Colorado PAR turning back on in 2025 marks a major change in how skilled care needs are evaluated and approved. On July 1st, 2025, the Department of Health Care Policy and Financing (HCPF) will implement a reliable assessment to determine a member's appropriate level of care through the PAR program. This update ensures applicants receive fair, accurate evaluations and access to services that match their needs. The new assessment also includes counseling to help members make informed decisions regarding their service options.
Developed by the University of Massachusetts in 2022, the new assessment is based on the existing Pediatric Assessment Tool (PAT), modified to include multiple components. These include the Long-Term Home Health-Registered Nurse (LTHH-RN), Long-Term Home Health-Certified Nursing Assistant (LTHH-CNA), and Private Duty Nursing (PDN) components. All components are used to identify the member's skilled care needs and health maintenance activities (HMA).
In addition to the Skilled Care Acuity Tool, a nurse assessor will assess members for all care services they may qualify for. By providing a complete assessment of the skilled care services, the assessor can help avoid conflicts of interest.
Children will need a complete reassessment each year, while adults will need Express Reviews. Members can also request a reassessment when their needs change.
Currently, the home health agency (HHA) determines the type of skilled care service each member receives based on their needs assessment or what they're willing to provide. This can create a conflict of interest as the members may not be fully informed about the available skilled care options. As a result, the member or patient doesn't receive the appropriate level of care they need.
With the new program to be implemented, the University of Massachusetts for Health Consulting team thoroughly assessed it by dividing their project plan into four sprint cycles. During each cycle, draft assessments were created and tested. Insights and feedback from their findings were used to improve the assessments. After the fourth cycle, sufficient data was available to help them test the reliability and accuracy of the new program.
Vendors will receive assessment training in May. They will begin system preparations the following month, and the new program will be fully implemented in July 2025. The Skilled Care Acuity Tool and Nurse Assessor will ensure that members receive high-quality, evidence-based care.
One of the biggest concerns when implementing the ColoradoPAR is delay. The vendor may be unable to accommodate high assessment demands, leading to backlogs. Members may also wait extended periods for the assessment, which can impact their skilled care needs.
To resolve the problem, the HHA can continue with its needs assessment but use the new acuity tool to ensure a more accurate result. The HHA can also manage its workload by extending the certification periods, giving its staff more time to work on the assessments.
Another problem that could arise is when the nurse assessor interprets the guidelines differently, leading to inconsistencies in the assessments. To resolve this, they will develop an effective training plan for the vendor to minimize or eliminate discrepancies.
Any changes or guidance will be sent to all parties involved, avoiding miscommunication that could lead to more problems down the road. To ensure quality, they may also implement a Quality Assurance program.
The nurse assessor may change the member's current service authorization during the reassessment. To alleviate this problem, the recommendation provided by the nurse assessor is just part of the approval process.
The HHA can always request additional support or hours if the assessment can't identify or capture the member's needs. If the CNA hours decrease, the HHA can use the Direct Care Calculator to determine each patient's or member's remaining care needs.
Another issue is when the assessor isn't knowledgeable or skilled in evaluating a member with cognitive impairment or developmental disabilities. This can be resolved by ensuring the vendor only employs professionals who can accurately diagnose I/DD.
When the member isn't satisfied with the assessment and complains, the staff can inform them how to appeal the decision. Make sure the members know how to request a new assessment.
The ColoradoPAR, set for 2025, aims to provide better and more accurate assessments, ensuring the members receive proper care. The new tool developed by UMass involves multiple components and a Nurse Assessor for a more accurate and effective assessment. While risks are possible, the program has proactive measures in place to address potential issues.
Do you need more resources about the PAR program or skilled care services in Colorado? Contact Abby Care today.
