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Informing Policy. Advancing Health.

A Ground-Level View of Colorado’s Long-Term Services and Supports System

November 15, 2012

How people enter the long-term services and supports (LTSS) system might not sound like a sexy topic in the health policy realm. But for people who work on the front lines and at the state level, this is an area that generates a lot of interest. Colorado’s LTSS workers are knowledgeable and committed, but often find themselves working in silos by population and program. At the state level, there is a broad view of LTSS from a policy perspective but it doesn’t always translate into a view from the customer’s experience perspective.

CHI has produced a graphic to help people understand the complexities of the eligibility and enrollment system for LTSS in Colorado. We conducted key informant interviews of workers on the front lines and at the state level. Using this information, we compiled an introductory map of how people move through the system. Because this system is so complex and varies by county and region, this puzzle and its pieces represent a very broad overview. While there are limitations to leaving out certain elements of LTSS, this graphic provides a foundational body of information to understand on a basic level how people access LTSS in Colorado.

What we found through our interviews is that system is complex and confusing to navigate for a person at a time of great vulnerability. Because Colorado has historically been ahead of the curve in providing home and community based services (HCBS), the pieces of the puzzle have really been pieced together incrementally as the needs of the system have changed. This piece-by-piece construction of a system has led to a complex and confusing set of pathways.

CHI presented this graphic to a group at the first annual Aging and Disability Conference, put on by the three health departments in Colorado. The presentation includes the graphic, what we heard from our interviews and some ideas about how to alleviate the sticking points in the system. Along with the graphic, we provided definitions and an example from Minnesota, which is an innovative state in the LTSS arena.

CHI plans a Phase Two of this project. We will take a deeper look at the finer details of the system and incorporate feedback from the presentation at the conference. We believe that a solid framework of understanding can help lead to innovative and collaborative health policy solutions. Stay tuned!