Department of Justice Findings Related to Community Living Options

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March 4, 2022

Yesterday, the Department learned that after a multi-year investigation, the Justice Department has concluded that Colorado is in violation of the Americans with Disabilities Act (ADA) and the Supreme Court’s decision in Olmstead v. L.C., for unnecessarily segregating people with physical disabilities in nursing facilities. A press release, which includes a link to their findings, may be found here:  Justice Department Finds that Colorado Violates the Americans with Disabilities Act | OPA | Department of Justice

The findings do not relate to individuals with intellectual or developmental disabilities or to children; the findings are specific to adults with physical disabilities. 

These findings do not detract from our shared, deep commitment to creating a system that ensures people with disabilities always have the option to receive their care in the community. Over the past decade, the Department, in collaboration with many of you, has made extraordinary progress in strengthening and enhancing the home and community based services that are available to people with disabilities. Thank you for your dedication to achieving this shared quest; already, more than 81%, or four out of every five individuals, receive Colorado Medicaid long term services and supports (LTSS) in the community. This is a number we have worked hard to achieve, increasing from 75.7% in just six short years. 

We have accomplished this through a number of initiatives. In fact, Colorado was the first state in the nation to implement a permanent Money Follows the Person program, which provides a suite of services aimed at supporting people with disabilities to transition from institutional settings back to the community. Since the implementation of this program in 2019, 687 people have successfully transitioned back to their homes. 

Going forward, we have enormous and promising initiatives and investments in process to advance Home and Community Based Services (HCBS) in this state, largely through the federal stimulus available as part of the American Rescue Plan Act (ARPA). ARPA offered states federal funding to strengthen community based services for people with disabilities. Our Department, in collaboration with our stakeholders, worked hard to leverage this opportunity and was the first state in the nation to receive full approval of our nearly $530 million spending plan to further improve our system. 

We are appreciative of the Centers for Medicare and Medicaid Services (CMS) and our state Joint Budget Committee (JBC) for their support in approving this bold plan, which includes 65 projects that are directly targeted at enhancing home and community based services to expand access, improve quality and streamline eligibility to ensure all individuals can receive care in their communities. 

As we just received the Department of Justice (DOJ) letter yesterday, we are working now to compare our HCBS initiatives in process to determine what other work we need to do to address the opportunities identified by the DOJ. Ultimately, we view the DOJ’s review and findings as an opportunity to help us better meet the needs of older adults with physical disabilities, and we are approaching these findings and our response in that way. 

After all, Colorado leads the nation in many aspects of LTSS services. As many of you know, in the national LTSS State Scorecard developed and released by AARP, Colorado has ranked in the top eight in the country for our LTSS system since the scorecard's inception in 2011. Notably, Colorado ranks in the top five for quality of life and quality of care, and 10th for our work to support transitions from institutions to the community. 

Still, there is more work to do. We are committed to working collaboratively and expeditiously with the Department of Justice to build upon our prior and planned work to address the opportunities identified and ensure members are connected to community support. In the spirit of transparency and to leverage our shared passion and expertise, we will work our comparative findings and engagement on addressing these opportunities into both standing and new stakeholder meetings conducted by our Office of Community Living. Please look for discussion invitations in the coming weeks. 

Thank you again for your partnership in achieving our shared goal of serving individuals with disabilities in the community. 

Sincerely, 

Kim Bimestefer, Executive Director, CO Dept of Health Care Policy & Financing

Bonnie Silva, Office Director, HCPF, Office of Community Living