Colorado Joint Health Commission hears SMART briefings from state agencies to inform 2023 budget requests – State of the Fix

The Colorado Joint Health Committee (JHC) held its meeting State measure of accountability, responsiveness and transparency (SMART) Government Act Briefing on Wednesdays and Thursdays and hear presentations from various government and health agencies, including the Departments of Public Health and Environment (CDPHE) and Healthcare Policy and Finance (HCPF), to gather information for the Legislature’s performance-based budget system.

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On the committee’s first day, OSA Director of Strategic Operations and Audit Director Jenny Page introduced to lawmakers Office reportwhich found that 93% of audit recommendations from July 2016 to June 2021 had been implemented as of July 2022.

“Today, I am pleased to note that most departments that you oversee do not have high-priority recommendations that need to be implemented,” Page said. This will include the Department of Human Services, CDPHE, and Connect for Health.

However, the HCPF has five high-priority recommendations that still need to be implemented.”

There are 10 audit recommendations all about implementing program administration and controls around Medicaid and CHIP payments and eligibility. The HCPF has notified the OSA office that the priority recommendations will be implemented in 2023.

CDPHE filed a file SMART Act reportwhere the department’s chief medical officer, Dr. Eric France, provided an update on suicides in the state.

“You are probably aware that we are in the top 10 across the country in terms of suicide rates in Colorado,” France said. “It’s true with the entire Intermountain West. It’s been like this for decades. And you might hear on the street that our suicide rates in Colorado are going up, particularly our rates among young adults, and I’d like to dispel that myth. Our rates haven’t gone up. As a matter of fact, they have been.” Adult suicide rates have been relatively stable since 2016.

In fact, among our 10- to 18-year-olds, we’ve seen a decrease in the past year. It’s not statistically significant, but hopefully it may indicate something of an upcoming trend.”

France said the Office for Suicide Prevention is using a public health framework to “attack a very complex issue,” citing housing, economics and mental health as causes of suicide and stressing that all departments in the state have a role to play in prevention. The office worked with 12 different departments last year in various ways to improve efforts to reduce suicides, including prevention programs in schools that use student leaders and help adults with stress management and interventions.

“We have gone from maybe six to 12 schools participating in 2018 to as many as 140 now,” said France. “We’re even looking at how to do that [this model can] To elementary school too.”

CDPHE has requested $880.3 million in total funds for its 2023-2024 fiscal year budget, of which $142.3 million will come from the General Fund. It proposes allocating 30% of that budget to the Department of Prevention Services and 5% to health facilities and emergency medical services.

HCPF members, led by Executive Director Kim Bimestefer, put on a presentation Section report On the second day of the session. The HCPF is requesting $14.9 billion in the next fiscal year, $4.43 billion coming from the General Fund. 2023 demand is more than 700 million dollars higher than personalization Received in fiscal year 2022-23.

“HCPF provides health insurance coverage and services to 1.74 million people or one in four Coloradins,” said Pemstefer. “The number of members has increased by 39% or 490,000 since the public health emergency began in March 2020. We cover about 43% of births in the state and about 43% of children in the state.

We offer these coverages and supports through Health First Colorado or Colorado Medicaid and CHIP… We pay about 30 million claims annually [to] More than 100,000 service providers are registered and we represent about 30% of the state budget.”

The department proposes allocating 75% of its budget to premiums for medical services, 7% to the Office of Community Life, and 8% to behavioral health community programs.

HCPF plans to use $262 million to increase provider rates, which includes a 0.5% increase in the overall provider rate. Colorado Medicaid will also eliminate subscriptions for its members in 2023. The funding will also rebalance provider rates based on the annual rate review cycle, critical needs for nursing home and home and community providers, targeted incentive payments to rural hospitals, and childbirth equity advances.

An additional $8.67 million will be allocated to support primary care providers’ transition to value-based payments with prepayment for care expenses. Under the department’s value-based payment methodology, providers will have the option to receive at least 25% of their proceeds upfront to allow for increased investment in improving care.

The department outlined how it plans to meet the governor’s goal of reaching the 250,000 Colorado residents served by primary care providers using alternative payment models (APMs). Actions include amending contracts with Regional Accountability Entities (RAEs) to enhance provider engagement in APM by mid-year and ongoing communication and engagement with stakeholders.

HCPF will also complete Colorado Hospitals Compliance Review Regarding price transparency and launching a government hospital price comparison tool by the middle of the year.

JHC members also heard from Department of Human Services (DHS) f Behavioral Health Administration (BHA) on Thursday. DHS is seeking $2.3 billion in total funding, of which $1.1 billion will come from the General Fund. DHS has proposed allocating 33% of its applications to the Office of Children, Youth, and Families, 11% to the Office of Adult, Aging, and Disability Services, and 12% to the BHA.

BHA Commissioner Dr. Morgan Medlock spoke about progress made last year towards building a “equitable behavioral health ecosystem”.

“First of all, we’re pleased to continue funding I Matter which is free therapy for every young person in our state, up to six sessions,” Medlock told panelists. “As I mentioned, we also issued $130 million about a month ago in grants and will award these opportunities on a rolling basis.

With that, we also released something called the Community Evaluation Toolkit, which supports local leaders in considering fairness considerations when they apply for these dollars. We will emphasize not only giving money to the person who writes the best grant, but thinking about projects that promote fairness and truth.”

Medlock said the BHA will release its strategic plan to provide a “continuity of whole person health” in Colorado on January 31st. BHA’s budget request for fiscal year 2023-24 proposed $25 million to address gaps in the behavioral health continuity of care in communities, as well as $34 million specifically for children, youth and families.

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