1. Back to our Roots – Spotlight on Colorado A New Medicaid Infrastructure Grant Beth MacKenzie & Karen Ferrington November 8, 2010

2. Expansion of Public Health Care Programs Colorado Governor Ritter signed House Bill 09- 1293, the Colorado Health Care Affordability Act on April 21, 2009. The Act authorizes the Department to collect a hospital provider fee. Colorado Governor Ritter signed House Bill 09- 1293, the Colorado Health Care Affordability Act on April 21, 2009. The Act authorizes the Department to collect a hospital provider fee. What does the Act accomplish? What does the Act accomplish? Expand health care access, increasing the number of insured Coloradans by 100,000 Expand health care access, increasing the number of insured Coloradans by 100,000 Improve the quality of health care for clients served by public health insurance programs Improve the quality of health care for clients served by public health insurance programs Reduce cost-shifting to private payers Reduce cost-shifting to private payers Secure increased funding for Medicaid and uninsured clients Secure increased funding for Medicaid and uninsured clients

3. Expansion of Public Health Care Programs Expansion of Public Health Care Programs Spring 2010 Spring 2010 Medicaid parents up to 100% FPL Medicaid parents up to 100% FPL CHP+ children up to 250% FPL CHP+ children up to 250% FPL CHP+ prenatal up to 250% FPL CHP+ prenatal up to 250% FPL Beginning Summer 2011, Phased In Beginning Summer 2011, Phased In Buy-In Programs for Individuals with Disabilities Buy-In Programs for Individuals with Disabilities Early 2012 Early 2012 Adults without Dependent Children (AwDC) up to 100% FPL Adults without Dependent Children (AwDC) up to 100% FPL Spring 2012 Spring 2012 Continuous eligibility for Medicaid children Continuous eligibility for Medicaid children

4. Outreach Stakeholder and Outreach Process to Date Summer 2009 ~ Develop initial guiding principles Summer 2009 ~ Develop initial guiding principles Winter 2009/2010 ~ Obtain additional input and share information Winter 2009/2010 ~ Obtain additional input and share information Fall 2010 ~ Share CMS’s guidance and feedback Fall 2010 ~ Share CMS’s guidance and feedback Spring 2011 ~ Share program status and details as well as outreach and training information Spring 2011 ~ Share program status and details as well as outreach and training information

5. Outreach Targeted Individuals and Groups  Current and potential clients interested in working  Employers  Community partners/advocacy organizations  Direct service workers (e.g., county social services, vocational rehabilitation)  Employment support services  Educators (high school as well as post-secondary)  Independent Living Centers  Others

6. 6 Outreach Activities and Tools  Disability Awareness Events for Employers  Think Beyond the Label National Campaign  2011 Calendar of Work Incentives (thank you Iowa and New Mexico!)

7. 7 MBI– Eligibility Considerations  Working and having a disability as determined by SSA (with no substantial gainful activity requirement  Income too high for Medicaid eligibility  Assets  Disregards  Definition of work

8. Stateholder Input on MBI Facilitate employment for individuals with a disability while preserving continued Medicaid coverage Facilitate employment for individuals with a disability while preserving continued Medicaid coverage Provide seamless, easy to access coverage Provide seamless, easy to access coverage Establish reasonable premiums Establish reasonable premiums Provide access to all state plan services Provide access to all state plan services Complement or supplement other insurance Complement or supplement other insurance

9. 9 Needs Assessment  To ensure MBI is best suited to Colorado’s needs  Listening to and communicating with stakeholders through interviews, focus groups, and surveys  Reviewing strengths, challenges, and lessons learned in other states to benefit from their experience  Compiling and analyzing current, relevant data  Formally obtaining perspectives through a needs assessment survey process

10. 10 Training Plan  Coordinating with Colorado WIN Partners to develop trainings for our target populations  Training will range from basic to advanced for customized delivery to various audiences  Live, in-person  Live webinars  Web-based, archived webinars  Workshops will be held throughout the state during Spring/Summer 2011

11. 11 Steering Committee and Work Groups  Steering Committee  20-member committee representing perspectives from across the spectrum of disability  Utilizing on-line portal for information sharing and gathering feedback  Work Groups:  MBI design  Employment issues  Life transitions  Training  Communications

12. Working Adults with Disabilities Current Status Continuing statewide outreach with stakeholders Continuing statewide outreach with stakeholders Working with CMS to obtain guidance on specific issues to ensure a path to success Working with CMS to obtain guidance on specific issues to ensure a path to success Engaging vendor to assist with forecasting costs and analyzing premium structure Engaging vendor to assist with forecasting costs and analyzing premium structure Working on systems changes (MMIS and CBMS) Working on systems changes (MMIS and CBMS) Developing trainings for eligibility staff, DVR staff, service providers, and clients and their family members Developing trainings for eligibility staff, DVR staff, service providers, and clients and their family members

13. Working Adults with Disabilities Next Steps Work with CMS Work with CMS Summer/Fall 2010 through implementation Summer/Fall 2010 through implementation Waiver submission to CMS Summer/Fall 2010 Waiver submission to CMS Summer/Fall 2010 Work with Contractor Work with Contractor Benefit design and cost modeling Benefit design and cost modeling Winter 2010 /2011 Winter 2010 /2011 Implementation Implementation Summer 2011 Summer 2011

14. Contact Information Beth MacKenzie Beth MacKenzie CO Health Care Policy and Financing (303) 866-3936 (303) 866-3936 Beth.MacKenzie@state.co.us Beth.MacKenzie@state.co.us Beth.MacKenzie@state.co.us Karen Ferrington Karen Ferrington CO Division of Vocational Rehabilitation (303) 866-3779 (303) 866-3779 Karen.Ferrington@state.co.us Karen.Ferrington@state.co.us Karen.Ferrington@state.co.us