CAFCA (not-at-all) BRIEF UPDATE

December 2003

HAPPY HOLIDAYS AND A HEALTHY NEW YEAR TO YOU AND YOUR FAMILIES FROM PEG AND MARY!
CAFCA will be closed December 24-26 and December 31-January 1

REMINDER: NO CAFCA General Membership meeting this month. The next General Membership meeting will be Friday, January 16^th.  Location: Lost and Found, 6700 W. 44^th Avenue, Wheat Ridge. Enter from the West entrance door. Note Time change: 9:30 a.m. Mendez Steadman and Peg will conduct training on How to Review a Bill and The Secrets of Successful Testimony. CTS meeting will follow at 10:30.

Important Employment Information
Last month Executive Directors received a copy of the Colorado Department of Labor’s letter exempting CAFCA member agencies from the overtime rule for shifts in excess of 12 hours.  This month, employment attorney Brad Shefrin provides answers to two questions that CAFCA members raised at the October employment workshop.

Question 1: Can an employer withhold from final wages money that an employee may owe to a cafeteria, flexible spending, or insurance plan?
Answer: Colorado Revised Statute Section 8-4-105(1)(b) permits a deduction from wages only for the repayment of loans, advances, goods or services, equipment, property or tuition reimbursement provided by the employer to the employee. But before making the deduction, there must have been in place a written agreement with the employee authorizing the employer to deduct these expenses from an employee’s final wages if reimbursement is not completed during the employee’s tenure. Typically, an employer will obtain written authorization for a wage deduction when the employer pays for an employee’s training or education and the employee has not maintained employee status for a minimum period of time following the training and expenditure.

Section 8-4-105(1)(d) provides that deductions for insurance, savings plans, pensions and the like are only deductible from final wages if: (1) the employer has a written agreement for such deduction; and (2) the authorization for the deduction is revocable.  To accomplish this, an employer must have separate written authorization that (1) identifies what may be deducted from final wages; (2) contains a statement that the authorization is revocable; and (3) states if the authorization is revoked by the employee, the employee’s benefit may immediately terminate or all debts due at the time of revocation become due and owing immediately. An employer may also request that an employee voluntarily sign a promissory note, but may not require such a note.

Question 2: What type of entity is eligible to change from the unemployment insurance payroll tax system to a reimbursement system?
Answer: Pursuant to Colorado revised Statue Section 8-76-110(1)(a), an employer may switch to the reimbursement method of paying its unemployment obligation if the employer is a “nonprofit organization.” This section defines a nonprofit organization as being organized under section 501(c)(3) of the IRS tax code.  Changes in the declaration must be made prior to December 1st.

HCPF ALERT!

CAFCA has been advocating for a fair and equitable audit and recovery process for child welfare providers of Medicaid reimbursable services. Our efforts have included letters and phone calls to members of the Medical Services Board, contacts by Fofi Mendez, and other actions.  We have been closely watching the Medical Services Board agenda for announcement of a hearing on these rules.  In the mean time, HCPF has taken a much more insidious approach to the audit and recovery process. On Friday, December 12th, the Medical Services board was presented with two initial rule packets containing substantive revisions to the general Medicaid provider audit and recovery regulations. These rules apply to all approved Medicaid providers. The revisions reduced 12 pages of program integrity rules to 3-1/8 pages and 6 pages of provider appeals rules to 3-1/8 pages. Both sets of rules significantly reduce provider notice and due process rights in the administrative setting.  One set eliminates the statutory distinction between false representation and innocent errors in the recovery process and allows the recovery rate to be based on “sound, scientific statistical analysis and extrapolation of data from a statistically valid selected sample of claims,” a method not authorized in statute.  CAFCA learned of these rules late Wednesday December 10th.  Peg quickly researched the applicable statute and existing regulations and prepared testimony for the board meeting.  Fofi Mendez contacted all members of the Medical Services Board and apprised them of our concerns. Our testimony was well-received by the members of the Medical Services Board, but less so by Executive Director Karen Reinertson and Director of the Medical Assistance Office, Vivianne Chaumont. The end result is that the Board members asked the Department to work with us on resolving our concerns.  Peg will develop a chart comparing federal regulatory requirements, state statutory requirements, current rules requirements, and proposed rules requirements and present this information to the Department. Fofi will discuss these rules with other Medicaid providers and seek their collaboration and support. The date for proposing the RTC rules remains uncertain, but CAFCA will move forward with opposition to the general Medicaid audit and recovery rules. Affected providers may be asked to assist Peg with this process.  

CDHS Update

Peg attended the Human Services Board hearing on December 5^th, at which emergency rules regarding the replacement for the Child Abuse Registry were heard.  CDHS did not waiver from its November 7^th proposed rules, which placed responsibility for the investigation, finding, data entry, and appeal processes squarely upon the counties.  The counties drafted and presented their own rules, which required CDHS to be primarily responsible for the final determination, data entry, and defense of an accused perpetrator’s appeal. Peg testified in favor of the counties’ proposed rules as more consistent with the intent of HB 1211, which abolishes the Central Registry as of January 1, 2004.  As grounds for this, Peg pointed out the difficulty providers would have with 64 different investigative, confirmation and appeals processes required by the CDHS proposed rules.  Additionally, the state rules required immediate entry of a name in the statewide database upon a finding of abuse, even if the alleged perpetrator appealed the finding.  This would have placed CAFCA members in immediate violation of their licenses with no recourse but to terminate an employee or foster family and move children, etc.   At the conclusion of hours of extensive testimony, the CDHS board unanimously rejected the state’s proposed rules and unanimously adopted the counties’ proposed rules.  While these rules are not perfect, they include an investigative and appeal process that is better for children and providers alike.

Kathy Chase has been named the new RTC Administrator and is now on board at the Department of Human Services.  She can be reached at 303 866-4098. Welcome Kathy!
CAFCA members interested in working with CDHS regarding new group home rules and receiving home procedures should contact Jean Abrams at: jean.abrams@state.co.us.

CAFCA NEWS

CAFCA members are working on completing drafts of Adoption and RTC White Papers similar to the 2002 Foster Care White Paper. The RTC paper will include a section on facility schools. If you have been assigned to research and write a section of either paper, please deliver your work product to Peg electronically ASAP. Thanks!

COMMITTEE UPDATES

Public Policy
CAFCA’s Position Paper and an Executive Summary have been completed and sent to all legislators, members of the Medical Services Board, JBC members, and governor’s office. Peg and Fofi have also personally met with three JBC members to discuss our concerns. The position paper gives a brief history of the RTC program and analyzes the HCPF concepts of the RTC waiver and the potential movement of the RTC program and funding from CDHS to HCPF.

CDHS has proposed CPA rules related to HB 03-1081and required statutory changes, addressing CPA conflicts of interest, audit, recovery and misuse of funds issues.  Peg has talked with Dana Andrews regarding our concerns with these rules, including reference to 150 pages of OMB circulars as a method of defining “misuse of funds.”  Peg will provide detailed information about our concerns to Dana, who is very willing to work with us on these. Peg will prepare testimony expressing our concerns about the audit, recovery and misuse of funds aspects of these rules in the event we are unable to resolve our concerns.

Two workgroups have formed to study the issues of excess costs and to develop rules to preserve positive aspects of the facility school environment.  Peg will share workgroup suggestions and products with the Facility Schools Task Force.  The workgroups will be asked to poll CAFCA RTCs with facility schools regarding: 1) How many sustained denied positions for excess costs on the grounds of incomplete credentials or paperwork; 2) What types of education costs were disallowed; and 3) whether CDE has provided enough guidance in rules to make the excess costs process consistent throughout the state.

We have had a bill drafted to delete the pre-birth notice provision in the voluntary relinquishment bill.  This correction is the result of a May 2003 Colorado Court of Appeals opinion that prohibits filing a D & N or adoption petition prior to the birth of the subject child. Fines for late CPA audits and the audit process itself are issues being addressed with CDHS. The CPA Network and CAFCA will collaborate with CDHS to attempt a resolution of these issues through rules rather than legislation.

The CAFCA RTC Position Paper regarding the RTC Waiver and potential movement of the funding and program oversight from CDHS to HCPF has been distributed to all legislators, members of the Medical Services Board and the Governor’s office. The paper and an executive summary are also posted on the CAFCA web page and maybe downloaded and shared with your board members and others as appropriate.  Peg has provided a copy to the MHASAs as well.  

Representative Al White may bring a bill to address the manner in which HCPF conducts its audit and recovery functions. Rep. Lauri Clapp is working on a Loving Care Home bill. The bill would likely involve the development of congregate settings, like orphanages or group homes. Rep. Cheri Jahn will likely sponsor a bill to clean up the contradictions and duplications in the Children’s Code. We may also see a bill to extend and expand the child care tax credit. It sunsets June 2004 and does not specifically include 24-hour facilities.  The proposed bill would extend sunset to 2014 and would include 24-hour facilities.

The next Committee meeting is Tuesday, January 6th^d, noon-2:00 p.m. at 1120 Lincoln St., 2^nd floor conference room. Cyndi Dodds continues as Committee Chair.

CTS
CAFCA members contacted Medical Services Board members regarding RTC rules which were thought to go before the board on December 12^th.  Once again, they were not on the agenda.  However, the initial general audit and recovery rules applicable to all Medicaid providers who are reimbursed and the appeal process rules were heard.  Please see above for the issues and outcome of that hearing.  Providers are once again reminded that they should keep track of monies owed them but not paid by Medicaid in the event they are audited, as they may be able to submit these amounts as counterclaims to recovery demands.  

The facility schools excess costs workgroup will meet this Thursday, December 18^th, 9-12 at 333 W. Hampden (8-story Bank One Building) in the basement conference room. Please contact Lisa Thoennes at Lkthoennes@aol.com for more information.

Adoption
Daniel Gallagher, Policy Analyst with State Judicial, attended the December committee meeting and shared the judiciary’s concerns and questions about the voluntary relinquishment staute. The committee is working with Rep. Lynn Hefley, who is the sponsor for a bill to clarify the notice and 4-day requirement in the voluntary relinquishment bill passed in 2003.  The group is also working with CDHS on regulation of out-of-state adoption facilitators working with Colorado birth mothers.  

A second stakeholder discussion meeting was held regarding a potential putative father registry bill.  The group is now focusing on a more comprehensive Voluntary Parentage Registry bill.  Kurt Olsson from LDS Family Services and Peg Long are attending the stakeholder group on behalf of CAFCA and will keep Adoption Committee members informed.

The next meeting of the Adoption Committee is January 8th, 9:00-10:30 a.m.  Location is Adoption Options, 2600 S. Parker Rd., Suite 2-320.  The meeting will be hosted by new Committee Chair Carol Lawson  (Adoption Options).

Foster Care
The Committee is working with the CPA Network and Sharen Ford of CDHS on issues regarding payment for foster families when foster children transition to adoption status. The preferred model is to pay foster parents until the adoption is finalized.  Sharen will be researching other models and will share this information.  If no resolution is achieved, CAFCA will support the Network’s move to propose legislation to address this issue. CAFCA members continue to host bimonthly provider-county luncheons to promote communication and cooperation. The next committee meeting is Tuesday, January 27th, 10:30-11:30 a.m., immediately preceding the county-CAFCA workgroup lunch. The location for both the meeting and the luncheon is Catholic Charities, 2525 W. Alameda, in Denver. Megan Aldritt of Catholic Charities continues as Committee Chair.

Membership/Communications
After pulling off one of the best annual meetings ever, the committee members took a brief rest.  Many thanks to the committee members for their hard work, creativity and excellent choices.  They have already begun planning next year’s annual meeting!  The next committee meeting is Thursday, January 15^th, noon- 2:00 p.m. at CAFCA, 1120 Lincoln St., 2^nd floor conference room.  Brad Bawmann of The Bawmann Group will join the committee for a strategic planning session under the facilitation of Jim Worthern (Namaqua Center), new Committee Chair.

Training
The Association’s Training Committee invites all who are interested in sharing their expertise by presenting at CAFCA’s annual conference to contact either Mary Simons (720 570-8402) or Rene Johnson, Committee Chair (303 780-9191 x62) Sessions will be 90 minutes in length with an average of 25-35 attendees. Presentation style may be experiential, lecture, facilitated discussion or panel discussion.  The next meeting of the Training Committee will be Thursday, January 7^th, 10:00 - 11:30 a.m., at Daybreak Princeton, 3640 W. Princeton Circle, on the Ft. Logan campus. Rene Johnson of Third Way is the new Committee Chair.

UPCOMING EVENTS OF INTEREST

The date for the Colorado Fiscal Policy Institute's 2004 Budget Works Seminar: Dollars and Democracy is Tuesday, January 6th, 2004. The event will be at the Colorado History Museum at 1300 Broadway in Denver. Registration begins at 1:00 PM and the event runs from 1:30-5:00. 

The event will include an overview of the state budget,, the Medicaid and CHP+ budget, and a panel discussion moderated by Elizabeth Arenales, Health Care Policy Director for the Colorado Center on Law and Policy. Cost this year is $25.00, but scholarships are available to those in need. You can register early by filling out the attached form and sending it back to us email, fax, mail. You can also pay-online this year through paypal.com. To register, please send information and payment to Dianne Lorang, 303-573-5669 ext. 307 tel, 303-573-4947 fax, 1490 Logan St., Suite 206, Denver, CO 80218, or dlorang@cclponline.org. 

On Friday, January 9^th, 10:00 a.m. -1:00 p.m., at the Denver Public Library, lower level Conference Center, 10 W. 14^th Avenue, Denver, the Mental Health Association of Colorado presents “The Future of Colorado’s Mental Health System: Applying the Recommendations of the President’s New Freedom Commission.” The keynote lunch speaker will be Michael F. Hogan, Ph.D., chair of the President’s New Freedom Commission on Mental Health and Director of the Ohio Department of Mental Health.  Admission is FREE, but seating is limited. Reservations must be received no later than January 2, 2004.  Call 303 377-4917 x 45, or email: MentalHealth@mhacolorado.org.

FREE Training! PRUDENTIAL POSITIVE PARENTING: A Train the Trainer Seminar for Early Childhood Child Care Staff, hosted by Nicholson, Spencer & Associates.  Date: Saturday, January 31, 2004, 9:00 a.m. – 4:00 p.m., at the Tennyson Center for Children, 2950 Tennyson St., 3^rd floor conference room, Denver.  No cost, but must pre-register by January 16^th: 720 855-3517.

FOSTER FAMILY-BASED TREATMENT ASSOCIATION is seeking proposals for their national conference in Nashville, TN, July 18-21, 2004.  Submit proposals online to: www.ffta.org/conference.html. Contact the FFTA office is you have any questions: (800) 414-3382, x. 113 or 121.  Proposal deadline is December 31, 2003.