The HCBS Brain Injury Medicaid Waiver Transitional Living Program
SB160, which proposed deleting 7 words out of the Transitional Living Program statute language, passed the last hurdle earlier this week. The removal of the language means that there is no longer a time limit for individuals getting services in this program.
In addition the JBC approved a ½% increase on reimbursement rates for facilities offering the TLP program.
What all this means is that individuals who have suffered a brain injury and need intensive rehab services in a residential facility can now receive those services for an unlimited period of time. And facilities have appropriate reimbursement rates for this service.
All in all, very good news, especially for the individuals who may have maladaptive behaviors as a result of their BI and are struggling to find somewhere to live.
The Colorado Dept of Healthcare Policy and Financing (HCPF) is asking the Joint Budget Committee for additional provider reimbursement funds and has offered he HCBS Brain Injury Waiver as an example of how those funds could be directed. With increased funding and a minor fix of the statute we believe that we will have a viable option for the post-acute ‘Hard-to-Place’ clients.
In order to fully utilize the Transitional Living Program we also need to run a bill to remove some language from current statute.
Our Lobbyist has secured Rep. Primavera (D) and Sen. Newell (D) as sponsors and is working on adding Republican sponsors before the bill is introduced.
This is very exciting for the BI community given the behavioral issues many survivors experience during their recovery
Here is the option from HCPF:
Option: Fund the Transitional Living Program for Brain Injury Clients
Rationale: The Transitional Living Program (TLP) assists clients with critical injuries in returning home and integrating back into their community. The program provides both rehabilitative and habilitative care. Due to rates, there are currently no providers for this integral service within the care spectrum for individuals who have suffered a brain injury. The lack of services requires these patients to remain in the hospital for longer periods of time with eventual discharge to a more costly service option. This option would fund TLP for brain injury patients. Extending TLP to brain injury clients should serve to reduce costs by shortening hospitals stays and avoiding nursing facility admissions.
Percent Rate Increase: $876,000. A 191.28% increase in the reimbursement rate.
Projected Total Cost per Year: $876,000.00
Timeline: The minor systems changes that are required can be implemented quickly. Minor amendments to the existing waiver can be completed within a few months and should not cause a delay in implementation. The waiver may be amended retroactively if necessary.
Brain Injury Alliance of Colorado