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Regarding the proposed Joint Budget Committee's Aging Caregiver & DSP (Direct Service Professional) Compensation Bill

This Bill from Alliance (lobbying group for CCBs/agencies), is a money grab for the CCBs. 

    Does NOT cleanly give a raise to Direct Support Professionals (who actually assist our loved ones), but gives money to CCBs to pay supervisors and other staff, pay CCBs to cover employee benefits, etc. We want ALL the dollars to go to the Direct Support folks!

     While funding the 300 off the waiting list is TERRIFIC, the Bill should NOT decide how the future waiting lists are designed. That job is for US FAMILIES to decide with the system folks. Also the Bill would require a Colorado survey of Satisfaction, and we already know that families throw out or are untruthful when we are surveyed about how “wonderful” services are, because we fear our scarce providers hearing anything negative from us.

Getting individuals off the DD wait list, and improving the rates, are great goals.

    However, the draft language did not require the provider to put the 6.5% rate increase directly to the worker's pay. The draft allowed for the agency to apply the rate to benefits, insurance, the employer portion of taxes and so forth.  The majority of the direct service providers are part time and do not receive benefits/insurance. And, those items are paid in a lump sum yearly by the agency, thus, making it impossible to delineate that money was for direct service providers and not all employees. 


    In addition, the bill requires an enormous compliance and administrative burden that is so great on an agency that any rate increase is eaten by the new requirements, especially for small agencies. For example, respite is reimbursed at $4.95 for a 15 minute unit. A 6.5% increase is $0.32 for a 15 minute unit. An agency is supposed to, according to the original draft, track how that $0.32 was used for that employee. HCPF is supposed to create a system for agencies to then report that $0.32 and HCPF is responsible for monitoring that agencies are reporting and using the funds correctly. If not, they are to be "clawing" it back. A minimum Hourly Provider Rate should be used instead as it is much cleaner and requires no additional procedures/systems for an agency. 


    Thus, we agree with the goals but completely disagree with the implementation. There needs to be stakeholder engagement (the actual workers, the individuals/families, and the agencies - not just CCBs and ARCs that do not represent our families) to ensure that the recommendations truly meet the goals and do not create excessive and meaningless compliance and administrative paperwork. HCPF has many more important tasks (CFCM, simplified waiver, SIS tool replacement) than tracking how an agency used $0.32 for employee x. 

    It is also unclear that, if this bill results in rate increases by service, e.g., 4.95 for a 15 minute increment of respite, does that go against the SPAL? If so, this will actually DECREASE services to families.

More excellent input, below, from an anonymous family about improving Case Managers and the CCB process. 

1.      Currently Case managers don’t work Fridays. Does the statement, “must provide services in accordance with State business operating hours/days” mean Case Managers will start working Fridays? 

2.      Why is the qualification for Case Manager not to be a relative?  Seems like that as his mom, that is who I am and what I do for my son.  The Community Centered Board Case Managers don’t seem to know about resources that I have already heard about.   I always seem to be retraining the next Case Manager who is well meaning, but uninformed. 

3.      Current “established referral systems” are not leading to effective “community referrals for services with other agencies.”  When parents ask for services we are referred to the CCB agency even though their wait list can be several months long.  Asking for referrals to agencies not a subsidiary of the CCB leads to disparaging looks and comments.  The parent must already know there is another agency providing the service and repeatedly ask for it. 

4.      How do the proposed new regulations prevent retaliation against individuals who fall out of favor with the CCB?  There was an instance of a parent finding out about resources and sharing that information with other families.  The CCB retaliated against that parent who let it be known there were resources available. 

5.      A vendor providing person centered services and supports did not receive referrals and did not receive payment from the CCB for the clients who did use the services.  How can we keep this from happening again? When families work successfully with a provider, how can families ensure the provider is paid? 

On the other hand, a vendor featured at the CCB resource fair was able to charge for several months without providing any measure of success, leading to frustration and wasted time and wasted funding.  Parents finally dismissed the vendor and pursued a different vendor, not recommended by the CCB, who worked wonderfully and successfully and achieved a meaningful outcome in a typical setting, not in a segregated setting. Besides trainings, what is being done to reward providers who are already doing person centered care? 

6.      In the past 3 years, vendors responding to RFPs sent out by the Case Managers are typically misinformed about our son’s goals and needs or are not equipped to meet his needs. Who would be supporting our son if we were no longer around and how would anyone find those supports?  That is when we get a response to an RFP. Usually the Case Manager offers to put out an RFP and no one responds.  We don’t even try anymore. 

7.      We tried to contact our Case Manager and waited weeks for a response.  We also left messages with the person who was supposed to be her supervisor and the receptionist at the front desk.  We later found out that some clients “were in crises” so the supervisor should have responded to the messages we left on the answering machine and emails we sent.  We later found out the supervisor whose name was on the voice mail was no longer there and the person we finally contacted was not in the Case Management department.

What private sector business would continue to pay for this kind of frustrating and ineffective service? 

YouTube and press coverage of the October 7, 2016, statewide “Abuse of Individuals with Intellectual and Developmental Disabilities” PAD-CO and CCDC joint press conference.

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