Your action is needed: Critical Friday Medical Services Board meeting Feb 13

A quick "fill in the blank" mad-lib form is at the bottom of this email, so that you can whip out an email or 2 minute testimony in a FLASH!

Quick lesson on the process of getting a mandate from the Legislature (called Legislative Intent which is in state law called Statute). The directive shall come from the legislature which then is sent to the medicaid department (HCPF) whose staff creates proposed rules which are the "how to logistics" on implementing the statute.

See this graphic below which is on the MSB website HERE which has a ton of info about the volunteer board, governor appointed members. The Governor's emergency rule skips all those steps in the engagement process which is highly problematic and even more so when the request is not truly an emergency.

I always say, the devil is in the rule making. It can be good or not good, and they need your input.

The MSB members were amazing last month, they asked hard questions and refused to accept HCPF staff member arguments when testimony and community experience were at odds. I have been following MSB for over ten years now and this shift is significant. They are listening and using their expertise to really protect our medicaid members. They are volunteers and last month were there over six long hours. Try not to repeat what was said and be appreciative.

It reminds me of 1977 Star Wars movie Princess Leia: Help me, Obi-Wan Kenobi. You're my only hope.

The Medical Service Board is the check and balance body on the department and even though the Governor appointed them, they are truly our best hope to stop the steam roller actions of HCPF at rule making.

We appreciate their volunteer service and very long days, so show some love! The are our best chance to stop the steamrolling of process at HCPF and the governor's executive orders.

You can take action with your story by emailing or testifying on Friday.

The MSB meeting starts at 9a Friday 13th. Last month's went on for over 6 hours and that emergency rule was not approved (wasn't event motioned for a vote!!).

Details are below for the rules AND at the end they have OPEN FORUM for any HCPF comments.

Please email in your comment TODAY before 5pm so it gets to the voting Medical Services Board members. See the fill in the blank form at end of this email to make it easy.

Testimony can be emailed to chris.sykes@state.co.us in advance of the meeting and will be distributed to the Medical Services Board members.

You can also sign up to speak for two minutes per item, either in person or remotely. Register online to speak on more than one rule packet AND you can sign up to speak at the end:

Open Forum for Public Comments for anything related to HCPF.

Sign up ​HERE

Make sure you compare the check the packet number and sign up for the correct agenda items.

REMOVED from MSB Agenda: 56 Hour per caregiver limit! A win!

The department removed the rule about 56 hour care giver limit from the agenda. Which is good news. This topic was commented on a lot at the Feb 2nd Joint Budget Committee open public comment hearing. The temperature is rising!! Keep up the heat folks!!

Emergency Rule packet A-MSB 25-11-06-B This is about soft caps (Community First Choice) and community connector age appropriate, types of tasks and more (CES & CHRP waivers)

They updated this packet on Feb 10. This is the last rule packet on the agenda so should be later in meeting. It is critical you click the button below this section and READ THE LANGUAGE so you can see the actual rule change proposed and speak knowledgeably. If you can call out specific proposed language that is problematic, that is very helpful for the board.

There are several components in one rule packet which in itself is concerning especially for an "emergency" rule.

1. Soft Cap on CFC: One of the major changes in this rule implements a soft cap on annual utilization for Personal Care, Homemaker, and Health Maintenance Activities (HMA) which are Community First Choice services. Included with this change is language for an exception process for individuals who demonstrate a need for service authorization above the cap.

Badass take: There is a problem with the assumption that an executive order has JBC approval. The executive order bypasses the legislative process which now is an issue at the MSB review. The proposed exceptions process is controlled by HCPF and has no appeals like other denials or reductions in services. It will continue to put administrative burden on case management agencies who already struggle with maintaining case managers. The exceptions process is not in the spirit of appeal rights. All the power is in the department with zero legal oversight or ability to escalate. This is not how medicaid member rights are preserved with due process.

2. Community Connector service: this rule includes language to implement a reduction to the annual cap on the number of units covered for Community Connector services (CES & CHRP waivers) and bolstering language to ensure units are age appropriate and do not supersede typical parent or legal guardian responsibility. Language in rule packet defines Age Appropriate Task standards and Legally Responsible Person. It mentions fall within typical Parental or Legal Guardian Responsibility are not covered. Read the rule packet to see all they are doing to LIMIT use and access here. . If you can call out specific proposed language that is problematic, that is very helpful for the board.

Badass take:

Before COVID parents could not be paid for ANY waiver services for members under 18.

During COVID they made a change due to emergency and having others come provide care was not feasible. So this again comes down to workforce issues.

Families again are seen as greedy for wanting to focus and build on skills in the community which is the entire point of a home and community based waiver (HCBS).

The combo of the 15% rate cut which takes it to respite level of low pay and now such minimally allowable hours means it won't be a usable service with non family members. So truly the aim is limiting service and community access to achieve cost savings.

The Governor also slashed the Community connector rate down to the respite rate low level, meaning no highly skilled non parent will want to do this job. Thanks Guv. Read that memo HERE. So now this higher paid access to community won't attract non-parents and now parents are reduced down to 5 hours a week.

3. Removal of the Nurse Assessor language from Health Maintenance Activities (HMA), a program which ended for skilled benefits including HMA. Including these minor changes in this rule set ensures Case Managers and provider agencies have clear regulatory authority to operationalize the sustainability changes.

Badass take: The debacle of the failed nurse assessor program and the millions wasted is now putting a medical assessment onto the plates of case managers to administer. And then caps on top of the questionable process to determine ours. Perfect storm for rationing of care and harm to our most medically vulnerable. Our community told HCPF to hit the pause button millions of dollars ago. If you can call out specific proposed language that is problematic, that is very helpful for the board.

When will someone put some responsibility of the failed leadership at HCPF on this? Instead they blame the disabled members. Unbelievable.

Rule packet 9 MSB 25-07-02-B Determination of Developmental Delay & Intellectual and Developmental Disability

This rule packet has its initial read today, it would need to be heard a second time before they can vote on it.

HCPF SAYS This change is necessary to improve accessibility, ensure consistency across HCBS case management rules, eliminate outdated language, and provide clear guidance to members, case management agencies, and Department staff. Consolidating the rules in a single location streamlines compliance, reduces confusion, and supports effective oversight of HCBS services.

It is critical you click the button below this section and READ THE LANGUAGE so you can see the actual rule change proposed and speak knowledgeably. If you can call out specific proposed language that is problematic, that is very helpful for the board.

Badass take

I smell something. Why consolidate now during our most tumultuous times? The entire focus at HCPF is cost savings and rationing of care. If they can make getting ID/DD determination more difficult, seems that would reduce people from getting benefits that they in fact deserve to access.

I will be diving deep into this rule packet Thursday to prepare for Friday. But I am very curious why make this change now, when we have so many storms happening... my spider sense is heightened.

Let me know what you think! . If you can call out specific proposed language that is problematic, that is very helpful for the board.

Open Forum for Public Comments, anything HCPF !

This is the last item on agenda, after they close the voting part of the meeting.

It is still two minutes.

Remember these members are our hope to stop the steamrolling of process at HCPF and the governor's executive orders.

Badass Take:

Use this time to speak your mind (in 2 minutes) things not related to rule packets

When will someone put some responsibility of the failed leadership at HCPF on this? Instead they blame the disabled members. Unbelievable.

FILL IN THE BLANK "Build a testimony form" As easy as it gets! Downloadable form.

This works for both written and spoken.

Prepare one for each rule packet and one for Open Forum.

Two minutes goes really really fast. Download pdf from Google Drive in button below!