By Tim Wheat
(DENVER, July 22, 2011) Gov. John Hickenlooper rejected ADAPT’s demand that he commit to Colorado pursuing the federal Community First Choice (CFC) Option within the Health Care Reform Legislation. CFC Option provides the state money to assist moving people from expensive institutions and nursing homes. Hickenlooper did believe it was a good idea and he did want to avoid delay in Colorado’s progress like we did in 2005 when we missed out on the first federal offering of the Money Follows the Person grant.
Dawn Russell gave the governor the opportunity to support the additional money by asking if he had heard the request.
“I got it,” said Hickenlooper.
Activists outlined the need for the CFC Option and changes to the Medicaid eligibility determination by the state. One ADAPT activist said that the group was still bitter that Colorado had failed to apply for Money Follows the person back in 2005. Colorado did apply for the federal funds last year and were awarded $22 million this April, but the delay has not only been expensive in millions of dollars, but also in the lives of people still trapped in institutions.
“If we don’t apply for CFC now we will just see that same kind of delay and our state missing out of federal funds to end the Medicaid bias,” said the ADAPT activist.
Hickenlooper got the message, but he would not go any further.
“I cannot make a commitment because I don’t know all the details,” said the governor.
Following the twenty-five minute meeting with the governor the ADAPT group met and discussed the next steps. The indirect message from the Department of Human Services is that they are too busy to commit to pursuing the federal funds; although everyone in the state Department seems to be in favor of the proposed option.
ADAPT confronted the governor with this because his commitment would prevent Colorado from missing out on a beneficial, needed program like we did in 2005. The federal offering takes state resources to apply for the program; however, the funds that come into the state will help to improve the existing Medicaid program.
“It is not only the federal money for Colorado,” said Dawn Russell, “but it also means saving a lot of money by moving people out of expensive institutions.”
Meeting Bicha and Birch
The evening before ADAPT met with the governor, Sue Birch, the Executive Director of the Colorado Health Care Policy and Finance Division (HCPF) and Reggie Bicha, the Director of the Colorado Department of Human Services were at Atlantis to directly confront the problems with Medicaid eligibility. People in Colorado Eligible for Medicaid services are often forced an in-human amount of time simply to be determined eligible by the state system.
“I was Medicaid eligible when I left Colorado, I was eligible when I moved to Washington,” said Alice Bozeman, “but when I moved back to Colorado it took 83-days for the system to find me eligible again. Atlantis provided me services during that time even though the Medicaid system told them not to; Atlantis saved my life.”
Director Birch said that the Administration was setting eligibility determination as a high priority and that by the end of October HCPF would have some clear improvements for customers and providers to look at.
“We will be back to say we need you to come to the table to tell us how we can make the system work,” said Reggie Bicha to Dawn Russell who pressed the bureaucrats for a realistic timeline. “We are building the team now.”
Getting people out of nursing homes is a passion of ADAPT and activists pointed out how the system would provide Medicaid Long Term Care services to people in the nursing home but on the day they move out, their status had to be re-coded by the state system that could take many months. Providers of home services don’t get paid until that re-coding is complete. Not only are many providers unwilling to take nursing home transfers, but the system is obviously bias to pay expensive facility care over home and community services.
Director Birch brought with her two employees of the statewide effort to interconnect the electronic information of Medicaid customers. Although there is much promise and millions of dollars being put toward the upgraded computer systems, those same systems have also often been the most oppressive of barriers that Medicaid recipients have faced.
Previously Dawn Russell had told of a person who she helped transition into the community out of a nursing home. Although he carried a letter with him from John Berry, the head of Long-Term Care in Colorado, no service provider would provide necessary services to him because the computer system did not list his Medicaid eligibility.
Even though someone in a nursing home is served by the same Medicaid program, it requires a human technician to “re-code” a person when they move out of the expensive facility. Regardless of the proposed computer system, this simple “human” glitch has slowed citizens move back to the community and is costly to the state.