State restructuring bill shifts program-integrity work; Larimer staff raise funding concerns

Heather O'Hare briefed commissioners on House Bill 26-14-29, which created a continuous quality improvement (CQI) committee that includes counties, Colorado Department of Human Services (CDHS), Health Care Policy & Financing, and the Department of Early Childhood. She said the law required an implementation working group and that counties are participating in monthly meetings to study whether services can be shared across counties for cost effectiveness.

O'Hare explained one substantive operational change: program-integrity duties (fraud investigations and benefit recovery) will be centralized at the state level and the state will contract with a single county to perform that work statewide. She said an RFP was imminent and warned the allocated funding for that contractor "is not sufficient to really operate that contract in a fiscally responsible way," noting many smaller counties currently do not perform program-integrity work because of funding constraints.

Commissioners discussed the implications for county staffing and liability; O'Hare said about two-thirds of Colorado counties currently do not perform that work and that centralization increases the state's exposure if counties are unable to carry out program-integrity activities. She said the county subcommittee (with 20 county reps) is examining model policies and will bring recommendations back to state meetings.