The Colorado Department of Health Care Policy and Financing’s (HCPF) Office of Community Living (OCL) provided its quarterly update on the state’s American Rescue Plan Act (ARPA) initiatives on Nov. 17th.
Colorado received $530 million of ARPA funds in 2021, which have been allocated to 63 Home and Community-Based Services (HCBS) initiatives lasting through March 2025.
OCL reported its expenditures for the first half of 2022, spending $73.3 million of the $296.1 million budgeted for FY 2022, the largest annual budget over the 4-year spending window.
To date, OCL has invested more than $160 million into HCBS projects and more than $275 million into direct care workforce support and rate increases.
Below are the projects that OCL provided updates on.
Mobile crisis response teams
One of the key ARPA-funded projects is the Mobile Crisis Response (MCR) Medicaid benefit that will provide crisis services to all Coloradans regardless of insurance status.
HCPF and the Behavioral Health Administration (BHA) are collaborating to design and launch MCR by July 2023.
HCPF is in the process of finalizing its draft plan and once complete, an amendment to the state Medicaid plan will be initiated to authorize the regulatory framework implementation.
As an expansion to the crisis continuum, multi-disciplinary MCR teams with specialized training would be dispatched through 988, 911, and other statewide crisis lines to meet clients where they are at and offer relief and stabilization.
“We are working in partnership with different co-response programs,” said Emily Holcomb, Behavioral Health Crisis Response Policy Advisor at HCPF. “This is a different approach however, so we want folks like [the] Denver STAR program to know about this resource and hopefully refer to us as needed if we don’t need the same response.
The new Medicaid [benefit] will allow providers to actually bill for this specific service, rather than bill a state general fund or billing for something else or being unable to bill if it’s a law enforcement response. These [crisis response] services are available, but this new benefit allows for providers to bill and hopefully this will be a motivation to actually access and bill the service.”
The aim of MCR is to improve crisis service quality, reduce unnecessary service utilization through community crisis resolution and de-escalation, connect clients to HCBS, and strengthen the network and capacity of local response. The teams would not replace crisis response services currently in place but provide services that meet federal requirements under ARPA funding.
HCPF and BHA will host weekly meetings through January to offer technical assistance and needs assessments to providers to ensure compliance.
Accountable Care Collaborative
HCPF provided an update to the development of Phase 3 of the state’s Accountable Care Collaborative, the state’s value-based payment model through which Regional Accountable Entities (RAEs) coordinate physical and behavioral healthcare for Medicaid members and administer Health First Colorado’s capitated behavioral health benefit.
The goals of Phase 3 are to improve healthcare quality, access, equity, and cost management while protecting member coverage, benefits, and provider reimbursements.
Current contracts with RAEs are set to end in June 2025 and the department has initiated program development and engagement with various stakeholders and community groups to inform its Request for Proposal (RFP) development for the Phase 3 contracts.
“[HCPF has] contracted with the Colorado Health Institute to help us with external stakeholder work,” said Mark Queirolo, Planning and Implementation Section Manager for the ACC Division. “We will be talking with people in a variety of venues over the next few months. That will be done in collaboration with our internal workgroups that are focused on a variety of topics right now and exploring what are the best policies [and] programs that they can work on with our external stakeholders.
[In March] we will release a series of concept briefs [that] will be very topic-specific on what are the new policies, programs, changes that the department is planning to make as part of the Accountable Care Collaborative.”
HCPF will gather public feedback on a draft RFP that will be released in November 2023, before issuing the final RFP for Phase 3 RAE contracts in April 2024. It will award vendor contracts in September 2024. ACC Phase 3 will go live in July 2025.