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Nurse Team Updates

Nursing Updates for March 2023

The Nurse Team is excited to announce a fully staffed team with the addition of Jamie Weidman! The nurse team consists or Morgan Struck RN, BSN, BA, Associate Director of Nursing, Heather Markham RN, BSN, BA Nurse Case Manager, Hannah Ivey, BS, Medical Coordinator, and Jamie Weidman, BS, Medical Coordinator.

Sleep Hygiene

 What is Sleep Hygiene?

‘Sleep hygiene’ is the term used to describe good sleep habits. Considerable research has gone into developing a set of guidelines and tips which are designed to enhance good sleeping, and there is much evidence to suggest that these strategies can provide long-term solutions to sleep difficulties. There are many medications which are used to treat insomnia, but these tend to be only effective in the short-term. Ongoing use of sleeping pills may lead to dependence and interfere with developing good sleep habits independent of medication, thereby prolonging sleep difficulties. Talk to your health professional about what is right for you, but we recommend good sleep hygiene as an important part of treating insomnia, either with other strategies such as medication or cognitive therapy or alone.

Sleep Hygiene Tips

1) Get regular. One of the best ways to train your body to sleep well is to go to bed and get up at more or less the same time every day, even on weekends and days off! This regular rhythm will make you feel better and will give your body something to work from.

2) Sleep when sleepy. Only try to sleep when you actually feel tired or sleepy, rather than spending too much time awake in bed.

3) Get up & try again. If you haven’t been able to get to sleep after about 20 minutes or more, get up and do something calming or boring until you feel sleepy, then return to bed and try again. Sit quietly on the couch with the lights off (bright light will tell your brain that it is time to wake up), or read something boring like the phone book. Avoid doing anything that is too stimulating or interesting, as this will wake you up even more.

4) Avoid caffeine & nicotine. It is best to avoid consuming any caffeine (in coffee, tea, cola drinks, chocolate, and some medications) or nicotine (cigarettes) for at least 4-6 hours before going to bed. These substances act as stimulants and interfere with the ability to fall asleep.

5) Avoid alcohol. It is also best to avoid alcohol for at least 4-6 hours before going to bed. Many people believe that alcohol is relaxing and helps them to get to sleep at first, but it actually interrupts the quality of sleep.

6) Bed is for sleeping. Try not to use your bed for anything other than sleeping and sex, so that your body comes to associate bed with sleep. If you use bed as a place to watch TV, eat, read, work on your laptop, pay bills, and other things, your body will not learn this connection.

7) No naps. It is best to avoid taking naps during the day, to make sure that you are tired at bedtime. If you can’t make it through the day without a nap, make sure it is for less than an hour and before 3pm.

8) Sleep rituals. You can develop your own rituals of things to remind your body that it is time to sleep – some people find it useful to do relaxing stretches or breathing exercises for 15 minutes before bed each night, or sit calmly with a cup of caffeine-free tea.

9) Bath time. Having a hot bath 1-2 hours before bedtime can be useful, as it will raise your body temperature, causing you to feel sleepy as your body temperature drops again. Research shows that sleepiness is associated with a drop in body temperature.

10) No clock-watching. Many people who struggle with sleep tend to watch the clock too much. Frequently checking the clock during the night can wake you up (especially if you turn on the light to read the time) and reinforces negative thoughts such as “Oh no, look how late it is, I’ll never get to sleep” or “it’s so early, I have only slept for 5 hours, this is terrible.”

11) Use a sleep diary. This worksheet can be a useful way of making sure you have the right facts about your sleep, rather than making assumptions. Because a diary involves watching the clock (see point 10) it is a good idea to only use it for two weeks to get an idea of what is going and then perhaps two months down the track to see how you are progressing.

12) Exercise. Regular exercise is a good idea to help with good sleep but try not to do strenuous exercise in the 4 hours before bedtime. Morning walks are a great way to start the day feeling refreshed!

13) Eat right. A healthy, balanced diet will help you to sleep well, but timing is important. Some people find that a very empty stomach at bedtime is distracting, so it can be useful to have a light snack, but a heavy meal soon before bed can also interrupt sleep. Some people recommend a warm glass of milk, which contains tryptophan, which acts as a natural sleep inducer.

14) The right space. It is very important that your bed and bedroom are quiet and comfortable for sleeping. A cooler room with enough blankets to stay warm is best, and make sure you have curtains or an eye mask to block out early morning light and earplugs if there is noise outside your room.

15) Keep daytime routine the same. Even if you have a bad night sleep and are tired it is important that you try to keep your daytime activities the same as you had planned. That is, don’t avoid activities because you feel tired. This can reinforce the insomnia.

This document is for information purposes only. Please refer to the full disclaimer and copyright statement available at https://www.cci.health.wa.gov.au regarding the information from this website before making use of such information. See website www.cci.health.wa.gov.au for more handouts and resources.

Joey Pic

Joey Celebrates One Year At His Job

Congratulations to Joey for his one year of working at Century Boulder! Joey started at Century as an usher last year. He would help clean the theaters after the movies. After doing that for a while, he expanded to working the box office and selling tickets. Joey is very proud of himself for getting more responsibilities at work, and he practices counting change at home so he can continue to improve his skills.

Joey’s next goal at work is to get to work at the concession stand and help sell popcorn and drinks. Joey’s dad has noticed that since Joey has started his job, there has been an increase in Joey’s independence, confidence, and social skills. Joey says his favorite thing about his job is getting to interact with the customers and coworkers. For his birthday, he was able to bring cupcakes and celebrate with all his coworkers, and he said that was his favorite part of the whole week.

When Joey is not at work you will find him hanging out with Dad and living his best life!

 

Conflict Free Case Management And Case Management Redesign (1)

ADP Voluntary Demographics Updates

Hello Support, Inc. Family,

As your employer, we’re committed to supporting a diverse and inclusive company. Any information you provide here helps us ensure we’re recruiting, investing, and growing to meet the needs of our associates.

If you choose to voluntarily share this information, it will be kept confidential and maintained in accordance with all applicable laws. Designated administrators can view company totals, but no one can view individual responses. This information won’t be used to make employment decisions.

To make changes first click Myself and the pencil button

On the right you can select changes to accurately identify.

The page will pop out below and you can select the appropriate identification for you. If what you feel comfortable with identifying as isn’t available please reach out to @AD NewHRAdmin.com and we can make those changes with ADP.

Stayed tuned for more ADP changes and updates coming soon! Your Relias user ID will be changing in the coming weeks as we integrate ADP (our HR management platform) with Relias. Be sure to keep an eye out for emails from the Human Resources Department for updates on timing and how to get your new user ID. And please do not hesitate to reach out to your coordinator with any further questions.

Conflict Free case managemet

Conflict Free Case Management and Case Management Redesign

You may be hearing the terms Conflict Free Case Management and/or Case Management Redesign from the case managers you work with. I wanted to provide some information about the changes that are coming from the state.

Conflict Free Case Management (CFCM)

CFCM is a federal mandate from Centers for Medicaid and Medicare Services (CMS) under the final settings rule. You’ve heard us talk a lot about the Final Settings Rule and what these changes look like for PASA’s. For community center boards (CCBs) the final settings rule requires there is a separation of case management and direct services. This means, a company cannot provide both case management (CCB) and program services (PASA), such as residential, day services or behavioral services to the same person. Many of Colorado’s CCBs operate within this conflict as they provide both case management and program services and are now required to eliminate this conflict.

The efforts of The Department of Health Care Policy and Finance (HCPF) to comply with federal requirements of Conflict Free Case Management (CFCM) have evolved into several initiatives called Case Management Redesign (CMRD).

Case Management Redesign (CMRD)

CMRD will help make accessing long-term services and supports easier by requiring Case Management Agencies (CMAs) to provide case management services to all Home and Community-Based Service (HCBS) waivers. This change will:

  • Establish a single entity people go to access services.
  • Make sure there are the right number of case management agencies in Colorado.
  • Increase the quality of case management services.

CMRD requires that one entity, now called a Case Management Agency provides case management services for all 10 HCBS waivers that are operated in the State of Colorado. Those HCBS waivers currently have unique case management through CCBs, single-entry points, or private case management. People who are seeking or receiving Long-term Service and Support (LTSS) often qualify for multiple programs and end up navigating between systems that are siloed by program, making the system difficult for members. CMRD is intended to simplify access and remove silos so members will be able to more easily navigate and find the right programs and services that work for them.

The change requires the case management agency to provide case management services for all waiver programs in each catchment area. The CCBs we work with now usually serve 1-3 catchment areas. Some of the catchment areas we are familiar with will be changing, and CMRD will only allow one Case Management Agency to operate in each catchment area.

Case Management Redesign Timeline

Below is a timeline for when these changes will take effect.  In January of this year, the Request for Provider (RFP) was opened for interested entities to submit their bid for the state’s contract to be the Case Management Agency (CMA) for a respective catchment area. CMA awardees will be announced in May 2023.

Organization Impact and What to Expect

We know that the current CCB system we are familiar with will be changing. The CMA contract may be awarded to a CCB we are familiar with, in other cases it may be a new entity we haven’t worked with yet.

Have patience and understanding. This is a major change for the CMA’s as they begin case management for additional waivers, learn new systems, and get to know us. As you hear a person on your caseload/ a person you support has a new case manager, take a moment to reach out and introduce yourself, and offer your expertise on the case. Additionally, we expect through the three-part phased transition indicated in the above timeline that response times may be slower than normal. As much as you can, be proactive if you need to request anything from the case manager(s) you work with.

Incoming and outgoing CMAs in each catchment area will receive support from the Department (HCPF) staff through the transition process to ensure a smooth transition. Before, during, and after CMA transitions, people receiving services will be notified of who to contact in order to get their needs met for waiver case management services.

HHP of the Month

Host Home Provider of the Month

Please join us in congratulating our Host Home Provider of the Month, Roxie!
Roxie has been a Host Home Provider with Support Inc since 2017, when Jay moved in with her. Jay was struggling with substance use and unhappy with his life when he moved in with Roxie, but over the years Roxie has offered phenomenal supports to Jay that help him live a healthy, happy, and productive life.
Thanks to Roxie, Jay is very involved in his church community. Jay goes to church every week and has built strong relationships with his fellow churchgoers. He also volunteers for events with the children’s ministry and attends church groups during the week. Jay is very thankful to Roxie for helping him find a place in his community. Jay has mentors through the church that he says he never would have found if not for Roxie. Roxie also connected Jay to his current employer, and Jay has been able to hold down employment for a year now – his longest time at one job. Jay says that Roxie helped him learn to take pride in doing a good job at work, and that she works with him daily to continue increasing his independence both at home and at work. Jay has said himself that if it wasn’t for Roxie, he would not be where he is now and would not have all these good things going for him.
Thanks Roxie for being such a great provider and excellent support!!

PW

Patrick and Shannon Travel to Texas

Family Caregiver Shannon recently arranged for her son Patrick to visit his sister in Texas! His sibling went away to college and he was really starting to miss her. So they planned a trip to visit during spring break and he had a blast. Patrick greatly enjoyed his time with his sister and also enjoyed meeting this giraffe 😊

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Public Health Emergency Ending

Public Health Emergency ending resulting in end to continuous coverage.

Background:

In January 2020, the U.S. Department of Health and Human Services (HHS) declared a public health emergency (PHE) in response to the outbreak of COVID-19. Congress passed legislation that ensured anyone enrolled in Health First Colorado (Colorado’s Medicaid program) was guaranteed to keep their health coverage during the PHE. This is known as the “continuous coverage requirement” and also applies to kids and pregnant people covered by Child Health Plan Plus (CHP+). Congress recently passed a bill that ends the continuous coverage requirement in spring 2023. U.S. Health and Human Services Secretary Xavier Becerra has formally extended the COVID-19 Public Health Emergency (PHE). The PHE can be extended for up to 90 days at a time and is expected to end on May 11, 2023. The Executive Office of the President, Office of Management and Budget, issued a Statement of Administration Policy on Jan. 30, 2023, that the Administration plans to extend the PHE to May 11.

What this means:

During the Public Health Emergency, Medicaid (managed by the county of residence) continued to send out redetermination packets and request for financial verifications. However, no one’s Medicaid coverage ended due to lack of redetermination submitted or verifications because of the ‘continuous coverage’ legislation. You likely continued to submit your packets as normal.

Beginning May 12th, the redeterminations that are sent out and requests for verifications that are sent out MUST be responded to within the time frame given, or eligibility will be affected.

 Suggestions from Health Care Policy and Finance (HCPF) on how to plan for the ending of PHE:

  1. Health First Colorado and CHP+ will return to normal eligibility renewal processes with renewals due in May and notice will be sent starting March 2023.
  2. The Department of Health Care Policy & Financing (HCPF) will take 12 months (14 months including noticing) to complete renewals for each of the approximately 1.7 million people currently enrolled.
  3. Members should:
    1. Update their contact information to ensure you receive your packet and you can be reached.
    2. Respond to and sign renewal paperwork to make sure you keep your Health First Colorado and CHP+ coverage if they are still eligible.
    3. Members can find out their renewal dates and access more information by going to the Health First Colorado Website.

 Additional info:

Creating a Peak account is an easy way to update member information (including address and contact information), access case information such as contact information on file, renewal dates, an online mailbox where all case communication is available (including redeterminations, requested verifications, and eligibility determinations), and coverage. Peak will also have a notice on the account home page if a redetermination is due or if documentation is needed. Use this link to access the PEAK Website.

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Celebrating IDD Awareness Month

In the spirit of IDD Awareness Month, we would like to share & celebrate the story of Joe B. (9-8-82 to 12-12-22). Joe was born without the Corpus Callosum and as a result he was non-verbal and used a wheelchair all his life. But Joe never let his challenges define him or stop him from living life to the fullest. Joe graduated from UCCS Pueblo with honors for a bachelor’s degree in fine arts. Joe discovered that visual art gave him a voice. The below paintings were part of a series in which each painting was partially black and white, partially color to respect how art brought color to his world. “Content provided by his HHP, Billie”