Page updated - December 8, 2022
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Benefits Utilization System (BUS)
Q. When will the BUS be retired?
A. The BUS will be retired when the CCM system goes live in Phase I, currently planned for March 2023. From this date, case managers will enter all member information, previously entered in the BUS, in the CCM system.
This will include:
- Member Demographics
- Assessments
- Service Plan (Initial, CSR and Revision)
- Service Plan DD Section
- Financial, Insurance and Legal information
- Case Status
- Critical Incident Reporting
- Log Notes
- Program Area
- Rights Modification
- Intake and Referral
- Enrollment Status
- Notice of Action and Appeals
Billing
Q. How would vendors still billing through the CCB’s Organized Health Care Delivery System (OHCDS) (i.e., Amazon) be entered?
A. There will be no change to how HCBS and Targeted Case Management (TCM) billing is performed; CCBs will still bill for services via the Colorado Medicaid Management Information System (MMIS).
Business Process
Q. What is a business process?
A. A business process is a set of activities and tasks that, once completed, will result in the delivery of a service, or product to a member.
There are three types of business processes:
- Management - focuses on planning and projecting the future of care and case management support provided to members.
- Operational - concerns the core business process i.e. providing care and case management services to clients such as creating the Support Plan.
- Supporting - support the management and operational processes such as answering the phones or employee training.
Bridge
Q. When will the Bridge be retired?
A. The Bridge will not be retired when the CCM system goes live at Phase I, currently planned for March 2023. The Department anticipates making all of the Bridge functionality available in the CCM system, once the RA, within the PCBA, is fully implemented.
Care and Case Management (CCM) System Functionality
Q. What is the name of the new CCM system?
A. The CCM system is the name the Department is using to describe MedCompass®, a configurable care management platform, a product of AssureCare, that will be customized to meet Colorado’s unique care management needs.
Q. When will the new CCM system go live?
A. The CCM system will go live in four phases. The Department is committed to a successful go-live of the CCM system and is working with all the respective vendors to understand the interdependencies, risks, and timelines.
Q. What will the new CCM system be used for?
A. The new CCM system consolidates case management functions that currently exist across several systems, including the BUS and DDDWeb (CCMS), into a single system. The Department anticipates making all of the Bridge functionality available in the CCM system, once the RA, within the PCBA, is fully implemented with a target date of 2024.
Q. What features will be included in the CCM system?
A.
- Colorado Single Assessment
- Person Centered Support Plan and Outputs
- Shared Case Security
- Intake Process
- Time Stamping/Tracking
- Plan Auto Population/Pull Forward
- Mobile Device Capability
- Offline Functionality
- Reporting
- Enrollment Status and Waiting Lists
- Program Status and Program Assignment
- Log Notes
- Notice of Action and Appeals
- Letters and Forms
- State Funded Programs
- Critical Incident Reporting
- Electronic Signature
- Upload Documents
- An interface with CBMS via PEAKPro
Q. Will the assessment need to be completed "live" with the member or can case managers continue to take notes and enter the assessment upon return to the office?
A. Case Managers will need a laptop computer, or other portable electronic device, to complete the CSA and the PCSP. Both the CSA and the PCSP include logic, pull forward answers and skip patterns and are not designed to be completed on paper. The CCM system will have offline capabilities, which will allow case managers to enter responses to the CSA and the PCSP as they are provided by the member, even when no internet is available. Case managers will receive CCM system specific training delivered by our partners Gainwell Technologies.
Q. Can case managers skip around in the new assessment in order to address each area as the member brings them up, or do they have to complete them in order?
A. Case managers will be able to address each area of the new CSA and the PCSP as the member brings them up. They do not have to be completed in order.
Q. If the majority of CMAs find that certain information would be beneficial in having, how hard would it be to build it into the new system after the initial roll out?
A. The CCM system is configurable. Any requests for system enhancements should be sent to the Department for consideration.
Q. How do we explain the difference between the Basic and Comprehensive Assessment?
A. The Department originally intended to roll out a Basic (mandatory responses only) and Comprehensive Assessment (required plus voluntary responses) as separate assessments, but these are now one assessment, the Needs Assessment. Case managers will receive CCM system training and CSA and PCSP training delivered by our partners Gainwell Technologies and the Staff Development Center.
Q. What do case managers do if the member wants them to leave before the assessment is completed?
A. The CSA and the PCSP are designed to support consistent collection of data within a person-centered process. Case managers will be able to save an assessment and return later to complete it.
Q. Will case managers be able to copy assessments and support plans?
A. In the CCM system, CMs will not be able to directly copy the CSAs and PCSPs but when new ones are created they will pull forward answers from the previous assessment.
Q. Will we still have quick links for case managers to check their due case items?
A. The CCM system will include tasks, reviews and appointments all designed to help case managers manage their caseload. The system will also include functionality allowing case managers quick access to recently accessed member records.
Q. Our agency relies on the CIR follow up notifications from the Department. Will there continue to be those notifications in the new system and is there any way to enhance notifications to CIRs?
A. The CCM system will include tasks and reviews which will help the case manager to manage their caseloads, including CIRs.
Q. What are good points of contact for any questions about the CCM system?
A. Send any CCM system questions to HCPF_CCM_Stakeholder@state.co.us
Case Management Caseloads
Q. I have heard the new Assessment and Support Plan will take much longer to complete than the old ones and will require more visits to the member. This may increase case manager travel time, staffing and mileage costs.
A. The new Colorado Single Assessment (CSA) and the Person-Centered Support Plan (PCSP) are designed to replace the existing ULTC 100.2 functional assessment, IADL assessment and Service Plan in the Benefit Utilization System (BUS). It will also include the new Needs Assessment. The Needs Assessment will replace the Support Intensity Scale (SIS) for IDD waiver members; there is not currently a comparable assessment for the non-IDD waivers.
When these new instruments were piloted in 2019, the entire process averaged 4 hours and 25 minutes. The Level of Care (LOC) Screen (replacement for ULTC 100.2) took 28 minutes; the Needs Assessment (replacement for SIS); averaged 2 hours and 17 minutes; and the Support Plan (replacement for BUS Service Plan) averaged 1 hour and 3 minutes. Therefore, the new LOC Screen and Support Plan do not take longer than their counterparts. The Needs Assessment does not take longer than the SIS; the average time for a SIS assessment is 3 hours. Also, during the pilot, the system did not include all of the automation functionality that will be present when it is fully implemented. We expect that the fully functional automation features, along with familiarity with the instruments- and system will reduce the completion times initially and over time.
The most significant change will be for those waivers that have not previously required a counterpart to the new Needs Assessment be administered, like the SIS. The new Needs Assessment is the first step in implementing the Person-Centered Budget Algorithm (PCBA), which will allow for person-centered, individualized budgets for members.
The expectation is that the process will require two visits; one to complete the new LOC Screen and the next to complete the new Needs Assessment and Support Plan. For some members, it may be appropriate to break up the Needs Assessment and Support Plan into separate visits.
Current rates for completing the Colorado Single Assessment (LOC Screen and Needs Assessment) are based on a time study completed in 2019. The Department will continue to review the process to determine the need to revise rates in the future, using data collected during the Soft Launch.
CCM System Support
Q. What system support will be available to case managers after go-live?
A. Helpdesk support will be available for CMAs to report system issues and/or outages.
CCM Terms
Frequently Used CCM System Terms
- Care and Case Management (CCM) System
- The CCM system is the name the Department is using to describe MedCompass®, a configurable care management platform product that will be customized to meet Colorado’s unique care management needs.
- The CCM system is the name the Department is using to describe MedCompass®, a configurable care management platform product that will be customized to meet Colorado’s unique care management needs.
- Colorado Single Assessment (CSA)
- The CSA is housed in the CCM system and designed to replace the existing ULTC 100.2 assessment, and other member acuity needs assessments, e.g., the Support Intensity Scale (SIS). The CSA will include Level of Care Eligibility Determination Assessment (LOC Screen) and Needs Assessment and promote consistent collection of member data within a person-centered process.
- The CSA is housed in the CCM system and designed to replace the existing ULTC 100.2 assessment, and other member acuity needs assessments, e.g., the Support Intensity Scale (SIS). The CSA will include Level of Care Eligibility Determination Assessment (LOC Screen) and Needs Assessment and promote consistent collection of member data within a person-centered process.
- Final Go-Live
- The Final Go-Live of the CCM system is currently planned for October 2022. This will include all CMAs and the implementation of all remaining CCM system functionality. Updates on the Final Go-Live will be announced on the Department’s Case Manager’s Corner newsletter (HCPF Communication Lists website).
- The Final Go-Live of the CCM system is currently planned for October 2022. This will include all CMAs and the implementation of all remaining CCM system functionality. Updates on the Final Go-Live will be announced on the Department’s Case Manager’s Corner newsletter (HCPF Communication Lists website).
- Person-Centered Budget Algorithm (PCBA)
- The Department will be developing a PCBA for Health First Colorado Home and Community-Based Services (HCBS) waiver programs. The PCBA will help identify the right amount of support for members based on assessed needs, and together with strengths and preferences identified during the assessment, contribute to a person-centered support plan. The PCBA is an important component of the assessment and support planning process to ensure a consistent, objective and equitable method for assigning budgets for all members receiving HCBS.
- The Department will be developing a PCBA for Health First Colorado Home and Community-Based Services (HCBS) waiver programs. The PCBA will help identify the right amount of support for members based on assessed needs, and together with strengths and preferences identified during the assessment, contribute to a person-centered support plan. The PCBA is an important component of the assessment and support planning process to ensure a consistent, objective and equitable method for assigning budgets for all members receiving HCBS.
- Person-Centered Support Plan (PCSP)
- The PCSP is housed in the CCM system and designed to replace the existing Service Plan in the Benefits Utilization System (BUS). The PCSP is more person-centered, comprehensive, and designed to address member preferences, personal goals and identified needs.
- The PCSP is housed in the CCM system and designed to replace the existing Service Plan in the Benefits Utilization System (BUS). The PCSP is more person-centered, comprehensive, and designed to address member preferences, personal goals and identified needs.
- Resource Allocation (RA)
- The maximum dollar amount worth of services to be authorized on a member’s PCSP during the applicable assessment period.
- The maximum dollar amount worth of services to be authorized on a member’s PCSP during the applicable assessment period.
- Soft Launch
- The Soft Launch of the CCM system is currently scheduled to begin Spring/Summer 2022. This will include a limited number of CMAs completing both the CSA and the PCSP for their members in the CCM.
Children’s Extensive Support (CES) Waiver
Q. Will a 3rd party reviewer still be required in the CES enrollment process?
A. The CES enrollment process will not change when the CCM system goes live. However, the CES application will be phased out as the information is now captured in the new PCSP. There will still be a third-party URC review for CES enrollments and CSRs.
Colorado Benefits Management System (CBMS)
Q. Will the CCM system interface with the interChange and CBMS?
A. At Final Go-Live, with streamlined eligibility, the CCM system will interface with the interChange/CBMS. Case Managers will be able to send member Level of Care information to CBMS, via PEAKPro, for financial determination and the CCM system will receive a nightly data feed from the interChange/CBMS. This feed will include notification of financial eligibility and member demographic data held in CBMS. Since this member demographic data flowing down from CBMS will be considered the source of truth, CMAs are encouraged to continue working on cleaning their member data in the BUS and CCMS (DDDWeb) and take care to prevent the creation of duplicate members.
Communication
Q. How will the Department communicate with CMAs and other stakeholders about the implementation of the CCM system?
A. The Department will be using the following methods of communication designed to keep you up to date with the progress of the CCM system implementation.
- Mailing List
- Case Managers can sign up to join the CCM system mailing list to receive updates, announcements and newsletters.
- Case Managers can sign up to join the CCM system mailing list to receive updates, announcements and newsletters.
- CCM System Web Page
- The CCM system web page will be regularly updated with news about Training, Known Issues, and other resources.
- The CCM system web page will be regularly updated with news about Training, Known Issues, and other resources.
- A dedicated email address
- CCM related emails can be sent to HCPF_CCM_Stakeholder@state.co.us
- CCM related emails can be sent to HCPF_CCM_Stakeholder@state.co.us
- Business Process Re-engineering (BPR)
- BPR related emails will be sent to your nominated BPR point of contact.
Community Contract Management System (CCMS)/DDDWeb
Q. Will the CCMS (DDDWeb) be retired when the CCM system goes live?
A. The CCMS (DDDWeb) will be retired at Phase 1 of the CCM system, currently planned for March 2023. From this date, case managers will enter all member information, previously entered in the CCMS (DDDWeb) in the CCM system. This will include:
- Member Demographics
- DD Determination
- State General Fund Program Oversight
- DD Waiver Waitlist Management
- Appeals
- Critical Incident Reports (CIRS)
- Intake Screen
- Case Status
- Program Area
Q. CCMS (DDDWeb) is used to house member and contact information which we utilize for mailing labels. Will that function be supported in the new system?
A. The Department is working closely with our partners Gainwell and AssureCare to create the reports which will be available in the CCM system. It is still to be decided if the CCMS (DDDWeb) mailing labels will be included.
Q. Will Waiting List status and Developmental Disability and Delay (DD) determination information be available in CCM regardless of which program the person is enrolled in?
A. All member DD and Family Support Services Program (FSSP) waiting lists will be migrated to the CCM system.
Q. What data/areas of the system will be available for export?
A. This will be determined later in the project, but it will likely be similar to the existing DDDWeb (CCMS) export functionality.
Consumer-Directed Attendant Support Services (CDASS)
Q. Will the existing process for completing the CDASS task worksheet change after the CCM system goes live?
A. The existing process for completing the CDASS task worksheet will not change after the CCM system goes live. When the PCBA is fully implemented with a target date of 2024, CMAs will no longer need to complete the CDASS task worksheet.
Contract Deliverables
Q. What will the impact be on our contract deliverables when the CCM system goes live?
A. The implementation of the CCM system does not have any foreseeable impact on the SEP or CCB contract deliverables.
Cost Containment
Q. How will we even know if someone is over cost containment? The PCBA might do away with cost containment, but if that doesn’t roll out in the beginning, we will need something.
A. The existing over cost containment process will not change after the CCM system goes live. The process will continue in its current form until the PCBA is fully implemented.
Data Dictionary
Q. Is there a data dictionary (for data exports) that can be made available to us for the new system?
A. The file layout of the exportable data has been made available to CMAs. No data dictionary is available. If you have any questions about the CMA data file, email HCPF_CCM_Stakeholder@state.co.us
Home Care Allowance (HCA)
Q. How will HCA/Adult Foster Care be incorporated into the new assessment/support plan model?
A. HCA will no longer be part of CCM. The Department of Human Services is working on a solution for HCA to be incorporated into CBMS. The Adult Foster Care program is no longer available.
Member Data
Q. Will CMAs have access to member data in the BUS after it is retired, and will there be a way to pull all members?
A. Three years of member data (current year plus two years) will be migrated from the BUS to the CCM system. The Department will archive all other historical BUS data in BIDM. This data can be accessed by CMAs with a data request made to the Department. It is anticipated the Department will have more details on this functionality as we approach Final Go Live.
Partnerships/Providers
Q. How will our existing partnerships, including with providers, be impacted by the CCM system go-live?
A. The Department anticipates existing partnerships will be affected positively when the CCM system goes live. The CCM system is designed to streamline processes which will enable enhanced performance oversight, improved workflows, and lower the number of systems used. CSA and PCSP information typically sent to community providers will now be more comprehensive, so the provider has a more complete understanding of the member’s needs. The CCM system will also interface with the interChange/CBMS. Case Managers will be able to send member LOC information to CBMS, via PEAKPro, for financial determination and the CCM system will receive a nightly data feed from the interChange/CBMS.
Person-Centered Budget Algorithm (PCBA)
Q. When does the Department expect to begin using the PCBA?
A. The Department is planning to begin using the CSA and PCSP summer of 2023 which is required to develop the PCBA as part of Phase 2. The Department w the PCBA to be implemented in January 2025
Q. How and when will the new budget algorithm be developed?
A. The new PCBA will be developed using data from the new CSA and the PCSP. Development will begin as new assessments are being conducted and will be finalized after the CCM system is fully implemented and there is enough data to finalize the algorithm. For more information, visit the PCBA web page.
Post Eligibility Treatment of Income (PETI)
Q. Will the existing process for completing the PETI worksheet change after the CCM system goes live?
A. The current process and requirements for PETI will not be impacted or changed with the implementation of the CCM system. The Department anticipates making all the Bridge functionality available in the CCM system when the PCBA is fully implemented.
Pre-Admission Screening and Resident Review (PASRR)
Q. Will there be changes to the process for over cost containment (OCC) or PASRR with the new system?
A. The current process and requirements for PASRR will not be impacted or changed with the implementation of the CCM system. The process will continue in its current form until the PCBA is implemented.
Prior Authorization Requests (PARs)
Q. Will the PAR creation process change after the CCM system goes live?
A. The PAR creation process will not change after the CCM system goes live. PARs will still be created in the Bridge and the CCM system will be integrated with the Bridge subsystem. The Department anticipates making all the Bridge functionality available in the CCM system when the PCBA is fully implemented.
Program of All-Inclusive Care for the Elderly (PACE)
Q. Will there be a difference in service planning requirement for nursing facility and PACE cases since SEP case managers just complete functional eligibility for these programs and PACE and NF's team complete these member's service planning?
A. Case Managers will continue to complete Level of Care eligibility determination for these programs in the CCM system. The service planning requirement for nursing facility and PACE providers will not change after the CCM system goes live.
Rate Methodology/Reimbursement
Q. Will the current rate methodology change to accommodate the additional expectations of the new assessment? Will CMAs be compensated for any increased costs associated with the implementation of the new Assessment and Support Plans?
A. Current assessment rates are based on the time study completed in 2019. The current payment structure includes a payment for the LOC Screen, Needs Assessment and the PCSP. Increased costs, such as travel time and mileage are included in the rate methodology and for extended travel, there is a rural travel add on. During the Soft Launch of the CCM system anticipated in Spring/Summer 2022, a new time study will be completed. The Department is committed to evaluating the current assessment rates and the reasonableness of the currently identified rate structure once more information is available.
Reconciliation Process
Q. Will the reconciliation process change?
A. The Payment Correction process for CMAs are outlined in the Fiscal Year 2021-22 contracts, and this payment correction will continue to be processed accordingly with no foreseeable changes.
Reporting
Q. Does the CCM system have a reporting capability and will all the existing BUS/CCMS (DDDWeb) reports be available in the CCM system?
A. Case management reporting will be available in the CCM system. The Department is working closely with our partners Gainwell and AssureCare to ensure reports similar to the ones currently generated in the BUS/CCMS (DDDWeb) are made available to CMAs in the CCM system.
State Plan/State General Fund (SGF)
Q. Will members on the State Plan be in the CCM system?
A. Yes, members on the State Plan will be in the CCM system.
Q. Will documentation and billing for SGF programs, change?
A. CCBs will continue to submit enrollment and termination documentation for SGF programs via the CCM system using processes similar to those used today in the DDDWeb (CCMS). CCBs will begin entering case management documentation for the SGF programs in the CCM system in a process like those used today by CCBs for HCBS waiver programs. CCBs will also begin entering service utilization in the new CCM system. The Department will use this data to generate reports and process payments. This will replace the existing invoice/deliverable reimbursement process used today for SGF programs. The Department will provide training/orientation on these processes closer to Final Go Live and communicate when we will transition from invoice/deliverable-based reimbursement to report-based reimbursement.
Supports Intensity Scale (SIS)
Q. Will the existing process for completing the SIS change after the CCM system goes live?
A. The existing process for completing the SIS will not change after the CCM system goes live. This process will be in effect until the PCBA is finalized and implemented in 2024.
System Interfaces
Q. Will an interface occur with Telligen for submission of OCC PARS, CHCBS cases, and PASRR?
A. The CCM system will not connect with Telligen when it goes live; however, Telligen will have access to the CCM system.
Q. Will we be able to upload data?
A. CCM system users will be able to upload documents, but the system will not be able to accept data uploads from case management systems used by CMAs.
Targeted Case Management (TCM)
Q. Will TCM billing be auto generated or accessed by HCPF as other billings are currently, or will the CCB still be required to generate and submit billing?
A. Implementation of the CCM tool does not change the processes CCBs or TCAs follow to submit billing to the Colorado interChange Medicaid Management Information System.
Technology
Q. What technology does the CCM system use?
A. The CCM system is built using C# programming language. The backend database is SQL server.
Q. Which devices will a case manager be able to access the CCM system with?
A. The CCM system is accessible from a laptop, notebook, or other mobile device with a secure internet connection. Google Chrome is the recommended browser. Operating systems should be Windows 10 platform, build 10.0.16299.0, or greater, or iPads with iOS 10.1 or higher. Older Windows operating systems are not recommended as they do not always tolerate upgrades to Windows 10 and 11 and may not be supported or receive security updates.
Testing
Q. Will the CCM system be tested before it goes live?
A. The CCM system will be tested by the Department in conjunction with our partner Gainwell Technologies.
Training
Q. Will case managers be trained before the CCM system goes live?
A. CMAs will receive CCM system specific training and training on the CSA and PCSP delivered by our partners Gainwell Technologies and the Staff Development Center. This training will also include portions of the Bridge/interChange that may be modified and utilize the Learning Management System (LMS). The training will be designed to give case managers the foundation for a successful transition to operation and use of MedCompass® and will be user-friendly, web-based, recorded and instructor-led and include an evaluation for case manager competency. After this initial training, ongoing reviews will be completed to assure consistency among case managers. Systems training will begin on January 9 and go through March 10. Policy training will begin in May.
Q. How do we schedule a CCM system demo?
A. The Department is putting together its system implementation training plan in collaboration with Gainwell and will provide additional information once it is finalized. CMA system training is currently scheduled to begin before implementation. Demos of the CCM system are currently being provided at the bi-weekly CCM CMA Update meetings hosted by Michelle Topkoff.
Trails
Q. How will the benefit plan assignment for Trails members work after the CCM system goes live?
A. Benefit plan assignment for Trails members will occur in the CCM system and flow into interChange to ensure correct claims adjudication.
Vendors
Q. Will vendors be pre-populated as approved, or will users have to enter?
A. The CCM system will not be pre-populated with vendors.
Workflows
Q. What workflows will the state system solve for?
A. With the implementation of the CCM system, the DSS 100 manual process will be automated. The system will send Level of Care eligibility determinations to CBMS, via PEAKPro, and receive back the eligibility determination for LTSS programs.