Colorado
I. Overview of a State's Comprehensive Person-Centered Employment Initiatives
“The Colorado Department of Health Care Policy and Financing,
the State Medicaid Agency, is developing several new initiatives related
to long-term care, consumer direction and systems change.
Colorado has received three new federal grants under the Systems Change
for Community Living initiative, sponsored by Centers for Medicare
and Medicaid Services. These grants are part of the federal New Freedom
Initiative, and are designed to help states address issues raised
by the Olmstead decision. All of the grants will be administered within
Health Care Policy and Financing, Long-Term Benefits Division, Systems
Change Section, but will involve collaboration with a variety of stakeholders.”
The above statement of initiatives in Colorado is taken from the Colorado
Department of Health Care Policy and Financing’s web site at
http://www.chcpf.state.co.us/SysChange/SystemChangeIndex.html
II. What's New and Persons to Contact
In April, 2003 a report was submitted to the Colorado Department
of Health Care Policy and Financing by a consultant that stated that
a cost neutral Medicaid Buy-In program is not feasible. The study
had been mandated by state legislation enacted in 2001.
Download a Word version of the
report
“Actuarial Study:The Feasibility of A Budget Neutral Colorado
Medicaid Buy-In Program Under TWWIIA and HB 01-1271”
For a direct link to a pdf version of the report
http://www.chcpf.state.co.us/SysChange/Actuarial_Study.pdfSee
Section III for the history of the development of the legislation
For a direct link to the Web site of the Medicaid Infrastructure Grant
Project and other Systems Change activities go to:
http://www.chcpf.state.co.us/SysChange/BuyInIntro.html
Persons to Contact:
Julie Friedman-Peremel
Colorado Department of Health Care Policy and Financing
Denver, CO
303-866-5600
julia.friedman-peremel@state.co.us
Julie Reiskin
Executive Director
Colorado Cross-Disability Coalition
655 Broadway Suite 775
Denver, CO 80203
303-839-1775
Jries29622@aol.com
Link to Web Page of Coalition: http://www.colorado2.com/ccdc/
III. Program Development - Past and Present
- Executive Branch Leadership, Cross Disability Coalition Leadership
and Interagency Working Groups
The Department convened a Task Force in 2000 and it met a
number of times including active participation of members of the Colorado
Cross-Disability Coalition.
- Initial Planning, Information Gathering and Program and Fiscal
Estimates
In April, 2003 a report was submitted to the Colorado Department
of Health Care Policy and Financing by a consultant that stated
that a cost neutral Medicaid Buy-In program is not feasible. The
study had been mandated by state legislation enacted in 2001.
Down load a Word version of
the report
“Actuarial Study:The Feasibility of A Budget Neutral Colorado
Medicaid Buy-In Program Under TWWIIA and HB 01-1271”
For a direct link to a pdf version of the report
http://www.chcpf.state.co.us/SysChange/Actuarial_Study.pdf
On April 17, the Colorado House approved H 1271, a bill which authorizes
the State Medicaid agency to submit a State Plan amendment to establish
a Medicaid Buy In program. The bill does not contain details on
the eligibility provisions of a Medicaid Buy In program. As amended
in the House, the bill requires that the program be budget neutral
and that the State must apply for and receive an Infrastructure
grand from HCFA for the program to be placed in operation.
Link to a page on the Colorado Legislatures web page to see the
history of the bill and a link to language of the bill and the fiscal
note.
http://www.leg.state.co.us/2001/inetcbill.nsf/fsbillcont/
B9877533D6D480C5872569CE004FEC39?Open&target=/
2001/inetcbill.nsf/billsummary/E0A3ADD7E1B38897
872569CB000A33D9
On November 1, 2000, the Colorado Department of Health Care Policy
and Financing submitted a report to the Colorado Senate and House
Health, Environment, Welfare, and Institutions Committees on "Employment
Incentives for People with Disabilities through Medicaid Buy-In
Options"
Download a file containing
the text of the report.
The following are the Taskforce recommendations from the report:
"The Taskforce recommends the following:
- Pursuing the Ticket to Work Work Incentives Improvement Act (TWWIIA)
Medicaid option and not the Disability Work Incentive Program (DWIN),
as TWWIIA is a more flexible and generous program and does not explicitly
limit eligibility. Also, the future of DWIN is uncertain, at best,
at this time.
- Implementing both Option I and Option II of TWWIIA. Option II
would not cost the state any additional dollars, as the only people
who could be included under Option II would be the ones that th
estate would already have been covering under Option I.
- No income cap. Such a cap would still limit an individual's full
ability to work and budget neutrality would not be compromised by
not limiting income.
- Including Home and Community Based Services (HCBS) waiver eligibility
under the TWWIIA program, as this will encourage employment by Home
and Community Based Services (HCBS) clients without increasing the
cost to the state.
- Conducting an actuarial analysis of a potential Medicaid buy-in
option under TWWIIA prior to making a final decision regarding the
viability of this program. Such an analysis would determine the
appropriate client cost sharing requirements and the cost savings
that can be incurred from state-only program and overall economic
benefits of employment."
IV. State Legislation - Adopted and Pending
On April 17, 2001 the Colorado House approved H 1271, a bill which
authorizes the State Medicaid agency to submit a State Plan amendment
to establish a Medicaid Buy In program. The bill does not contain
details on the eligibility provisions of a Medicaid Buy In program.
As amended in the House, the bill requires that the program be budget
neutral and that the State must apply for and receive an Infrastructure
grand from HCFA for the program to be placed in operation.
Link to a page on the Colorado Legislatures web page to see the history
of the bill and a link to language of the bill and the fiscal note.
http://www.leg.state.co.us/2001/inetcbill.nsf/fsbillcont/
B9877533D6D480C5872569CE004FEC39?Open&target=/
2001/inetcbill.nsf/billsummary/E0A3ADD7E1B38897
872569CB000A33D9
History
The Colorado Legislature during the 2000 session, included in an Appropriation
Act (HB 0-1451 Footnote 50b) a requirement for the Department of Health
Care Policy and Financing to meet with consumers with disabilities
and Medicaid providers and to submit a report to the Legislature delineating
options and recommendations related to te new Federal Work Incentives/Ticket
to Work Act.
State Legislation Enacted in 2000
Footnote 50b of HB 0-1451
"Department of Health Care Policy and Financing, Medical Services
Premiums - It is the intent of the General Assembly that the Department
meet with Medicaid consumers with disabilities and Medicaid providers
to examine state options with regard to the new Federal Work Incentives/Ticket
to Work Act. The Department is requested to submit a report delineating
options and recommendations for providing incentives for persons with
disabilities to return to work. This report is requested to be submitted
to the Senate and House Health, Environment, Welfare, and Institutions
Committee by October 15, 2000. This report is requested to include
a discussion of the pilot programs created in S.B. 97-147 and analysis
and recommendations on whether this existing initiative can be accomplished
under the new Act without the requested waiver."
State Legislation Enacted in 1997 to Establish a Medicaid Buy-In
Program under a Medicaid Waiver
S.B. 97-147
Download file of S.B. 97-147
V. Current State Policies and Program Descriptions
- State Policies: State Plans, Regulations and Waiver Requests to
Federal Agencies - Pending and Adopted Programs
- Ensuring Informed Choice and Person - Centered Programs: Benefits
Counseling, Work Force Investment Act Implementation and Related Educational
Services
- Descriptions for Consumers and Staff Training Activities
VI. Program Data and Impact
- Medicaid Buy-In Data
- Consumer Surveys and Evaluations Studies
VII. Comprehensive Employment Initiatives
Personal Assistance Services
Colorado Community Personal Assistance Services and Supports (COmPASS)
Grant
A primary intent of the grant is as follows:
“Design and implement a PASS option in which consumers exercise
control over key aspects of the service: selection of attendants,
scheduling, location and service delivery decisions, care planning
and training.”
Link to description of the grant
http://www.chcpf.state.co.us/SysChange/SysChg_Hndout_03.html
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