Commissioners’ Conference Room
Second Floor – County Administration Building
10:00 am - Noon
In Attendance: Commissioner Donnelly, Commissioner Johnson, Neil Gluckman, Ginny Riley, Laura Walker, Marsha Ellis, and Eileen Brittingham
Guests in Attendance: Maureen Hewitt, Beverly Dahan
Introductions & Announcements
Commissioner Donnelly welcomed everyone and called the meeting to order. Commissioner Donnelly excused Commissioner Gaiter from the meeting.
Everyone in attendance introduced themselves and stated their position for the listening audience.
Director Ginny Riley asked the Commissioners if they had any other agenda items. Commissioner Johnson asked for an explanation of horizontal and vertical integration being discussed with regards to Medicaid and the Health Exchange at the state level. Ginny responded that she would provide an explanation at the end of the meeting.
Ginny asked the Commissioners if they would like an update on new services the department has added in the last 15 years. This agenda item was a request by Commissioner Gaiter. The commissioners agreed that they would prefer to skip that agenda and will contact Ginny with any questions. Ginny distributed the handout she had prepared in response to Commissioner Gaiter’s request, stating that if he needed further information she could schedule a separate meeting with him at a later date.
Ginny announced that the Child Care Assistance Program has started moving parents off the waiting list and onto the program. Teen parents have been given the opportunity to come off the waiting list first. Also, Temporary Aid to Needy Families (TANF) who have had coverage while on that program will no longer be subject to the waiting list as they have been since the list’s inception.
Ginny announced that there is a potential 50% cut federally to the Low Income Energy Assistance Program (LEAP). Ginny has heard that there is some carry over money from 2010 at the State level and may cover 65% of the program administration. Benefit eligibility has be reduced to no more than 150% of the Federal Poverty Level (FPL). This will not have a significant impact on Larimer County’s cost to administer the program but will impact community members.
Commissioner Johnson asked, “Has the cost to administer LEAP always been covered at 100%?” Ginny replied that we have never used County monies to support the administration of that program.
Benefits Processing Timelines
Ginny explained that the State of Colorado, Department of Human Services is working to meet the guidelines set forth by a settlement agreement in the Colorado Benefits Management System (CBMS) lawsuit. Ginny distributed a handout on Larimer County’s status in meeting processing timelines set forth in the settlement agreement. Currently, Larimer County is meeting all the requirements to date. Currently there are not requirements on redeterminations of benefits, but we expect the parties to establish goals for those as well and we are focusing our efforts on our Medicaid redeterminations to bring them more current.
Commissioner Johnson asked what will happen if the State does not meet the settlement agreement. Ginny responded that she is not sure but the case would probably go back to court. Ginny explained that Medicaid only applications are being processed by a Maximus, a third party contractor hired by the State. Ginny gave kudos to the benefits technicians and staff for a great job processing applications.
A discussion on Maximus, Medicaid applications and backlog of applications at Maximus ensued.
President and CEO, Maureen Hewett and Vice President of Regulatory Affairs, Beverly Dahan presented information on the plan to open a Program of All-inclusive Care for the Elderly (PACE) in Northern Colorado.
PACE is a non-profit organization, serves about 20,000 people annually, and employs about 1,700 individuals. PACE is a health care model with a mission to help frail seniors live with dignity in their communities. PACE coordinates a comprehensive service package to integrate primary, acute, and long-term care services through an individualize plan of care. PACE provides all Medicare and Medicaid services plus community long-term care services.
Maureen and Beverly provided a detailed presentation on: the program, enrollment requirements, adult day care center, cost savings, current operations, proposed expansion to Northern Colorado, next steps in the process, and goals.
Maureen asked the Commissioners if they had any questions. The Commissioners did not have any questions. Commissioner Donnelly asked if Beverly could present at the Office on Aging Advisory Council Meeting. Ed Rutherford will coordinate with Beverly.
Update on Setting or Performance Measure process
Ginny announced that the Department has increased the number of Proposals for Service from four to eight. The Department also identified 96 total performance measurements. Ginny and Laura have worked with the County’s Performance Management Team to reduce the performance measures to 35. The performance measures selected are already used by management to assess outcomes. Ginny asked the Commissioners to contact her if they identify an area they would like to see measurements in.
Client Activity Report
Deputy Director Laura Walker explained that moving forward the department will present information on client activity information rather than just on complaints received by the Director’s office. This will provide the Commissioners with a broader picture of the department’s activities and align with the budget performance measurements.
Business Operations Coordinator Eileen Brittingham presented an overview of the department’s client activity. Eileen reviewed: monthly average caseloads, program activity, complaint totals, and client follow up survey regarding complaints from April 1, 2011, through June 30, 2011.
During the 2nd Quarter:
· The Food Medical & Financial Assistance program averaged 26,194 cases
· The Benefits Information Center took 11,694 calls
· Adult Program averaged 1,212 cases
· Child Support averaged 6,419 cases and collected $4,270,883.00
· Children, Youth and Family (Child Protection) average 1,347 cases, received 1,439 referrals, with 96% of children involved with our services remaining in their homes.
· The Director’s office received 22 complaints in the prior quarter.
Horizontal/Vertical Integration of Medicaid with the State Health Exchange
Ginny explained that under the Federal Patient Protection and Affordable Care Act, all states have a responsibility for implementation of new federal policies.
One critical area for planning is the development of exchanges, or virtual marketplaces, where thousands of currently uninsured Coloradans will seek information to select and purchase health insurance. Many of these individuals and families will be eligible for federal subsidies to help them pay their insurance premiums.
Under federal requirements there needs to be a seamless application process for those applying for Medicaid or the Health Care exchange. In order for this to happen there needs to be a good integration of the Health Care exchange computer system with Colorado Benefits Management System (CBMS)/Medicaid. The question is how to accomplish this. Ginny states that the idea of vertical intergration is off the table, that horizontal integration will be pursued to meet these federal guidelines. What this means is that both system will be linked together to coordinate as one system.
Ginny explained that many counties are worried that an integration of the Health Care Exchange system with CBMS will have a negative impact on CBMS and the clients. In addition, it has been difficult to get a county voice on to the Health Care Exchange committee. Ginny asked the Commissioners if they had any questions on this. They did not.