Joint Budget Committee Hearing: Office of Community Living (OCL) December 14, 2017 Gretchen Hammer, Medicaid Director Bonnie Silva, Deputy Director, Office of Community Living Josh Block, Budget Director 1
Our Mission Improving health care access and outcomes for the people we serve while demonstrating sound stewardship of financial resources 2
What are Long-Term Services and Supports? At Home (e.g. personal or family home; group homes; assisted living facilities) In Community (e.g. day programs; supported employment) Within Institutions (e.g. nursing homes; intermediate care facilities) 3
2016 Medicaid LTSS & Enrollment Children’s Children with Life Persons with Brain Children with Autism Habilitation Limiting Illness Injury Waiver Waiver Residential Program Waiver Waiver 430 73 167 46 Home and Children’s Home and Community Mental Community Elderly, Blind, and Spinal Cord Injury Community-Based Health Support Based Disabled Waiver Waiver Services Waiver Waiver Services 26,984 84 1,548 3,853 (HCBS) Waivers Persons with Children’s Extensive Supported Living Developmental Support Waiver Services Waiver Disabilities Waiver 1,766 4,981 5,392 Home and Community-Based Program of All-Inclusive Care Nursing Homes and Service (HCBS) Waivers for the Elderly (PACE) Intermediate Care Facilities 44,562 4,015 15,304 4
Who Receives LTSS? 7% 44% 49% Children & Adolescents Adults Older Adults ages 20 & younger ages 21-64 65 or older & qualifying former foster care youth Source Note: CY 2016 data; Data represent percentage of people receiving Medicaid LTSS in various age groups 5
Budget Requests Summary • R6 - Electronic Visit Verification • R7 – HCBS Transition Services Coordination • R8 - Medicaid Savings Initiatives • R9 - Provider Rate Adjustments • R10 - Drug Cost Containment Initiatives • R11 - Administrative Contracts Adjustments • R12 – Children’s Habilitation Residential Program Transfer • R13 - All Payer Claims Database (APCD) Funding • R14 – Safety Net Program Adjustments • R15 - CHASE Administrative Costs • R16 - CPE for Emergency Medical Transportation • R17 – Single Assessment Tool Financing • R18 – Cost Allocation Vendor Consolidation • R19 – IDD Waiver Consolidation Administrative Funding 6
Intellectual and Developmental Disabilities System Policy Questions 1-15 7
“All Coloradans – including people with disabilities and aging adults – should be able to live in the home of their choosing with the supports they need and participate in the communities that value their contributions .” - Governor John Hickenlooper 8
Vision for Future State ACCESS COORDINATE RECEIVE Streamline Access Improve Service Increase Service to Services Coordination Options and Quality 9
STREAMLINE IMPROVE SERVICE INCREASE SERVICE ACCESS TO SERVICES COORDINATION OPTIONS AND QUALITY Person-Centered Support No Wrong Door (NWD) Self-Direction Tools Planning Process Person-Centered Budgets New Functional Assessment Tool Colorado Choice Transitions (CCT) Cross System Crisis Response Financial Eligibility Reform Regional Center Task Force CHRP CCB Case Management Medicaid Buy-In Expansion Community First Choice Waiting List(s) Elimination (State Plan Option) Intensive Case Management for Regional Center Transitions Housing & Transportation CHRP – Cut Child Welfare Requirement Case Management Redesign CDASS & IHSS Expansion OPERATIONAL EXCELLENCE INTIATIVES Employment First + WIOA • Background Checks • Electronic Visit Verification Waiver Redesign • Conflict-Free Case Management • Mandatory Reporting • Rate Setting • CHRP Transfer GJRC Relocation • COMMIT/Revalidation • eLTSS Record + Personal Health Record • CCB Transparency • OCL Re-org HCBS Settings Rule Compliance 10
Waiver Redesign Interdependencies Rate Setting Case Waiver Management Redesign Restructuring Support Consumer Planning Directed Process Services Assessment Tool HCBS Final Settings Rule 11
Office of Community Living (new structure) Case Management and Benefits and Services Policy, Innovation, and Operations and Quality Performance Management Division Engagement Division Administration Division Division Oversee all finance Administer all 11 Oversee intake, Direct strategic functions-budget Home and eligibility, and case alignment of allocation, Community Based management for initiatives contract Service waivers all services management, etc. Administer Conduct internal Provide internal Ensure quality and nursing facility, performance administrative and compliance in case intermediate care management project support management facility, PACE Provide strategic Manage data and IT communication Oversee consumer- system direction and directed programs performance and engages design stakeholders Work with CMS on Implement new approvals, quality, initiatives and compliance 12
Children’s Habilitation Residential Program Transfer Question 16 13
Office of Community Living Cost and Caseload Adjustments Questions 17-19 14
Service Option Platform Questions 20-22 15
https://www.healthfirstcolorado.com/find-doctors/ 16
Regional Centers Questions 23-25 17
Compensation Adjustments for Direct Care Positions at DHS (CMS Authority) Question 26 18
Thank you 19
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