ARPA Project Pulse Newsletter
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Happy spring! We hope that everyone has enjoyed the changing weather lately and is looking forward to warmer temps as we enter April. ARPA projects are picking up steam as we continue work on phase 1 and 2 projects, and phase 3 projects prepare for their launch in April. The Department is excited to be onboarding passionate and experienced new staff who will help to make these projects possible. We still have more positions to hire and will continue to post opportunities throughout the spring.
This month's newsletter focuses on projects in the category Support Post-COVID-19 Recovery & Innovation. Within this category, there are a number of very exciting projects with big potential for transformation of Colorado’s home and community-based services (HCBS) system. We hope that you learn something new and join us in this dynamic and innovative work in the months and years ahead.
-The ARPA Team
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Community First Choice
Project Category: Support Post-COVID-19 Recovery & Innovation
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Background:
Community First Choice (CFC) was established by the Affordable Care Act in 2010 and allows the Department to offer attendant care services on a state-wide basis to eligible members, instead of only those who meet the criteria for a 1915(c) waiver. CFC is an option available to states to provide home and community-based services (HCBS) through the Medicaid State Plan that allows participants to direct their own care as much as possible and promote independence in the community.
What services are provided in CFC?
In a CFC program, members can get services that help with Activities of Daily Living (ADLs) and with Instrumental Activities of Daily Living (IADLs). ADLs are activities that you need to do to be able to live, like moving from place to place, using the toilet, washing, and eating. IADLs are activities that you need to do to be able to live independently, including house cleaning, shopping, and managing your money. CFC would offer support with both ADLs and IADLs according to a member’s specific needs identified in the individual’s person-centered support plan.
In addition, CFC would offer help with health-related tasks like organizing medications and remembering to take them or helping a member maintain medical devices that they need.
Finally, one of the primary goals of CFC is to put members in control of their own care as much as possible.
In addition to the benefits outlined above, there are other optional benefits that states can include in CFC which will be discussed during the Department’s stakeholder engagement process.
How is ARPA Funding Tied to CFC in Colorado?
The Department will use ARPA funding to cover the administrative costs associated with the development and implementation of CFC, including system costs, stakeholder engagement, staff, and a new Wellness Education Benefit. CFC implementation is set to occur by Jan. 1, 2025. Once implemented, the state would qualify for a 6% ongoing federal enhanced match on the services that make up the CFC option.
To develop and implement CFC, the Department will need the following:
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CFC Council: The CFC Council will collaborate with the Department on the design and implementation of a CFC option in Colorado. The CFC Council primarily consists of individuals with disabilities, those 65 years or older, and their representatives. The experience and expertise of the council will help ensure that CFC is implemented in a way that best meets the needs of Coloradans with disabilities. The Department is recruiting participants for the CFC Council through April 1, 2022. Please see the Call to Action below for details.
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System Changes: System changes will be required to add the existing HCBS benefits into the State Plan which necessitates changes to the provider subsystem, financial subsystem, prior authorization subsystem, the prior authorization system, and the care and case management system. This work will include ongoing testing and maintenance to ensure the changes made were accurate and operating correctly.
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Wellness Education Benefit: This new benefit will include sending participants a newsletter that provides educational material tailored to improve health outcomes and information on how to use Medicaid resources to improve community integration and independence. Receiving the newsletter will be considered a waiver service and helps ensure all participants in CFC also receive waiver services. The Department will utilize a contractor to develop and manage the Wellness and Education Benefit. The cost of this benefit will be absorbed by the Department once CFC cost savings are realized.
Next Steps for the CFC ARPA Project: The Department will launch the new CFC Council on May 4, 2022, which will serve as the primary vehicle of stakeholder engagement for the project. You can find information about and keep up to date on the CFC Council on the Department’s CFC page or receive email updates by signing up for the CFC Updates Email List. All CFC Council meetings will be open to the public.
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Members Needed to Join the Community First Choice Council
The Department needs your help to develop and launch CFC.
Please consider applying for the CFC Council, which will include a diverse group of individuals with disabilities, adults 65 and older, or their representatives. The CFC Council will help design CFC through regularly scheduled CFC Council meetings, recommendations to the Department, and participation in policy discussions on CFC and its potential effects.
CFC Council meetings will be held via webinar and call-in using Google Meet. The Council meetings will be held on the first Wednesday of each month, and participants will likely have opportunities to participate in smaller ad hoc workgroups. The monthly time commitment is estimated to be about five hours, with the design and launch work of the Council to last approximately one year.
The Department is dedicated to the full inclusion and diversity of our members, which includes race, color, ethnic or national origin, ancestry, age, sex, gender, sexual orientation, gender identity and expression, religion, creed, political beliefs, and disability. We encourage all interested Health First Colorado members and stakeholders to apply, especially:
- People with disabilities, their parents, people 65 and older, or their representatives
- Rural, frontier, and urban disability community members
- Black, Indigenous, People of Color (BIPOC)
- Those familiar with home and community-based services
- Those familiar with consumer-directed services
- Those familiar with the experiences of people with disabilities or older adults
The Department is accepting applications for 10 CFC Council positions. Applicants may submit the CFC Council Member Application Form or contact Jordan Larson, CFC Policy Advisor, at 303-866-3580.
Applications are due by 5 p.m. on Friday, April 1, 2022.
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The amount of ongoing enhanced federal funding match the state would receive on certain HCBS services if CFC is implemented.
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The number of states currently offering CFC (CA, CT, MD, MT, NY, OR, TX, and WA)
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Name: Michele Craig
Title: Complex and Supportive Services Section Manager
Office: Community Living
How long have you been with the Department and how would you describe your role?
I have been with the Department, in the Office of Community Living, for 9 years. Prior to coming to the Department, I had the honor of spending many years working for agencies serving people with intellectual and developmental disabilities. I began my career as a direct care staff and still have occasional dreams worrying that I’m running late for my overnight shift! I would describe my role now as working with and for Coloradans on continuous systemic improvement so people can access the services and supports they want and need.
What excites you most about the current ARPA Projects that you are leading?
I’m excited about all of it! These projects present such a fantastic opportunity to explore and engage in the innovation of residential services in a new way. We are able to focus on what the possibilities are and how we get there. I think what rises to the top for me is creating options where we can all access individualized, equitable, and culturally competent services and supports when we need to with dignity, respect, and choice.
How do you envision the future of home and community-based residential services to look?
I see the future as the vision people have for themselves. People leading their lives in the places they want to live and interacting with their community as they choose with services and supports that provide a foundation rather than a structure to fit into.
What are you learning as the Department researches new systems of care?
I’m intrigued by all the innovation that is happening in pockets across our state and the country. There is a lot to learn and new voices to bring to the table through this work that will provide valuable insight and ideas to build on. It’s always great to learn about things I had not been aware of, like home sharing programs, that could be more broadly available and utilized.
Can stakeholders who have innovative ideas get involved in these projects?
Yes! I’m really looking forward to the stakeholder engagement aspect of these projects. Stakeholders will play a pivotal role in these projects and we will offer a variety of methods for people to get involved. We are in the early stages of planning our engagement opportunities and as we have things finalized we will post them on the APRA website and in the ARPA newsletter and through the Department’s typical communications such as provider bulletins and sharing at existing stakeholder meetings.
What’s a favorite book that you’ve read in the past 12 months?
A book I’ve particularly enjoyed is The Night Watchman by Louise Erdrich. It’s one of those books that is so absorbing that it is hard to put down, yet I wanted to take my time to make the story last longer.
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Reminder!
A temporary rate increase using Home and Community-Based Services (HCBS) American Rescue Plan Act (ARPA) funding was implemented on Nov. 4, 2021. A 2.11% increase has been applied retroactively to April 1, 2021, and will be in effect through March 31, 2022, but providers must submit or adjust previously paid claims.
Do not lose out on the increase. Be sure to submit your claims or adjust your paid claims ASAP!
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