Care and Case Management FAQ

Last Updated: December 15, 2020

 

Assessment 

Do we have an idea of the time it will take to complete the Basic Assessment compared to the Comprehensive Assessment?

A time study of the assessments in their current form has been completed for all the Comprehensive Assessment modules. We do not yet have a valid comparison for the Basic Assessment.

Will there be a requirement that anyone having an initial assessment completed will need to have a Comprehensive Assessment completed?

By design, selection of the Basic versus Comprehensive Assessment will be the member's choice. The intent is to avoid a default selection scenario such as, all initial referrals will require a Comprehensive Assessment, or all Continued Stay Reviews would require a Basic Assessment. The Comprehensive Assessment will include all questions from the Basic Assessment, with additional questions added for a deeper understanding of the members needs and wants. It is anticipated that a deeper review would be beneficial to someone, for example, who has more complicated needs, recent change or may be a newer Health First Colorado member. A similar suggestion could be made that the Basic Assessment would benefit someone with fewer needs, or who has historically been a Health First Colorado member, has stable needs/services, and is familiar with the program.

Is the Person-Centered Budget Algorithm (PCBA) able to be determined whether the person chooses to complete a Basic Assessment or a Comprehensive Assessment?

All variables that inform the PCBA will be included in both assessment models. The Basic Assessment will be designed to include all required elements that inform the PCBA. The Comprehensive Assessment will be designed with all required items that inform the PCBA, in addition to questions that provide further insight into a person's needs and may benefit support planning, but do not impact the budget.

Will the Assessment be able to be copied year to year, so as not to have complete all of the information from scratch, similar to the 100.2 assessment in the BUS?

The Department hopes that the use of a single Care and Case Management system will simplify the process. The system design will include features that share information across the member record and throughout the person-centered assessment and support planning process, as well as into the Continued Stay Reviews (CSR).

 

Person-Centered Budget Algorithm (PCBA)

Our understanding is that the assessment is just a piece of the algorithm that will be used to determine an individual's PCBA. What are the other pieces that will contribute to the PCBA algorithm?

The PCBA will be developed using items from the new Assessment tool. The PCBA will provide a range of resources for individuals to be used as part of their planning process. The individual and case manager will utilize the PCBA output alongside other information gathered during the assessment process to create a person-centered support plan.

When will we be provided more information on the Exceptions Process for the PCBA. Will it be a similar process to the Support Level Review or Request for SIS reassessment process in place currently?

The development of the PCBA Exceptions Process will include opportunities for stakeholder feedback once the PCBA has been developed and prior to implementation. The PCBA Exception Process will likely differ significantly from the current SIS Support Level Review or Request for Reassessment process.

 

Support Plan

Our understanding is that the assessment will auto populate into the Support Plan - will this be for both a Basic Assessment and/or a Comprehensive Assessment?

The auto populate function of the Care and Case Management system will be used for both the Basic and the Comprehensive Assessment.

Will data entry for service utilization (currently manually entered into the Bridge) be done automatically within the system, eliminating the need for manual entry of units into the Bridge/new system?

The ultimate goal of the Care and Case Management system is to eliminate duplicate data entry. Because of the role the Bridge currently has, it's tied to the PCBA and so the Department is working with all involved vendors to develop a seamless interface which will minimize the need for duplicative entries.

Will the system be able to recognize certain service limitations or unit caps automatically, or does there still need to be person oversight provided for this?

The Department is working with all our vendors to automate interface functions to the extent possible with inputs from the PCBA. There may still be a need for manual entry of certain service unit limitations.

 

Training

Will the current training manuals for each module on the Long-Term Services and Supports (LTSS) website be utilized in Case Management (CM) training on the system? Have these manuals been updated with any changes to the system after the assessment and support plan pilot?

The training manuals that were developed alongside each module will be one of the tools used in training case managers on the new Assessment and Support Plan. The manuals will be updated to accurately reflect the individual modules.

What is the timeframe we can expect for CM training and what will training look like?

Training of case managers and other staff at Case Management Agencies is planned for the months prior to GoLive of the new Assessment and Support Plan and the new Care and Case Management system. Training will incorporate different modalities (e.g. training manuals, recorded step-by-step instruction, live instruction, etc.) and training topics (e.g. use of the new Care and Case Management Tool, training on the individual modules, guidance on best practices, etc.).