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HomeMy WebLinkAbout20241533.tiffRESOLUTION RE: APPROVE APPLICATION FOR 2024-2025 COUNTY GRANT PROGRAM FOR LONG-TERM CARE COORDINATION CASE MANAGEMENT AND AUTHORIZE DEPARTMENT OF HUMAN SERVICES TO SUBMIT ELECTRONICALLY WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with an Application for the 2024-2025 County Grant Program for Long -Term Care Coordination Case Management from the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Services, to the Colorado Department of Health Care Policy and Financing, with further terms and conditions being as stated in said application, and WHEREAS, after review, the Board deems it advisable to approve said application, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the Application for the 2024-2025 County Grant Program for Long -Term Care Coordination Case Management from the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Services, to the Colorado Department of Health Care Policy and Financing, be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that Jill Colavolpe, Department of Human Services, be, and hereby is, authorized to electronically submit said application, effective June 6, 2024. cc: HSD, c\cT(cv/co) OZ7o57 L 2024-1533 HR0096 APPLICATION FOR 2024-2025 COUNTY GRANT PROGRAM FOR LONG-TERM CARE COORDINATION CASE MANAGEMENT PAGE 2 The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 12th day of June, A.D., 2024, nunc pro tunc June 6, 2024. ATTEST: ...0,44;6k Weld County Clerk to the Board B o1 . otl'c eputy Clerk to the Board AP "• EDA County A orney Date of signature: 0 BOARD OF COUNT WELD COUNTCOLORADO Mike Freeman tt K. James ri Saine SIONERS 2024-1533 HR0096 BOARD OF COUNTY COMMISSIONERS PASS -AROUND REVIEW PASS -AROUND TITLE: Health Care Policy and Financing FY 2024-25 County Grant Program Application DEPARTMENT: Human Services DATE: June 4, 2024 PERSON REQUESTING: Jamie Ulrich, Director, Human Services Brief description of the problem/issue: The Department is requesting to apply for the Health Care Policy and Financing (HCPF) FY 2024-25 County Grant Program. This grant opportunity will be used to fund one (1) Case Manager position that has already been approved by the Department but is currently vacant. If approved, the Department will be requesting $107,552.55 in grant funds that will be used for salary, benefits, mileage/travel, and equipment costs. The grant period will be for the FY 2024-25 and funding must be expended no later than June 30, 2025. What options exist for the Board? • Approval to respond to the HCPF FY 2024-25 County Grant Program. • Deny approval to respond to the HCPF FY 2024-25 County Grant Program. Consequences: The Department of Human Services' Home and Community Supports Division will not be able to apply for the grant funding. Impacts: The Department of Human Services' Home and Community Support Division will not have additional funding to provide assistance to our at -risk long-term population. Costs (Current Fiscal Year / Ongoing or Subsequent Fiscal Years): • Total grant request = $107,552.55 (No matching funds required). • Funded through Colorado Department of Health Care Policy and Financing. • Term: July 1, 2024 through June 30, 2025. Pass -Around Memorandum; June 4, 2024 — Not in CMS 2024-1533 Co/IZ Recommendation: • Approval to respond to the Colorado Department of Health Care Policy and Financing FY 2024-25 Grant Program and authorize the Department to submit the application electronically. Support Recommendation Schedule Place on BOCC Agenda Work Session Other/Comments: Perry L. Buck, Pro-Tem Mike Freeman Scott K. James Kevin D. Ross, Chair Lori Saine ,cP �nF Pass -Around Memorandum; June 4, 2024 — Not in CMS Project Name & Brief description (25 words or less) Long -Term Care (LTC) Coordination Case Manager (CM) This position will provide comprehensive assistance to current and pending LTC Medicaid members who need assistance to successfully navigate and complete the financial eligibility processes. (25) Detailed explanation of how the proposed project meets HCPF's Strategic Pillars or Preferred Project (350 words or less): We propose establishing a case manager position dedicated to assisting our LTC members and families with the eligibility process will reduce our current backlog to historical levels. The Long - Term Services and Supports community have undergone multiple changes in a short timeframe, ranging from the Public Health Emergency and recent unwind, Case Management Redesign, systems issues impacting communication and eligibility, and provider shortages and frustrations. The recipients and families of Long -Term Care have higher needs than most of the population and rely heavily on the services and supports that LTC provides to ensure their health, safety, and well-being. Our county is fortunate to have our case management agency and public assistance eligibility teams within the Department of Human Services. However, it is a struggle for some of our most at -risk long-term care members throughout the eligibility and/or annual redetermination process to successfully navigate and comply with both the functional and financial eligibility requirements. Current case management or eligibility staff cannot always provide the level of support an individual may need to understand and complete the process requirements, including completing and providing the required documentation. This often creates negative outcomes for eligibility, leaving members and families upset and without necessary benefits, adversely impacting relationships between members and families, and leaving employees feeling frustrated and defeated. This position will be a conduit between functional and financial eligibility processes to ensure efficient and effective applications and redeterminations. They will conduct member outreach to capture missing documentation and signatures, improve outcomes related to time for approval, reduce and/or eliminate gaps in coverage, and improve customer service and employee satisfaction. We believe it will improve member access to Long -Term Services and Supports by reducing denials and terminations. It will improve our eligibility determination process by ensuring applications are completed accurately upon submission and/or additional information requested is returned expeditiously. Reducing denial rates and terminations, quickly fixing, or preventing gaps in coverage and reducing days to determine initial eligibility will reduce backlog, improve the customer experience for members, families, and partners, and will increase customer and employee satisfaction. (341) Data and Metrics used for tracking goals and objectives: We will track the individuals we serve to better understand which waivers/programs may be most impacted and how many people we assisted. Our goals and objectives are to reduce backlog and increase productivity for out LTSS programs, increase access to LTC services, reduce gaps in coverage, increase collaboration between CMA and LTC Financial Eligibility, and to improve staff member satisfaction and customer service. Total number of members served by the LTC Coordination Case Manager o Total number of new applicants o Total number of redeterminations (RRR) o Reason for assistance o Type of assistance provided. o Outcomes Workload/backlog o Number of denials/Number of terminations o Weld County "tracking" -prevent gaps in coverage. o Days (within the CMA) from Intake to On -going Case Management o LTC Financial Eligibility workload/backlog o CMA Transition Data —financial eligibility impacting PAR Customer experience- improve customer service: o Number of escalations from HCPF o Number of walk-ins at the county o Calls/talk time on LTC ACD line Staff experience — pre/post interviews or surveys for feedback and input Other important details about the proposed project (750 words or less). Provide a high-level description of the proposed project, including implementation timelines; responsible individuals; data and metrics utilized to implement and/or measure outcomes; and other important details about the proposed project. Our proposed project is designed to help Long Term Care (LTC) Medicaid members (new applicants and ongoing) successfully complete the Medicaid application and redetermination process. Financial eligibility can be an overwhelming process to navigate. Complex rules and complicated correspondence can be challenging for most, but they become significant barriers for our more at -risk LTC members. We will assist members with the process when they may not have other resources available to assist them. It is difficult for an individual with cognitive and/or memory issues, hearing or vision loss, or someone struggling with a variety of other physical, medical, or mental health challenges, to complete a LTC application and return all the necessary paperwork and documentation required to determine eligibility. We are proposing the creation of a new position called the LTC Coordination Case Manager. The position will be located within the Weld County DHS Home and Community Supports Division. Our division consists of our Long -Term Care Financial Eligibility, Case Management Agency (CMA), Area Agency on Aging, and Adult Protective Services. Our unique set up, with these programs, creates an environment conducive to collaborative efforts that can enhance service delivery and outcomes for our shared population. This project creates an opportunity to be proactive versus reactive for at -risk members. We will work together to have this position prevent denials, terminations or breaks in coverage for cases that might otherwise have a negative outcome. Recently, there have been several factors that have impacted our LTC population and created a backlog in processing applications and/or redeterminations. We believe that dedicating a position to assist our most at -risk members with navigating the eligibility process and completing and submitting the necessary documentation will have a multi -faceted positive impact. It will assist members in need to qualify for services, reducing denials and/or delays. It will dedicate a position to assisting new and current members with the intricacies specific to their personal situations as it relates to eligibility, allowing the current intake and on -going case managers to focus on their respective duties. Also, allowing the LTC technicians to focus on processing and providing them accurate and compete documents, reducing the number of "touches" on each case, creating efficiencies that will increase productivity and decrease delays and denials. We anticipate filling the position within 30 days of the grant award. We plan to create interest and excitement around the project, simultaneously training existing staff on how to identify and refer members in need to the LTC Coordination Case Manager for assistance. This will us to identify members in need right away and provide the ability for the new position to start working on these cases during training. Also, creating a workflow for sustained productivity. The Coordination CM will communicate directly with the member and/or their legal representative/family to determine what level assistance they require. This assistance will involve home visits, seeking needed documentation from financial institutions, insurance companies, obtaining birth certificates, completing the actual applications, etc. The position will be supervised by a CMA Supervisor. Both the staff member and the supervisor will work closely with the Division Deputy Director, LTC Supervisor and other supervisors and key staff to ensure sharing of information, aligned process and positive outcomes. Additionally, they will establish connections with the Older Americans Act and Adult Protection program teams to help high risk clients access LTC Medicaid. The Coordination CM, with the guidance of the supervisor and input from other key staff members, will develop a comprehensive tracking system that will identify which members were served, what assistance was provided, why was the assistance needed, and the outcome. We are committed to data driven decision making and recognize that the type of data we collect may evolve over the period of the grant. We are interested in determining barriers to the LTC eligibility process, creating efficiencies within our workflow, and identifying systems changes that we can make to improve the process. We will know this project has been successful when we are able to significantly reduce our LTC financial eligibility workload. Reducing backlog, denials/terminations, and wait time for members, families, providers, and Case Management Agencies will have a tremendous impact on our goals and a positive impact for the LTC population. (702) Data Metrics that will be tracked to identify the project's success in both the current and future states of affairs (500 words or less) Describe the intended plan for measuring and tracking goals and objectives of the project, identifying the individuals responsible for each activity. Detail and/or provide the type of tracking tool that will be utilized and specify how often the data will be tracked and how trends will be identified for the quarterly report submission (upload data metrics plan). Our goals and objectives are to reduce backlog and increase productivity for our Long -Term Services and Supports (LTSS) programs, increase access to LTC services, reduce gaps in coverage, increase collaboration between CMA and LTC Financial Eligibility, and to improve staff member satisfaction and customer service. We plan to track the individuals we serve to better understand which waivers/programs may be most impacted and how many people we assisted. We will implement a referral process, to efficiently and effectively identify members who may need assistance to successfully navigate the LTC application or redetermination process. We will track who each member is, if they are an initial application or redetermination, the reason they require assistance, the type of assistance we provided and the outcome. Historically, it has been challenging to pull reliable data for LTC from our existing systems. However, we would like to utilize all the systems and data available to us, to find the number of denials pre and post implementation of the LTC Coordination Case Manager. We will also track LTC workload with the goal of reducing the backlog and finding a "new normal", after the PHE Unwind and Case Management Redesign process, that allows us to be working current documents and to consistently remain within timeframe expectations. Our CMA and LTC Eligibility unit will collaborate to track members pending approval or redetermination to prevent long waits for initial approval and gaps in coverage. We will also research the average time it takes within the CMA from application to assignment of an on- going case manager. Our hope is to see a reduction in the time it takes to start Long -Term Services and Supports. We believe this data can provide insight into our process and create the potential for additional efficiencies. In addition to assisting our LTC population with successfully navigating a challenging and complicated eligibility process, we believe that this position can help improve employee satisfaction within our Case Management Agency (CMA). Case Managers have experienced several challenges over the past few years, such as the pandemic, Case Management Redesign, and the new case management system, that have reportedly left many feeling stressed, ineffective, and ultimately reducing job satisfaction. We believe that having an identified case management position responsible for assisting members with eligibility concerns will reduce strain currently being experienced by on -going case managers trying to complete these tasks in between traditional case management duties. We will interview and survey our staff pre and post project to gain additional insight into the effectiveness of this position and to identify any potential opportunities for improvement moving forward. The grant project budget request includes personnel costs for one Full -Time Employee (FTE). Our annual projection includes salary, benefits, equipment costs, and mileage expenses. The budget request includes personnel costs for one Full -Time Employee (FTE) including salary, anticipated benefits, equipment costs, and mileage expenses. This position will strongly prefer prior CMA and/or LTC experience to reduce the amount of training needed to benefit individuals as quickly as possible. To track and account for this position's expenses separately from other county administrative expenses, our fiscal Department will assign a new code to be used by the LTC Coordination Case Manager when reporting time for payroll and salary expenses, requesting mileage reimbursement and to bill for equipment necessary to perform basic case management duties. We recognize that there will be additional resources within the county required to support the success of this project. The additional recourses provided by the county are outlined below. Additional County Resources being dedicated to the project: HCSD Deputy Director — time/salary for administration and project oversight CMA Supervisor — time/salary for position and project oversight, collaboration, communication, process changes, tracking and reports. LTC Supervisor- time/salary for collaboration, communication, process changes, tracking and reports. CMA Case Aide — administrative support if/when needed. CMA Case Managers- surveys and/or interviews related to project and impact on job satisfaction. Home and Community Supports Division training so all staff understand purpose of the position and how to access and utilize support for members. Position specific training completed by CMA Program Specialist and LTC Program Resource Specialist DHS Fiscal Department — assistance with assigning codes specific to the project and accurate tracking and reporting • DHS Employee Support & Resource- assistance with recruiting and filling of position. • Year End Report Out- travel costs Additional questions (200 words or less): How will the county determine if the project was a success based on data collected and analyzed? Has the county set benchmarks that are feasible to achieve over the grant cycle? What are the benchmarks? If the project is a success, how will the project be sustained without funding from the County Grant Program? What best practices has the county considered in the project design? We are aiming to provide outreach and navigation assistance for the LTC application process and will also collect and analyze data to reduce the time it takes from application to approval and service implementation, reducing and/or preventing gaps in coverage for redeterminations and improving member, family, and staff satisfaction. We appreciate the positive impact that collaborative relationships between the CMAs and County Eligibility can have on our LTC population. We will know this project has been successful when we are able to return our LTC financial eligibility workload back to pre -pandemic numbers. Reducing backlog and wait time for members, families, providers, and Case Management Agencies will have a tremendous impact on our goals and a positive impact for the LTC population. • We are currently utilizing a county approved Case Manager position to "fill" this project position. Our hope, is that the extra year this grant funding would provide, will allow us additional time to stabilize our new Case Management Agency, have a better understanding of the budget, and be able to retain this position with existing CMA funds after the grant funding is exhausted. We recognize the importance of providing additional assistance to our most at -risk members and families. Weld County Data and Metrics Plan FY 2024-25 HCPF County Grant Program Data and Metrics: Measuring and Tracking Goals and Objectives Data and/or Metric Tracking tool How often Person responsible Members Served Excel Spreadsheet Upon receipt of referral with weekly updates LTC Coordination Case Manager (CM) Number of denials and terminations CBMS, CCM, HSC- charted internally Pre -project and then monthly to compare CM Breaks or gaps in coverage for RRR's Excel Spreadsheet- (occurred & prevented) Data recorded weekly CM Days to services Excel Spreadsheet Monthly CMA Intake Supervisor LTC workload/backlog CBMS and HSC- Excel Spreadsheet CMA Transition Data - spreadsheet Monthly LTC Supervisor Calls/talk-time to LTC ACD line ACD line report- spreadsheet Monthly LTC Supervisor Employee satisfaction Interviews/surveys Pre/post project HCSD Deputy Director Quarterly overview Report with all data/metrics available (above) Quarterly check -ins and/or site visits proposed: October 4, 2024 January 6, 2025 April 7, 2025 Final Report June 2025 CM, CMA Supervisor and HCSD Deputy Weld County Project Budget FY 2024-25 HCPF County Grant Program Project Budget: Itemization of Detailed Project Costs ITEM BRIEF DESCRIPTION RATE AND UNIT OF MEASURE QUANTITY TOTAL FOR PROJECT Salary $60, 083.00 annual 1 Full -Time CM $60, 083.00 Benefits $42, 119.55 annual 1 Full -Time CM $42, 119.55 Mileage/Travel $2,050.00 annual Average for 1 CM $3600.00 Equipment Costs $1,750.00 annual Average for 1 CM $1,750.00 PROJECT BUDGET TOTAL $107,552.55 Weld County Project Work Plan FY 2024-25 HCPF County Grant Program Project Work Plan: Major Task/Activities and Due Dates MAJOR ACTIVITY TASK OR TASK/ACTIVITY/START/COM PL ETION DATES RESPONSIBLE INDIVIDUAL DELIVERABLE Hiring Coordination Case of Manager LTC Start Complete: 7/31 /24 date: 7/1 /24 Recruitment Process: HCSD Deputy and Director Hiring Final received Department Director/Deputy Position approval from filled programs) for HCSD Start Complete 7/1 /24 7/31/24 HCSD Deputy Director All within have on how access programs project our been to /utilize division trained and Training (all Position Trained Start Complete 7/31 /24 8/2/24 CMA and Resource LTC Program Program Specialist Specialists Position and independently working trained Development tracking of Development Completed: racking ongoing start: 7/15/24 7/1/24 7/1/24 and Development: Intake HCSD Deputy Supervisor CMA Director position and system and Tracking developed utilized continuously start: CM member system continues Tracking: Continue and current sheets updating tracking utilizing Start: ongoing 7/1/24 and continues LTC CMA Supervisor Intake Supervisor Updating tracking denials in of ACD number and and or days LTC LTC Line to Technician Ledgers, Utilization, Workload Spreadsheet Updating tracking of terminations, breaks coverage, service implementation Develop for feedback project Case questions Managers pre- Start: Complete: 7/1 /24 7/31 /24 HCSD Deputy Director Feedback and documented received Quarterly Start: October 2024 HCSD Deputy Director 3 quarterly reports overviews and January 2025 CMA Et LTC Supervisors and 1 final report yearend report April 2025 CM position complete Complete final report: June 30, 2025 Houstan Aragon From: Sent: To: Subject: Co Dept of HCPF <noreply@onspring.tech> Thursday, June 6, 2024 5:18 PM Jill Colavolpe Your FY 24-25 Competitive Grant Application has been submitted Caution: This email originated from outside of Weld County Government. Do not click links or open attachments unless you recognize the sender and know the content is safe. rit lir SwF Hello, Slat it J Thank you for submitting a FY 24-25 Grant Application for your county! The County Relations team will be in touch soon to schedule your application interview. For questions regarding your Competitive Grant application or interview, please submit a support request through the County Relations webform or contact HCPFCountyRelations@state.co.us. Thank you, County Relations Team Please reach out to the County Relations Team at hcpf countyrelations@state.co.us for any questions. Si This email was sent to colavojx@weld.gov by noreply@onspring.tech. If you do not wish to receive email from this sender. clic Unsubscribe and you will be removed from all future email messages sent from ohcpf.onspring.com. Colorado Department of Health Care Policy & Financing 1 1570 Grant Street I Denver, CO 80203 I 1 Hello