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Day Habilitation Changes starting Jan 15 2021January 12, 2021
DDRC friends, family, and stakeholders –
We hope you all had an enjoyable holiday season! We want to let you know about important changes to day services that the Colorado Department of Health Care Policy and Financing (HCPF) has made in response to the COVID-19 pandemic. These changes will take effect January 15th, 2021, and are intended to be in place through the remainder of the public health emergency as outlined in memo HCPF OM 20-105, https://www.colorado.gov/pacific/sites/default/files/HCPF%20OM%2020-105%20Updated%20Day%20Habilitation%20Services%20in%20Response%20to%20COVID-19.pdf.
The state is implementing a new tiered day service option. In addition to traditional group services, which currently can be provided remote or in-person, members can now revise their service plans to begin receiving 1:1 Specialized Habilitation (SH) and/or Supported Community Connections (SCC) under the new tiered structure. Members are not required to add 1:1 services and can choose to continue receiving services under their current service plan model. However, members who do want to add 1:1 SH or SCC services will need to remain within their pre-pandemic Day Habilitation utilization dollar limits. Members adding individualized 1:1 services may utilize the new service and the existing service in any way that works for their needs, up to their utilization levels in the year prior to the pandemic. If a member is new to the HCBS-DD or HCBS-SLS waiver and would like to add 1:1 to their service plan, they would need to remain within the previous years’ average utilization of their Support Level.
Changing to the new tiered service option for Day Habilitation is optional for members; no member is required to revise their Prior Authorization Request (PAR) to add the new tiered delivery model. If a member is interested in adding tiered Day Habilitation services to their PAR, they should begin by having a conversation with their Resource Coordinator to discuss their options. Resource Coordinators will then need to work with both service providers and waiver members to discuss the changes that will be made and if an update to the member’s PAR is required to reflect how the member would like to receive Day Habilitation services moving forward, as well as the providers’ ability to provide services. For more information from HCPF on these changes and their up-to-date communications, please see HCPF’s 2020 Memo Series Communications page, https://www.colorado.gov/hcpf/2020-memo-series-communications.
Jamie Haney, Director of Access, DDRC
Liz Pahr, Director of Resource Coordination, DDRC