Conflict Free case managemet

Conflict Free Case Management and Case Management Redesign

by Information & Resources

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

by Information & Resources
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!!

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Public Health Emergency Ending

by Information & Resources

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

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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”

 

Boy With Down Syndrome Happy To Spend Day Among Family And Friends

Developmental Disability Awareness Month

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March is Developmental Disability Awareness Month!

Ronald Reagan declared March the month for National Developmental Disabilities Awareness in 1987 after the deinstitutionalization movement of the 1970’s and 1980’s.

The campaign seeks to raise awareness about the inclusion of people with developmental disabilities in all aspects of community life, as well as awareness of the barriers that people with disabilities still sometimes face in connecting to the communities in which they live.

Throughout the campaign, individuals with and without disabilities will share their experiences through stories, photos and videos. This year’s campaign also highlights artwork created by individuals with disabilities and is featured in the Developmental Disabilities Awareness campaign imagery. For more information on Developmental Disabilities Awareness Month, visit https://nacdd.org/ddam1/

Colorado hosts an annual Intellectual & Developmental Disability Awareness Day at the capitol. This year’s event will be held on March 29th, 2023, there are opportunities to join in-person or virtually. For more information about attending the event or link to watch virtually, check out Alliance’s IDD awareness website.

Adult Man Portrait with a Down Syndrome in a Daycare Center

A Family Affair: Amber Lends a Hand to Help Her Grandmother, A Host Home Provider With Support, Inc.

by Information & Resources

When Support, Inc. hired Karen Gray’s granddaughter to be a Direct Support Professional, we were excited to see Amber dive into the world of Intellectual and Developmental Disabilities.

Karen Gray is a strong provider and has worked with us for over 20 years. For Amber’s entire life, this line of work is all Karen has ever known. Karen’s career as a Host Home Provider has led her to help countless individuals, including a few that have stayed with her for over 10 years at a time. Amber has been inspired watching her Grandmother help those in need.

I’m grateful I grew up around IDD services. Society can be very uneducated and misinformed about the IDD population. I’m so glad I always knew how to work with and interact with IDD individuals

Amber also reports that this work and growing up around IDD services has made her more empathetic in general to people and society! Her uncle also has IDD, so he joins Amber and Karen’s individuals on vacations and road trips. They also come together as a small group to attend sporting events and other fun activities in the community.

Now as a DSP, Amber spends half the week at day program and the other half out in the community- activities include shopping, museums, zoos and helping individuals develop their skills when interacting with community members. Amber started with Support, Inc. in November 2022. She relays that she loves the work she does and working with the individuals we serve!

As far as future plans are concerned, Amber wants to stay in the IDD field. She likes being a DSP and might consider being a Host Home Provider in the future. She has a passion for this work and wants to make a career out of it.

Thanks again, Amber, for being an excellent mentor and leader in the field!

If you or someone you know would like to learn more about becoming a Direct Support Professional please email Cathy at Cathy.Kellogg@supportinc.com To apply with us, please follow this link.

HHP of the Month

Host Home Provider of the Month

by Information & Resources

Please join us in congratulating Mercia and JoJo for Host Home Providers of the Month! The following nomination was produced by Rich Shaw with the Denver Metro 3 Team-

I would like to nominate Mercia and JoJo for Providers of the Month. They started working with Support Inc. by taking over from providers who were leaving the agency to pursue other things. After about a year, they became a home with three individuals. From the start, these Providers were eager to do the best job they could, not only by following the compliance requirements of being a Host Home, but also providing quality care to the individuals in their home. This was very evident when an individual in the home started having some major issues with their mental and physical health and needed round-the-clock support. These providers went though many difficulties and trials in trying to get the support needed from the medical professionals including the hospitals and ERs. They ran into many roadblocks and obstacles for several months, but never gave up when a lot of people would have.  For high performance in compliance and dedication to this individual, they have received the Host Home Provider award.

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Black History Month at Support, Inc.

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In celebrating Black History Month, our DEI Council wanted to share some of our perspective into what this Black History Month means for us. As we know, the past several years has created an intense focus human right. Our organization has focused on created a positive impact on the experiences of our Black stakeholders through inclusivity, diversity, equity, accessibility efforts. This work is impactful for me, Dr. Nicholas Manning, (head of the DEI Council) as a bi-racial person, this work connects to my soul.

I think of the struggles and triumphs of my family. From my grandfather, Lt. Colonel George Lane II, flying his P-39 fighter as a part of the Tuskegee Airmen to my cousin Danielle who challenged voting rights throughout the United States, my chest is full of pride thinking of my family. However, times have not always been easy for us. We have been challenged by racism and bias yet believe that there is so much positive work to be done in bringing our country together.

Black history month is a time to help reframe narratives that can be shaped by a person’s agenda. From Langston Hughes and Maya Angelou to Muhammad Ali and Martin Luther King Jr., there is so much beauty and remarkable characteristics of the Black community. This sentiment is not only true for our employees and caregivers, but especially each Black person with disabilities (in and out of services). We have an opportunity to help our entire community better understand themselves by celebrating Black history.

Could you tell me a little about your current role? I’m the Director of People Operations at Support, Inc. My role primarily consists of supporting the experience of our in the execution of our Production Management responsibilities.

 

What do you enjoy most about it? There’s a new and unique challenge of helping our organization’s attunement to our stakeholders. We must be dynamic in managing our risk, increase our connection, and create a caring culture of accountability.

 

What’s the most important part of Black History Month to you? There are two important aspects to Black History Month that are important to me: firstly, teaching (and learning) my history in its truest form and secondly, recognizing the achievements of our Black community.

 

What will you be reflecting on and discussing with your network this year? As a proud advocate for IDEA, I love connecting with other professionals about their efforts.

 

How will you be celebrating Black History Month with your colleagues? I plan on participating in an IDEA webinar this week and advocate for the voices of our stakeholders.

 

Who is an inspirational Black historical figure who inspires you and why? My grandfather. He was and will always be my hero.

 

https://www.famousauthors.org/10-influential-black-authors-you-should-read