It is way past due to overhaul CO Medicaid's CMHS Waiver

Montana—Home and Community Based Waiver for Adults With Severe Disabling Mental Illness • Section 1915(c) waiver

• Services:
  • case management,
  • adult residential care,
  • supported living,
  • adult day health,
  • personal assistance and "specially trained" attendant care,
  • habilitation,
  • homemaking,
  • respite care,
  • outpatient occupational therapy,
  • psychosocial consultation including extended mental health services,
  • chemical dependency counseling,
  • dietetic and nutrition services,
  • nursing services,
  • personal emergency response systems,
  • specialized medical equipment and supplies,
  • nonmedical transportation,
  • illness management and recovery, and
  • wellness recovery action plan

  • • Objective: allow an individual with a severe, disabling mental illness a choice of receiving long-term care services in a community setting as an alternative to a nursing home setting.
  • • Eligibility: individuals with mental illness aged 18 years and older; the consumer must meet nursing home level of care requirements and reside in an area of the state where the waiver is available.
       We used to just rack up Colorado's ineffective Medicaid MI/CMHS (Community Mental Health Supports) Waiver to the vagaries of history which never got corrected:  it is pretty close to identical to the HCBS-EBD (Home and Community Based Services for Elderly Blind and Disabled) Waiver and largely designed for people with physical disabilities.
          AND then the Hickenlooper administration decided to add an even more pernious and discriminatory requirement for the CMHS Waiver -- no doubt to save money.
           They changed the Waiver Targeting Criteria to those with Mental Illness who need Assistance with Activities of Daily Living.
              https://www.colorado.gov/pacific/sites/default/files/
Changes%20in%20Community%20Mental%20Health%20Supports
​%20Waiver%20Targeting%20Criteria-October%202015.pdf  

                    Well all that makes perfect sense when you've got an CMHS Waiver that's really a physical disability waiver -- which isn't to say there wouldn't be some overlap -- BUT this is ridiculous when  it isn't gross malfeasance AND IT IS GROSS MALFEASANCE.
             This waiver has historically had a LOT of problems, including a dismal 2007 CMS AUDIT in which the State was spending only $12 a day for people who qualified for Medicaid long term care waiver services.  
               There are a LOT of things that need to be done to serve  the long term care needs of people with serious mental illness -- these targeting measures for activities of daily living weren't it.
                This waiver needs to overhauled with an eye to the true long term care needs of people with serious mental illness.
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