Imagine! The Future

January 31, 2024

The following letter and information is being sent to indivdiuals receiving services from Imagine!'s Case Management department.

Dear Friend of Imagine!,

We are sending this letter to clarify the important upcoming changes that are happening with case management services and how specifically they will impact you.

As you know, starting July 1, 2024, the company called Imagine! will only provide direct services (residential, behavioral, day program, etc).   Then, Imagine! case management operations will join with Adult Care Management, Inc. (ACMI), an agency currently serving people on Medicaid waivers such as the Brain Injury (BI) waiver and the Elderly, Blind, and Disabled (EBD) waiver.  The two agencies will form the new case management agency (CMA) serving Boulder, Broomfield, and Gilpin counties.   The name of the new agency will be announced later this month.

How does this impact you?

If you live in Boulder, Broomfield or Gilpin county, starting on July 1, 2024, you will be served by this case management agency. Your Case Manager likely will not change.

If you live outside of Boulder, Broomfield, or Gilpin counties, you will need to send an e-mail to your Case Manager letting them know you would like to remain with your current Case Management Agency.

Please see notes below for more information about this process.

For more information on these changes, you can visit: https://hcpf.colorado.gov/my-hcbs-case-management

Sincerely,

Jenna Corder, Director of Client Relations

jcorder@imaginecolorado.org

 

Case Management Redesign Member Exceptions Policy & Process

January 22, 2024

 

Background
Since 2014, the Colorado Department of Health Care Policy and Financing (HCPF) has worked to come into compliance with the federal law that requires case management be provided by an agency that is separate from the agency that provides direct care. By eliminating conflicts of interest, case managers can make objective decisions. This approach fosters trust, promotes transparency, and safeguards against potential exploitation or biased decision-making, ultimately enhancing the quality of care provided.

To comply with this federal requirement, Colorado's case management system is changing. There will now be one case management agency (CMA) in each defined service area (DSA). Each case management agency will serve everyone within their DSA, regardless of age, disability type, or HCBS waiver. Additionally, CMA’s will not be required to serve any individual that is outside their DSA.  CMA’s will have the discretion to allow exceptions when they have the capacity to do so.

CMA’s have been selected through a State procurement process to perform case management duties in their DSAs. Adult Care Management, Inc. (ACMI), has served as the single-entry point (SEP) agency serving people with non-IDD disabilities for more than 30 years, and will create the new CMA with Imagine!’s case management branch, which has provided IDD case management services for 60 years.  These two agencies, which have a combined legacy of serving people with disabilities for close to a century, will form the new CMA serving Boulder, Broomfield, and Gilpin counties. Currently, the name Adult Care Management, Inc. (ACMI) is being used on all communication regarding this area due to the nature of the State procurement process. Ultimately, the CMA serving these areas will change from ACMI/Imagine! to a new name, which is currently being selected. The transition process for this change will take place over several months in this current fiscal year of 2024, and is scheduled to be completed by July 1, 2024.

 

ACMI/Imagine! Member Exceptions Policy

The dedicated and hard-working staff at Adult Care Management, Inc. (ACMI) and Imagine! will continue to provide exceptional case management services to all residents residing in DSA 8, serving Boulder, Broomfield, and Gilpin counties regardless of their age, disability, or waiver. ACMI’s case management service for Members in Clear Creek county will be transferred to Jefferson County DHS, which was awarded the CMA for the Jefferson / Clear Creek counties service area.  For Members who reside outside of Boulder, Broomfield, and Gilpin counties but wish to remain in our combined agency, after July 1, 2024, please see the exceptions process below:

• Members residing outside of this DSA may make a written request through their current ACMI/Imagine! case manager to remain in the new DSA. If the individual requesting the exception meets the following criteria, an exception will be granted automatically:
  1. Member lives in Berthoud, Mead, Firestone, Frederick, Dacono, Erie, Northglenn, Thornton, Westminster, or Longmont in Weld County.
  2. Member is in an active crisis and continuity of care is imperative to stabilize the individual’s circumstances. We will continue serving individuals in this category for a maximum of 60 days following implementation on 7/1/2024.
• If one of the above criteria is met, the ACMI/Imagine! case manager will submit the following information via the Member Exceptions Notification email template to ACMI/Imagine! leadership for a final decision:
  • Medicaid ID
  • First and Last Name
  • Date of Birth
  • Social Security Number
  • County in which Member resides
  • Designated Service Area
  • Exception criteria met (#1 Member lives in approved city, #2 Member is in crisis)
• ACMI/Imagine! leadership will provide written notification of approval to the Case Manager within 5 business days of receipt of the request.  Case Manager will pass decision along to the client and/or family within 5 business days.
• If the Member does not meet the above criteria then the ACMI/Imagine! case manager will submit the following via the Member Exceptions Notification email template information to ACMI/Imagine! leadership:
  • Medicaid ID
  • First and Last Name
  • Date of Birth
  • Social Security Number
  • County in which Member resides
  • Designated Service Area
  • Reason for request for Member to be served at ACMI/Imagine!
  • How Member plans to support ACMI/Imagine! with ensuring that Member needs are met and contractual requirements for in person monitoring and assessment will be completed as necessary. (e.g., Member is willing to engage in virtual case management, Member does not require mill levy emergency funding to remain stabilized)
• ACMI/Imagine! leadership will provide written notification of approval to the Case Manager within 5 business days of receipt of this request.  Case Manager will pass decision along to client and/or family within 5 business days.
• ACMI/Imagine! reserve the right to deny requests at the discretion of the CMA leadership. Denied requests will not be subject to an appeal process.
• ACMI/Imagine! will track all Members served outside of the DSA 8 by adding information to the HCPF CMA Exception tracking document on Sharepoint.
• ACMI/Imagine will update this information to Sharepoint by the last day of each month and no later than 5 business days after the last day of the month per OM23-056.

Transfers of Denied Requests of Individuals Currently Served by ACMI/Imagine!

• For individuals currently being served by ACMI/Imagine! whose request for an exception has been denied, the following steps will be taken:

1. ACMI/Imagine! staff will contact the Member’s designated CMA to initiate a transfer and identify a transfer date.
2. ACMI/Imagine! staff will provide a transfer packet to the Member’s designated CMA with pertinent records and forms.

Members with ACMI/Imagine! as the CMA in DSA 8 who request a transfer to another CMA: ACMI/Imagine! will support the choice of any individual who wishes to receive their case management services through an agency other than ACMI/Imagine!  It will be up to the other CMA on whether they choose to accept the individual.

This policy is subject to change upon review by ACMI/Imagine! leadership.

Effective Date: January 2, 2024

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January 16, 2024

Dear friend of Imagine! –

For the past six months, we have been sharing with our community information on how Imagine! will be undergoing some significant changes in the near future due to the State of Colorado’s implementation of Case Management Redesign (CMRD).

The changes brought on by CMRD will have ripple effects across the entirety of Imagine!. The organization that you currently know as Imagine! will be split into two separate organizations: a Program Approved Service Agency (PASA), which will retain the Imagine! name and provide direct services for people with intellectual and developmental disabilities (IDD), and a Case Management Agency (CMA), which will have a new name and will provide care coordination for people with IDD as well as other disabilities.

To help clarify the process, we have created a short video to explain what will be different after the split, and what will be the same:

 

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November 21, 2023

The following letter was sent to Imagine! clients and families from Jenna Corder, Imagine!’s Director of Client Relations.

Dear Friend of Imagine!,

Imagine! recognizes you have now received two letters regarding Case Management Redesign – one from the Colorado Department of Health Care Policy and Financing (HCPF), and one from Imagine!.

We are sending this letter to clarify the important upcoming changes that are happening with case management services. 

In 2017, a law was passed that said a person being served in a waiver cannot receive both direct services (for example, day program) and case management from the same company.  In order for Imagine! and all other case management agencies in Colorado to be compliant with this rule, some changes need to be made.  You may already know that Imagine! currently provides direct services and case management. You might even be receiving both of these from Imagine!.  Starting July 1, 2024, the company called Imagine! will no longer be able to provide both. This will require us to separate case management and direct services into two separate companies. One company will keep the Imagine! name and will continue providing direct services, and the other company will provide case management. 

Imagine! case management operations are joining with Adult Care Management, Inc. (ACMI), an agency currently serving people with non- Intellectual and Developmental Disabilities (IDD) disabilities.  The two agencies will form the new case management agency (CMA) serving Boulder, Broomfield, and Gilpin counties.   Due to this process, the case management agency serving these areas will change from Imagine! to a new name, which is currently being selected. The transition process to combine the two case management entities will take place over several months starting in Spring of 2024.

How does this impact you?
Starting on July 1, 2024, you will have a new case management agency. While this new case management agency does not have an official name yet, we will let you know as soon as that is decided. In the meantime, if you have questions about your assigned case management agency, please reach out to Imagine! or your Imagine! case manager.
 
We expect no interruptions in your Case Management services as a result of these changes.  We are working closely with HCPF and our partners at ACMI so that this transition is seamless for clients and providers.  For more information on these changes, you can visit: https://hcpf.colorado.gov/my-hcbs-case-management. 
 
Sincerely,

Jenna Corder, Director of Client Relations
jcorder@imaginecolorado.org

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November 17, 2023

The following email was sent to all Imagine! staff members by Stephen Shaughnessy, Imagine!’s Chief Services Officer. While not specific to CMRD, it offers a good glimpse into one of Imagine!’s primary focuses currently, as well as post-CMRD.

Housing is a topic that seems to be on everyone’s minds as of late.  We see headlines about the availability and affordability of housing across our state and we see stories on the news about the issues facing our local municipalities as it relates to our unhoused neighbors and Coloradans.  It’s no surprise that Governor Polis made housing one of his top priorities when he released his annual budget request on November 1^st. 

At Imagine!, we know a thing or two about residential supports and services for individuals with I/DD, however, we also know that disability services and housing options do not always line up because of constraints on both sides. Medicaid waiver rules and regulations don’t always lend themselves to the types of housing options that individuals and families seek for their loved ones.  Housing subsidies, that make housing more affordable, are scarce and often hard to access for individuals with physical and intellectual disabilities.  Despite these challenges, I am encouraged by the work that is currently happening in and around the IDD service delivery and support system to acknowledge these barriers and work collaboratively to seek solutions that create more opportunity and options for affordable, accessible and neuro-inclusive housing options for adults living with I/DD in Colorado.

I recently had the privilege of attending a conference, hosted by Trailhead Developers, a Colorado based organization that helps to encourage, mentor and develop neuro-diverse housing communities.  The conference brought together expertise from the housing development and building space, I/DD service providers, families, and self- advocates to provide resources and networking opportunities with the goal of providing the nuts and bolts necessary to help move the housing development work forward in an effort to support more neuro-diverse housing projects. One of the conference sessions I attended that was particularly impactful was titled More Than Homes, Building Inclusive Communities. The session featured three projects in different states that have had great success in aligning housing, long-term support services and supportive amenities that resulted in neuro-inclusive housing communities.  Not only was this a great opportunity for Imagine! but I was so pleased to see participation at the conference from our partners at Boulder County and Boulder and Broomfield’s housing authorities as well as ACL and their housing committee members.  It felt great to share that space with so many passionate and dedicated members from our community who share our enthusiasm for advancing housing options for adults living with I/DD.

In addition to the conference experience, I was recently invited to join the Inclusive Housing Coalition steering committee, and Robin Grey COO/CFO and I were invited to join a cohort that is helping to support the development of a new housing project led by Broomfield Housing Alliance. These are exciting times and while change can take time we are committed to being at the table to lend our expertise to help move this work forward and connect disability services to housing options that are affordable, inclusive and integrated.  Stay tuned for future updates on this subject and as always, thank you for your commitment to creating a world of opportunities for all abilities.

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September 13, 2023

The following email was sent to all Imagine! staff members from Fred Hobbs, Imagine!’s Director of Public Relations.

Over the past few months, you have been receiving updates from various members of the executive team to keep you posted on what’s happening as Imagine! moves ever closer to a state-mandated split between the care coordination and direct service delivery sides of Imagine!, better known as Case Management Redesign (CMRD). With the July 1, 2024 deadline looming, the Imagine! PR team has been preparing to do all we can to ensure the split brings as little disruption as possible, especially to our clients and employees, including:

Communication

Hopefully by now you are aware of the Imagine! The Future webpage on the www.imaginecolorado.org  website. Up to now, this has been our primary communication tool for all things CMRD related. However, now that we have been given the official date for the split, July 1, 2024, we are preparing to engage in a much more determined communication effort, starting with communication to all impacted clients currently receiving case management services from Imagine!. This effort will include multiple email, traditional mail, and social media communications. The first communications are set to go out as early as this week. After the first round of communications, we will also follow a similar pattern for communicating with clients currently receiving direct services from Imagine!.

A very important note on communication with clients: the Colorado Department of Healthcare Policy and Financing (HCPF) is requiring that all communication from Imagine! and ACMI with clients regarding CMRD be approved by them. I ask patience and understanding as we navigate this added challenge in our efforts to be open, clear, and concise with all of our stakeholders regarding this huge shift in how services for people with disabilities are funded and delivered in our state.

Branding/Marketing

As one organization becomes two, it will be vitally important that both organizations are set up for long term success. For my position, that means establishing a strong brand for the new Case Management Agency (CMA) and to build upon the Imagine! brand for Imagine! services.

Why is this important? As competition creates infinite choices, organizations look for ways to connect emotionally with clients, become irreplaceable, and create lifelong relationships. A strong brand stands out in a densely crowded marketplace. People fall in love with brands, trust them, and believe in their expertise. How a brand is perceived affects its success, regardless of whether it’s a start-up, a nonprofit, or a product.

On the CMA side, this branding starts with selecting a name. Up to now, we have been using “A & I CMA” as a placeholder for the name of the organization. We have developed a plan to select an official name. The plan does include opportunities for staff members from Imagine! and from ACMI to weigh in on options. The hope is to have a name officially selected by November. Look for more information on that process soon.

On the services side, the branding process has already begun. In fact, it began 60 years ago. If you are not yet aware, the Program Approved Service Agency (PASA), or services, side will retain the Imagine! name. This should provide a tremendous advantage to the PASA moving forward, as the Imagine! name is well known and well respected in our community. But a community’s perception of a brand can’t survive without constant nurturing, which is why Stephen Shaughnessy and I have formed an Imagine! PASA marketing subcommittee to help set up the next generation of Imagine! leaders for success in building and maintaining the Imagine! brand.

Websites

One of the fundamental elements of branding in the 21^st Century is a website. Websites are an extension of an organization’s identity and serve as a hub for information, as well as receives visitors and expands upon an organization’s identity. Therefore, one of my main efforts in the coming months will be to build out websites for both the CMA and PASA.

Fortunately, we have a head start on this effort. Several years back, when it appeared the CMRD split was imminent, the Imagine! PR team created two separate websites – www.imaginecolorado.org, primarily including information for the Care Coordination side of Imagine!’s work, and www.imaginedirectservices.org, primarily including information about Imagine!’s direct services. Although the state’s delay in the implementation of CMRD made the two websites exist longer than we had planned, and occasionally led to confusion, the foresight is now paying off. It will be much easier to use existing content on both current sites for the new sites to come. Because the PASA will retain the Imagine! name, the plan is to use the imaginecolorado.org URL for that site, the URL for the CMA is TBD, dependent upon the new name of the organization.

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September 7, 2023

The following letter is being sent to all Imagine! clients on Home and Community-Based Services (HCBS) waivers and the Family Support Services Program.

Dear Friend of Imagine!,

We are writing to inform you about an important change that is happening with case management for Home and Community-Based Services (HCBS) waivers and Family Support Services programming in your area.

Since 2014, the Colorado Department of Health Care Policy and Financing (HCPF) has worked to come into compliance with the federal law that requires case management be provided by an agency that is separate from the agency that provides direct care. By eliminating conflicts of interest, case managers can make objective decisions. This approach fosters trust, promotes transparency, and safeguards against potential exploitation or biased decision-making, ultimately enhancing the quality of care provided.

To comply with this federal requirement, Colorado's case management system is changing. There will now be one case management agency in each defined service area. Each case management agency will serve everyone within their defined service area, regardless of age, disability type, or HCBS waiver. 

Case management agencies have been selected through a legal process to perform case management duties in their defined service areas. Imagine!’s case management operations are joining with the case management operations of  Adult Care Management, Inc. (ACMI), which has served as the single-entry point agency serving people with non-IDD disabilities for more than 30 years.  These two agencies, which have a combined legacy of serving people with disabilities for close to a century, will form the new case management agency (CMA) serving Boulder, Broomfield, and Gilpin counties.  

Due to this process, the case management agency serving these areas will change from Imagine! to a new name, which is currently being selected. The transition process for this change will take place over several months in fiscal year 2023-2024, and is scheduled to be completed by July 1, 2024. Please feel free to direct any questions you may have to your current case manager at Imagine! throughout this process.  We expect no interruptions in waiver services or in Family Support Services as a result of these changes.

You will be receiving an official communication from HCPF over the coming weeks with this same information.  They are currently using the name ACMI to designate the new agency until a new name is selected.   Therefore, you will see the name of the new agency listed as ACMI, but please know, Imagine! is here to continue to serve you without interruption through the year and into the future.  We will continue to communicate regularly throughout this process. You can also find updates about the process on Imagine!’s website at https://imaginecolorado.org/imagine-the-future.

We are working closely with HCPF and our partners at ACMI so that this transition is seamless for members and providers, but please reach out to us in the meantime with any questions. For more information from HCPF on these changes, you can visit: https://hcpf.colorado.gov/my-hcbs-case-management.  

Sincerely,

 

Kathryn M. Arbour, Ph. D.

CEO

 

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August 28, 2023

Imagine! CEO Kathryn Arbour shared the following information in an email to all Imagine! employees:

We met two big milestones last week in our work towards achieving the major outcome of the conflict-free case management redesign (CMRD) mandate – the separation of our case management operations (CMA) and direct services (PASA).  

On Wednesday, case management staff from ACMI and Imagine!, partners in establishing the new CMA, met at Nissi’s in Lafayette for a teambuilding day designed to help staff get to know who their new teammates will be when the new CMA officially launches on July 1, 2024.  Jenna Corder, Imagine!’s Director of Client Relations, Jennie Giurgila, ACMI’s Assistant Director of Case Management , and Kristen Lundy, Imagine!’s Assistant Director of Intake and Case Management, collaborated  with me and Barb Wilkins-Crowder, Executive Director of ACMI,  to create an interactive and dynamic agenda, including the masterful facilitation of teambuilding exercises provided by former Imagine! employee and current chief strategist and facilitator/trainer at the ACL Boulder, Caitlin Looney.  Be sure to check out the photos attached to last Friday’s Digest to see the group in action.   We extend deep thanks to all participants, to those who planned the day to make it a great success and to Caitlin for bringing her talents and energy!

We will be posting some of the questions and answers that we discussed at the event on our Imagine! the Future web page later this week.  Be sure to check that page often as we continue to make progress towards our many milestones ahead.  

On Friday, the PASA Future Subcommittee comprised of four of Imagine!’s Board Directors and two of Imagine! Foundations Board Directors met for the last time on its purpose to review and recommend the array of services for the PASA as we continue to prepare for the separation of the direct services and case management operations, to be made official on July 1, 2024.   The group worked on their recommendation and will prepare a presentation to make to the Imagine! Board of Directors on September 19 at the Board of Directors meeting.  As you know, we have shared widely over these weeks and months that the committee has spent many hours understanding Imagine!’s services and how they operate as well as investing heavily in understanding the PASA landscape here in Colorado and especially in the counties surrounding Imagine!.   There is great respect and passion for those we serve and it is likely the PASA will emerge with a service line up that looks very similar.  We will share with you the extent of the recommendation after the Board meeting in September, of course, in my weekly communications and with postings on our Imagine! the Future web page.

The Executive Team and I will continue to work on the details of the separation of these two major parts of Imagine! in close collaboration with the Executive Committee of the Board of Directors comprised of Don Brown, President; Jodie Gilbert, Vice President; Brenda Kaser-Burger, Chair of the Finance Committee; Rebecca Rose, Chair of the Nominating Committee; Sara Boylan, liaison to Boulder County mill levy funding; JoAnn Ross, representative of the Services Committee.  Heidi Storz, who recently returned as a member of the Board after her one year hiatus after she reached term limits in 2022, will also be seated as a member of the Executive Committee in September given her extensive history with Imagine! as an employee, a generous donor and as a Board leader.   

The Joint CMA Board Subcommittee will continue to serve in its advisory capacity throughout the remaining months of transition as well.  You may recall that this committee was formed by appointment of 4 members of our Imagine! Board of Directors (Don, Jodie, Brenda, and Brian Rome) and two members from the ACMI Board of Directors (Patrick Mayne and Dottie Longobardi) last November once ACMI and Imagine! signed the legal letter of intent to join case management operations to form the CMA that would serve Boulder, Broomfield and Gilpin counties as part of the implementation of case management redesign (CMRD). 

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July 20, 2023

Imagine! Director of Client Relations Jenna Corder sent the following CMRD information to all Imagine! staff:

 

As you know, we received an intent to award letter from Health Care Policy and Financing (HCPF) on June 12.  We still have not received official communication of our award declaring we will be the Case Management Agency (CMA) for Boulder, Broomfield and Gilpin counties.  We are also anxiously awaiting our transition date – this is the day we will officially become the CMA for this newly defined catchment area and provide case management for all ten Home and Community Based Services (HCBS) waivers in Colorado.  We hope to hear this month!

 

We submitted our Transition Plan on July 15, which outlines how we will continue providing case management services to the 1,400 people we currently serve, through the transition of adding the non-IDD waivers (in other words joining forces with Adult Care Management, Inc - ACMI). 

 

Soon, Imagine! and ACMI will have the opportunity to apply for ARPA grant funding to support the transition to our newly created Case Management Agency.  These funds will be available for providing support to CMAs to implement CMRD, transition, change management, strategic and organizational planning, capacity, and ensuring member access to a CMA, including developing an infrastructure for a learning collaborative so that CMAs have access to individual resources relevant to their change management needs. The three areas that these funds can be directed towards are:

• Case Management Agencies can use the funding to support the transition and minimize disruption to services. 
• Case Management Agencies can purchase new, mobile touchscreen computing devices. These touchscreen computer devices will be used to support the new Care and Case Management (CCM) system, which will use electronic signatures in the completion of the Colorado Single Assessment and the Person-Centered Support Plan, with members.
• Case Management Agencies can purchase or update an Electronic Health Record (EHR) system. 

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July 10, 2023

In the video below, Imagine! CEO Kathryn Arbour sits down with ACMI Executive Director Barb Wilkins-Crowder to discuss a newly formed Case Management Agency that will combine the talents of their two organizations.

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July 5, 2023

The following information was shared by Imagine! CEO Kathryn Arbour with Imagine! staff in a company-wide email.

I attended a stakeholder session on June 27 hosted by HCPF specifically regarding the rules revisions change work triggered by case management redesign (CMRD). This work has been underway for several months with regular meetings and feedback sessions regarding opportunities for stakeholders to propose changing some of the rules to streamline service access and bring the rules into compliance with the changes foreseen by the creation of the single case management agency (CMA). As of that meeting, which was the last public meeting to accept new changes, over 500 lines of Colorado rules and regulations were redlined through this effort. In listening sessions throughout the past 8 or 9 months, HCPF has accepted over 75% of the recommended changes from stakeholders. Among the details discussed at last week’s meeting were details regarding processes to be followed when a client would like to change the CMA to which they will be assigned because of where they live. For examples, clients living in Boulder, Broomfield or Gilpin counties will come through the new CMA of which our case management operations will be a part. If a client assigned to this region has a reason to change CMA either because they are moving physically or have some other concern, there is a defined process to use to request the change from HCPF. Some of the stakeholders on the Zoom meeting still wanted HCPF to loosen some of the process steps to be followed to request such a change. Ultimately, in matters like this, HCPF will make the final ruling. The timeline calls for final adoption of new rules in January 2024. There will be several other key steps including the requirement for HCPF to apply to the Medical Board for their approval in September. HCPF has recorded all the stakeholder meetings and they are available along with other meetings on HCPF’s You Tube Channel.

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June 20, 2023

Imagine! CEO Kathryn Arbour hosted a “Town Hall Meeting” for all Imagine! employees today, and shared the following slides with CMRD information.

 

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June 14, 2023

The following email was sent jointly from Imagine! CEO Kathryn Arbour and ACMI Executive Director Barb Wilkins-Crowder to staff members at both organizations.

Hello to you, all joint ACMI and Imagine! Case Management Staff.

We are thrilled to announce together to you, all the case managers and related case management staff at both our agencies, that our proposal to be the sole CMA for all waivers, all ages and all disabilities in Boulder, Broomfield and Gilpin counties, was accepted by Health Care Policy & Financing (HCPF). 

As of late Monday, June 12, we have received our “intent to award” notice.  We now await more information (from HCPF) about the target date for our full transition into a combined CMA. We will send out more details as we have them.  There are lots of layers to move through but we commit to keeping you informed in a timely fashion.

As we start this journey together, we want to put these thoughts and commitments at the front of our work:

• This is a joining of our case management operations.  It will be a full partnership in every way.  As we have said from the launch of this collaboration, one agency is not acquiring the other and neither has more authority or power than the other.
• Our mission will remain essentially the same: to provide high quality case management services to those who qualify for long-term support and services to assist them in their choice of community living setting. 
• The expertise among the support staff, case managers, supervisors, and management teams in each agency will be honored and will be needed to fulfill our mission.
• We will continue to manage this change in front of us as we have managed the strategic planning and competitive bid preparation – in collaborative conversations and decision-making processes.
• We will begin our journey together under the name “A & I CMA” and will look for the right moment to investigate and pursue a permanent new name, logo, and mission statement.

We will have more information soon on joint gatherings of our teams so that we can start getting to know each other as we build our sense of shared identity.  And we will soon host some opportunities for us to listen to your ideas about how we build a healthy, vital new CMA.

We have exciting times ahead! 

In partnership,

Kathryn & Barb

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June 12, 2023

The following email with fantastic news was sent by Imagine! CEO Kathryn Arbour to Imagine! staff members:

Hi, Everyone.

Late Monday we received word from the Department of Health Care Policy & Financing (HCPF) that they have accepted the proposal Imagine! and ACMI submitted to combine our case management operations and form a case management agency built on the history and strength of our two organizations.  As the awarded CMA of the new service area 8, the combined case management operations will provide Case Management, Intake, and Family Support expertise to Boulder, Broomfield and Gilpin counties.   We are thrilled and await more details specific to our transition timeline.  Many thanks to our internal team of experts – Robin Grey, our CFO, Jenna Corder, Director of Client Relations, and Kristen Lundy, Assistant Director of Client Relations/Case Management – and our ACMI partners, Barb Wilkins-Crowder, Executive Director, and Jennie Giurgila, Case Management Manager.  Together we produced such an excellent and winning proposal!

We expect to hear and share more details soon.

Thank you all again for your patience and support through the process so far and for the next phases of work that will follow.

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May 31, 2023

Imagine! CEO Kathryn Arbour recently sent an email to Imagine! employees updating them on many things happening in the organization. The information below is from that email, and relates to CMRD and Imagine!’s future.

The Program Approved Service Agency (PASA) Future subcommittee also held its regular meeting last week.  As I have recorded here, much of the work going on right now is establishing a baseline of information about how our services work and the general demand for our services.  As some of you know, clients and their families/guardians have a number of ways they learn about services.  They often work with their case managers to describe their interests and goals and case managers help prepare a request for proposal (RFPs) that is sent to a variety of PASAs that are listed as offering those services.  Some clients and their families want to stay within a particular location or have a PASA in mind and in those cases a family member might reach out personally to a PASA regarding availability in a particular program.  Our case managers send out hundreds of RFPs every year.  And our Imagine! PASA receives dozens of RFPs from Imagine! and other CCBs in Colorado nearly every day.   The State does not have a central methodology for tracking RFP requests, so getting a handle on true demand for services across the State and in our service area is a challenge.  Our case management team is working currently on some ways to refine internal tracking and general data management of the RFP process.  What we do know is that there is always demand for many types of services.  Not all PASAs offer the same array, so finding services to match needs can often be a significant challenge for clients. 

The State provides a PASA list in Excel format.  You can check it out here.  If you spend any time searching through it, though, you will find a number of issues, not the least of which is that the list won’t work with certain web browsers.  It is often outdated, as well. Mostly you will notice that there are hundreds of PASAs listed.  The State approves PASAs of all types – for-profits, nonprofits, big companies, small companies, and even individual PASAs that are set up by a family to provide care for their loved one only.  So, getting through the list in a meaningful way often takes some guidance from case managers or providers. 

Earlier this year Imagine! learned about an enterprising Colorado software developer, who previously worked as a Direct Service Professional (DSP) in several PASAs, including Easter Seals.  He has been tackling this list of Colorado PASAs for several years now, working on ways to make it more accessible and searchable.  His tool, Wayfinder, is still being refined, but is at an advanced enough stage to prove useful.  We have partnered with him and another CCB to test this tool.  Our case management team and some of their clients are using it currently.  Results are still in the early stages as we just started using it toward the end of March, but having taken some time myself to dig in a bit, I can say it seems infinitely easier to use than the spreadsheet.  Regardless of whether one is using the State provided list or Wayfinder, though, PASAs have the responsibility to keep the updated and relevant.  As those of you working in our direct services know, there is always new information about services, changing waiting list numbers, and shifting staffing needs.  No one has quite figured out yet an easy process for PASAs to keep their information consistently updated. 

So, as we on the Executive Team and the Board Members serving on the PASA Future subcommittee work through establishing a baseline so we can build the future of our Imagine! PASA on sturdy ground, we continue to examine these questions about the number of PASAs and distinct service offerings available to clearly understand the true demand for services and the opportunities to provide meaningful experiences to people with intellectual and developmental disabilities.   Imagine!’s senior strategic business analyst, Matt Barnert, has taken on some of the research behind this work.  Thank you, Matt.  Here are some of the numbers:

 

The business of PASAs burgeons, and yet we know that only a handful offer some services, in particular.  For example, we seem to be one of only one of four that provides any type of school age services programming, for example. We continue to research more fully.  Stay tuned.  We will share this work and more specifics as the PASA Future subcommittee continues its work through the summer months.

I also participated in a couple of work sessions last week to refine the Bylaws for what we expect will be the new Case Management Agency (CMA) of the future.  As you may recall, The Colorado Department of Healthcare Policy and Financing (HCPF) will announce the new Case Management Agencies (CMAs) in mid-June (according to their latest advisements).  We fully expect that the proposal submitted jointly between Imagine! and ACMI to combine Imagine!’s case management operations with those of ACMI’s to become the new CMA will be accepted to become the new CMA for Boulder, Broomfield and Gilpin counties.  The Board-comprised CMA subcommittee, which I have referenced previously in these emails, is tasked with helping guide progress towards creating what will become a new organization in the future.  Developing Articles of Incorporation and Bylaws that accurately reflect the future without losing the rich histories of either organization is critical work.  The Executive Director of ACMI, Barb Wilkins-Crowder, and I are playing lead roles in those efforts, including some detailed revision work before our attorney and the subcommittee put their finishing touches on these documents, which represent the backbone of an organization. 

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May 18, 2023

Imagine! CEO Kathryn Arbour recently presented to Imagine! supervisors and managers on what’s happening currently at our organization. Included in her PowerPoint were these two CMRD related slides.

 

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May 11, 2023

The following was sent in an email from Imagine! IT Director Kevin Harding to Imagine! staff members. It provides a good example of how we’re exploring options for administrative functions in light of CMRD.

 

For the last several months, the IT department at Developmental Disabilities Resource Center, the CCB in Jefferson County, has been short an IT Director.  DDRC was looking for an immediate solution and given the changes coming in our system, asked if I could step in as acting IT Director.  This seemed like the perfect opportunity to see if a business support unit from one CCB could combine with another to provide services to multiple organizations.  I’m happy to say that so far, the experiment seems to be working.  While there hasn’t been a lot of cross team support, that’s about to change.  Imagine!’s Carla Rapp will be working with a member of DDRC’s IT team, Chris Dowd, to project manage an Electronic Visit Verification (EVV) implementation at DDRC.  In addition, members of DDRC’s team will be assisting Imagine!’s Micah Rountree as we roll out Microsoft upgrades.  I hope this cooperation can be a model for other support departments like the business office and human resources as we navigate the case management redesign waters.

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May 1, 2023

The following was sent in an email from Imagine! CEO Kathryn Arbour to Imagine! staff members and members of the Imagine! and Imagine! Foundation Boards of Directors.

As part of the CMRD conflict-free mandate, Imagine! has the mighty task of separating the two key parts of our business – the case management component and the direct services delivery component. 

As you know, Imagine! had some strict deadlines from HCPF to participate in the first part of the work surrounding case management.  The Department sent out an RFP late December for applications to become the new Case Management Agency of the future.   A decision was made to combine Imagine!’s case management operations with those of ACMI, the Single Entry Point serving Boulder, Broomfield and Gilpin counties.  Imagine!s CEO and ACMI’s Executive Director submitted a proposal to HCPF at the end of February.  HCPF has said they will select the awardees and make announcements in June of 2023.  You can see a number of details related to this part of that important work in the links below.

There has been much work going on at Imagine! regarding our direct services that includes fortifying an organizational structure for the future with the creation of the Chief Services Officer position in the Fall of 2022 and the selection of its permanent leader in March of 2023.   We also created an additional leadership layer of Assistant Directors to ensure support for current day operations and to prepare for the future of change.  Our intent has been to stay focused on today to strengthen services in preparation for the separation that will occur prior to June 30, 2024. 

To get situated in the work going on now around direct services, we offer the following FAQs.  As we did previously, we will address every question submitted and post responses on a regular basis.  Town hall meetings and other forums will also occur throughout the coming months.   As always, everyone is invited to send a personal email to our CEO, Kathryn Arbour or to anyone on the Imagine! executive team.  There is also a form located on this page for you to send your question or comment anonymously.  Responses to those will be posted on this page.

Q:           What is a PASA and why are we referring to our direct services as such going forward?

A:           The Program Approved Service Agency (PASA) is the name HCPF assigns to services for people with IDD that go through an approval process with the State of CO.  There are hundreds of PASAs in CO and as Imagine! we have been authorized to offer services to those on waivers or to clients who pay directly for their services.  As the separation of case management operations and direct services takes place prior to June 30, 2024, our work is to “stand up” our direct services as a full PASA that will compete and complement IDD services delivery to clients across the state. 

Q:           Why haven’t we heard much about the work going on in direct services?

A:           We have been proceeding with “business as usual” on the direct services side of Imagine! while we made changes to the structure and to some programs to strengthen them for the future.  We also have had to address emergent situations, like the one that brought about a decision to close the group home residential services in the Charles Family SmartHome, throughout this past year.  Our intent has always been to stabilize as much as possible after the COVID years and the leadership changes that happened over the past three years.  Updates on these day-to-day service realities have been delivered through the usual mechanisms of emails, town hall meetings, the Digest, and ongoing meetings within work teams.  Our CEO has also spent a number of months learning in depth from other PASAs throughout the State, speaking with their leaders, understanding the array of services being offered statewide and especially in our Boulder and Broomfield counties and surroundings, including how other CCBs are separating the case management and service areas of their organizations, and visiting programs and services.

Q:           What is the specific work to separate and “stand up” the Imagine! PASA?

A:           The good news is that because the case management operations will be separating to join with ACMI’s case management operations to form a new entity, a lot of “work” – especially all the legal and official type things – for the PASA is already done.  For example, direct services as the PASA keep the very special name of Imagine!.   And the details about registering with the State of CO, tax exemption status, and the like?  Same as today.

Q:           What else has to be done?

A:           There is important work that has started with a subcommittee comprised of some Board members from Imagine!’s Board of Directors and some from Imagine!’s Foundation Board members to serve in an advisory capacity to help us look at each program’s strengths and opportunities for growth.  The PASA Future Subcommittee has met twice so far and will continue to meet regularly every other week through the summer.  They will help Imagine!’s leaders develop models to ensure the PASA can separate in a way that has financial viability, leadership strength and the ability to survive and thrive without being part of a much bigger organization, like today, where expenses and support functions can be shared more widely.  Of great importance to the subcommittee and to all of us is honoring our strong legacy of service, preserving much needed services and the high quality always associated with Imagine!, and ensuring as seamless transitions as possible for clients and staff into the newly defined world of the PASA as one of many in the State.  Well, as the best, we hope!

Q:           What about support functions like HR, IT, and financial/business office?

A:           These are such critical areas of our current day operations.  And we must ensure that both the CMA and the PASA have access to high quality services.  We do not currently have any details to share on this work, although the leaders of each area are looking at how they can optimize their service models and researching how some of the other CCBs are approaching these same questions.  We will provide future updates on this part of our ongoing work.

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March 13, 2023

On March 13, Imagine! CEO Kathryn Arbour hosted a meeting for Imagine! Supervisors, and shared the following CMRD related slides:

February 28, 2023

Exciting news!

Imagine! and ACMI  were able to complete and submit, at the end of day February 27, the RFP for the competitive bid released by the Colorado Department of Health Policy & Financing (HCPF) in order to serve as the Case Management Agency (CMA) for our catchment area, as we had originally planned.  We have confirmation of receipt in hand! We will share more information about next steps once we have them.

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January 17th, 2023

Imagine! CEO Kathryn Arbour sent an email to the Imagine! community about CMRD. You can see her message here.

January 12th, 2023

On Wednesday, January 11, Imagine! CEO Kathryn Arbour hosted an all staff Town Hall meeting at Imagine!. The slide below, with the latest information on CMRD, was shared during her presentation.

December 2nd, 2022

Imagine! CEO, Dr. Kathryn Arbour, hosted a Leadership Town Hall today for Imagine! supervisors. Below are some bullet points on what to expect around CMRD for the next 2-3 months at Imagine!:

 

For Case Management work:

• Focus on design and structure of the new Case Management Agency (CMA) (formed by joining case management operations, processes, histories, expertise of Adult Care Management, Inc. (ACMI) and Imagine!)
• Complete financial feasibility studies with information currently available; adjust as new information regarding rates is released
• Identify new name for CMA Prepare to respond to the CMA RFP by deadline (March 2023)

For Program Approved Service Agency (PASA) work:

• Continue to learn about direct services at other Community Centered Boards (CCBs) and how they are considering the future
• Continue to strengthen our current services offerings and mix

November 4th, 2022

On November 4, Imagine! CEO Dr. Kathryn Arbour sent the following email to Imagine! staff members.

Hello,

As we focus on providing as much support for Imagine!’s direct services staff and clients as possible, and with the prospect of significant changes ahead driven by the conflict-free case management redesign (CMRD) mandate, I am happy to share news with you today about some promotions and related organizational changes. Our goals with these changes are to provide support to staff and continuity to our much needed client services for today AND to tackle and address any changes that may lay ahead for us and other CCBs and PASAs over the next year or so. Keeping our clients at the heart of all our work now and in the future will continue to be our best compass for navigating change!

To that end, we have created a single role, Chief Services Officer, to provide leadership across all direct service areas. Laurel Rochester, currently Imagine!’s Director of Residential, Therapeutic and Nursing Services, will take on this critical role in an interim capacity for several months. I am so grateful to Laurel for her willingness to provide the stability and array of talents we need at this time. We will post and hire for this new position, launching our search for a long-term Chief Services Officer soon.

To support Imagine!’s direct services programs and the Chief Services Officer, we have restructured to have three Assistant Directors. Kristin Halvorson will now be an Assistant Director overseeing Therapeutic Services, Family Recruited Employment and our School Age Services program. Brodie Schulze will now be the Assistant Director of Community Services, Employment Services and the Social Enterprise program. Both have provided excellent oversight, stability and support to staff most impacted by many recent changes. I offer sincere appreciation to them both on behalf of our organization for having shown such commitment to staff and clients.

We will be posting for the role of Assistant Director of Residential and Nursing Services shortly. As always, we encourage qualified internal candidates to apply for this position.

As with all organizational changes, we will invest time and talent to make transitions as smooth as possible. We also invite conversation, questions, and ideas as the process of the transition unfolds over the next few months. 

Thank you as always for the passion and commitment you bring every day to your work!

Warmly,

Kathryn

October 26th, 2022

On October 26, Imagine! CEO Kathryn Arbour sent the email message below to Imagine! employees.

Hi, Everyone.

I am pleased to provide you with another important update regarding the statewide Case Management Redesign process (CMRD) currently underway. As we have explained previously, it has been the ongoing intent of Imagine! to apply for the competitive bid to be released by the Colorado Department of Health Policy & Financing (HCPF) in order to serve as the Case Management Agency (CMA) for our catchment area.

As we continue to explore the various approaches our organization can take as we consider the “conflict free case management” mandate, we have opened and pursued conversations with the case management organization currently servicing the five Medicaid waivers not served by Imagine! for Boulder and Broomfield counties. ACMI, located in Lafayette, has been the Single-Entry Point (SEP) awarded the contract for these Medicaid waivers in Colorado for over 30 years, and specifically in our catchment area for just over 25 years. Because ACMI and Imagine! currently are responsible for critical components of what will constitute the new case management agency (CMA) which will result from this process, it makes sense for our two organizations to come together to explore the ways we can join our expertise, experience and passion for ensuring clients have access to all the services they need to achieve their possibilities and potential. Our shared goal, as Imagine! and ACMI build this new agency, will always be to minimize disruptions to our clients, retain the expertise of our valued staff and stay true to our mission of creating a world of opportunities for all abilities.

A reminder that the current catchment area will expand to include Gilpin county in the future, which means the number of clients needing care coordination/case management and services will grow.

Our companies’ Boards of Directors have authorized me and the Executive Director of ACMI to sign initial agreements outlining our intentions to share information, including confidential and proprietary information, about each of our businesses, and to begin including key employees in assessing the feasibility of working together and establishing some initial designs about what joining forces might look like.

Imagine! will work closely with ACMI over these next two months to find a path for a joint submission to the RFP once it is released in January 2023.

We are excited and honored to be working alongside ACMI, an organization with a 30-year history of providing conflict-free case management to thousands of clients with disabilities throughout Colorado. As we clarify the opportunities for joining our organizations’ case management experience and expertise, we will update you and provide forums for more discussion.

For today, it is business as usual for everyone at Imagine!. We have critical work to do delivering case management expertise and an array of services to clients who rely on us to stay focused on them and their needs.

Thank you for your commitment to our important work and for all you do everyday.

Warmly,

Kathryn

October 17th, 2022

Recently, Imagine! CEO Kathryn Arbour sat down with members of our leadership team to discuss the future of Imagine! in light of CMRD. Below are some key takeaways from her presentation.

How does CMRD impact Imagine!?

Currently, Imagine! provides both service coordination (case management) and direct services. After July 2024, we will no longer be able to do this. There must be a complete separation.

Therefore, Imagine! has made the following decisions:

• Imagine!’s Direct Services, which includes Residential Services, Employment Services, School Age Services, Adult Community Services, Mental and Behavioral Health Services, Imagine!'s Social Enterprise, and Family Recruited Employee Services, will take the name Imagine! and serve as a Program Approved Service Agency (PASA).
• Imagine! will respond to the Request for Proposal (RFP) from Colorado to serve as the Case Management Agency (CMA) for our catchment area (catchment area is the geographical area of service).
• If Imagine! is awarded the contract to serve as the CMA for our catchment area, the CMA will take on a new name and provide case management services to individuals who have intellectual or developmental disabilities (IDD) on the following waivers: Developmental Disabilities waiver, Supported Living Services waiver, Children’s Extensive Support waiver, as well as for individuals on the following waivers: Brain Injury waiver, Community Mental Health Supports waiver, Elderly, Blind and Disabled waiver, Spinal Cord Injury waiver, Children’s Home and Community Services waiver, and Children with Life Limiting Illness waiver.

If Imagine! is awarded the contract to serve as the CMA for our catchment area, our organization is likely to resemble the visualization below post-CMRD:

What steps is Imagine! taking in preparation for responding to the RFP to serve as the CMA?

Imagine! is currently (as of Oct. 11, 2022) engaging in due diligence for how best to respond to the RFP, including:

• Exploring potential partnerships
• Vetting viability of options through legal, financial, cultural lenses
• Working with a transition coach and an attorney to explore viable organizational structures

Are there any details to share regarding where Imagine! Early Intervention (EI) services and coordination components will land with the future given the mandate to separate Case Management services from PASA services?

EI is under the direction of the Colorado Department of Early Childhood (CDEC -a newly created department in Colorado) and not Health Care Policy & Financing (HCPF) and Medicaid waivers, so how we plan for the future of EI is not dictated by the CMRD conflict-free mandate as defined in Colorado.

Additional resources:

The Colorado Department of Healthcare Policy and Financing has created a web page full of information and resources regarding CMRD. 

Check out this brief history of CMRD.

August 14, 2023

The Colorado Department of Healthcare Policy and Financing (HCPF) recently sent out the memo below, titled “Case Management Agency (CMA) Request for Proposal (RFP) Status Update”

Note: ACMI and Imagine! Case Management services team partnered together to win the RFP under ACMI’s name as discussed below and will be combining operations to provide case management to Boulder, Broomfield and Gilpin Counties effective July 1, 2024.

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June 30, 2023

The Department of Health Care Policy & Financing has clarified that it will notify those who are selected to serve as the Case Management Agency (CMA) for specified regions no later than July 21, 2023 regarding the transition timelines.  We are working currently with our case management partner, ACMI, to submit the required transition/change management plans due to the Department on July 15.  Watch this space for more information soon.

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June 23, 2023

The Notice of Intent to Award the CMA designation to A & I CMA was received from the Department of Health Care Policy & Financing (HCPF) on June 12.  Because HCPF must allow a period of time between announcing the “intent to award” and officially recognizing the awardees in case there are any challenges presented, our communications must be limited and clear.  This period ends on June 27^th.  HCPF has further explained that they will make all official communications regarding the CMA awards in July.  Until that time, we will continue to plan.  Imagine! will send our broader communications to clients and other stakeholders after HCPF releases its official communications next month. 

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May 8, 2023

HCPF has pushed out the date to the middle of June 2023 for the notification to those organizations that will become the newly defined Case Management Agencies (CMA). They have also pushed out to July 15 the due date for the Change Management Plan required by all CCBs, SEPs and counties that may be involved in a transition of some kind around CMRD.   

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May 16, 2023

The Colorado Department of Healthcare Policy and Financing (HCPF) recently shared the following information around CMRD:

Regarding transitions between agencies once CMA’s are announced (mid-June):

Regarding who will be communicating with members:

• HCPF will be communicating via letter and e-mail
• In a nutshell, if you are currently being served outside of your catchment area (i.e. Weld County person being served by Imagine!), you will be moved to the new Weld County CMA if you do not respond to the communication. 

Question to HCPF:

If the State keeps track of clients that we serve outside our catchment area is there a tipping point when they will say, “no you can’t serve any more outside of your catchment area. You are at the limit. “?

Answer: There will not be a limit. We are welcoming family choice.

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March 1, 2023

On December 15, 2022, The Colorado Department of Health Care Policy and Financing (HCPF) shared an informational memo announcing Case Manager Retention Payments in response to Case Management Redesign (CMRD).

One of HCPF’s goals during CMRD is to create stability for the case management system during this transition. To help meet that goal, HCPF allowed Case Management Agencies like Imagine! to apply for a Retention Payments Grant.  We were very excited about this opportunity, and applied for a grant on 1/30/2023.  On 2/10, we received notification of approval! 

HCPF requires that anyone receiving a retention payment must have been employed with Imagine! for six months or longer, must have completed training, and be in good standing with their employer.  However, Imagine! feels strongly that our employees are our number one asset, and we wanted to ensure we were able to pay retention bonuses to as many employees as possible.  To that end, we asked Boulder County to fund retention payments for individuals who have been employed here for six months or less, and that request was approved.

Consequently, all qualified Imagine! Case Managers will be receiving a retention payment of $500 at the end of the month. 

 

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February 7, 2023

As part of the ARPA 3.01 Equity Study, HCPF aims to identify and better understand disparities across HCBS. We are reaching out to members and their families, case managers, providers, connectors, and other advocates to ask for your expert input into understanding more about member and provider experiences pertaining to:

 

• Awareness/Outreach
• Enrollment
• Use of HCBS

The survey should take approximately 10 minutes to complete. Responses to this survey are anonymous and cannot be traced back to the respondent. Please complete this survey by Feb. 19, 2023. Access the survey here. Thank you in advance!

Have Questions? Click here to fill out the form and let us know!

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