October 23, 2025 Minutes

Weld County Case Management Agency - Community Advisory Committee Meeting Minutes

Date: Thursday 10/23/2025
Time: 9:00am-11:00am
Facilitator: Angela Korthaus
Note Taker/Timekeeper: Cassie Bixler
Attendees: Dawn Simmons, Leticia Arguello, & Victoria Moul.
Not present: Brittany Louge & Cathy Laws

Agenda Items

  • 08:55-09:00 

    Welcome & Introductions

    • Briefly confirm meeting agenda and expectations.
  • 09:00-09:03

    Review/approval of meeting minutes from 7/24/2025

    • Reviewed how to find CAC notes on website and confirmed formatting
  • 09:03-09:46

    CMA Updates (PowerPoint)

    • Review Power Point to discuss Updates
    • Notes: 
      • Staffing: Currently at 56 Full time Case Managers, 2 Part time Case Managers, 5 Program Specialists, 3 Case Aides, 8 Program Supervisors, 2 Program Managers, & 2 Billing Specialists.
        • Currently looking to hire an additional 2 Case Managers. 2026 Budget is also being reviewed to see if team can expand for an additional 5 Case Managers and 1 Supervisor.
        • All Case Managers have cell phones now and are giving members their direct number to members and we’ve received feedback members are appreciating the ability to text their Case Managers. They also have hotspots on their cells which give them more access to use their computers and enter information directly during meetings.
      • 2025 we’ve seen a major increase in referrals (April 2025: 276, May 2025: 302, June 2025: 280, July 2025: 317, Aug 2025: 329, Sept 2025: 333). They have increased 311% since March 2024. We anticipate referrals will continue to grow. CMA is planning to add a position to Intake to accommodate need. Looking to hire from Ongoing Team but will take some time to back fill, expected to occur in December 2025/Jan 2026.
    • Ongoing Case Management
      • Non-IDD Case Managers (EBD, CMHS, BI, CIH waivers): 24 case managers with an average caseload size of 75
        • 1 new case manager finish up training and receiving a caseload as of 11/1/2025. 1 case manager on leave; expected to return mid December 2025
      • IDD Case Managers (DD and SLS waivers): 7 case managers with an average caseload size of 62
        • 2 CM’s who started 10/20/2025 and in training. They will receive a caseload either 12/1/20205 or 1/1/2026
      • Children's Waivers Case Managers (CES, CHRP, CwCHN waivers): 8 case managers with an average caseload size of 67
        • 1 case manager who started 10/22/2025. She will receive a caseload either 12/1/2025 or 1/1/2026.
      • FSSP and State SLS: 2 Case Managers who with an average caseload size of 104
      • Throughout programs there are 3 Case Managers currently going through training and many of the newer ones are still receiving intensive oversight and will continue to receive this level of oversight through their first year.
    • Nurse Assessor: Went into effect 8/1/25.
      • Nurse Assessor is contracted through Telligen, and they are doing the acuity assessment and sending results to Case Manager and the individual. Then the Case Manager reviews the acuity assessment recommendations and determines if they will be accepted as is or if they will make changes to align with needs. There have been many meetings regarding the Nurse Assessor program and many discussions how to realign with needs.
      • Every CMA is operating a little differently. Weld is reviewing the recommendations from the Nurse Assessor, and our approach is each Case Manager will review the NA acuity assessment recommendations with their supervisor to determine appropriateness and if a deviation is required. Many recommendations are for unskilled care rather than skilled care. After meeting with Supervisor, Case Manager will talk to family about what the new plan will be.
        • Victoria- Many PASA’s padded hours during covid. Is push for the hours through the nurse assessor or through the PASA? Who is determining the hours? Many folks, through advocacy groups are confused about how these are being determined or changed and why there is such a large change in hours. What is the best way to explain this to families?
        • Angela- Case Managers must justify all hours. Through covid we did our best to work with agencies that were requesting excessive hours. This is why our approach is that all recommendations are staffed with a supervisor to determine appropriateness.
          • Example of homemaking- Weld case managers have seen NA recommendations as high as 30 hours a week and the case manager upon review is only able to justify 7-10 hours a week.
          • Another issue case managers are experiencing is the NA recommendations being sent directly to the individual. It creates an adversarial relationship between the individual and the case manager when the case manager does not agree with the NA recommendations and reduces the recommended hours.
      • Dawn- Is it in the scope of the Nurse Assessor to advise a higher level of care or only share hours?
      • Angela- We have not seen that in our CMA, but we have also seen a recommendation for 26 hours of care a day. The CMA has received member feedback that some of the meetings have been so short (30 minutes) that they have not gone into the details needed to have accurate hours. Very thankful the CMA has the right to supersede the Nurse Assessor hours with justification.
      • Dawn- What is the process to choose different hours?
      • Angela- There is a deviation process the Case Manager goes through for the skilled nursing hours to explain their justification with the member/family after that review with the Supervisor. We’ve received feedback that members feel we have been very communicative with these changes and deviation processes. Sometimes there is an increase in hours and sometimes a decrease, but it is all based off the members’ needs. We especially see this with children as they will have changes in their needs as the child grows. Most families understand these changes and are okay with this. If they disagree with the decision, we send a Notice of Action, and they have the right to Appeal the decision.
      • Victoria- Talking to CMA’s there are many instances of yelling, cussing, attacks they are dealing with from Home Health Agencies. They went out advertising how many hours a family could receive for care. Concern some of these agencies are not properly educated and families are having to rely on these agencies for information which is causing issues all around because the agency started miscommunicating the information. She has experienced having the same hours year to year to provide for her kiddos and has back-up plans because she is getting concerned funding may be pulled. Concerned these companies are causing issues for program and CMA having to re-educate on what the hours could be. She is aware of some of the other programs and resources that are available but other families may not be aware of the other options. It’s unrealistic as the agencies are spinning stories on these families, they could make so much more money and be able to go on trips and then create such unrealistic expectations. Victoria is concerned that the state/HCPF/agencies are not taking in seriously to provide the education and make sure it’s accurate/honest education that’s being provided. Victoria expressed concern these waivers are being utilized for their monetary benefits rather than the actual purpose of making sure they still have the services they need.
      • Angela- The Weld CMA approach isn’t perfect, but we are very aware of members/families trying to ‘pad’ care plans to get a certain amount of dollars. When the Case Managers first meet with members/families we are very clear this is not a career job change and will change with the individual’s need and the hope is the individual will improve and will need less care someday which would result in them getting less hours. We have experienced an increase with IHSS agencies, especially with 2 of them that are demanding members receive specific hours and have escalated both agencies to the State (HCPF). HCPF is working with these agencies and has communicated the importance of not sharing misinformation with potential members/families. We have had open conversations with both agencies and explained the information they’re sharing is not appropriate and causes issues for the families. We are not afraid to have those conversations with the families, agencies, and escalate to the HCPF when needed. One thing we found interesting was HCPF had noted other CMA’s had reached out with concerns regarding the same agencies.
      • Victoria- Has experiences a large change with how agencies are operating and families when they are upset with the re-education.
  • 09:46-10:31

    Review of CMA Policy and Procedures
     Data Entry, Monitoring and Integrity- Comments. Agree with formatting concerns.

    • Comment (Page 4: Annual Comprehensive Review)- Question if “Department” is defined? Is this WCCMA or DHS or something else? May be beneficial to move away from stating the Department. We should keep this in mind for all Policies & Procedures.
    • Comment (Page 4: Annual Comprehensive Review)- Concern with the last portion of the sentence “…like the system cleanup efforts that took place during contract transitions.”
      • It feels like a statement that would only make sense to someone who was in the department during that period of time. Consider alternative wording to describe what the comprehensive review would be like.
        • Discussion: Would made sense to remove the highlighted section as it causes confusion. OR revisions to note the goal of having the record be accurate and complete.
    • Dispute Resolution Handout- Comments. Agree with formatting concerns.
      • Comment (Page 2: 1st Bullet)- Agree “ARC of Weld County” should be changed to “The Arc of Northeast Colorado”
    • Human Rights Committee- Comments. Agree with formatting concerns.
      • Comment (Page 3: 1st Bullet)- Question if this should be communicated by WCCMA within a certain timeframe, so the sending agency has time to correct documentation issues?
        • Discussion- It would be beneficial to discuss what the consequences are if the Agency does not complete timely follow up. Also helpful to note in this what the actual time frame expectations are. Also, it is important to note how long Weld CMA HRC must review the packet and then reach out to the agency.
    • Insurance Requirements- No Comments. Agree with formatting concerns.
    • Investigations Policy and Procedure- Comments. Agree with formatting concerns.
      • Comment (Page 2: 1st Link)- Agreement that link will need fixed and should be consistent going through similar LawJustia.com website
      • Comment (Page 3: Bullet 5)- Question if what qualifies as “timely reporting” should be defined.
        • Discussion- May be beneficial to separate or note that CIR’s would need to be reported to Law Enforcement within 24 hours since Telligen reviews have a variety of timelines for follow up. Could possibly note following Colorado Mandatory Reporting Laws. Should or does this policy note the Mandatory Reporting with supersede the CIR process. Case Managers would be directed to report following Mandatory reporting process and then separately follow CIR process but both processes would be required. Maybe separate the note of “Law Enforcement” to a separate bullet point for clarity
      • Comment (Page 4: Point 2b)- Concern this notes “…five (2) days….” and unsure of which date is correct.
        • Discussion- Believes it should be 2 days but will follow up to confirm and correct.
    • Member Satisfaction Survey- Comments. Agree with formatting concerns.
      • Comment (Page 3: 1st Bullet)- Question if this bullet should define the timeline for report distribution.
        • Discussion- Will need to follow up with HCPF. HCPF had stated they would be completing surveys, so we have not experienced one yet. Will also check when they will occur.
          • Note- It would be beneficial for CMA to do these. Also, would be concerned with the current climate if these would be used to air general grievances rather than CMA related concerns
    • Monitoring Contacts- Comments. Agree with formatting concerns.
      • Comment (Page 2: Point 2, 1st Bullet)- Question can the member decide where they want to meet, or does it have to be at one of these two places?
        • Discussion- May be beneficial to note this is a CMS requirement to have at least 1 in-person monitoring contact.
      • Comment (Page 2: Point 3, 4th Bullet)- Question if there are more contacts completed where/how are they documented?
        • Discussion- These are still noted in CCM. No further clarification requested.
      • Comment (Page 3: Point 3, 2nd Bullet)- Question is there a form for this or is it a general discussion?
        • Discussion- These are documented in the CCM log note but are from a general discussion.
    • Prioritizing Urgent Inquiries- Comments. Agree with formatting concerns.
      • Comment (Page 2: Point 4, 3rd Bullet)- Recommendation to change “Ten business day referrals” to state the program type of referral for clarity. Change to “HCBS and CFC referrals”.
      • Comment (Page 3: Point 4, 1st Bullet)- Recommendation to change “Five business day referrals” to state the program type of referral for clarity. Change to “PACE and Nursing Home referrals”.
      • Comment (Page 3: Point 4, 2nd Bullet)- Recommendation to change “Two business day referrals” to state the program type of referral for clarity. Change to “Hospital referrals”.
    • Purchasing and Returns OHCDS Policy- Comments. Agree with formatting concerns.
      • Comment (Page 2: Document Verification…. 9th Bullet)- Questions how long is permitted for the case manager to verify before submitting to the billing coordinator?
        • Discussion- What would be an appropriate timeline?
        • This should be worked backwards from the timeline the billing coordinator needs to process. To stay consistent with timeframes, possibly 5 business days?
      • Comment (Page 2: Review by Billing Coordinator 3rd Bullet)- Question how long does the billing coordinator have to review the documentation and either email the case manager or submit it to the director?
        • Discussion- Timelines will need reviewed and added.
  • 10:32-10:44
     Review of Complaints/Trends (September 2025)
     Review Excel sheet with complaints.
    Discussed to meet requirements during the month there is not a CAC meeting, is it agreeable to send this monthly in a secured email to meet reviewing requirements. The CAC confirmed this new process will work and we will review next meeting if this is effective.
  • 1st Complaint- Discussion on there will need to be clarifying conversations on what individuals are looking for when they request a record. There is the issue that CCM log notes are not easily pulled to share.
  • 2nd Complaint- Discussion that confusion does stem from separate programs that do not connect with each other which cause issues (example of Trails and CBMS). There are ongoing conversations in Weld DHS on how to process these moving forward so this type of issue does not occur again.
  • 3rd Complaint- No concerns.
    • Members noted there seem to be very few complaints about the current caseload sizes.
  • 10:45-10:46
     Review of Exceptions to the Defined Service Area
     There was 1 exception in August 2025. It was granted because they are very close to Weld, and their case manager was able to continue working with them.
  • 10:46-10:51
     CMA Budget Process Review
     Billing is going through audits to refund funds that were not used to ensure all billing is accurate.
    • Dawn- Question if that happens often.
    • Angela- It does not happen often but does occur sometimes due to systems that are used, and they are reviewing alternative things they can do to try and minimize receiving funds that are not needed or will need returned.
    • Kelly is working closely with fiscal department for new positions to show capacity and available funding to support additional staffing. Hoping to have approval and be able to post positions for hiring in December 2025.
      • Dawn- What team would Supervisor position be used for?
      • Angela- It’s still being reviewed which team the supervisor would support.
  • 10:51-10:51
     Member Updates
     None
  • 10:52-10:58
     Meeting Close
    • Next meeting 1/22/26 from 9-11am.
    • Victoria- Is there ever a separate meeting that discusses budget?
    • Angela- It’s reviewed by County Commissioner to see where there is room for space. CMA is unique as our budget is based on our monthly billing. If you have specific questions about budget, please reach out and we can get the information prior to the next meeting.
    • Dawn- It is important to note that while Weld might take some time to approve budgets they emphasize being fiscally responsible to make sure its acceptable growth and there won’t be layoffs or a deficit in our county
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