Service Delivery

The U.S. Department of Health and Human Services estimates 70 percent of adults over the age of 65 will need some form of paid long term services and supports (LTSS). LTSS may include home and community based services, such as:

• Assistance with housekeeping
• Bathing and dressing
• Transportation 
• Food preparation and nutrition, and 
• Other activities of daily living or instrumental activities of daily living.

LTSS may also include facility based care such as assisted living facilities, skilled nursing facilities or memory care facilities.
    
The majority of Older Coloradans want to age in community. In order to support this desire, Colorado can support the LTSS needs of older adults in home and community based settings. The state of Colorado provides or supports LTSS through many state agencies, including, but not limited to:

• Colorado Department of Human Services deploys Older Americans Act funding and State Funding for Senior Services through the State Unit on Aging to 16 regional Area Agencies on Aging. CDHS also administers the Home Care Allowance (Google Doc) program to provide cash assistance to cover home care providers. Additionally, the Adult Protective Services (APS) Program and Colorado APS database (CAPS) checks process help ensure older adults are protected from abuse and neglect and reduce self-neglect. 
• Colorado Department of Health Care Policy and Financing (HCPF) deploys Home and Community Based Services (HCBS) waivers through Health First Colorado (Colorado Medicaid). HCPF also convenes the Direct Care Workforce Collaborative to support the agencies and staff providing care to older adults.
• Colorado Department of Transportation provides transportation services to older adults and Coloradans with disabilities with 5310 Funds.
• Colorado Department of Public Health and Environment oversees the licensing and credentialing of long term care agencies including:
  • Assisted living facilities
  • Home care organizations
  • Skilled nursing facilities
  • Community based health care programs and others.
• Colorado Department of Labor and Employment’s Division of Labor Standards and Statistics provides support and resources for direct care workers, including the Direct Care Workforce Stabilization Board recommendations (Google Doc).

Our goal is to provide more Coloradans with the Long Term Services and Supports in the most effective and economical methods possible. In order to accomplish this goal, Colorado is in need of significant systems change to most adequately provide resources for older Coloradans in need. This systems change will include:

• Data Collection strategy refinement
• Alternative funding models
• Trust building amongst skeptical older adults
• Increasing service provider capacity
• Developing and stabilizing the direct care workforce

Though most older adults want to age in their community, facility based care may be the most appropriate option for some older Coloradans. Colorado strives to reduce the stigma associated with facility based care and reduce the cost burden to Colorado families by improving safety and quality of care.

Additionally, Colorado recognizes the 600,000 family caregivers who provided 560 million hours of unpaid care. Further development of respite services, training resources and payment models will provide a blueprint to support the unpaid caregiving cohort in Colorado.

Colorado has consistently been a national leader for state funding for older adult services. With older adult population increases, this MPA recommends exploration of innovative older adult funding streams to keep pace with the growing population. We will identify the most efficient and effective funding strategies to ensure older Coloradans have access to necessary supports. This includes federal advocacy, philanthropic engagement, business community participation and analysis of our state funding levers. Our goal is to provide the most effective resources to more older Coloradans.