Implement Conflict-free Case Management

Joint Budget Committee. The bill implements conflict-free case management for persons with intellectual and developmental disabilities who are enrolled in home- and community-based services under Colorado's medicaid program.

The definition of conflict-free case management is included in the bill and reflects the policy that case management services are provided to a person with intellectual and developmental disabilities who is enrolled in home- and community-based services by an agency that is not also providing the same person services and supports unless a federal exemption is approved.

The bill defines and creates case management agencies that will provide case management services, and contains provisions for the department of health care policy and financing's (department) oversight of case management agencies. The state medical services board (state board) shall promulgate rules upon the enactment of the bill for the certification and decertification of case management agencies, as well as rules that ensure that a person with intellectual and developmental disabilities enrolled in home- and community-based services has access to case management services and that there is a process for a person to select the case management agency of his or her choice. A case management agency shall develop an individualized plan for these persons. Designated community-centered boards shall continue to develop individualized plans for a child with disabilities from birth to age 2 and for persons eligible for other programs. The bill makes conforming amendments in existing statutes to add references to case management agencies, where relevant.

The bill contains time frames for the implementation of conflict-free case management in Colorado. Initially, the department shall determine the options for community-centered boards to become compliant with conflict-free case management when serving persons with intellectual and developmental disabilities who are enrolled in home- and community-based services. Conflicted community-centered boards are required to develop a business continuity plan to transition to providing either case management services or services and supports to these persons. The bill includes a date by which all persons receiving home- and community-based services will be served through a system of conflict-free case management.

The bill authorizes the department to seek a federal exemption from conflict-free case management in geographic areas within the state where the only willing and qualified entity to provide case management services is also the only willing and qualified entity to provide home- and community-based services in that geographic area. The bill contains procedures and time frames for rural community-centered boards, as defined in the bill, to request that the department seek the federal exemption. The bill includes provisions relating to the denial of a federal exemption and requires state board rules for when a federal exemption is pending and for when there are multiple agencies operating in the same geographic area.

The bill authorizes and prioritizes the use of money in the intellectual and developmental disabilities services cash fund (cash fund) for systems changes related to the implementation of conflict-free case management and repeals the cash fund in 2022.

(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)