Welcome to our November edition of the ARPA Project Pulse Newsletter. We're thrilled to share the incredible strides we're making in our ARPA projects, focusing this edition on initiatives that prioritize equity. We're excited to spotlight the various projects underway that aim to bridge health care gaps, address disparities, and uplift underrepresented communities. From innovative outreach efforts to targeted support programs, we're dedicated to fostering a more equitable health care landscape in Colorado.

Join us as we delve into the impactful stories, success highlights, and community-driven approaches that are reshaping the health care ecosystem in our state. The passion and commitment of our team, coupled with the unwavering support of our community, continue to drive these essential projects forward, bringing us closer to a more equitable and accessible health care system for everyone.

~ The ARPA Team

The Civic Consulting Collaborative is a consortium of independent nationwide consultants with a shared mission to collectively support clients in making a meaningful impact.

Amy Engelman is a founding member of the Civic Consulting Collaborative and is the founding principal of Intentional Inquiry, her community psychology practice. Amy's doctoral training was in community-based participatory action research; thus, she has been engaging historically marginalized individuals and communities in systems change for over 20 years, supporting mutually beneficial collaborations between theoretical and technical experts with cultural and practical experts for relevant and equitable impact. Her master's degree is in early childhood/special education.

Roshan Bliss is a facilitator, trainer, consultant, and accomplished nonprofit leader based in Denver whose work is infused with the insights and perspective he has gained from over a decade of community organizing, anti-oppression training, youth development work, and policy advocacy. Grounded in values of authenticity, accountability, and democracy, Roshan applies his expertise in service of supporting decision makers, organization leaders, and everyday community members to shift how we think about and take action toward positive social change by building and supporting processes that help us walk the difficult, messy path to a transformed world while staying grounded in their mission and values.

Jack Becker is a board member with the Civic Consulting Collaborative. As the founder and principal of Grounded Solutions, LLC, which is dedicated to leveraging the power of relationships and user-centered design work to accelerate and expand the impact of innovative social sector programs. Jack’s vision is for healthy, vibrant communities for all.

Fernando Pineda-Reyes is the executive director and founder of CREA Results (Community + Research + Education + Awareness = Results), a social enterprise of Community Health Workers (CHWs)/Promotores de Salud (PdS) advancing health equity, environmental stewardship, and workforce development. He has implemented and supported hundreds of programs to address health disparities through the state of Colorado, México, and Puerto Rico where he helped design and launch the first Puerto Rico Public Health Trust Office of Community Engagement. He currently serves on the boards of Colorado Access, Sheridan Health Services, and the National Parent Leadership Institute. He is the current Chair of the Board for the American-Mexican Association.

Fernando has dual degrees in clinical biochemistry and pharmaceutical chemistry from the Universidad Nacional Autónoma de México (UNAM). He is a Leadership Denver Class of 2017 Fellow as well as a Community Resource Center Leadership Development Program and Regional Institute of Health and Environmental Leadership (RIHEL) Fellow. He received the 2022 Water Hero Award from the Colorado Water Conservation Board. 

Will you provide an overview of the ARPA 3.01 - Equity Study?

This project focused on understanding barriers and improving access to Home and Community-Based Services (HCBS) for members and eligible Coloradans with disabilities. The project began with an internal study to identify disparities of use within the HCBS system. This illuminated that most historically disenfranchised groups continue to be underutilizing HCBS. Thus, the second phase engaged existing external HCBS partners as well as community-driven health organizations outside of the HCBS network to gain insights into the barriers and opportunities for developing impactful strategies for improving HCBS access and equity.

Who was involved in leading this project? 

The project team was overseen by the Office of Community Living (OCL) within HCPF, which provided strategic direction, conducted the internal equity study, and engaged community-driven organizations at every step of the way. The Civic Consulting Collaborative (CCC) was the lead consulting partner, spearheaded by Amy Engelman, Jack Becker, and Roshan Bliss. The CCC developed the overall engagement design and conducted the outreach, facilitation, research, and report writing. The CCC partnered with CREA Results, led by CEO and Founder Fernando Pineda-Reyes, which served as an advisor and led the outreach and engagement activities with Spanish speaking community leaders and the Hispanic/Latino community broadly.

The project emphasized the role of community-driven organizations. Will you explain what this means and elaborate on why these organizations were involved as key partners? 

Community-driven organizations specialize in supporting marginalized populations through their deep expertise in their communities, cultures, histories, and unique needs. They understand the nuances of the populations they serve, recognizing that a one-size-fits-all approach does not work. These organizations work with individuals, respecting their diverse backgrounds and experiences, and tailor their support accordingly. Their expertise is evident in their ability to bridge cultural gaps, address linguistic challenges, and ensure services align with their community's values and expectations. Thus, community-driven organizations are uniquely positioned to support equity as they are driven to serve the health and well-being of their historically marginalized community. Part of that commitment has driven them to cultivate a nuanced understanding of complex systems, such as Medicaid. They act as trusted intermediaries who connect individuals and families with health care services, including HCBS. Their role extends beyond providing information as they offer emotional support, advocate for their clients, and help them overcome systemic and cultural barriers, thus ensuring better access to health care services. By involving them as key partners, we aimed to leverage their expertise in removing barriers at the individual level to develop systems level strategies and recommendations to make HCBS more accessible for communities like theirs across Colorado. 

Will you elaborate on how these organizations were engaged and their contribution to the project recommendations and next steps?

We engaged community-driven organizations in 'learning exchanges,' which were two-hour co-designed conversations that facilitated a two-way dialogue, respecting the multitude of expertises in the partnership. We shared insights about HCBS and the system's complexities while the community-driven organizations shared their knowledge about how they support their communities in navigating complex barriers to accessing health care systems and social services. Their real-world perspectives, ability to identify the cultural and linguistic nuances, and strategic suggestions to remove barriers to access informed every element of the recommendations. Their insights ensured that our proposed solutions are culturally relevant and would yield meaningful impact for underserved communities.

In what ways do these community organizations possess expert ability to help their communities navigate complex systems like Medicaid, and how does this expertise benefit the individuals they serve? What were some examples of how community-driven organizations act as bridges or brokers for their communities in accessing services that have traditionally excluded them, either explicitly or implicitly?

Community resource navigation work is highly contextual and nuanced, responding to the unique cultural, regional, economic, linguistic, and logistical circumstances of individuals and communities. Organizations are constantly identifying and problem solving systemic challenges in addition to navigating the impact of generational and current traumatic experiences with systems that their communities face in order to help them access services and support to meet their basic needs, including complex health care. These organizations describe themselves as “the place where people show up with lots of questions” because “people feel comfortable coming to [them] to express needs and concerns.” These organizations specialize in warm, even hot, hand-offs to support their communities in (re)engaging in systems and services that they often mistrust. They navigate these complex barriers to champion health equity through 1) Authentic, personal relationships grounded in dignity and respect; 2) Language and cultural justice; 3) Individualized navigation and support across the social determinants of health; and 4) Strong personal, professional connections with other organizations. 

How are you supporting HCPF in building on these new partnerships to further reduce disparities in health care access within the disability community and among marginalized populations? What steps are being taken to ensure that the recommendations made in the reports are translated into concrete actions for the benefit of HCBS recipients and eligible Coloradans with disabilities?

We are actively supporting HCPF in building on these new partnerships to reduce disparities in health care access within the disability community and other historically marginalized populations. Currently, we are working with HCPF on the ARPA Initiative 3.04 to re/design member-focused materials for HCBS. To ensure these materials are optimally accessible and culturally relevant, we convened a group of representatives from community-driven organizations and agencies to guide, critique, and develop member-facing materials. Many of these individuals were part of our learning exchanges and broader stakeholder summits from APRA 3.01. We are beginning a second phase of strengthening connections between HCPF and community-driven organizations by continuing the learning exchanges with Certified Application Assistance Sites (CAAS) that work with historically marginalized populations. We will also be working with the CAAS and other community-based support systems on more effective communication strategies to ensure that community-driven organizations have the resources they need to raise awareness of HCBS in their communities and to assist in the enrollment process effectively. 

What impact do you anticipate the collaborative efforts will have on the community and the broader health care system in Colorado?

Collaborative efforts between community-driven organizations, HCPF, and other stakeholders that build trust and relationships have the potential for profound impact on the community and the broader health care system in Colorado. These relationships are the foundation for responsiveness by agencies to community needs, which reduces barriers to access. This collaboration is expected to directly result in increased awareness and more equitable enrollment in HCBS for people with disabilities, thus, increasing individuals’ and families’ quality of life because they will be getting more of the necessary support they need in their homes and communities.

How can stakeholders read the report and learn more about ongoing work in this area? 

More information about the project, project results, and key documents is on the 3.01 - Equity Study Website.

3.04 - Member-Facing Materials

The ARPA 3.04 team is in the process of redesigning existing and creating new member materials aimed at increasing knowledge about HCBS to support awareness, enrollment, and utilization of these waiver programs. In partnership with our vendor, Civic Consulting Collaborative, we have completed a survey that aimed to get the HCBS community's input on the prioritization of these materials as well as feedback on the first round of draft materials for members. We have also been working with a User Design group to help refine the materials to better speak to members, their families, and networks. The User Design group includes Spanish speakers to better target the materials in Spanish. An LTSS pamphlet and a brochure for all 10 of the HCBS waivers will be finalized soon. Member facing informational videos on LTSS have been created and posted to the My HCBS Case Management website.

3.05 - Translation of Materials

A key aspect of ensuring equity across HCBS programs is translated materials for people to access accurate information in their preferred language. This ARPA project is working to identify materials used by members through the navigation, enrollment and utilization of HCBS processes and making sure those materials are in plain language, are accessible, and are translated into Spanish and additional languages. As materials are translated, they will be added to the website and provided to Case Management Agencies. 

Provider Search Tool Enhancements

6.03 - Find a Provider Tool

This project is updating the “Find a Doctor” search tool for PEAK, the Health First app and HealthFirstColorado.com. These updates will give members the most accurate and relevant information to choose the best health care provider to meet their specific needs. It also provides more relevant and location-specific information for members looking for Long Term Serivces and Supports (LTSS).  

LTSS providers will be able to indicate the counties in which they provide services across the state. It will also update the tool to allow for an Advanced Filter functionality that will include more culturally competent and member-oriented filter criteria (e.g., “Community Associations”, languages spoken, telehealth options, etc.) for all providers. Lastly, the update will allow for all providers to include a new preferred name that the provider operates under. This name will take priority over other name types (DBA, business name, personal name) when displayed in the provider search tool.

6.02 - Specialty Search

The new Provider Specialty Search Tool will allow prospective or existing providers to search HCBS specialties by waiver, specialty name, enrollment, and revalidation requirements. A link to the HCBS Specialty Search Tool is at the top of the updated HCBS provider enrollment webpage. This will allow providers to potentially enroll into other similar services and across populations. 

Grant Incentives, Pilots, and Community Funding Opportunities

*Coming Soon*

4.07 - New Systems of Care

Complex Needs Grant

The ARPA 4.07 team will soon be accepting applications for grants to serve individuals with complex needs. Potential uses of the grant by providers include purchasing specialized equipment not otherwise covered by Medicaid, engaging a consultant to make recommendations for environmental safety improvements, and other creative solutions to serve individuals with complex needs. Please frequently check the HCPF ARPA Grant page for updates on the opening of the request for applications process.

7.02 - Member Emergency Preparedness

Battery-based, Power Backup Systems

HCPF recognizes the importance of reliable and safe power backup in the event of an emergency power outage. As a result, this project is focusing on distributing battery-based, power backup systems to eligible Coloradans.

In order to apply for this program you must:

• Be enrolled in Health First Colorado, Colorado's Medicaid program,
• Utilize life-sustaining equipment that requires electricity to operate,
• Complete an application where you will be asked about your life-sustaining device(s) that require electrical power to operate. This includes equipment prescribed by a doctor for mobility and/or home use. Devices used for therapy generally do not qualify.

Examples of life-sustaining equipment include, but are not limited to:

• Chair Lift
• Dialysis Machine
• IV Infusion Pump
• Medication Refrigeration
• Oxygen Concentrator
• Power Wheelchair
• Ventilator

If a member lives in a licensed residential setting such as a group home, supported living program, or alternative care facility, they won't be eligible because these facilities are already required to have backup power supplies for residents. Each application will be reviewed by staff from the Center for Inclusive Design and Engineering and HCPF. Applications will be approved based on medical needs and the availability of Backup Power Supplies.

Application Due Date: Ongoing while devices are available

For more information about eligible devices and details about the program, visit the Surviving in Place website.

Apply Today!

7.02 - Member Emergency Preparedness

"Go-Kits"

HCPF recognizes the importance of being prepared for an emergency or evacuation. With funding made available through ARPA and in collaboration with The Center for Inclusive Design and Engineering (CIDE), HCPF will be distributing pre-assembled, starter Emergency Go Kits to eligible Health First Colorado members. An Emergency Go Kit is a collection of essential items specific to your needs that you can quickly grab and take with you in an emergency or evacuation. 

You must be enrolled in Health First Colorado (Colorado's Medicaid program) to qualify for this program. If you are interested in receiving an Emergency Go Kit, please complete the brief application. Once received, the application will be reviewed, information verified, and an eligibility determination is made. There is a limited supply and a final decision will be made on eligibility and the availability of the kit materials. All applicants will be notified of their determination within two months of receipt of the application. Send all questions to Julia Beems at 303-315-1284 or julia.beems@ucdenver.edu.

Application Due Date: Ongoing as supplies are available

For more information, visit the Surviving in Place website.

Apply Today!

1.05 Training Fund Grants Open for Individual Direct Care Workers and HCBS Providers 

HCPF is offering short-term grant funding to incentivize and expand training opportunities for the Home and Community-Based Services (HCBS) workforce. The grants will fund higher-level skills that will promote greater retention within the HCBS workforce. The maximum award amount per application for direct care workers is $500 and for HCBS providers is $100,000.

Eligible applicants include:

• Individual, age 18 or older, who is currently working in a direct care role within any of Colorado’s Home & Community-Based Service (HCBS) Waivers; or
• Individual, age 18 or older, who desires training to enter direct care within Colorado’s HCBS Waiver workforce; or
• Also included within this workforce, are Certified Nurse Aides and Home Health Aides within Long-Term Home Health; or
• Currently enrolled Home and Community-Based Services (HCBS) waiver providers; and
• Training vendor/provider that develops/delivers training/specialization for the HCBS workforce. 

Interested in learning more about how this grant could support higher-level skills for the HCBS workforce?

Visit the grant program information page to get more details and apply today!

Questions? Email us at hcpf_dcworkforce@state.co.us 

Featured Opportunity

👉Webinar: Quarterly ARPA Updates - All Stakeholders👈

An update for all interested stakeholders on key projects specifically funded by the American Rescue Plan Act (ARPA) of 2021 within the Office of Community Living and the Health Policy Office.

Audience: Members, Family, Advocates, Case Management Agencies (CMAs), Community Centered Boards (CCBs), Home and Community-Based Services (HCBS) Providers, Nursing Facilities, Providers, Single Entry Point (SEP) Agencies

Webinar documents are on the OCL Webinar Page and the ARPA Stakeholder Engagement Page.

The webinar will be held:

Thursday, Nov. 16, 2023

3 - 4:30 p.m. MT

Register via Zoom

- - - -

Direct Care Workforce Compensation & Benefits Action Group

This Action Group works collaboratively with stakeholders to identify and move forward strategies to support the recruitment and retention of Colorado's direct care workforce. This group intends to meet every other month on the third Friday from 1 – 2 p.m. MT.

For more information, please see the Direct Care Workforce Collaborative webpage.

The meeting will be held:

Friday, Nov. 17, 2023

1 to 2 p.m. MT

Join via Zoom

Join by Phone:

Meeting ID: 993 1700 7314, Passcode: 396389

Join via Phone: 1-877-853-5257

- - - -

Direct Care Workforce Value & Awareness Action Group

Supporting the Direct Care Workforce Collaborative, this Action Group brings stakeholders together to develop awareness and advocacy strategies that increase community understanding and support for this workforce. All interested stakeholders are welcome.

For more information, please see the Direct Care Workforce Collaborative webpage.

The meeting will be held:

Friday, Dec. 1, 2023

1 to 2 p.m. MT

Join via Zoom

Join by Phone:

Meeting ID: 969 40536000, Passcode: 115140

Join via Phone: 1-877-853-5257

- - - -

Reasonable accommodations will be provided upon request for persons with disabilities. Auxiliary aids and services for individuals with disabilities and language services for individuals whose first language is not English may be provided upon request. Please notify John Barry at 303-866-3173 or John.R.Barry@state.co.us or the 504/ADA Coordinator at hcpf504ada@state.co.us at least one week prior to the meeting to make arrangements.