New Assessment and Person-Centered Support Plan

Pilot Information

The Department piloted the process with participants seeking or receiving LTSS, and case managers from across the state to test the assessment content and automation of the new LTSS Assessment and Support Plan. These pilots occurred in two primary phases.

Pilot Phase 1 and Phase 2

Pilot Phase 1

The first component of this phase, the level of care (LOC) pilot, has been completed. During the LOC pilot case managers assessed participants using both the current LOC eligibility assessment, the ULTC 100.2 and the new LOC pilot screening tool. The purpose of the pilot was to compare responses incurrent and new items. The comparative analysis of these items can be found by following these instructions: Site Visits, Stakeholder Meetings and Regional Forums>, 2019 Meetings >, May 2019 >, LOC Pilot Analyses.

The second component of this phase, the Nursing Facility (NF) Hospital (H) LOC and Reliability Pilot (NF/H-LOC & Reliability Pilot), is ongoing. This pilot will collect data necessary for the Department to fulfill the following functions:

• Replicate the current Nursing Facility-LOC thresholds for adults using the new assessment items
• Establish a more objective Nursing Facility-LOC criteria for children
• Establish objective and prospective Hospital-LOC for Colorado's relevant HCBS Waivers
• Test reliability, including the inter-rater reliability, of selected items in the new assessment potentially to be used for NF-LOC, H-LOC and individualized budgets.

Pilot Phase 2

The second phase will assess the workflow of the assessment process using the automation that is intended to be used in the field. During this pilot, a smaller group of case managers will conduct the comprehensive assessment and Support Plan. The data from this phase will be analyzed and feedback sessions will be conducted with case managers and participants. The assessment and support plan will be updated based on these results and the changes will be incorporated in the automation. Case managers will then be trained on the updates and will begin assessing participants as part of the Time Survey pilot. This pilot will collect data to understand how long the new process takes. Additional feedback sessions with participants and case managers will be conducted during this phase.

The pilot is scheduled to last through April 2020.

Level of Care Pilot Comparative Analysis Report

The Department contracted with HCBS Strategies to pilot its new assessment and support planning process for Medicaid-funded long-term services and supports (LTSS). The Department undertook this effort because of concerns about the reliability and validity of the items in the current tool used for eligibility determinations, the Uniform Long-Term Care (ULTC) 100.2, the lack of consistent collection of all necessary data, and the ability of the current tool to support a person-centered process, including the development of a person-centered Support Plan. This report compares individual ULTC 100.2 items and matching items in the new process. The findings highlight the fundamental flaws of the ULTC 100.2 and reinforce the need to change this tool.

Final Draft Colorado Level of Care Pilot Comparative Analysis Report - June 2019