Imagine! The Future

As many of our stakeholders already know, 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 entire Imagine! organization. Our goal throughout the process is to minimize disruptions in services and to ensure that we do all we can to continue our mission of creating a world of opportunity for all abilities.

To help us meet that goal, we pledge to share all the information we can about the process to help prepare all members of the Imagine! family – clients, families, employees, donors, and community members – for the new world of IDD services coming to our state.

To that end, this web page will serve as the central repository for information about the future of Imagine!. On this page, we will share success stories and victories and let you know what we’re excited about, while also acknowledging what we don’t know and what challenges we are facing. You are encouraged to bookmark the page and visit often.

You can also use this page to submit questions to Imagine!’s leadership about CMRD and other changes at Imagine! using the comment form at the bottom of this page. Comments and questions can be submitted anonymously if you prefer. Click here to jump to the form.

Change doesn’t need to be bad or scary. Together, we will come out on the other end of these changes stronger and more committed than ever to supporting the potential of all.

 

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. 

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.

 

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.

May 12, 2023

Below are some new FAQs based on new information and questions we've received through this page.

Q:          Who are the Board Members who are serving on the PASA Future subcommittee?

 

A:           From Imagine!’s Governing Board, Chris Dewhurst, Marie Gambon, Rebecca Rose, Walt Pounds, and from the Imagine! Foundation Board of Directors, Brad Bickham and Jessie Thompson.  Our Imagine! Governing Board of Directors President, Don Brown, and Vice President, Jodie Gilbert are also attending on a regular basis to support this ongoing work. 

 

Q:          What’s the purpose of the subcommittee?

 

A:           They are an advisory group to the executive team members whose job it is to think about the ways that Imagine! can separate case management and direct services that are least disruptive to clients and staff.  A smaller group of Board members like this can dive more deeply into some of the details about services that are relevant to the work underway because they are able to dedicate regular time to the work.   Over the summer the subcommittee will learn more about other PASAs, demands for direct services and where there are gaps still to be filled for clients on the part of PASAs.  The goal of the subcommittee is to be prepared to review, advise on and present to the rest of the Board of Directors the specific ways that Imagine! can stand strong and sustainably as a PASA on its own and without the larger structure of today that provides administrative structure and support. 

 

Q:          What is the timeline for the mandated separation of Imagine!’s case management operations and our direct services organization?

 

A:           The timeline is still to be determined and is largely connected to the transition date that HCPF will establish for the transition of the case management agency (CMA) once they announce who those CMAs will be. Announcements are due in June of 2023.  Change management plans for agencies who will be awarded the CMA for a particular service area are due to HCPF by July 15.  We expect to know what our transition date will be sometime in mid-summer.   

 

Q:          How is Imagine!'s IT department getting ready for the future changes especially since with the mandated separation of case management operations and direct services IT cannot look like it does today, one central IT department supporting both parts of the organization?

 

A:           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 Kevin Harding 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.  We’re 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.  We 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.

May 11, 2003

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.

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.   

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.

 

April 7, 2023

An Imagine! Board of Directors appointed Program Approved Service Agency (PASA) Future subcommittee held its first meeting on April 4, 2023. There are four Imagine! Board of Directors members assigned. Two members of the Imagine! Foundation Board of Directors have also agreed to serve on this advisory subcommittee. The PASA Future strategic work plan, presented to and approved by the Executive Committee of the Imagine! Board of Directors, is now in the hands of all Board and Foundation Board members and the Executive Team. We are in discussions about ensuring the process also gathers the voices of supervisors and managers across Imagine! as well as direct care staff. There will be more about this process as the subcommittee has time to meet and get grounded with information regarding our Imagine! PASA today and the landscape in which we operate in Colorado.

 

 

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.

 

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.

 

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. 

 

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!

January 25th, 2023

The Colorado Department of Healthcare Policy and Finance (HCPF) recently issued this Operational Memo - Case Management Redesign (CMRD): Conflict-Free Case Management Waiver (Jan. 20, 2023). The purpose of this Informational Memo is to inform stakeholders that the Home and Community-Based Services (HCBS) waiver amendments submitted to the Centers for Medicare & Medicaid Services (CMS) on Sept. 16, 2022, were approved.

January 6th, 2023

The Colorado Department of Healthcare Policy and Financing (HCPF) is seeking member feedback through a Member Case Management Agency Survey. This survey provides stakeholders an opportunity to share involvement in the Case Management Agency selection process while maintaining the integrity of the competitive process and state procurement law.

The Department will gather all responses submitted during the procurement inquiry period, which ends on Wednesday, Jan. 18, 2023.

The Member CMA Survey is available in English here and in Case Management Redesign webpage.

Meeting for Members: The Department will host a Member CMA Survey Live Response on Thursday, Jan. 12, 2023, from 10:30 a.m. - 12 p.m. to help members fill out their surveys. You’ll find meeting information in the OCL Stakeholder Engagement & Calendar webpage.

December 30th, 2022

The Case Management Agency (CMA) Request for Proposal (RFP), which we have been discussing here for some time, has been released!

From the Colorado Department of Healthcare Policy and Financing (HCPF): "The Department is soliciting competitive, responsive proposals from experienced and financially sound organizations to perform as a Case Management Agency (CMA). The CMA will serve within a geographical Defined Service Area to provide case management services to individuals enrolled or enrolling into Long-Term Services and Supports (LTSS). For more information, see Informational Memo 22-046."

December 20th, 2022

The Colorado Department of Healthcare Policy and Financing (HCPF) has created a retention payment grant to encourage staff to remain employed with current Case Management Agencies (CMAs) throughout their companies’ transition phases related to Case Management Redesign. You can see details from HCPF regarding the grant here. Imagine! is currently exploring options available to us regarding the grant.

December 14th, 2022

The Colorado Department of Healthcare Policy and Financing released some talking points around CMRD. While they are designed for Case Management Agency (CMA) leaders, the information is valuable to all and worth sharing. You can view those talking points here: CMRD Talking Points.

October 19th, 2022

On October 12, 2022, The Colorado Department of Healthcare Policy and Financing (HCPF) sent a message to CCBs, CEPs and private case management agencies, including Imagine!, saying the Department has made the decision to pause the work being conducted by Health Management Associates (HMA) effective October 15, 2022 and will resume that work after the RFP proposal submission deadline has concluded on approximately March 1, 2023. The Department will be sending out additional communication regarding the current work underway with HMA in the coming weeks. There were no additional explanations offered in that communication. What it means from a practical standpoint is that the work we had been doing with our transition coach on assignment from Heath Management Associates (HMA) is suspended until after the RFP submission period has passed. We will keep you posted on any additional information from HCPF as it is made available.

 

Upcoming Meetings

Based on the flow and progress of the meetings held so far, the Colorado Department of Healthcare Policy and Financing (HCPF) has made further changes to the CMRD Rule Revision stakeholder meeting series. Please see the current schedule below.

Background

The Department will update rules and regulations pertaining to HCBS waivers and non-waiver programs to come into alignment with new CMRD statute, policy, and language. Rule updates are required to clean up areas in existing rule and waivers that are repetitious, obsolete, or difficult to follow and understand. CMRD also implements changes to the rule structure. The vision behind the structure change is to make the Home and Community-Based Services (HCBS) rules easier to find, read and understand for all stakeholders. Rules must be in effect no later than Nov. 1, 2023, at which point the first cohort of new Case Management Agencies under CMRD will transition.

The Department wants to hear from stakeholders about each of the rule revision topics listed below to ask questions and receive feedback based on your knowledge and experience with navigating HCBS rules. The goal is to make these rule revisions work for all HCBS stakeholders. The Department will post the section of rule or waiver to be discussed on the CMRD webpage one week prior to each meeting. Stakeholder engagement, feedback, and Department responses will be tracked through listening logs posted on the CMRD webpage.

Note: The revised meeting information below is posted on the OCL Stakeholder Engagement & Calendar webpage.

The meeting access information remains the same for all the CMRD meetings:

Join via Zoom

Meeting ID: 873 9014 4539, Passcode: 597847

Join via Phone:

Toll-free: 1-877 853 5257

The following meetings have been canceled. If you have uploaded these meetings to your individual calendar, please remove them:

Tuesday, Jan. 31, 2023

Tuesday, Feb. 14, 2023

Tuesday, Feb. 28, 2023

Tuesday, March 14, 2023

The following revised meeting dates and topics are now in effect:

Tuesday, March 28, 2023 9 - 11 a.m. MT

Case Management Agency Requirements. This meeting provides explanation and review of changes/updates to the Case Management Agency Requirements and Responsibilities rules as it relates to CMRD, including stakeholder feedback and responses as they relate to the rule language, clarity and flow.

Tuesday, April 11, 2023 9 - 11 a.m. MT

Case Management Agency Requirements / Case Manager Requirements and Functions. This meeting continues to provide explanation and review of changes/updates to Case Management Requirements and Responsibilities rules as it relates to CMRD, including stakeholder feedback and responses as they relate to the rule language, clarity and flow. Case Manager responsibilities and functions will also be covered.

Tuesday, April 25, 2023 9 - 11 a.m. MT

Case Manager Requirements and Functions. This meeting continues to cover Case Manager responsibilities and functions.

Tuesday, May 2, 2023 9 - 11 a.m. MT

Home and Community-Based Services (HCBS) Benefits and Services Rules, Part One. This is the first of a three-part explanation and review of changes/updates to the HCBS Benefits and services rules, including stakeholder feedback and responses as they relate to the rule language, clarity and flow.

Tuesday, May 16, 2023 9 - 11 a.m. MT

HCBS Benefits and Services Rules, Part Two. This is the second of a three-part explanation and review of changes/updates to the HCBS Benefits and services rules, including stakeholder feedback and responses as they relate to the rule language, clarity and flow.

Tuesday, May 30, 2023 9 - 11 a.m. MT

HCBS Benefits and Services Rules, Part Three. This is the third of a three-part explanation and review of changes/updates to the HCBS Benefits and services rules, including stakeholder feedback and responses as they relate to the rule language, clarity and flow.

Tuesday, June 13, 2023 9 - 11 a.m. MT

HCBS Provider Requirement Rules. Explanation and review of changes/updates to the HCBS Provider requirement rules, including stakeholder feedback and responses as they relate to the rule language, clarity and flow.

Tuesday, June 27, 2023 9 - 11 a.m. MT

Wrap-up, Follow-up, Next Steps in the Process. We will wrap up everything we have gone over and discussed regarding the changes and updates to the HCBS rules and explain what happens next, including stakeholder feedback and responses as they relate to the rule language, clarity and flow.

HCPF is hosting meetings bi-weekly with stakeholders to go through the rule changes they have proposed line by line.

  • Meeting calendar is available on HCPF Department website.
  • The purpose of the meetings is for the Department to update rules and regulations pertaining to HCBS waivers and non-waiver programs to come into alignment with new Case Management Redesign (CMRD) statute, policy, and language. Rule updates are required to clean up areas in existing rule and waivers that are repetitious, obsolete, or difficult to follow and understand. CMRD also implements changes to the rule structure. The vision behind the structure change is to make the HCBS rules easier to find, read and understand for all stakeholders.
  • Rules must be in effect no later than Nov. 1, 2023, at which point the first cohort of new Case Management Agencies under CMRD will transition
  • This is the new rule structure:

More Information about the CMRD Rule Revision Stakeholder Meeting Series

Originally Posted on Nov. 29

CMRD Rule Revision Stakeholder Feedback Meeting Series

The Department will update rules and regulations pertaining to Home and Community-Based Services (HCBS) waivers and non-waiver programs to come into alignment with the new CMRD statute, policy and language. Rule updates are required to clean up areas in existing rule and waivers that are repetitious, obsolete or difficult to follow and understand. CMRD also implements changes to the rule structure. The vision behind the structure change is to make the HCBS rules easier to find, read and understand for all stakeholders. Rules must be in effect no later than Nov. 1, 2023, at which point the first cohort of new Case Management Agencies under CMRD will transition.

The Department wants to hear from stakeholders about each of the rule revision topics listed below to ask questions and receive feedback based on your knowledge and experience with navigating HCBS rules. The goal is to make these rule revisions work for all HCBS stakeholders. The Department will post the section of rule or waiver to be discussed on the CMRD webpage one week prior to each meeting. Stakeholder engagement, feedback and Department responses will be tracked through listening logs posted on the CMRD webpage.

Case Management Redesign (CMRD) Rule Revision Stakeholder Feedback Meeting Series Topics:

  • HCBS Waiver Program Eligibility Rules, Part 2
  • Case Manager Requirements
  • Case Manager Requirements & Client Rights and Responsibilities
  • Follow-Up Session for Case Management Rules
  • HCBS Benefits and Services Rules, Part 1
  • HCBS Benefits and Services Rules, Part 2
  • HCBS Benefits and Services Rules, Part 3
  • HCBS Provider Requirement Rules
  • Wrap-Up, Follow-Up and Next Steps

Past Meetings

January 11th, 2023

Case Management Redesign (CMRD) Rule Revision: Member Rights and Responsibilities This HCPF meeting provides explanation and review of changes/updates to the Member Rights and Responsibilities rules as they relate to CMRD, including stakeholder feedback and responses as they relate to the rule language, clarity and flow.

The meeting will be held: Tuesday, Jan. 17, 2023 9 - 11 a.m. MT

November 29th, 2022

The Colorado Department of Healthcare Policy and Financing is hosting a meeting tomorrow, Nov. 30, for CMRD Stakeholder Engagement. Information below.

CMRD Policy Updates

Case Management Redesign refers to several initiatives that will help make accessing long-term services and supports easier by changing case management agencies to serve all HCBS waivers so people have one place to go, making sure there are the right number of case management agencies in Colorado, and increasing the quality of case management services.

This is a statewide public meeting to provide updates to stakeholders on all aspects of CMRD and policy updates.

All interested stakeholders are welcome.

Nov. 30, 2022 9 - 11:30 a.m.

Join Online Meeting

ID: 873 9014 4539, Passcode: 597847 Join via Phone: 1-877-5257 (Toll-free)

 

Please note, all of these will appear on the FAQ page which can be found here: CMRD FAQs

 

March 7th, 2023

When will the RFP be posted to the website?

The RFP we submitted to HCPF was a document that was almost 300 pages long, filled with proprietary information about ACMI and Imagine!, and meant only to be seen by HCPF. It is not something we are currently able to share publically. You are encouraged to reach out to HCPF for more information about the RFPs they received.

 

January 19th, 2023

Imagine!’s Director of Client Relations and Kristen Lundy, Assistant Director of Client Relations, met with the Imagine! Case Management team to answer questions about CMRD. Below are some of their responses. These can also be found on our FAQ page.

Is there going to be competition for this catchment area?

We won’t know for sure until the list of bidders is posted, which we expect sometime after March 1.

Will Case Managers have to learn all 10 waivers?

We are in discussion with another CCB who currently manages the IDD/SEP contracts together already who is experimenting with mixed caseloads right now. From this vantage point, we would not expect one single person to be a Case Manager for 10 waivers. It is a great opportunity, though, for people who want to expand their knowledge to dip into the non IDD field. Just a reminder, though, that post award we will work to become one agency bringing together experience and expertise in all waivers, serving all ages and all disabilities. We have no doubt we will figure out how to provide quality case management efficiently AND any needed specializations among case managers.

Will ACMI be moving in with us?

We will be one combined agency headquartered at one of the current buildings on the Imagine! campus, most likely 1400 Dixon Avenue given the layout which does allow us to optimize desk sharing options. We will be looking for creative and innovative ways to use our space and meet all needs. As noted in a different FAQ recently, there are still some decisions to be made at Imagine! on how we will divide our assets, including the use of our current buildings.

Is ACMI going to get rid of their building?

ACMI currently rents space at 1455 Dixon Avenue. We do not anticipate needing that footprint to house our new, combined case management agency, but that has not been determined yet.

What happens with IT, PR, HR and the business office if we can’t share with the PASA anymore?

The PASA must have its own administrative services once we make the split. ACMI and Imagine! have different models currently that deliver these services which each offer particular advantages. As we work to become the new combined Case Management Agency (CMA), we are also looking at a number of best practices for creative solutions to help us manage costs and optimize efficiencies.

Will we have a new name?

Yes! The new CMS entity will have a new name that ideally identifies us as the newly combined entity that joins and optimizes all of Imagine!s and ACMI’s decades of case management experience and expertise. Imagine!’s services (the PASA side) will retain the Imagine! name after the CMA and PASA entities are split.

Will we have a new logo?

Yes!

January 18th, 2023

We’ve had a number of questions come in through our submission form, below are a few answers. These can also be found on our FAQ page.

Will non-waiver programs remain under the management of the Case Management Agency (CMA) when the process is completed and awards are made?

Per HCPF, State-general funded programs, such as FSSP and the State Supported Living Services (SLS) Program, will remain under newly appointed CMAs once those decisions are made in the spring. As of this response, we are planning to manage other non-waiver programs, not funded by the State General Funds, as we do today, under the leadership of the newly formed case management agency (CMA) as determined by HCPF at the time awards are made this spring.

How will the CMRD affect the support our son with an intellectual disability son is receiving today?

Imagine!’s goal throughout this process is to minimize disruptions in services and to ensure that we do all we can to continue our mission of creating a world of opportunity for all abilities. A reminder that the State of Colorado and the State of Colorado and the state’s Department of Healthcare Policy and Financing (HCPF) are directing this process. Therefore, we are unable to answer specific questions about the future of individual services until we have more information from HCPF.

How will various departments, services, and the CMA be housed in Imagine!’s buildings?

We don't know yet just how we will divide our campus assets when we develop and finalize our plans for separating services and case management. There will be communication as we clarify these details.

Will individuals on the Children’s Home and Community Based Waiver (CHCBS) still be served by Imagine! or ACMI folks?

The CHCBS waiver is included in the waivers that will be served by the new Case Management Agency, so assuming Imagine! and ACMI are awarded the contract we would continue to serve children on that waiver.

December 5th, 2022

There are so many acronyms around here. Is there a list somewhere that explains some of these, especially for those of us who are new to CMRD?

Yes, we have a link to a comprehensive list of acronyms here.

In addition, The State of Colorados Office of Community Living (OCL) has created this Acronym Glossary.

November 15th, 2022

We’ve answered some more questions for our FAQ page:

What happens to the Imagine! Foundation? Will they serve the CCB or the PASA?

It is likely all fundraising activities will be associated with the PASA in the Imagine! world post-CMRD implementation, although there are many considerations yet to be made. At the moment, our attorney is reviewing all of our legal entities, including the Foundation, reading through Articles of Incorporation and Bylaws to understand any particular legal considerations that must be taken into account as we plan the future. Stay tuned as we learn more and continue to study the possibilities.

Will Imagine! Case Management staff be able to view responses to the RFP?

We are deferring on responding to this question for the moment since we are still learning about the RFP process. We understand it to be a very competitive and proprietary process so undoubtedly there will be a level of care in sharing some of the specific responses pre-submission. There will be a collaborative process in preparing and vetting our responses to ensure accuracy, of course, but what that looks like right now is hard to define. Stay tuned for more information regarding all things RFP as we learn more.

When can Imagine! program managers begin meeting with the leadership team at ACMI?

The process is soon to include Case Management leadership from both agencies who will help define the work ahead and levels of engagement likely prior to submission of the RFP. Timelines for submission, post submission, and pre-implementation (assuming we win the RFP award) will be drawn up over the coming weeks and will include plans for engagement and ongoing communication.

October 24th, 2022

We have a couple new FAQs added to our FAQs:

How will the distribution of Mill Levy dollars look post-CMRD?

Boulder County controls how Mill Levy dollars are distributed. We are in discussion with the County, of course, about how their thinking is emerging regarding the future state of things with the changes being brought about separating case management agencies from PASAs. They do not have anything definitive regarding this topic, but commit to continue funding the IDD community with mill levy dollars. For mill levy funding for the calendar year 2023, we will be having the first of what is likely to be a few meetings with Boulder County in November regarding their priorities for the coming year and what format they are planning to use for our submission request. There have been no specific discussions on the various programs or positions currently funded partially by those mill levy dollars, only the overall topic.

Are there limits on how many regions an agency can bid on the RFP for?

The Colorado Department of Healthcare Policy and Financing (HCPF) has not specified a limit to how many “catchment areas” an entity can bid for. A reminder that HCPF has defined the new catchment areas for implementation of CMRD, and you can find the information memo released by HCPF and the map here. HCPF has further reiterated just in the past week that the bidding is “an open competitive process that will result in the Department selecting offerors ‘whose proposal is determined in writing to be the most advantageous to the state (C.R.S. §24-103-203(7)). HCPF said additionally that “this competitive process encourages proposals from all agency types and will result in the Department conducting a comprehensive, thorough, complete and impartial evaluation of each proposal received.

 

November 28th, 2022

Today we are excited to announce that, with the approval of our respective Boards of Directors, Imagine! and ACMI have signed a Letter of Intent to “…to join their case management expertise, experience, staff, operations, processes and certain assets to form a new case management agency serving Boulder, Broomfield, and Gilpin Counties for all disability waivers in a manner and timeline as defined by HCPF” in preparation for applying 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.

This is an exciting development which we believe will strengthen both of our abilities to continue to build upon our combined 90-plus years of serving our communities. Stay tuned!

October, 28th, 2022

On October 26, 2022, Barb Wilkins-Crowder, Executive Director of Adult Care Management, Inc. (ACMI), sent the following message to her staff members. The message is about how ACMI and Imagine! are engaging in the … “processes of creating formal agreements and establishing some initial designs about how we might bring our two agencies together as the new, post CMRD, single case management agency (CMA).” We thank Barb for letting us share her message here. For more information on this, see also Dr. Kathryn Arbour’s message to Imagine! employees in the October 26 update below.

Dear ACMI Team, The competitive bid cycle for our contract with HCPF is not new to many of you. In Colorado’s Single-Entry Point system, only 3-4 agencies have ever had to competitively bid on contracts. The majority have been assigned their work as branches of local, county governments (DHHS, Public Health, or County Nursing agencies). As a stand-alone, nonprofit agency, ACMI has had to bid for our contract every time RFPs have been published. Overall ACMI has written RFP responses about 8 - 10 times since its founding in 1986, and Barb has been part of the team writing those bids 5 – 6 times. Since our first bid to serve the Boulder, Clear Creek, and Gilpin area in 1994, we bid to add Broomfield County in 2001 and have successfully rebid to serve all 4 of those counties 4 times.

In the CCB (community-centered boards) world, the IDD waiver case management has been assigned to those agencies providing the CCB functions. The coverage area for some CCBs has mirrored that of the SEP, for others it has been different. The CCB in our area, Imagine!, has served the IDD community since 1963.

HCPF intends to issue an RFP in early 2023. The significant difference in this bid cycle is that due to Colorado’s case management redesign (CMRD) initiative: 1) counties have been reapportioned into new catchment areas; 2) all catchment areas will be rebid to award the work to a single case management agency in each area; and, 3) the winning CMA will serve all populations enrolled in all of Colorado’s long-term care Medicaid waivers. The area ACMI currently serves will be reduced in size as Clear Creek County has been reassigned to the catchment area with Jefferson and Summit counties.

That was all background to help me explain ACMI’s planned response to this RFP cycle. Given that ACMI and Imagine! both have extensive expertise, experience, and passion for providing high quality case management in our area, the Executive Leadership and Boards of Directors of both agencies have decided to combine our strengths and we are planning for a joint RFP response to ensure the most seamless transition to the CMRD-required, sole CMA, for our clients, our staffs, and our communities. We are in the processes of creating formal agreements and establishing some initial designs about how we might bring our two agencies together as the new, post CMRD, single case management agency (CMA).

Please know that the new CMA will be built on the expertise, experience and passion of the case managers, case aides, support staff, supervisors, administrators, and boards of both agencies. Winning the RFP bid comes first, then the transitions into a single agency will happen between the summer of 2023 and summer of 2024. The goal, as ACMI and Imagine! 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 supporting independence and choice for all disabilities.

You will have lots of opportunity to give input and hear about the plans as they are developed. For today, it is business as usual for everyone at both ACMI and Imagine!. We all have a dedication to this work and together we will continue to provide high quality case management even as we chart our way through these changes in Colorado’s long-term care system.

On we go,

Barb Wilkins-Crowder