Alliance Public Policy & Budget Priorities
Alliance is committed to working toward a system of services and supports that honors individual choices, promotes self-determination and brings out the potential in each and every individual with whom we work. We realize that the community is a place to live, learn and grow, and that the choices individuals make should reflect their values and priorities. Alliance believes that a system built on the principles of self-determination is a more efficient, elegant and effective way of providing services and supports. More importantly, we believe that creating a system that offers the opportunity for self-determination and the right to make choices is the right thing to do for the individuals we are privileged to serve.
Alliance Public Policy Priorities
Community Capacity for Intellectual and Developmental Disability Services
Medicaid Home and Community-Based Services and other state programs that provide services and supports to people with IDD must be adequately funded to ensure access to timely services. Individuals and families should never have to wait for services that are essential to their livelihood.
Wait lists for services and community capacity issues are inextricably linked. Colorado must continue its commitment to reducing and eliminating wait lists for services by creating reimbursement rates that reflect the true cost of providing services and supports in Colorado and update these rate structures annually to account for inflation.
Inadequate rates prevents agencies from hiring and retaining the most qualified case managers and providers which is perhaps the most essential component of quality services and supports. Colorado must support case managers and direct support professionals through adequate wages, benefits, and training to create a stable and professional workforce.
Person-Centered & Consumer-Directed Services
Individuals with IDD and their families expect and deserve person-centered services and supports. Alliance members have led efforts to design and implement a statewide person-centered training initiative. Colorado must support agencies to obtain person-centered training to transform the current service system for individuals with IDD into one that incorporates person-centered policies, principles, and practices at its foundation.
As part of a person-centered approach, individuals with IDD should have the maximum opportunity to direct their services to the degree that they choose, including employer and budget authority. Colorado should offer a consumer-directed option in all Medicaid HCBS waivers.
Conflict-Free Case Management
Colorado’s case management services are under examination as the State works to comply with new federal rules. Colorado must work with Community-Centered Boards, Program-Approved Services Agencies, individuals with IDD, their families, and advocates to ensure that any changes to the current system do not harm individuals with IDD through disruption to, or reduction of, case management services. Colorado must ensure that case management services continue to be provided by locally accountable and knowledgeable providers.
Early Intervention services are essential for the growing population of children from birth to three years old who are at risk of developmental delay or disability. Early Intervention services can also prevent the need for more expensive interventions later in childhood. Colorado must adequately fund Early Intervention program growth and service coordination to ensure access to services for these children.
Employment is the primary way that most of us engage with our communities, through both relationship-building and wages that support active community life. Colorado must advance Employment First strategies, policies, and practices that target integrated employment at minimum or prevailing wages or above for all individuals with IDD. These strategies must include incentives for employers or other solutions that will expand work opportunities for individuals with IDD in competitive, integrated jobs. Colorado should expand the Medicaid Buy-In program to encourage higher wages for people with IDD and increase resources for supported employment, workforce development programs, transition programs, and model program development.
Significant gaps have been identified in behavioral services for individuals who have co-occurring intellectual and developmental disabilities and mental and/or behavioral health needs. Colorado should support innovative projects to enhance services for this population as well as efforts to scale them for statewide implementation.
Right to Technology and Information Access
Technology plays a central role in creating opportunities for people with IDD to communicate and participate in education, employment, independent living, and decision-making. Colorado must ensure that individuals with IDD have access to comprehensible information and usable communication technologies to promote self-determination and meaningful engagement in all aspects of life.
Community providers continually run into regulatory barriers to providing the person-centered services that individuals and families expect. Colorado must work to create a regulatory framework that encourages person-centered practices and allows individuals with IDD to exercise maximum control over their lives while balancing health and safety concerns. This must include streamlining requirements between multiple state agencies and between federal and state rules, as well as eliminating rules that impede person-centered practices.
Alliance Budget Priorities
Create Viable Community Provider Rates to Reduce and Eliminate Wait Lists
Alliance urges the Governor’s Office and the General Assembly to continue their commitment to reducing and eliminating wait lists for intellectual and developmental disability (IDD) services. Wait lists and community capacity issues are inextricably linked. Efforts to eliminate wait lists must include meaningful investments in community capacity through IDD rate increases.
We appreciate the efforts of the Governor’s Office, the JBC, and the General Assembly to partially restore eroded IDD rates in recent years. However, IDD rates continually fail to keep pace with inflation, while the cost of providing quality services continues to rise each year.
IDD providers and case management agencies (CMAs) have lost purchasing power year after year. Inadequate rates prevent providers from responding to requests to serve individuals with IDD, thereby limiting individuals’ access to, and choice of, services. Agencies increasingly struggle with high turnover rates among staff, including case managers. IDD providers and CMAs are particularly impacted by inadequate rates because Medicaid pays for approximately 95% of these services. The disparity between IDD rates and costs must be addressed in order to ensure ongoing access to services statewide. Alliance urges Colorado to:
Substantially increase IDD rates to ensure access to quality services and supports, enhance individual choice, and reduce wait lists for services.
Provide Adequate Resources for Ongoing Needs
Alliance urges the Governor’s Office and the General Assembly to include the following budget items to address ongoing needs:
Allocate HCBS-DD Emergency Resources to ensure continuity of care when individuals experience crises, such as the loss of a caregiver.
Fully fund Early Intervention growth and service coordination to ensure access to services.
Allocate HCBS-DD resources for all children aging out of foster care to ensure continuity of care for these children who experience multiple and challenging conditions.
Allocate HCBS-DD and HCBS-SLS resources for all children aging out of HCBS-CES, who cannot remain in the family home without continued services.
Now that the HCBS-SLS and HCBS-CES wait lists have been eliminated, allocate enough resources on an annual basis to keep up with program growth.
Allocate State-funded Supported Living Services for those who do not qualify for Medicaid waiver services.
Maintain current funding levels for Family Support Services.