S_HHS_2021A 01/22/2021 10:22:48 AM Committee Summary

Ms. Michelle Collin, Office of the State Auditor (OSA), introduced the presentation. Ms. Collin discussed the total number of audit recommendations that are made to state departments and how OSA operates.

Ms. Jenny Page, OSA, introduced the performance audit for the Department of Human Services (DHS), specifically the update on the Colorado Adult Protection Services Programs (CAPS), which can be found online here: https://leg.colorado.gov/sites/default/files/images/lcs/osa_adult_protective_services_2020.pdf. 

The audit of the CAPS looked at how the program can be improved, and OSA found that the program can do better when it comes to protecting adults.

The audit found that the CAPS program does not report sufficient information on findings of mistreatment to employers looking to hire individuals. OSA recommended that they improve the reporting in an effort to improve employment outcomes. Key recommendations from the report included:

• improving the process for perpetrators to appeal findings of mistreatment;
• training counties on screening reports of mistreatment;
• implementing written guidance and training for documenting county guardianships; and
• streamlining the quality assurance review of county services.

DHS agreed with most of the recommendations.

Ms. Page responded to questions from the committee.

Committee questions continued.

Pooja Tulsian, OSA, presented to the committee the report on the health department audits recommendations that have yet to be implemented by DHS and the Department of Health Care Policy and Financing. The Annual Report: Status of Audit Recommendations Not Fully Implemented, as of June 30, 2020 was distributed to the committee and can be found online here: https://leg.colorado.gov/sites/default/files/images/lcs/osa_annual_report_status_of_audit_recommendations.pdf.

Ms. Tulsian recommended that the committee ask the presenting departments about the outstanding recommendations and pointed to the end of the report showing where more information about the audits can be found. She responded to questions from the committee.

Ms. Page responded to questions.

Kim Bimestefer, Executive Director, Department of Health Care Policy and Financing (HCPF), introduced the presentation and referred to a slide deck throughout (Attachment B). She began with an overview of the department and introduction of staff presenting. Due to technical difficulties she could not continue her portion of the presentation.

Tom Massey, Deputy Executive Director, HCPF, introduced the legislative agenda of the department. Their priorities included telemedicine refinement, case management redesign, skilled nursing facilities, remote supports to Home and Community-Based Services programs, and expanding the Canadian prescription drug importation program.

Mr. Massey summarized the regulatory agenda and rule review process. The 2020 review included Provider Screening, Hospital Screening, Pharmaceuticals, State Funded Programs, and Health Care Affordability and Sustainability Fee Rules.

Director Bimestefer resumed her presentation and discussed an overview of HCPF, including funding sources, populations served, and types of providers. She continued with a summary of the department’s COVID response which included the Residential Strike Force aimed at protecting the most vulnerable populations. She discussed the impacts of the public health emergency on Medicaid enrollment, unemployment rates, and types of health coverage Coloradans are utilizing.

Director Bimestefer responded to a question.

Director Bimestefer presented the department performance plan including their Wildly Important Goals (WIGs). The WIGs included delivering health care coverage during the economic downturn and managing health care costs.  

Director Bimestefer presented the five strategic pillars of HCPF department goals which are member health, care access, operational excellence and customer service, Medicaid cost control, and affordability leadership. She provided examples of how HCPF is implementing these goals.

Director Bimestefer responded to questions about unimplemented audit recommendations and the affordability model.

Ralph Choate, Chief Operating Officer/Medicaid Operations Office Director, discussed streamlining client correspondence and need to conform to federal mandates related to required information and notices. He informed the committee that in a recent review, HCPF found that their correspondence process and accuracy had vastly improved compared to previous reviews.  

Director Bimestefer presented an update on Senate Bill 18-266, which requires HCPF to provide information to providers participating in the Accountable Care Collaborative regarding cost and quality of medical services. She informed the committee that they are on target to meet the required savings.

Director Bimestefer commented on adding health equity to HCPF's mission and made closing comments. Committee discussion followed.

Director Bimestefer asked the committee for continued feedback on the department’s equity mission. She informed the committee that HCPF is focused on the auditor's work and thanked healthcare workers for their work during the ongoing public health emergency.

Director Bimestefer commented on benefits of telemedicine and the COVID-19 vaccine.

The committee reconvened.

Michelle Barnes, Executive Director, Department of Human Services (DHS), presented the DHS SMART Act and referred to a slide deck through out the presentation (Attachment C). She discussed the mission of DHS and how the department focuses on the whole family.

Amanda Robinson, Equity, Diversity, and Inclustion Program, presented on CDHS' Equity Action Plan.

Director Barnes referred to slides 7 and 8 of the slide presentation. She discussed the diversity of the staff and the variety of locations staff are located.

Kevin Neimond, Policy and Legislative Affairs at DHS, discussed the department's legislative agenda.

Mr. Neimond presented DHS’s budget requests and responded to committee questions.

Mary Alice Cohen, Office of Early Childhood in DHS, responded to questions.

Jeremy Hill, Administrative Solutions in DHS, presented on the department's performance management goals. 

Mr. Hill spoke about the Administrative Solutions Office and discussed their performance indicators and WIGs.

Mr. Hill responded to committee questions about diversity in the leadership of DHS and the performance of workers who are working remotely.

Yolanda Webb, Office of Adult, Aging, and Disability Services in DHS, discussed the activities of the office.

Ms. Webb responded to committee questions and suggested the committee refer questions about Adult Protective Services to the HCPF.

Ms. Webb responded to committee questions about disability services the department provides.

Dr. Robert Werthwein, Office of Behavioral Health (OBH) in DHS, spoke about the Behavioral Health Task Force blueprint beginning on slide 32 of the slide presentation.  He discussed the three phases of implanting a behavioral health system that puts people first and elaborated on the goals of the Behavioral Health Task Force.

Ms. Minna Castillo Cohen, Director, Office of Children, Youth, and Families, began on slide 41 of the slide presentation with an overview of the programs of the office. She discussed the Division of Youth Services (DYS) and the changes in the caseload that has occurred over the last several years.

Ms. Cohen continued with the performance indicators within DYS, which included increases in treatment and education services.

Ms. Cohen responded to questions.

Ms. Mary Alice, Director, Office of Early Childhood (OEC) in DHS, began on slide 55 of the slide presentation with an introduction of the office. She discussed the performance indicators of OEC which include maintaing care capacity, early childhood workforce retention and support, and Early Childhood Mental Health consultation.

Director Barnes responded to questions about the waiting list for the Home and Community Based Services Developmental and Disabilities waiver and the potential for more interdepartmental solutions. She affirmed that the office will work with HCPF to see what more they can do about the backlog.

Ms. Webb responded to a question about the Adult Protective Services program and spoke about efforts to make sure the standard curriculum and processes are being utilized across counties.

Senator Fields made concluding comments about the presentation and asked about culturally competent trauma training.

Ms. George responded to questions about vouchers and how the program impacts individual counties.