#1HCPF Case Management Redesign Statewide Stakeholder Meeting COLORADO Department of Health Care Policy & Financing June 16, 2021 1#2ESCATE THE SAIN Our Mission: Improving health care equity, access and outcomes for the people we serve while saving Coloradans money on health care and driving value for Colorado. COLORADO Department of Health Care HCPF Policy & Financing 2#3Goals for Today HCPF · · • • Understand current case management system Understand need for case management redesign Report on catchment area survey results Set expectations for upcoming listening sessions and stakeholder engagement Get excited about CMRD COLORADO Department of Health Care Policy & Financing & 3#4M HCPF COLORADO Department of Health Care Policy & Financing Live Poll 4#5M HCPF COLORADO Department of Health Care Policy & Financing Background LO 5#6. Medicaid Basics Health insurance for eligible low-income adults, children, pregnant women, elderly adults and people with disabilities • Entitlement program currently covering nearly 72 million Americans nationwide States given the option to participate > Funded jointly with State and Federal Funding ➤ Some mandatory requirements ➤ Some flexibility for States to tailor their Medicaid program to their needs and population HCPF COLORADO Department of Health Care Policy & Financing 6#7. Home and Community-Based Services (HCBS) Waivers Alternative to institutional care ➤ Provide institutional level of care to individuals who prefer to live in their home or community Home and Community-Based Services (HCBS) Waivers allow states flexibility to: ➤ Waive certain income/eligibility criteria ➤ Provide specific services to target groups or geographic regions ➤ Can have waiting lists or enrollment caps ➤ Provide individuals more choice and independence HCPF COLORADO Department of Health Care Policy & Financing 7#8HCPF COLORADO Department of Health Care Policy & Financing Benefits Pyramid Optional Benefits: HCBS Waivers Waivers, participant-directed services, transition services Long-Term Care State Plan (Regular Medicaid) Mandatory Benefits: Nursing facility services, home health Optional Benefits: PACE, case management Mandatory Benefits: Inpatient and outpatient hospital services, physician services, laboratory and x-ray services, more... Optional Benefits: Prescription drugs, dental services 8#910 HCBS Waivers in Colorado Adult Waivers Brain Injury Waiver (BI) Community Mental Health Supports Waiver (CMHS) Developmental Disabilities Waiver (DD) Elderly, Blind and Disabled Waiver (EBD) Spinal Cord Injury Waiver (SCI) Supported Living Services Waiver (SLS) Children's Waivers Children's Extensive Support Waiver (CES) Children's Home and Community Based Services Waiver (CHCBS) Children's Habilitation Residential Program Waiver (CHRP) Children with Life Limiting Illness Waiver (CLLI) hcpf.colorado.gov/long-term-services-and-supports-programs HCPF COLORADO Department of Health Care Policy & Financing 9#10Assessment What is Case Management? Service Plan Service Referral and Coordination HCPF COLORADO Department of Health Care Policy & Financing Quality Monitoring 10#11HCBS Waivers and Case Management Currently, the HCBS waiver a person chooses to pursue determines the type of case management agency they will go to. Single Entry Point (SEP) Agency Serves waivers targeted to individuals without an IDD . Brain Injury Waiver (BI) Community Mental Health Supports Waiver (CMHS) • Elderly, Blind and Disabled Waiver (EBD) • Spinal Cord Injury Waiver (SCI) • Children With Life Limiting Illness Waiver (CLLI) Community Centered Board (CCB) Agency Serves waivers targeted to individuals with an IDD • Developmental Disabilities Waiver (DD) Supported Living Services Waiver (SLS) • Children's Extensive Support Waiver (CES) • Children's Habilitation Residential Program Waiver (CHRP) Private Case Management Agencies Serves children with significant medical needs • Children's Home and Community Based Services Waiver (CHCBS) HCPF COLORADO Department of Health Care Policy & Financing 11#12Moffat Rio Blanco 16 Garfield 12 Mesa Delta Current SEP and CCB Regions Routt Jackson Larimer о Weld 23 Grand Boulder Broomfield Gilpin Denver Clear Creek Eagle Adams Arapahoe Summit efferson 11 Douglas Elbert Pitkin Lake Park 24 Chaffee Gunnison 6 21 Teller Montrose 14 Ouray San Miguel Fremont 4 Saguache Custer 2 Hinsdale Dolores San Juan Mineral Rio Grande Alamosa 13 Monte ma La Plata 22 Archuleta Costilla Conejos 5 HCPF COLORADO Department of Health Care Policy & Financing O El Paso Pueblo 19 Sedgwick Larimer Weld Moffat Sedgwick Logan Phillips Logan Jackson Routt Phillips 8 10 Morgan 7 Yuma Mozan 15 Washington Rio Blanco Yuma Kit Carson 8 Lincoln Cheyenne Mesa 13 Delta Gunnison Grand Boulder Gilpin 16 Adams 15 Washington Clear Denver Creek Arapahoe Garfield 14 Eagle Summit Jefferson 6 Elbert Kit Carson Douglas Pitkin Lake Park Teller 20 Lincoln Cheyenne El Paso Chaffee 19 Kiowa Fremont Kiowa Crowley Montrose 17 3 Ouray Bent Prowers Otero San Miguel Hinsdale Saguache Custer 2 Pueblo Crowley 12 17 Prowers Bent Otero Dolores 18 Baca San Juan Huerfano Mineral Alamosa 3 Rio Grande 18 Montezuma Las Animas Baca La Plata Costilla Archuleta Conejos Huerfano 10 10 Las Animas SEP Agency Location SEP Covered Counties 12#13HCPF Challenges with CM in Colorado • . Inconsistent Quality Disjointed IT systems • Members' experiences of support differ based on agency and location Inequity between populations • Lack of flexibility to access services COLORADO Department of Health Care Policy & Financing 13#14M HCPF COLORADO Department of Health Care Policy & Financing Live Poll 14#15Case Management Redesign M HCPF COLORADO Department of Health Care Policy & Financing 15#16HCPF Bringing Change Executive Order and CLAG One place to go for all waivers Conflict-Free Case Management New Assessment and Person-Centered Support Plan Process = Case Management Redesign COLORADO Department of Health Care Policy & Financing 16#17HCPF Key outcomes of CMRD Federal Compliance COLORADO Department of Health Care Policy & Financing Quality Simplicity Stability Accountability Person- Centered Member Experience 17#18Determine financial eligibility with County Case Management Agency PERSON CENTEREDNESS CO COLORADO Department of Health Care HCPF Policy & Financing Intake & Eligibility Ongoing Case Management Functions · Initial & Continued Stay Review (CSR) Assessment • Service Planning • Monitoring • · Financial Eligibility Assistance Determination of Developmental Disability (DD)/Delay Children's Extensive Support (CES) Application Resource Navigation Outreach Regional Accountable Entity (RAE) Coordination & Engagement Community Advocates • Revisions Admin Functions • Waiting List Management • Operational Guide • Human Rights Committee (HRC) • Complaint Trends • Appeals • State Funded Programs • Critical Incident Reporting (CIR) ⚫• Supports Intensity Scale (SIS) Organized Healthcare Delivery System (OHCDS) Standardized Training Select Service Providers 18#19# HCPF Colorado Case Management Redesign Easier to navigate with less silos Program & Policy Changes (Summer 2024) Infrastructure Changes (Summer 2021) One place to go regardless of HCBS need New Care & Case Management IT Platform Streamline processes and increase efficiency for members and case managers Member experience is driven by goals, preferences and need Serve all HCBS waivers New Assessment Tool & Implement a more rather than waiver Support Plan comprehensive and objective determination of member goals, preferences, and needs Increase consistency, accountability and quality across the system RFP for all Case Management Person- Centered Allocate resources based on Agencies Budget Algorithm new, more robust assessment tool COLORADO Department of Health Care Policy & Financing 19#20HCPF Future of Case Management Supports members regardless of disability Increases compliance and accountability COLORADO Department of Health Care Policy & Financing • • • • Case Management Agency Serves members based on where they live Determines eligibility for all HCBS waivers Helps person choose waiver based on eligibility Helps person plan for and find services Robust training for all case managers Uses common tools and IT system 20 20#21CO COLORADO Department of Health Care HCPF Policy & Financing Questions? 21#22#h HCPF COLORADO Department of Health Care Policy & Financing CMRD updates 22#23HCPF • ● Case Management Redesign HB21-1187 Passed and signed Goal: To achieve a high performing case management system that creates a person centered member experience ➤ To streamline operations, increase administrative efficiencies and implement innovative initiatives that further increase stability, quality, and accountability Repeals CFCM language in current statute and creates Case Management Agencies that serve all populations ➤ Goes into effect July 1, 2024 ➤ Requires the Department to work with stakeholders and release a timeline for system changes by December 31, 2021 COLORADO Department of Health Care Policy & Financing 23#24Fall/Winter 2021 Key Decisions • • Catchment areas Quality CM Engagement High-Level Timeline CCB Designation/OHCDS/ OWQP Implementation Timeline Engagement Summer 2022 Key Decisions • • Human Rights Committee Release Request for Information (RFI) Summer 2023 to 2024 Transition • Finalize rules and waiver amendments Transition to new Case Management Agencies (July 2024) Topic Engagement • • . Case management rates Quality Case management CM rates Winter/Spring 2022 Stakeholder Engagement Throughout Quarterly meetings to include updates on entire project and timely topics for feedback Contracts Release Request for Proposals (Dec. 2022) • Award contracts (July 2023) Winter/Spring 2023 HCPF COLORADO Department of Health Care Policy & Financing 24#25Colorado Case Management Redesign Easier to navigate with fewer silos Program & Policy Changes (Summer 2024) Infrastructure Changes (Summer 2021) One place to go regardless of HCBS need New Care Streamline processes and & Case Management System increase efficiency for members and case managers Implement a more Member experience is driven by goals, preferences and need Serve all HCBS waivers New Assessment & rather than waiver Support Plan comprehensive and objective determination of member goals, preferences, and needs Increase consistency, accountability and quality across the system RFP for all Case Management Agencies Person- Centered Budget Algorithm Allocate resources based on new, more robust assessment tool COLORADO Department of Health Care HCPF Policy & Financing 25#26HCPF COLORADO Department of Health Care Policy & Financing Related Work New Assessment and Person- Centered Support Plan Streamlined eligibility determination for members New IT system Person-centered budget process 26#27Roadmap to Implementation Case Management Infrastructure Summer 2022 Pilot PCBA Rollout pilot of resource allocation for all waivers, called Person- July 2024 take, Eligibility, & Management Agency ERSON CENTERCENESS Summer 2023 Implement PCBA . • Implement PCBA for all waiver members ⚫ Phase out temporary Bridge functionality and use of SIS Winter 2021 Go Live! July-Nov. Centered Budget 2021 Algorithm (PCBA) Soft Launch & Training Soft Launch: Begin conducting assessments and support plans in the new IT system Training: Case manager training on new member access processes and new IT system HCPF COLORADO Department of Health Care Policy & Financing February 2021 Communications Kick-Off Launch regular communications to members, case managers and the broader community about coming changes New Member Access . Processes: • Assessment Person-Centered Support Plan Eligibility Determination Changes New IT System: Care & Case Management Temporary Bridge functionality 27#28What is NOT changing? #h HCPF COLORADO Department of Health Care Policy & Financing 28#29HCPF COLORADO Department of Health Care Policy & Financing What is not changing? • Access to services • Person Centered approach Required Case Management Local Knowledge and expertise 29#30#h HCPF COLORADO Department of Health Care Policy & Financing HCPF commitments to engagement 30#31CO COLORADO Department of Health Care HCPF Policy & Financing Questions? 31#32Current Work Underway #h HCPF COLORADO Department of Health Care Policy & Financing 32#33HCPF Work Required for Case Management Redesign Current Contract Work Future Contract Work ■ Catchment area analysis • Determination of Medicaid authority ⚫ Re-evaluation of Rural Exceptions ("only willing and qualified provider") Organized Health Care Delivery System (OHCDS) analysis Human Rights Committee (HRC) analysis □ Quality case management research Children's Home and Community Based Services (CHCBS) □ Community Centered Board Designation ☐ Regulation and Waiver Crosswalk ☐ Case Management Implementation Timeline ⚫ Human Rights Committee research Follow Up on Critical Case Management Components COLORADO Department of Health Care Policy & Financing 33 33#34Moffat Rio Blanco 16 Garfield 12 Mesa Delta Current SEP and CCB Regions Routt Jackson Larimer о Weld 23 Grand Boulder Broomfield Gilpin Denver Clear Creek Eagle Adams Arapahoe Summit efferson 11 Douglas Elbert Pitkin Lake Park 24 Chaffee Gunnison 6 21 Teller Montrose 14 Ouray San Miguel Fremont 4 Saguache Custer 2 Hinsdale Dolores San Juan Mineral Rio Grande Alamosa 13 Monte ma La Plata 22 Archuleta Costilla Conejos 5 HCPF COLORADO Department of Health Care Policy & Financing O El Paso Pueblo 19 Sedgwick Larimer Weld Moffat Sedgwick Logan Phillips Logan Jackson Routt Phillips 8 10 Morgan 7 Yuma Mozan 15 Washington Rio Blanco Yuma Kit Carson 8 Lincoln Cheyenne Mesa 13 Delta Gunnison Grand Boulder Gilpin 16 Adams 15 Washington Clear Denver Creek Arapahoe Garfield 14 Eagle Summit Jefferson 6 Elbert Kit Carson Douglas Pitkin Lake Park Teller 20 Lincoln Cheyenne El Paso Chaffee 19 Kiowa Fremont Kiowa Crowley Montrose 17 3 Ouray Bent Prowers Otero San Miguel Hinsdale Saguache Custer 2 Pueblo Crowley 12 17 Prowers Bent Otero Dolores 18 Baca San Juan Huerfano Mineral Alamosa 3 Rio Grande 18 Montezuma Las Animas Baca La Plata Costilla Archuleta Conejos Huerfano 10 10 Las Animas SEP Agency Location SEP Covered Counties 34#35• Catchment Area Analysis Goal is a proposed map that shows the Case Management Agencies (CMA) catchment areas ➤ Minimize disruptions ➤ Welcome input about existing integration efforts Factors considered: # of current members, caseloads, # assessments and support plans, geographic considerations (e.g., mountains, distance to offices) Conducted operational focus discussions HCPF COLORADO Department of Health Care Policy & Financing 35 55#36Colorado CMRD Catchment Area Survey Summary Report M HCPF COLORADO Department of Health Care Policy & Financing 36#37I work for a Community... I work for a Single Entry... My agency provides cas... I am a direct service... I am an individual w... I am a family member/frien... I am an advocate for... Other (please specify) Who Participated in the Survey? ANSWER CHOICES RESPONSES 27.97% 172 I work for a Community Centered Board (CCB) 9.43% 58 I work for a Single Entry Point (SEP) My agency provides case management outside of the SEP/CCB structure 3.74% 23 16.10% 99 I am a direct service provider 8.94% 55 I am an individual with a disability or older adult I am a family member/friend of someone with a disability or older adult 38.86% 239 I am an advocate for people with disabilities and/or older adults 14.63% 90 9.92% 61 Other (please specify) Total Respondents: 615 096 10% 20% 3096 10% 50% 60% 70% 8096 90% 10046 M HCPF COLORADO Department of Health Care Policy & Financing 37#38Denver Metro Catchment Area Results (Adams, Arapahoe, Denver, Douglas, Elbert, and Jefferson counties) HCPF COLORADO Department of Health Care Policy & Financing 38#39nit } Boulder Gilpin Brgenfield Adams Denver Clear Creek Jefferson, Park 3 Arapahoe 2 Elbert Douglas Teller El Paso Scenario 1 Morgan Boulder Was! Wash Gilpin Broondfield Adams 1 Denver Clear Creek Jefferson, Arapahoe 3 2 Douglas Elbert Boulder Gilpin Was Broomfield Adams 2 Clear Creek Jefferson, Park Park Lincoln Lincoln Teller El Paso } d Boulder 1 Brgenafield Gilpin Adams Denve Clear Creek Jefferson, ummit Arapahoe 1 Park Douglas Teller El Paso • No Opinion Other Scenario 4 HCPF COLORADO Department of Health Care Policy & Financing Elbert Morgan Washin Scenario 2 Boulder Arapahoe 3 Elbert Douglas Teller El Paso Scenario 3 Wash Adams Brochofield Denve Arapahoe Gilpin Clear Creek Jefferson Park Lincoln Douglas Elbert Teller El Paso Scenario 5 Lincoln Lincoln 39#40All Respondents: Which of the following scenarios would you prefer as the approach for CMAs serving the Denver Metro Catchment Area (Adams, Arapahoe, Denver, Douglas, Elbert, and Jefferson counties)? No Opinion Metro Denver Scenario 1 ANSWER CHOICES RESPONSES Metro Denver Scenario 2 No Opinion 34.27% 171 16.23% 81 Metro Denver Scenario 1 Metro Denver Metro Denver Scenario 2 14.23% 71 Scenario 3 Metro Denver Scenario 3 13.03% 65 Metro Denver Scenario 4 Metro Denver Scenario 4 3.41% 17 Metro Denver Scenario 5 11.42% 57 Metro Denver Scenario 5 7.41% 37 Other TOTAL 499 HCPF Other 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% COLORADO Department of Health Care Policy & Financing 40#41All CMA Preferences for the Metro Denver Catchment Area: No Opinion Metro Denver Scenario 1 ANSWER CHOICES RESPONSES 35.58% 74 No Opinion Metro Denver 20.19% 42 Metro Denver Scenario 1 Scenario 2 12.98% Metro Denver Scenario 2 2 27 Metro Denver 12.98% 27 Scenario 3 Metro Denver Scenario 3 4.33% 9 Metro Denver Scenario 4 Metro Denver Scenario 4 Metro Denver Scenario 5 8.17% 17 5.77% 12 Metro Denver Scenario 5 Other TOTAL 208 HCPF Other 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% COLORADO Department of Health Care Policy & Financing 41#42Other Preferences for the CMAs serving the Metro Denver Catchment Area: No Opinion Metro Denver Scenario 1 ANSWER CHOICES RESPONSES No Opinion 33.13% 106 Metro Denver Scenario 2 Metro Denver Scenario 1 13.44% 43 15.31% 49 Metro Denver Scenario 2 Metro Denver Scenario 3 Metro Denver Scenario 3 13.44% 43 43 2.81% 9 Metro Denver Metro Denver Scenario 4 Scenario 4 Metro Denver Scenario 5 13.44% 43 Metro Denver 8.44% 27 Other Scenario 5 TOTAL 320 Other 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% COLORADO Department of Health Care HCPF Policy & Financing 42#43Feedback Supporting Scenario 1 . Most evenly distributes population, workload, and geographical distances . Ensures continuity of service providers for IDD population • Aligns with other services in area • Keeps mill levy funding for the IDD populations intact HCPF COLORADO Department of Health Care Policy & Financing 43#44• Feedback Supporting Scenario 2 Groups similar geographic areas • Most evenly distributes population and geographical distances ⚫ Possible solution for city of Aurora COLORADO Department of Health Care HCPF Policy & Financing 44#45HCPF Gilpin and Clear Creek Catchment Area Results COLORADO Department of Health Care Policy & Financing Moffat Routt Rio Blanco Garfield Mes a Delta Montrose Jackson Larimer Weld Grand Boulder Gilpin Broomfield Adams Denver Clear Creek Eagle Arapahoe Summit Jefferson Pitkin Lake Park Chaffee Gunnison Fremont Elbert Douglas Teller El Paso Morgan Crowley Pueblo Custer Saguache Ouray San Miguel Dolores San Juan Hinsdale Mineral Rio Grande Alamosa Montezuma La Plata Archuleta Conejos Costilla Huerfano Las Animas Sedgwick Logan Phillips Washington Yuma Kit Carson Lincoln Cheyenne Kiowa Bent Prowers Otero Васа 45#46All Respondents: Which counties should be in the same catchment area as Gilpin and Clear Creek counties? No opinion Boulder and Broomfield ANSWER CHOICES RESPONSES 51.32% 253 No opinion 16.84% 83 Boulder and Broomfield 21.50% 106 Jefferson Jefferson Other counties, describe: 10.34% 51 TOTAL 493 Other counties,... 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% M HCPF COLORADO Department of Health Care Policy & Financing 46#47All CMA Preferences: Which counties should be in the same catchment area as Gilpin and Clear Creek counties? HCPF No opinion Boulder and Broomfield Jefferson Other counties.... ANSWER CHOICES RESPONSES 53.88% 111 No opinion 13.59% 28 Boulder and Broomfield 25.24% 52 Jefferson 7.28% 15 Other counties, describe: TOTAL 206 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% COLORADO Department of Health Care Policy & Financing 47#48Other Preferences: Which counties should be in the same catchment area as Gilpin and Clear Creek counties? No opinion Boulder and Broomfield Jefferson Other counties.... ANSWER CHOICES RESPONSES No opinion 48.25% 152 Boulder and Broomfield 18.10% 57 Jefferson 20.32% 64 Other counties, describe: 13.33% 42 TOTAL 315 0% 10% 20% 30% 40% 50% 6096 70% 80% 90% 100% COLORADO Department of Health Care HCPF Policy & Financing 48#49Summit County Catchment Area Results HCPF Moffat Routt Rio Blanco Garfield Jackson Larimer Weld Grand Boulder Broomfield Gilpin Adams Denver Clear Creek Eagle Arapahoe Summit Jefferson Elbert Douglas Pitkin Lake Park Mes a Delta Chaffee Gunnison Montrose Fremont Teller El Paso Morgan Crowley Pueblo Saguache Custer Ouray San Miguel Dolores San Juan Hinsdale Mineral Rio Grande Alamosa Montezuma La Plata Archuleta COLORADO Department of Health Care Policy & Financing Conejos Costilla Huerfano Las Animas Sedgwick Logan Phillips Washington Yuma Kit Carson Lincoln Cheyenne Kiowa Bent Prowers Otero Васа 49#50All Respondents: Which catchment area do you see as the best fit to serve Summit county? No opinion Clear Creek Eagle Grand Lake Park Other proposed approach HCPF ANSWER CHOICES RESPONSES 62.53% 297 No opinion 8.42% 40 40 Clear Creek Eagle 16.21% 77 2.53% 12 Grand 1.89% 9 Lake 1.47% 7 Park 6.95% 33 Other proposed approach TOTAL 475 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% COLORADO Department of Health Care Policy & Financing 50#51All CMA Preferences: Which catchment area do you see as the best fit to serve Summit county? No opinion Clear Creek Eagle ANSWER CHOICES No opinion Clear Creek Eagle Grand Grand Lake Lake Park Park Other proposed approach HCPF Other proposed approach TOTAL 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% COLORADO Department of Health Care Policy & Financing RESPONSES 63.37% 128 10.40% 16.34% 21 21 33 33 2.48% 5 0.50% 1 2.97% 60 3.96% 8 202 51#52Other Preferences: Which catchment area do you see as the best fit to serve Summit county? No opinion Clear Creek ANSWER CHOICES No opinion Eagle Clear Creek Eagle Grand Grand Lake Lake Park Park Other proposed approach HCPF Other proposed approach TOTAL RESPONSES 60.33% 181 7.67% 23 16.33% 49 2.67% 00 8 2.67% 8 00 0.67% 2 9.67% 29 300 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%6 COLORADO Department of Health Care Policy & Financing 62 52#53Feedback for Clear Creek vs. Eagle Feedback Supporting Clear Creek: • Population Similarities Service Delivery Model Similarities ● Feedback Supporting Eagle: Geographic barriers Similar resources and population HCPF COLORADO Department of Health Care Policy & Financing 53#54Northwest Colorado Catchment Area Results (Moffat, Routt, Rio Blanco, Jackson, Grand, Garfield, Eagle, Pitkin) HCPF COLORADO Department of Health Care Policy & Financing Moffat Routt Rio Blanco Garfield Jackson Larimer Weld Grand Gilpin Clear Creek Eagle Boulder Brgenfield Adams Denver Arapahoe Summit Jefferson, Elbert Douglas Päkin Lake Park Mes a Delta Chaffee Gunnison Montrose Fremont Teller El Paso Morgan Crowley Pueblo Custer Saguache Ouray San Miguel Dolores San Juan Hinsdale Mineral Rio Grande Alamosa Montezuma La Plata Archuleta Conejos Costilla Huerfano Las Animas Sedgwick Logan Phillips Washington Yuma Kit Carson Lincoln Cheyenne Kiowa Bert Prowers Otero Baca 54#55HCPF All Respondents: Should Northwest Colorado be a single catchment area or two catchment areas? No opinion The entire area should... ANSWER CHOICES No opinion RESPONSES 61.12% 283 The entire area should be one catchment area 11.23% 52 Two catchment areas: Area ... Two catchment areas: Area 1- Moffat, Routt, Rio Blanco, Jackson, Grand; Area 2- Garfield, Eagle, Pitkin 23.97% 111 Other proposed approach, describe: TOTAL 3.67% 17 463 Other proposed approach,... 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% COLORADO Department of Health Care Policy & Financing 55 55#56All CMA Preferences: Should Northwest Colorado be a single catchment area or two catchment areas? No opinion The entire area should... Two catchment areas: Area... Other proposed approach.... HCPF ANSWER CHOICES RESPONSES No opinion 61.11% 121 7.58% 15 The entire area should be one catchment area Two catchment areas: Area 1- Moffat, Routt, Rio Blanco, Jackson, Grand; Area 2- Garfield, Eagle, Pitkin 29.80% 59 Other proposed approach, describe: TOTAL 1.52% 3 198 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% COLORADO Department of Health Care Policy & Financing 56#57Other Preferences: Should Northwest Colorado be a single catchment area or two catchment areas? No opinion The entire area should... Two catchment areas: Area ... Other proposed approach,... HCPF ANSWER CHOICES RESPONSES No opinion 59.25% 173 14.04% 41 The entire area should be one catchment area Two catchment areas: Area 1- Moffat, Routt, Rio Blanco, Jackson, Grand; Area 2- Garfield, Eagle, Pitkin 21.58% 63 Other proposed approach, describe: TOTAL 5.14% 15 292 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% COLORADO Department of Health Care Policy & Financing 44 57#58Across all respondent groups, the majority preference was to have two catchment areas because it is too large of an area to just have one. Feedback Supporting Two Catchment Areas: • More manageable for CMA • • Too large for person centered approaches to CM Significant geographic barriers Feedback Supporting One Catchment Area: ● • Reduce duplication of services Economic Allows more shared resources between communities HCPF COLORADO Department of Health Care Policy & Financing 58#59Southwest Colorado Catchment Area Results (Dolores, Montezuma, San Juan, La Plata, and Archuleta) HCPF COLORADO Department of Health Care Policy & Financing Jackson Larimer Moffat Weld Routt Rio Blanco Garfield Mes a Delta Montrose Grand Boulder Brandfield Gilpin Adams Denver Clear Creek Eagle Arapahoe Summit Jefferson Pitkin Lake Park Chaffee Gunnison Fremont Elbert Douglas Teller El Paso Morgan Crowley Pueblo Custer Saguache Ouray San Miguel Dolores San Juan Hinsdale Mineral Rio Grande Alamosa Montezuma La Plata Archuleta Conejos Costilla Huerfano Las Animas Sedgwick Logan Phillips Washington Yuma Kit Carson Lincoln Cheyenne Kiowa Bent Prowers Otero Baca 59#60All Respondents: Should Southwest Colorado be a single catchment area or two catchment areas? No opinion The entire area should... ANSWER CHOICES No opinion The entire area should be one catchment area RESPONSES 62.50% 285 23.46% 107 Two catchment areas: Area... Two catchment areas: Area 1- Dolores, Montezuma; Area 2- San Juan, La Plata, Archuleta 10.75% 49 Other proposed approach, describe: TOTAL 3.29% 15 456 Other proposed HCPF approach,... 0% 10% 20% 30% 40% 50% 6096 70% 80% 90% 100% COLORADO Department of Health Care Policy & Financing 60#61All CMA Preferences: Should Southwest Colorado be a single catchment area or two catchment areas? No opinion The entire area should... Two catchment areas: Area ... Other proposed approach.... ANSWER CHOICES RESPONSES No opinion 64.10% 125 20.00% 39 The entire area should be one catchment area Two catchment areas: Area 1- Dolores, Montezuma; Area 2- San Juan, La Plata, Archuleta 13.85% 27 Other proposed approach, describe: TOTAL 2.05% 4 195 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% M HCPF COLORADO Department of Health Care Policy & Financing 61#62Other Preferences: Should Southwest Colorado be a single catchment area or two catchment areas? No opinion The entire area should... ANSWER CHOICES RESPONSES 59.93% 172 No opinion 26.48% 76 The entire area should be one catchment area 9.06% 26 Two catchment areas: Area Two catchment areas: Area 1- Dolores, Montezuma; Area 2- San Juan, La Plata, Archuleta Other proposed approach, describe: TOTAL 4.53% 13 287 Other proposed approach,... 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% COLORADO Department of Health Care HCPF Policy & Financing 62#63• Feedback for One vs. Two Catchment Areas Feedback Supporting One Area: Population is too small to support multiple catchment areas. • Feedback Supporting Two Areas: Too large to cover for one agency . Allow for shared resources and streamlined services from larger population centers. HCPF COLORADO Department of Health Care Policy & Financing • Geographic barriers • The two areas have very separate cultures. 63#64South Central Colorado Catchment Area Results (Costilla, Conejos, Rio Grande, Mineral, Saguache and Alamosa) HCPF COLORADO Department of Health Care Policy & Financing Moffat Routt Rio Blanco Garfield Mes a Delta Montrose Jackson Larimer Weld Grand Boulder Gilpin Broomfield Adams Denver Clear Creek Eagle Arapahoe Summit Jefferson, Elbert Douglas Pitkin Lake Park Chaffee Gunnison Fremont Teller El Paso Sedgwick Logan Phillips Morgan Washington Yuma Crowley Pueblo Custer Saguache Ouray San Miguel Dolores San Juan Hinsdale Mineral Rio Grande Alamosa Montezuma La Plata Archuleta Conejos Costilla Huerfano Las Animas Kit Carson Lincoln Cheyenne Kiowa Bent Prowers Otero Baca 64#65All Respondents: Should South Central Colorado be a single catchment area or two catchment areas? No opinion The entire area should... ANSWER CHOICES No opinion RESPONSES 69.11% 311 The entire area should be one catchment area 17.11% 77 Two catchment areas: Area ... Two catchment areas: Area 1 - Saguache and Alamosa; Area 2 - Costilla, Conejos, Rio Grande, Mineral 9.78% 44 Other proposed approach, describe: TOTAL 4.00% 18 450 Other proposed HCPF approach.... 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% COLORADO Department of Health Care Policy & Financing 65#66All CMA Preferences: Should South Central Colorado be a single catchment area or two catchment areas? No opinion The entire area should... Two catchment areas: Area ... Other proposed approach.... HCPF ANSWER CHOICES RESPONSES No opinion 71.96% 136 The entire area should be one catchment area 16.93% 32 Two catchment areas: Area 1 - Saguache and Alamosa; Area 2 - Costilla, Conejos, Rio Grande, Mineral 8.47% 16 Other proposed approach, describe: TOTAL 2.65% 5 189 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% COLORADO Department of Health Care Policy & Financing 66#67Other Preferences: Should South Central Colorado be a single catchment area or two catchment areas? No opinion The entire area should... ANSWER CHOICES RESPONSES 66.08% 189 No opinion 17.13% 49 The entire area should be one catchment area Two catchment areas: Area ... Two catchment areas: Area 1 - Saguache and Alamosa; Area 2 - Costilla, Conejos, Rio Grande, Mineral 11.54% 33 Other proposed approach, describe: TOTAL 5.24% 15 286 Other proposed HCPF approach.... 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% COLORADO Department of Health Care Policy & Financing 67#68Across all respondent groups, the majority preference was to have one catchment area because there is not enough members to justify more than one. Feedback Supporting One Catchment Area: ● Resource distribution • Few geographical barriers ● Small population Feedback Supporting Two Catchment Areas: • Geographically too large to serve as a single catchment region HCPF COLORADO Department of Health Care Policy & Financing 68#69# HCPF Feedback on the 22-Region Draft Map Jacks on Larimer 10 Moffat Routt Weld 9 Grand Boulder Rio Blanco 8 Gilpin Broomfield Adams Denver 8 Clear Creek Jefferson Eagle Garfield 18 Summit 7 Pitkin Lake Park Mes a 18 Delta Chaffee Gunnison Montrose 19 20 Ouray San Miguel Saguache 14 Dolores San Juan Hinsdale Mineral Rio Grande Alamosa 21 Montezuma La Plata 22 Archuleta COLORADO Department of Health Care Policy & Financing Conejos 13 Fremont Arapahoe 5 Douglas Elbert Teller El Paso Morgan Crowley Pueblo 12 Custer 15 Costilla Huerfano Las Animas Lincoln Sedgwick Logan Phillips Washington 1 Yuma Kit Carson Cheyenne Kiowa Bent Otero Prowers 2 Baca 69#70Additional Stakeholder Feedback Area 3 Feedback (Bent, Crowley, Otero) Recommendation to make single county a central hub/fiscal agent to coordinate case management for six county region (Bent, Crowley, Otero, Baca, Prowers, Kiowa) Area 11 Feedback (Park, Teller, El Paso) ● . Recommendation to include Park County with Jefferson County due to services. Recommendation to include El Paso with Pueblo due to winter weather and accessibility. Area 13 Feedback (Lake, Chaffee, Fremont, Custer) • The distance between Custer County and Lake County is significant and Fremont County could benefit from more localized services. HCPF COLORADO Department of Health Care Policy & Financing 70 10#71The Department's Key Stakeholder Driven Outcomes After considering the current draft catchment map, do you feel the draft catchment areas will achieve the following key stakeholder driven outcomes: HCPF COLORADO Department of Health Care Policy & Financing 71#72Federal compliance: Develop a Case Management system that follows all federal requirements, including the requirement that CMAs only provide case management without the conflict of also providing direct care services. Strongly agree Agree ANSWER CHOICES RESPONSES Strongly agree 20.73% 79 33.07% 126 34.12% 130 Disagree 9.45% 36 Strongly disagree 2.62% 10 TOTAL 381 Neutral Agree Neutral Disagree Strongly disagree 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% COLORADO Department of Health Care HCPF Policy & Financing 72 22#73Quality: Develop a Case Management System that is rooted in quality with an emphasis on measurable performance and outcomes that drives success. Enhances partnership between Department and CMAs to work on continuous quality improvement. Strongly agree HCPF Agree ANSWER CHOICES RESPONSES 26.96% 103 Strongly agree Neutral 33.25% 127 Agree 26.70% 102 Disagree Strongly disagree Neutral Disagree Strongly disagree TOTAL 9.69% 37 3.40% 13 382 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% COLORADO Department of Health Care Policy & Financing 73#74Simplicity: Develop a Case Management system that is easy to access, efficient, and provides members with the tools they need to navigate system processes and benefits without heartache. Strongly agree Agree ANSWER CHOICES RESPONSES 34.20% 131 Strongly agree Neutral 28.46% 109 Agree Neutral 22.98% 88 Disagree Disagree Strongly disagree 9.92% 38 4.44% 17 TOTAL 383 Strongly disagree 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% COLORADO Department of Health Care HCPF Policy & Financing 74#75Stability: Develop a Case Management system to be a consistent and reliable place to assist members to understand and interact with a complex structure. Strongly agree HCPF ANSWER CHOICES Agree Neutral Disagree Strongly agree Agree Neutral Disagree Strongly disagree TOTAL Strongly disagree RESPONSES 31.33% 120 30.29% 116 26.89% 103 8.88% 34 2.61% 10 383 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% COLORADO Department of Health Care Policy & Financing 75#76Accountability: Develop a Case Management system that values transparency and its responsibility to its members and stakeholders to deliver support in the manner expected. Strongly agree HCPF Agree ANSWER CHOICES Strongly agree Neutral Disagree Agree Neutral Disagree Strongly disagree TOTAL Strongly disagree RESPONSES 32.29% 124 30.21% 116 27.08% 104 7.03% 27 3.39% 13 384 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% COLORADO Department of Health Care Policy & Financing 76#77M HCPF HCBS Strategies Recommendations for Catchment Area Map Jackson Larimer 10 Moffat Routt Weld 9 Grand Boulders Rio Blanco Gilpin Broomfield Adams Denver Clear Creek Garfield 15 Eagle Summit 7 Arapahoe Jefferson Mes a 17 Delta Montrose 18 19 Ouray Pitkin Lake Park Chaffee Gunnison 13 Fremont 5 Douglas Elbert Sedgwick Logan Phillips Morgan Washington Yuma Lincoln Teller 11 El Paso Pueblo 12 Custer Saguache San Miguel Dolores San Juan Hinsdale 14 Mineral Rio Grande Alamosa 20 Montezuma La Plata Archuleta Conejos COLORADO Department of Health Care Policy & Financing Huerfano Las Animas Costilla Crowley Kit Carson Cheyenne Kiowa Bent Otero Prowers 2 Baca 77#78M HCPF COLORADO Department of Health Care Policy & Financing Next Steps 78#79HCPF Member Listening Sessions HCPF wants to hear from: Members Family members Natural supports COLORADO Department of Health Care Policy & Financing 79#80. Further Engagement Case Management Redesign Website Quarterly Stakeholder engagement/outreach HCPF COLORADO Department of Health Care Policy & Financing 80 50#81HCPF COLORADO Department of Health Care Policy & Financing What is important to people using Case Management services? 81#82M HCPF COLORADO Department of Health Care Policy & Financing Live Poll 82#83CO COLORADO Department of Health Care HCPF Policy & Financing Questions? 83#84HCPF Contact Info Amanda Lofgren Case Management and Quality Performance Division Director [email protected] Tiffani Domokos Case Management Redesign Policy Advisor [email protected] Katy Barnett Community Liaison [email protected] COLORADO Department of Health Care Policy & Financing 84#85HCPF COLORADO Department of Health Care Policy & Financing Thank you! 85