of Community Living.
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Centered Boards (CCBs)
Points (SEPs)
NOTE: CCBs also provide direct services.
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Children & Adolescents
ages 20 & younger & qualifying former foster care youth
Older Adults
ages 65 or older
Adults
ages 21-64
SOURCE: FY17-18 data; Data represent percentage of people receiving Medicaid LTSS in various age groups.
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47% of members in intellectual and developmental disabilities waivers also have a physical disability
NOTE: The rates are based on whether Colorado Medicaid paid a claim with a diagnosis listed in FY 17-18. If the member is untreated for the condition or only Medicare paid the claim, we do not have those data. Intellectual and developmental disabilities (IDD) refers to those receiving services under the three IDD waivers in Colorado.
80% of members receiving Long Term Services and Supports have one or more chronic condition
➢ Compared to 36% of members not receiving LTSS
8 Children with Life Limiting Illness Waiver 179 Children’s Habilitation Residential Program Waiver 39 Children’s Extensive Support Waiver 1,972 Children’s Home and Community- Based Services Waiver 1,673 Brain Injury Waiver 521 Community Mental Health Support Waiver 3,793 Elderly, Blind, and Disabled Waiver 26,610 Persons with Developmental Disabilities Waiver* 5,631 Spinal Cord Injury Waiver 129 Supported Living Services Waiver 5,359
Certain federal Medicaid rules can be waived to provide services for eligible members to live in the community. Home and Community- Based Services (HCBS) Waivers Home and Community- Based Services (HCBS) Waivers 45,938 Program of All-Inclusive Care for the Elderly (PACE) 4,899 Nursing Homes and Intermediate Care Facilities 15,044
SOURCE: FY 2017-18; based on claims in MMIS. * There is a waiting list for the HCBS-DD waiver. As of September 2018, there were 3,059 people registered as waiting for enrollment into the HCBS-DD waiver with a timeline of “As Soon As Available.”
State-Funded Only Programs 4,150 Supported Living Services (SLS) 588 Family Support Services Program (FSSP) 3,562 State- Funded Only Programs
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SOURCE: 2017 Long-Term Services and Support State Scorecard can be found at: http://www.longtermscorecard.org/.
People with Intellectual and Developmental Disabilities
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Conflict Free Case Management (CFCM)
July 2019 Department completes analysis of BCPs June 2020 Case management agencies complete required changes FY 2021-2022 By June 30, 2021, at least 25% of individuals are receiving conflict- free case management, and by June 30, 2022, all individuals 2nd and 3rd Quarter 2019 Department engages stakeholders and implements choice in case management for IDD waivers FY 2015-16 6 meetings with CCBs 15 Town Hall Meetings 4 Regional Forums 1 statewide webinar 2015 HB 15-1318 passed requiring Department to develop a CFCM implementation plan (submitted July 1, 2016) 2017 HB 17-1343 passed, redefining case management in Colorado and requiring the Department to implement CFCM by June 30,2022 2017 and 2018 Department working with case management agencies on rural exceptions and business continuity plans (BCPs) March 2014 CMS released final HCBS rule, which required separation of case management from service provision
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In year 3 of a 5-year plan to revise the State Supported Living Services (SLS) allocation methodology Developing State SLS specific regulations and improving contractual requirements Enhanced Benefits Utilization System (BUS) to create additional customized reports for CCBs Recovered all Targeted Case Management (TCM) overpayments in July 2018, found no additional instances of overpayment Developing written clarification to better define reasonable billing practices Working to review payments for service claims without prior authorization and make recoveries
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➢ 81% of individuals on the waiting list are receiving other
services, including some HCBS
➢ Estimated annual total of $204,153,367 ➢ Four years
NOTE: Waiting list numbers are as of September 30, 2018. The Department’s calculations for eliminating the waiting list are based on the methodology from its FY 2017-18 R-I-1 request “Elimination of the HCBS-DD Waiting List,” updated to reflect current waiting list numbers, per capita costs, and various administrative cost.
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