Third supplemental filing details continuing discriminatory case management practices for people with disabilities, calls for action from U.S. Department of Health and Human Services
DENVER, CO — September 23, 2024 — On September 16, 2024, the National Health Law Program (NHeLP) and Colorado Center on Law and Policy (CCLP), one of NHeLP’s Health Law Partnerships, formally submitted an administrative complaint to the Office for Civil Rights in the U.S. Department of Health and Human Services, addressing the ongoing discriminatory provision of case management services for individuals with disabilities in Colorado. This supplemental complaint follows a previous filing made by CCLP and NHeLP on February 21, 2024, with subsequent supplemental information provided on February 28 and March 12.
The complaint details still-unaddressed delays and systemic issues in Colorado’s case management system. These deficiencies have resulted in serious obstacles for individuals with disabilities seeking essential services. Key findings from the complaint include:
- Extreme Delays in Enrollment and Service Delivery: Despite changes in policy to protect individuals with pending applications, new Medicaid applicants continue to face extreme delays. The Colorado Department of Health Care Policy and Financing (HCPF) has not met federally mandated timelines for processing applications, with hundreds of applications from 2023 still unresolved as of August 2024.
- Lack of Tracking and Accountability: There is a critical absence of tracking mechanisms at both county and Case Management Agency (CMA) levels, leading to significant delays in the processing of disability applications. Advocates report cases where counties have failed to forward applications for months, compromising individuals’ access to necessary care.
- Ongoing Backlogs at ARG: The vendor responsible for disability determinations, Arbor E&T LLC dba Action Review Group (ARG), continues to struggle with backlogs, with over 1,000 cases pending beyond the legally required 90 days. This situation is exacerbated by staffing shortages and ongoing technology issues.
- Continuing Systemic Problems: Previous issues highlighted in earlier complaints remain unaddressed, leading to cumbersome processes and extended wait times for applicants. Advocates express frustration over the lack of effective solutions to systemic issues within the Care and Case Management (CCM) system.
“HCPF’s main job is Medicaid administration,” said Bethany Pray, CCLP’s Chief Legal and Policy Officer. “These continuing systemic challenges and barriers to access are not only a disservice to Coloradans, but a violation of federal law. Federal agencies must hold Colorado accountable and ensure that individuals with disabilities receive the timely support they deserve.”
CCLP and NHeLP are calling on the federal government to expedite the review of this complaint and take immediate action to ensure that Colorado complies with federal standards for timely and equitable case management services. Meanwhile, CCLP continues to meet with HCPF representatives and with Colorado legislators in the effort to find proactive solutions to the Medicaid eligibility crisis. The most recent of these public engagements was a hearing held on September 19 by the Joint Budget Committee (JBC) of the Colorado General Assembly.
“We appreciate the state’s continued attention to this urgent issue,” said Katherine Wallat, Legal Director for CCLP. “HCPF staff are meeting with the public regularly, and are working hard to address concerns. Though the issues we identified earlier this year continue to wreak havoc on the lives of Coloradans with disabilities, this public accountability is an encouraging sign of a positive resolution to come.”
About The National Health Law Program (NHeLP)
The National Health Law Program (NHeLP), founded in 1969, protects and advances the health rights of low-income and underserved individuals through advocacy, education, and litigation at the federal and state levels. For 55 years, NHeLP has worked with national, state, and local partners to ensure that individuals with disabilities have the Medicaid services they need.
About Colorado Center on Law and Policy
Founded in 1998, Colorado Center on Law and Policy is a nonprofit, non-partisan organization that stands with diverse communities across Colorado in the fight against poverty through research, legislation, and legal advocacy. Driven by our core values of equity, integrity, strategic advocacy, collaboration, and community engagement, CCLP envisions a Colorado where everyone has what they need to succeed.
