Colorado CPASS Summary | advancingstates.org

<A NAME=\"COCPASS\"></A> <P ALIGN=\"RIGHT\"><EM>Community-Integrated Personal Assistance Services and Supports</EM></P> <H2 ALIGN=\"CENTER\">COLORADO</H2> <H3>Identified Problems with the State's Long-Term Care System</H3> <P> <UL> <LI>Chronic provider and worker shortages.</LI> <LI>Lack of consumer knowledge of PASS options due to multiple programs, each with their own eligibility rules, benefits, and options for consumer-direction.</LI> <LI>Inflexibility of home health agencies restricts the ability of people with disabilities to pursue traditional jobs.</LI> <LI>Incorrect application of Medicare's "homebound" standard to Medicaid clients.</LI> <LI>Barriers to high-quality PASS services include regulatory and statutory obstacles, quality measurement issues, and the extensive training needs of stakeholders.</LI> </UL> </P> <H3>Perceived Strengths</H3> <P> <UL> <LI>The state is recognized as a national leader and innovator in long-term care services, demonstrated through the "Consumer Directed Attendant Support" (CDAS) waiver.</LI> <LI>Coverage of PASS through the Medicaid state plan.</LI> <LI>The disability community and the Department of Health Care Policy and Financing (HCPF), the state's Medicaid agency, have a collaborative relationship.</LI> <LI>Support from the legislature for consumer-directed PASS programs.</LI> </UL> </P> <H3>Primary Focus of Grant Activities</H3> <P> <UL> <LI>Increase the availability of consumer-direction in PASS programs.</LI> <LI>Improve the quality of PASS.</LI> </UL> </P> <H3>Goals, Objectives, and Activities</H3> <P><STRONG>Overall Goal.</STRONG> Connect clients to PASS options that enable them to live in integrated community settings appropriate for their individual support requirements and preferences.</P> <P><STRONG>Goal.</STRONG> Promote independence and self-sufficiency through community integration.</P> <P><STRONG><EM>Objectives/Activities</EM></STRONG> <UL> <LI>Conduct PASS Regulatory Review.</LI> <LI>Develop PASS recommendations and PASS program development plan.</LI> <LI>Increase education and outreach activities to attract a larger PASS labor pool.</LI> <LI>Implement PASS program development plan.</LI> </UL> </P> <P><STRONG>Goal.</STRONG> Improve quality of attendant support through enhanced consumer control.</P> <P><STRONG><EM>Objectives/Activities</EM></STRONG> <UL> <LI>Train consumer trainers on the current PASS options.</LI> <LI>Pilot and evaluate a home health consumer-directed program, one rural and one urban, in Colorado.</LI> <LI>Develop, pilot, evaluate, and revise consumer and provider training materials.</LI> <LI>Develop, pilot, evaluate, and revise case manager materials and conduct case manager trainings.</LI> <LI>Develop quality measures for consumer-directed PASS.</LI> <LI>Develop CDAS Waiver evaluation recommendations.</LI> <LI>Develop Nursing Board recommendations regarding attendant certification.</LI> </UL> </P> <H3>Key Activities and Products</H3> <P> <UL> <LI>Implement PASS program development plan.</LI> <LI>Develop consumer direction materials for consumer, case manager, and provider trainings.</LI> <LI>Develop quality measures for consumer-directed PASS.</LI> <LI>Implement a Home Health Agency Consumer-Direction Pilot that would test a model that is an alternative to both the CDAS model and to traditional home health services.</LI> </UL> </P> <H3>Consumer Partners</H3> <P>Colorado established a consumer-directed advisory committee whose input was utilized to develop major portions of the grant application. Advisory committee members included consumers, advocates, other state departments (i.e., Vocational Rehabilitation, Health and Environment, and Human Services), and consultants with expertise in developing new community projects. A grant writer was hired on a contract basis to write the grant application.</P> <H3>Consumer Partners and Consumer Involvement in Planning Activities</H3> <P>There are approximately five consumer partners who are members of the advisory committee. They participated as full committee members in an advisory capacity prior to grant implementation. They also participated in the hiring of some COmPASS staff.</P> <H3>Consumer Partners and Consumer Involvement in Implementation Activities</H3> <P>COmPASS shares an advisory committee with the Systems Change Section's CDAS program. The committee is comprised of approximately 20 members, including five consumers or family member caregivers of consumers. Private partners on the committee include representatives from home health agencies, independent living centers and from the single entry point administrators. The committee serves in an advisory capacity on program design, evaluation and implementation processes. Additionally, the committee identifies methods to solicit broader input, such as public meetings, existing or special list-serves, and Websites.</P> <H3>Public Partners</H3> <P> <UL> <LI>Department of Human Services/Developmental Disabilities Services.</LI> <LI>Department of Human Services/Mental Health Services.</LI> <LI>Department of Public Health and Environment.</LI> <LI>Division of Vocational Rehabilitation.</LI> <LI>Regional CMS office.</LI> </UL> </P> <H3>Private Partners and Subcontractors</H3> <P> <UL> <LI>Home health agencies.</LI> <LI>Personal care and homemaker agencies.</LI> <LI>Independent living centers.</LI> <LI>Single Entry Point agencies.</LI> <LI>Case Management agencies.</LI> </UL> </P> <H3>Public and Private Partnership Development/Involvement in the Planning Phase</H3> <P><STRONG>Public Partners</STRONG></P> <P>Staff from the Department of Public Health and Environment and the Division of Vocational Rehabilitation provided input, reviewed drafts and helped with letters of support.</P> <P><STRONG>Private Partners</STRONG></P> <P>Private partners helped in the development of the proposal, provided feedback on various program designs, and helped to provide outreach to consumers and home health agencies about the availability of consumer-directed programs.</P> <H3>Public and Private Partnership Development/Involvement in Implementation</H3> <P><STRONG>Public Partners</STRONG></P> <P> <UL> <LI>The Department of Public Health and Environment will conduct provider agency certification.</LI> <LI>The regional CMS office assisted in the approval process for required waiver amendments.</LI> <LI>The other public partners are participating in the Advisory Committee.</LI> </UL> </P> <P><STRONG>Private Partners</STRONG> <UL> <LI>The Single Entry Point Agencies will inform and educate consumers about the availability of self-directed programs and advise them on participant rights and responsibilities.</LI> <LI>Case Management Agencies will inform new participants of program availability and assist them in the application process.</LI> <LI>ACS, the subcontractor that the state contracts with to handle contracting and billing, will work with provider agencies in the claims reimbursement process.</LI> </UL> </P> <P><STRONG>Existing Partnerships That Will Be Utilized to Leverage or Support Project Activities</STRONG></P> <P>The Department of Human Services will support grant activities in the development of the Home Health Agency Pilot and RFP process.</P> <H3>Oversight/Advisory Committee</H3> <P>The Advisory Committee will review policies and procedures and recommend needed changes, review statistical reports, and assist the Department of Health Care Policy and Financing in making design modifications to the PASS program development plan.</P> <H3>Formative Learning and Evaluation Activities</H3> <P> <UL> <LI>The project design incorporates the Continuous Quality Improvement principles of collecting data, monitoring progress, and feeding evaluation data back into the design process.</LI> <LI>Pilot sites will be selected for evaluating training materials and testing the feasibility of consumer-directed PASS benefits within a home health agency.</LI> <LI>Quarterly and final reports will record progress.</LI> </UL> </P> <H3>Evidence of Enduring Change/Sustainability</H3> <P> <UL> <LI>Training activities will have an enduring impact through the development of materials (i.e., manuals, videos, brochures), curricula development, and the training of trainers.</LI> <LI>The purpose of the grant is to design and implement the program, which is already being supported by the state legislature. In 2002, legislation was passed authorizing two new consumer directed initiatives, Consumer Directed Care for the Elderly and In-Home Support Services, which provide new services for consumers wanting to self-direct their care.</LI> <LI>Changing regulations will institutionalize improvements in PASS programs.</LI> </UL> </P> <H3>Geographic Focus</H3> <P>Statewide.</P>