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County and Tribal Relations

County and Tribal Relations. Update for Medical Services Board. Joshua Montoya, County & Tribal Liaison Breanne Benbenek, County Relations Coordinator. HCPF Mission. Agenda. Introductions: The County Relations team County Relations: Human Services County Relations: Local Public Health

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County and Tribal Relations

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  1. County and Tribal Relations • Update for Medical Services Board • Joshua Montoya, County & Tribal Liaison • Breanne Benbenek, County Relations Coordinator

  2. HCPF Mission

  3. Agenda • Introductions: The County Relations team • County Relations: Human Services • County Relations: Local Public Health • Tribal Relations • Q&A

  4. County Relations – Human Services • HCPF Work They Do • Their Role and By the Numbers • Funding and Resources • HCPF/CDHS Work and Allocations • County Administration and Programs • County Relations

  5. Counties – The (HCPF) Work They Do • Financial eligibility determinations • Functional eligibility determinations • Healthy Communities sites • Local Public Health Agencies • No Wrong Door Pilot Sites • Colorado Choice Transitions Sites • And more!

  6. Counties – Their Role • Responsible for local administration of the Department’s programs • Colorado is a state-supervised, county-administered system • Role of counties as administrative entities overseen by the Department is in state statute • Boards of County Commissioners hire county directors and determine local administration

  7. Counties: By the Numbers • 64 counties, 4,000+ eligibility workers • 5 county districts • Classified based on caseload: • Small: 32 counties • Medium: 22 counties • Large: 10 counties • Different structures in different communities: • 31 county departments of human services • 22 county departments of social services • 10 county departments of health & human services • 1 county department of housing & human services

  8. HCPF County Funding • $50 million in County Administration funding • Based on allocative split of enhanced vs. non-enhanced • $4.3 million in Incentives Program funding • General Fund only; no federal funds • Funding earned is unrestricted; once earned, counties can utilize as needed • $1 million in Grant Program funding • $200k in PARIS Program funding

  9. Availability of Resources • Typical administrative costs split (financial eligibility determinations): • Non-Enhanced Match • 50% federal funds, 32.69% state funds, 17.31% local funds • Enhanced Match • 75% federal funds, 16.34% state funds, 8.66% local funds • Based on the activity being performed • Different resources available in different communities

  10. Counties – The (CDHS) Work They Do • Supplemental Nutrition Assistance Program • Temporary Assistance to Needy Families • Adult Financial Program • Child Welfare • Chaffee Program • Adult Protective Services • Low Income Energy Assistance Program • Employment First/Workforce Development

  11. CDHS vs. HCPF Funding to Counties

  12. FY 2014-15 County Administration Changes • Budget Request R6–2013: Some county administration funding allocated to create a County Incentive Program • Encouraged increased county eligibility processing performance and community collaboration • Contracts signed by all 64 counties – for the first time! • Incentive Program funding is $4.3 million per fiscal year • Incentives funds earned are unrestricted - can be used per county discretion

  13. FY17-18 Incentive Program • Eligibility Timeliness and Backlog Incentive • 95% timeliness for applications and redeterminations • Maximum limits based on county size – S, M, L • Collaboration Incentive • Required 3 partners; minimum 1 meeting per quarter • Training Incentive • 75% of county eligibility technicians require minimum training hours based on generalist vs. specialist • LTSS Collaboration • 80% timeliness for LTC, HCBS, PACE cases • Child Welfare • RCCO enrollment and minimal coverage gaps for youth

  14. Incentives: Timeliness and Backlog • Timeliness: June 2015 v. June 2016: • Backlog: June 2015 v. June 2016:

  15. County Grant Program • Authorized by Budget Request R6–2013 • Funds one-time infrastructure or business process improvements • Grant program funds must be used on Medicaid clients only • Proposals that include public assistance programs other than Medicaid are cost allocated at a 60 local/40 HCPF split • Four years of grants: FY14-15, FY15-16, FY16-17, FY17-18

  16. County Grant Program - Statistics

  17. County Relations • Engagement with Colorado Counties, Inc. (CCI) and Colorado Human Services Director’s Association (CHSDA) • Regional CHSDA Meetings • Policy Advisory Committee and Sub-PACs • CBMS Governance Structure

  18. County Relations – Local Public Health Agencies • The Department engages with local public health agencies and the Colorado Association of Local Public Health Officials (CALPHO) regularly • We have been providing additional support regarding billing in the new interChange system • Continue to work on implementing R-12 Change Request “Local Public Health Agency Partnerships”

  19. Tribal Relations • Overview of Colorado’s Tribes • Colorado Commission of Indian Affairs • Tribal Relations: Next Steps

  20. Tribal Relations • Two federally-recognized Tribes in Colorado • Ute Mountain Ute Tribe (UMUT) • Southern Ute Indian Tribe (SUIT) • Tribal interests are represented to the state through the Colorado Commission of Indian Affairs • HCPF has a Memorandum of Understanding (MOU) for annual Formal Tribal Consultations • March 16, 2018 is tentatively scheduled for HCPF’s third Formal Tribal Consultation

  21. Ute Mountain Ute Tribe • 2,060 enrolled members who reside both on and off the reservation • 575,000 contiguous acres • Colorado – Montezuma County, New Mexico & Utah • Ute Mountain Ute Service Unit= Indian Health Service

  22. Southern Ute Indian Tribe • 1,408 enrolled members who reside both on and off the reservation • Checkerboard reservation with tribal member allotments and tribally owned land • Colorado – La Plata & Montezuma Counties • Southern Ute Indian Tribe Health Center= Tribal 638

  23. Urban Indian Population • 46,395 AI/AN alone live in Metro-area • 104,464 Colorado identify as AI/AN alone or in combination with 1 or more races • Increased 35% since 2000 Census • Lakota – largest tribal group • Navajo Nation – largest growing tribe • Denver Indian Health & Services = Urban Indian Health Program & Medical Assistance Site

  24. Chaired by the Lt. Governor • Official liaison between the Southern Ute Indian and Ute Mountain Ute Tribes and the State of Colorado • Ensures direct contact with the Tribes and Colorado’s urban Indian communities • Four Committees: • Economic Opportunities and Resources • Education • Health and Wellness • Reinterment

  25. Tribal Relations: Next Steps • R-7 budget request passed in FY 2016-17 legislative session • Goal: $1.5 million in cost savings through maximizing 100% FMAP for services referred from Indian Health Services providers • Authorizes four new Tribal FTEs • Will focus on Tribal population physical and behavioral health initiatives, maximizing FMAP, cultural competency, Tribal and Provider Relations

  26. Questions or Concerns?

  27. Contact Information • Joshua Montoya • County & Tribal Liaison • joshua.montoya@state.co.us • Bre Benbenek • County Relations Coordinator • breanne.Benbenek@state.co.us

  28. Thank You!

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