Colorado RCSC Summary | advancingstates.org

<HR ALIGN=\"left\" ALT=\"Horizontal rule dividing sections\"> <A NAME=\"CORC\"></A> <P ALIGN=\"RIGHT\"><EM>Real Choice Systems Change</EM></P> <H2 ALIGN=\"CENTER\">COLORADO</H2> <H3>Identified Problems with Colorado's Long-Term Care System</H3> <P> <UL> <LI>Lack of information about community-based, long-term care options, and difficulty qualifying for home and community services, leads to institutional rather than community placement.</LI> <LI>Lack of consumer control over their services and supports.</LI> <LI>Lack of capacity in community-based, long-term care system to provide high-quality, comprehensive long-term care services, cited by the state's consumer and advocacy community.</LI> <LI>An inadequate quality assurance system that does not utilize available incentives and sanctions, does not focus on consumer outcomes, and does not have a program to monitor the quality of home and community services.</LI> </UL> </P> <H3>Perceived Strengths</H3> <P> <UL> <LI>Extensive system of home and community service options through nine HCBS (1915c) waiver programs and two Section 1115 waivers.</LI> <LI>Single-entry point system that provides client assessment, care planning, service arrangement, and client monitoring.</LI> <LI>There is strong consumer advocacy through the state's Independent Living Centers (ILCs) to improve services and provide more consumer-directed, personal assistance services.</LI> <LI>Innovative programs have helped build the state's capacity to implement best practices in delivering home and community services.</LI> </UL> </P> <H3>Primary Focus of Grant Activities</H3> <P> <UL> <LI>Identify service needs and gaps in the system.</LI> <LI>Decrease fragmentation of the state's long-term care systems.</LI> <LI>Enhance quality assurance and quality improvement systems.</LI> <LI>Increase consumer and provider knowledge of community-based, long-term care options.</LI> <LI>Make policy recommendations to increase and improve community-based, long-term care options.</LI> <LI>Develop an education awareness campaign about community-based service options for consumers and providers.</LI> </UL> </P> <H3>Goals, Objectives, and Activities</H3> <P><STRONG>Overall Goal.</STRONG> Improve the existing long-term care system by expanding the number of and quality of community-based, long-term care options to enable consumers to live in the most integrated setting appropriate to their individual needs.</P> <P><STRONG>Goal.</STRONG> Identify service needs and gaps in the existing system, focusing on problems in the frontier and rural areas.</P> <P><STRONG><EM>Objectives/Activities</EM></STRONG> <UL> <LI>Compile and review current data and reports on long-term care in Colorado.</LI> <LI>Review existing federal and state laws, rules, policies and practices in order to identify barriers to consumers receiving community support services. Design and implement a statewide, service-capacity survey of all long-term care service providers to identify the need for and gaps in services.</LI> <LI>Design and conduct a sample-based, statewide needs assessment for community care and support.</LI> <LI>Use needs assessment data to identify key trends and issues, including what services are available, institutional bias and procedural barriers.</LI> <LI>Prepare a comprehensive report on limitations and problems in current community care systems, and include recommendations to make the system more effective for consumers.</LI> <LI>Analyze barriers and issues in recruiting and retaining long-term care support staff.</LI> </UL> </P> <P><STRONG>Goal.</STRONG> Decrease fragmentation of state systems involved in coordinating long-term care services.</P> <P><STRONG><EM>Objectives/Activities</EM></STRONG> <UL> <LI>Create Web-based forms and applications for long-term care services across state and local systems.</LI> <LI>Conduct a one-day, cross-training workshop in eight regions for 100 case managers across systems on different program capabilities and new Website options.</LI> </UL> </P> <P><STRONG>Goal.</STRONG> Enhance the quality assurance and quality improvement systems for all community services throughout the state.</P> <P><STRONG><EM>Objectives/Activities</EM></STRONG> <UL> <LI>Review the existing quality assurance program for institutional long-term care and identify key elements for establishing a similar program for community long-term care.</LI> <LI>Make policy recommendations to the Department of Health Care Policy and Financing and the Department of Human Services for an updated quality assurance program to be implemented statewide.</LI> </UL> </P> <P><STRONG>Goal.</STRONG> Develop and implement new programs (demonstration or pilot programs) to increase community services and options for consumers.</P> <P><STRONG><EM>Objectives/Activities</EM></STRONG> <UL> <LI>Develop and implement a rural, seed-money grants program to develop community care for sparsely populated rural areas.</LI> <LI>Develop a mental health client assessment tool to screen and identify consumers with mental illness residing in nursing facilities who may be better served in the community.</LI> <LI>Train 30 Mental Health Assessment and Service Agency (MHASA) case managers on the new mental health-screening tool statewide.</LI> <LI>Study the feasibility of developing community respite care.</LI> <LI>Prepare a report to the department with proposals for alternative funding sources for Mental Health Community Treatment.</LI> </UL> </P> <P><STRONG>Goal.</STRONG> Develop an education and awareness campaign on community-based, long-term care service options for consumers and providers.</P> <P><STRONG><EM>Objectives/Activities</EM></STRONG> <UL> <LI>Identify best practices in programs delivering supportive services in Colorado and other states and include the information on the project Website.</LI> <LI>Conduct a symposium on best practices in service delivery and potential for service consolidation in rural areas.</LI> </UL> </P> <P><STRONG>Goal.</STRONG> Develop a system that coordinates funding and resources so that funding remains with the client.</P> <P><STRONG><EM>Objectives/Activities</EM></STRONG> <UL> <LI>Hire a consultant to conduct an analysis of the multiple funding streams currently used by consumers with disabilities or chronic conditions in Colorado.</LI> <LI>The consultant in conjunction with the consumer task force, will make recommendations to the department for implementing the concept of money follows the client.</LI> </UL> </P> <H3>Key Activities and Products</H3> <P> <UL> <LI>Preparation of a comprehensive report on the limitations and problems in current community-based care systems, which will include recommendations to make the system more effective for consumers.</LI> <LI>The development of Web-based forms and service applications to be used across service delivery systems.</LI> <LI>Recommendations and proposals for an updated quality assurance program to be implemented statewide.</LI> <LI>Development of an education and awareness campaign for consumers and providers on community-based service options.</LI> <LI>Development and implementation of a rural, seed-money grants program to develop community-based care options for sparsely populated rural areas.</LI> <LI>Development of a mental health client assessment tool to screen and identify consumers with mental illness residing in nursing facilities who may be better served in the community.</LI> <LI>Identification of options for "money follows individual" consumer-directed services.</LI> <LI>Identification of methods by which Mental Health Assertive Community Treatment may be provided with alternative funding sources.</LI> </UL> </P> <H3>Consumer Partners</H3> <P> <UL> <LI>The Steering Committee comprising consumers, advocates and agency staff participated in the planning phase of the grant.</LI> <LI>The Consumer Task Force is essentially the same group of people as the steering committee, but includes more participants.</LI> </UL> </P> <H3>Consumer Partners and Consumer Involvement in Planning Activities</H3> <P>The Steering Committee participated in the design of the grant application by attending planning meetings, providing input, and reviewing drafts.</P> <H3>Consumer Partners and Consumer Involvement in Implementation Activities</H3> <P>The Consumer Task Force will be involved in project implementation through participation in work groups, and the monitoring and evaluation of grant activities. Activities will include providing guidance on implementation efforts, participation in major decision-making, and the hiring of key staff.</P> <H3>Public Partners</H3> <P> <UL> <LI>Developmental Disabilities Services.</LI> <LI>Mental Health Services.</LI> <LI>Aging and Adult Services.</LI> <LI>Department of Human Services.</LI> <LI>Developmental Disabilities Planning Council.</LI> </UL> </P> <H3>Private Partners and Subcontractors</H3> <P>Center for Research Strategies LLC.</P> <H3>Public and Private Partnership Development/Involvement in the Planning Phase</H3> <P><STRONG>Public Partners</STRONG></P> <P>The Colorado Department of Human Services has several representatives serving on the Consumer Task Force that have responsibility for administering Medicaid-funded waiver programs. They attended planning meetings, provided input, and reviewed drafts for the grant application.</P> <P><STRONG>Private Partners</STRONG></P> <P>There are eleven private, nonprofit organizations represented on the Consumer Task Force, including service provider and advocacy organizations. These organizations attended planning meetings, provided input and reviewed drafts for the grant application.</P> <H3>Public and Private Partnership Development/Involvement in Implementation</H3> <P><STRONG>Public</STRONG> <UL> <LI>The Colorado Department of Human Services, Mental Health Services Division will create a mental health assessment tool through an interagency agreement with the Department of Health Care Policy and Financing as part of the grant.</LI> <LI>Public partners who serve on the Consumer Task Force will be involved with the implementation of grant activities as described above in Consumer Partners Involvement in Implementation.</LI> </UL> </P> <P><STRONG>Private</STRONG> <UL> <LI>The Centers for Research Strategies LLC is a private survey research firm subcontracted to conduct the grant's first activity, which is to design and implement a provider capacity survey and a consumer needs assessment.</LI> <LI>Private partners who serve on the Consumer Task Force will be involved with the implementation of Grant activities as described above in Consumer Partners Involvement in Implementation.</LI> </UL> </P> <P><STRONG>Existing Partnerships That Will Be Utilized to Leverage or Support Project Activities</STRONG></P> <P>Staff for the Real Choice Grant will provide policy analysis and data analysis to the CPASS Grant, the NFT Grant, and consumer-directed waiver programs.</P> <H3>Oversight/Advisory Committee</H3> <P>The Consumer Task Force will monitor and evaluate project activities. Consumer Task Force members will review the grant's work products (e.g., survey reports and proposals) for completeness, accuracy, and lessons learned, and review quarterly progress reports.</P> <H3>Formative Learning and Evaluation Activities</H3> <P> <UL> <LI>Grant staff will call meetings of the Consumer Task Force when the grant activities need to be reviewed and revised due to difficulties encountered in project implementation.</LI> <LI>Grant staff will prepare quarterly progress reports and distribute them to the Consumer Task Force, workgroup members and other partners for their review.</LI> </UL> </P> <H3>Evidence of Enduring Change/Sustainability</H3> <P> <UL> <LI>The report on limitations and problems in the current community care system will make recommendations for action and legislative initiatives, and provide a foundation for overall enduring systems-change initiatives to ensure the availability and adequacy of services in the long-term care system.</LI> <LI>Cross training of case managers across systems on program options and new Website services will increase cross-system collaboration and improve coordination of long-term care services. The Department of Health Care Policy and Financing will fund Website maintenance when the grant period ends.</LI> <LI>The development of a mental health client assessment tool will identify consumers with mental illness residing in nursing facilities who may be better served in the community. The Colorado Department of Human Services will develop the tool through an interagency agreement with the Department of Health Care Policy and Financing.</LI> <LI>Policy recommendations for revisions to improve Colorado's quality assurance program and for an independent ombudsman program for community care will enhance the current quality assurance system.</LI> </UL> </P> <H3>Geographic Focus</H3> <P>Statewide.</P>