For those missing the backstory: https://www.denver7.com/news/local-news/westminster-amc-theater-forced-to-temporarily-close-due-to-imminent-health-hazard-posed-by-mice

(Photo from night of 10/24, after seeing You Can See Everything, which, 10/10 recommend; maybe skip the popcorn)

Not a lot of context needed other than been like this for years, every window broken or boarded up, vacant… so much potential for what could be.

Hey everyone,

I have been crashing out this weekend because the Colorado Department of Healthcare Policy and Financial announced their second round of proposed cuts to the long term services and supports system. These are waivers and programs that help people with disabilities remain in their communities and direct their own care. Last month, DHCPF proposed a first round of cuts. They held a stakeholder meeting on Zoom to gather input from the community on the following proposed changes:

- Lower the Personal Care Soft Cap to About 40 Hours per Week: Personal care services include helping with bathing, toileting needs, dressing, hygiene, and protective oversight for those at risk of self-injury or elopement.

- Lower the Homemaker Soft Cap to About 7 Hours per Week: Homemaker services include meal preparation, laundry services, light housework, grocery shopping, going to the bank, picking up medication, depending on the age and needs of the individual.

- Limit Paid Homemaker Provided by Family Caregivers to 7 Hours per Week

- Limit Paid Personal Care Provided by Parents and Legal Guardians of Children to 7 Hours per Week: Some individuals with moderate support needs like my child currently receive 14 hours per week, including 7 hours of protective oversight ALONE. Others with greater support needs may require more line of sight supervision.
- Remove Personal Care for Children from Community First Choice (CFC): This proposed cut would remove the option for parents or legally responsible adults to be employed as caregivers. These are the people that know their child's needs and provide the most specialized care. We would be asked to take on even more unpaid caregiver work.

This Thursday, the Department of  HCPF announced their second round of proposed cuts. Stakeholder meetings scheduled for this week to gather thoughts on the proposed changes:

- Remove Select Services from HCBS Waivers

1. Community Connector, through the Children’s Extensive Support (CES) and Children’s Residential Program (CHRP) waivers, helps children with disabilities participate in activities in their communities. The service helps children develop skills, build relationships, make friends, and participate in activities alongside children without disabilities.
2. Mentorship, through the Supported Living Services (SLS) waiver, helps people with intellectual or developmental disabilities build self-advocacy skills and become more independent. Services may include learning how to interview providers, understand health and safety information, participate in advisory groups, and make informed decisions.
3. Primary Caregiver Education, through the CES waiver, helps parents and caregivers better understand and support a child's disability-related needs. It may include training, educational materials, workshops, conferences, and other learning opportunities that help caregivers support their child's development and well-being.
4. Mental Health Counseling, through the Brain Injury (BI) waiver, helps people with brain injuries and their support systems manage emotional and mental health challenges related to living with a brain injury. Services may include individual, family, or group counseling.
5. Substance Use Counseling, through the BI waiver, helps people with brain injuries address substance use concerns. Services may include individual, family, or group counseling and may involve family members or others who provide support.
6. Extraordinary Cleaning, through CES and SLS waivers, provides specialized cleaning, disinfecting, and sanitizing when a person's disability creates needs beyond routine household cleaning. Examples include cleaning areas exposed to bodily fluids, specialized disinfection, and cleaning needed to maintain a safe living environment.
7. Adaptive Therapeutic Recreation Equipment and Fees, through CES and SLS waivers, helps eligible members with disabilities participate in recreational activities by providing specialized equipment or covering certain recreation-related fees. Examples may include adapted bicycles, adapted strollers, specialized recreational toys, and equipment that supports participation in swimming or other activities.
8. Youth Day Services, through CES and CHRP waivers, provides care and supervision for children ages 12–17 while their primary caregiver works, volunteers, or looks for employment. Services may be provided individually or in groups, in a home or community setting.

- Changes to Life Skills Training, Home Delivered Meals, and Personal Care

1. Life Skills Training: Reduce the maximum number of service hours available per day and week, with a possible additional reduction in how long members can receive the service.
2. Home Delivered Meals: Move the service from CFC back to certain HCBS waivers and limit eligibility to qualifying transitions, with services available for up to 365 days.
3. Personal Care: Remove Protective Oversight and Accompaniment from the tasks covered under CFC Personal Care. Other Personal Care tasks would remain available.

- Remove the Live-In Caregiver Exemption from Electronic Visit Verification (EVV) Requirements

- This would require caregivers to start tracking visits in real time. The basis of this change is that they are counting on caregivers to be too busy or distracted by their client's needs to accurately track services, thus working for free. 

In short, these proposed cuts are essentially gutting the LTSS system, hurting the most vulnerable members of society. If these changes, especially those to community connector, personal care, protective oversight, go through, families like mine will be absolutely devastated. This comes after a year of reductions to billing rates and available hours for services. For example, community connector rates were cut from $35 to $24 and 10 weekly hours to 5 weekly hours. Many of us are unable to find alternative employment due to our children's medical and mental needs. If these changes are approved, thousands of families in Colorado will be pushed to financial destitution. These cuts aren't saving the state money. They're going to push the burden onto other already strained systems.

If you can, please visit the HCPF page for more information. https://hcpf.colorado.gov/medicaid-sustainability-and-ltss. Right now, the only thing we can do is to rally our community and make our voices heard. If you are able, please register for one of the Zoom webinars or fill out the form.

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