Joint Committee Committee on Joint Health and Human Services (03/16/2005)

Final
STAFF SUMMARY OF MEETING

COMMITTEE ON JOINT HEALTH AND HUMAN SERVICES

Date:	03/16/2005	ATTENDANCE

Time:	10:05 AM to 01:01 PM	Berens	*
		Clapp	X
Place:	HCR 0112	Cloer	X
		Frangas	X
This Meeting was called to order by		Green	X
	Senator Hagedorn	Hanna	X
		Johnson	*
This Report was prepared by		Kester	*
	Elizabeth Burger	Lundberg	X
		McGihon	X
		Mitchell	*
		Riesberg	*
		Sandoval	*
		Shaffer	X
		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
Departments' Presentation Counties' Presentation Community Health Centers' Presentation Hospitals' Presentation Colorado Legal Services' Presentation Departments' Response to Community Presentations		- - - - - -

10:06 AM - Presentation by the Departments of Human Services and Health Care Policy and Financing on the Colorado Benefits Management System

A number of handouts were distributed to the committee prior to the meeting (Attachments A through C). Senator Hagedorn discussed a press released issued by the Governor on the Colorado Benefits Management System (CBMS).

10:08 AM -- Ron Huston and Stephen Swanson, Colorado Department of Human Services, and Lisa Esgar and John Wagner, Colorado Department of Health Care Policy and Financing, came to the table to present on CBMS.

10:09 AM -- Mr. Huston updated the committee on difficulties implementing CBMS and distributed an outline of the Departments' presentation to the committee (Attachment D). He discussed the number of active cases in CBMS and the emergency processing unit, which was required by court order to be implemented. He discussed the volume of client calls processed through the emergency processing unit and the court-ordered criteria used to evaluate situations in which immediate action must be taken to restore benefits. Mr. Huston addressed the benefit freeze flag which was put in place to ensure that clients did not lose their benefits while being transferred into CBMS. He commented the number of counties that have finished converting their cases to CBMS and the number of cases which have active help desk tickets. Mr. Huston discussed measures that have been taken to improve CBMS and the Governor's CBMS taskforce, and distributed the recommendations of the task force (Attachment E) to the committee. Mr. Huston discussed the departments' budget supplemental request to fund additional costs associated with CBMS. He listed the emergency call center hotline number.

10:36 AM -- Mr. Huston responded to questions from the committee regarding software defects in CBMS and the pilot program that tested CBMS prior to its release. Mr. Huston discussed staffing reductions at the Department of Human Services and responded to questions from the committee regarding why CBMS was not implemented in phases.
10:48 AM - Presentation by representatives of Colorado counties on the Colorado Benefits Management System

Susan Beckman, Roxane White, and Tom Mayer, representing Colorado counties, came to the table and distributed a handout from Colorado Counties Incorporated (Attachment F).

10:49 AM -- Roxane White, Denver County, distributed a handout concerning the implementation of CBMS in Denver County (Attachment G). She discussed progress made addressing the backlog of cases to be entered into CBMS and stated that the greatest challenge faced by Denver County in implementing CBMS is in determining the eligibility of persons for Medicaid. She discussed the Departments' supplemental budget request. She stated that financial reports generated by CBMS are so inaccurate that they may affect the ability of counties to audit programs, which, in turn, may affect counties' bond ratings.

10:54 AM -- Tom Mayer, Boulder County, stated that progress has been made regarding CBMS but that the system is still not functional for counties. He stated that counties have had to use their own dollars to reduce the backload of cases waiting to be entered into CBMS and that urgent action by the state and the counties is needed to help address the problems with CBMS.

10:58 AM -- Susan Beckman, Arapahoe County, discussed county recommendations for addressing problems with CBMS. She stated that the legislature should require accurate reports from CBMS, that legislators and counties need to better understand the contract between the Departments and the CBMS vendor, Electronic Data Systems (EDS), that the counties should be included in the identification of problems and the development of benchmarks to address the problems, and that the counties should be included in any process determining the appropriate amount of funding for the Departments' supplemental budget request. She stated that the counties need additional dollars to address problems with CBMS. She further discussed county recommendations for improving CBMS, including reviewing the definition of system overpayments and conducting an independent evaluation of CBMS, with legislative review.

11:04 AM -- The representatives from the counties responded to questions from the committee regarding staff training necessitated by the implementation of CBMS. Mr. Mayer discussed the contractual obligations of EDS and Ms. Beckman responded to questions from the committee regarding overpayments of benefits. A handout regarding Department of Human Services county administration funding was distributed to the committee (Attachment H). The county representatives responded to questions regarding the overpayment of benefits.
11:35 AM - Presentation by representatives of community health centers on the Colorado Benefits Management System

11:36 AM -- David Myers, Metro Community Provider Network, discussed the application backlog for Medicaid and the amount of unreimbursed care that is being provided by the Metro Community Provider Network as a result of problems with CBMS. He stated that there is a lack of client case management as a result of the implementation of the new system. He stated that clients feel lost in the system, and that they have difficulty understanding their eligibility for benefits. He discussed stories of clients who have had difficulties with CBMS.

11:45 AM -- Mike Bloom, Sunrise Community Health Center, discussed the amount of unreimbursed care that is being provided by Sunrise Community Health Center as a result of the implementation of CBMS. He discussed the increased number of clients who are being seen by health centers and who are waiting for their Medicaid eligibility to be determined. He further discussed the effects of delayed Medicaid eligibility determinations on Sunrise Community Health Center.

11:52 AM -- B.J. Scott, Peak Vista Community Health Center, discussed the amount of unreimbursed care that is being provided by Peak Vista Community Health Center as a result of the implementation of CBMS. She discussed the number of clients who are treated by community health centers that are waiting verification of their Medicaid eligibility.

12:00 PM

Representatives of community health centers responded to questions from the committee regarding Medicaid eligibility determinations and the danger of community health centers closing as a result of the inability of community health centers to receive payments from Medicaid.
12:04 PM - Presentation by representatives of Colorado hospitals on the Colorado Benefits Management System

12:04 PM -- Larry Wall, Colorado Health and Hospital Association, discussed Colorado hospitals' experiences with CBMS and distributed a handout to the committee (Attachment I). He discussed increases in pending Medicaid eligibility determinations and resulting increased costs to hospitals as a result of CBMS.

12:08 PM -- Bill Voloch, Medical Center of Aurora, discussed challenges experienced by hospitals as a result of the implementation of CBMS. He stated that hospitals are increasingly having to hold patients that could be transferred to other facilities because the facilities cannot accept patients who are still waiting for a determination of their Medicaid eligibility.
12:12 PM - Presentation by Colorado Legal Services on the implementation of the Colorado Benefits Management System

Linda Olsen, Colorado Legal Services, discussed the challenges faced by low-income persons as a result of CBMS. She state that clients often receive multiple inaccurate notices, or no notices at all, regarding their benefits as a result of the new system. She stated that clients have difficulty accessing their caseworkers and that they often receive an inaccurate amount of benefits. She stated that standards for addressing the problems need to be developed and that CBMS needs to be evaluated by an outside evaluator.

12:24 PM -- Ms. Olsen responded to questions from the committee regarding the use of the emergency hotline number.
12:26 PM - Response of the Departments of Human Services and Health Care Policy and Financing

Ron Huston, Department of Human Services, and Lisa Esgar, Department of Health Care Policy and Financing, returned to the table to discuss delays in Medicaid payments and Medicaid eligibility determinations. A handout regarding Medicaid expenditures was distributed to the committee (Attachment J). Ms. Esgar discussed non CBMS-related issues that may cause delays in Medicaid payments. She stated that it is important to ensure accuracy when determining Medicaid payments.

12:33 PM -- John Wagner, Department of Health Care Policy and Financing, discussed timely filing of Medicaid claims. He stated that the Medicaid payment system is accurate and up-to-date.

12:38 PM -- Ron Huston, Department of Human Services, discussed the goals of CBMS.

12:38 PM -- Stephen Swanson, Department of Human Services, gave a brief history of the development of CBMS.

12:41 PM -- Mr. Huston discussed the funding for CBMS.

12:42 PM -- Department officials responded to questions from the committee regarding the chronology of the development of CBMS. Department officials responded to questions from the committee regarding problems with the system.

12:45 PM -- Wade Livingston, First Assistant Attorney General for Colorado, stated that the Colorado Attorney General's office is currently reviewing the liability of EDS for problems with CBMS.

12:48 PM -- Pauline Burton, Department of Human Services, responded to questions from the committee regarding the liability of the state or counties for the overpayment of food assistance benefits.

12:51 PM -- Ron Huston responded to questions from the committee regarding the validation of reports from CBMS and the Departments' supplemental budget request.

12:58 PM -- Representative Soper posed a number of questions to the Department representatives. Representative Lundberg requested that Department representatives determine a date when the system will be either be fixed or abandoned. Senator Hagedorn commented on the viability of CBMS.

01:01 PM

The committee adjourned.