QA COrner

QA Corner: Case Management Redesign & Conflict Free Case Management

CONFLICT FREE CASE MANAGEMENT (CFCM): In 2014 Centers for Medicaid and Medicare Services published the Federal Final Settings Rule requiring home and community-based services (HCBS)  meet certain criteria. As part of the rule, there must be a separation of case management services and direct services (residential, day program, employment, behavioral services, etc.). Entities cannot provide both case management and direct services to the same person. The efforts of the Department of Health Care Policy and Finance (HCPF) to comply with federal requirements of Conflict Free Case Management have evolved into several initiatives called Case Management Redesign.

CASE MANAGEMENT REDESIGN (CMRD): Case Management Redesign requires a Case Management Agency (CMA) to provide case management to all 10 Home and Community Based (HCBS) waivers offered in the State of Colorado. CMRD will simplify access to Long-Term Services and Supports (LTSS) by having one entity manage all HCBS programs. We are about halfway through the case management redesign process. Some transition timelines have been updated. Below is a graphic explaining each service area we work with, who the new case management agency (CMA) will be and which phase they are transitioning in.


Catchment Case Management Agency Transition Phase
Catchment Area 5:  

Arapahoe, Douglas, and Elbert Counties

Developmental Pathways (DP) Phase 1:

Aug. 1-Oct. 31, 2023

Catchment Area 6:  

Adams and Denver Counties

Rocky Mountain Human Services (RMHS) Phase 1:

Aug. 1-Oct. 31, 2023

Catchment Area 11:  

El Paso, Park, and Teller Counties

The Resource Exchange (TRE) Phase 1:

Aug. 1-Oct. 31, 2023

Catchment Area 1:  

Cheyenne, Kit Carson, Lincoln, Logan, Morgan, Phillips, Sedgwick, Washington, and Yuma Counties

Northeastern Colorado Association of Local Governments (NECALG)  Phase 2:

Nov. 1, 2023 – Feb. 29, 2024

Catchment Area 9:  

Weld County 

Weld County Area Agency on Aging Phase 2:

Nov. 1, 2023 – Feb. 29, 2024 

Catchment Area 12:  

Pueblo County 

The Resource Exchange (TRE)  Phase 2:

Nov. 1, 2023 – Feb. 29, 2024

Catchment Area 10:  

Larimer County 

Foothills Gateway, Inc.  Phase 2:

Nov. 1, 2023 – Feb. 29, 2024

Catchment Area 7:  

Clear Creek and Jefferson Counties

Jefferson County Phase 3:

March 1-June 30, 2024

Catchment Area 8:  

Boulder, Broomfield, and Gilpin Counties

Adult Care Management, Inc. (ACMI) Phase 3:

March 1-June 30, 2024


Along with the change in Case Management Agencies, the state will also be transitioning to the Person-Centered Support Plan (PCSP) which will serve as the plan for all HCBS services and is relacing the current Service Plan (SP). HCPF has also created a new level of care screening and needs assessment. The state anticipates these new tolls will be implemented in February 2024.