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
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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
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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
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Colorado Department of Health Care Policy & Financing 1 1570 Grant Street I Denver, CO 80203 I
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