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The Public Health Emergency, what is it and what happens when it ends?

I for one never thought I would be living through a global pandemic, let alone one for over 18 months. As we all have made major changes in our lives due to COVID-19, one that the federal and state governments made was declaring a Public Health Emergency (PHE). Now this PHE impacts many areas of Colorado Medicaid services, such as general access to medical services and to waiver supports. As with all things, COVID-19 will be behind us, some day, and this PHE will come to an end. When that ends it might impact you or your loved ones Medicaid services. Let me try and explain the PHE, it coming to an end, and how you can be prepared.

To start the Public Health Emergency (PHE), when boiled down to bare bones allowed the federal and state government to not follow certain rules and regulations related to people’s eligibility. Thus, allowing people to stay covered by Medicaid (and CHP+) even if they would not be eligible if not for COVID-19. An example is if a person on a Medicaid waiver exceeds the $2000 financial limit, during normal times they would be terminated from the waiver and Medicaid. Due to the PHE they cannot be terminated for having more than $2000, until the end of PHE. Another example is someone cannot age out of a waiver during the PHE, so if a kid on one of the child waivers turned 18 during the last 18 months, and they would not qualify for an adult waiver, they were allowed to stay on their child waiver, until the end of the PHE. Most of the individuals or families, who are on a waiver and work with The Arc are eligible and will more than likely not lose eligibility when the PHE ends.

The PHE also allowed for other helpful policies like “maintenance of effort” which allowed people to continue to access services and supports at the same level prior to the pandemic, during the pandemic. Without worrying about going over caps or budgetary restraints. An example of this is if an individual had a set number of hours for personal care supports, but those hours were based on the individual going to work or a day program a handful of times a week. Due to COVID-19 shutting things down and impacting how people with disabilities can “return to normal” that person might be using more personal care supports than anticipated, thus are close to or over the cap for this service. The PHE allows for them to maintain the service.

Individuals and families will need to prepare for when the PHE comes to an end. They will go back to the level of support there was prior to the pandemic. So talking with a case manager about the increased needs, to see how adjustments can be made may be necessary.

The PHE also provided additional funding from the federal government, which has been critical during this economic downturn.

Lastly the PHE kept people who need Health First Colorado (Colorado’s Medicaid program) and Child Health Plan Plus (CHP+) members covered during the PHE, so they do not have to worry about their health and wellbeing during this challenging time.

 

Now no one knows how long the PHE may last, currently it is is extended through Jan 15th, 2022. The Biden administration has indicated they will keep extending the PHE throughout 2021, and maybe beyond. We need to be aware of how it is impacting you or your loved ones and take steps to prepare for it to end. The State of Colorado has stated it would give 60 days’ notice of the PHE ending and not everything will end on the date the PHE ends. Most supports, services and eligibility will not end until the end of the month the PHE is ended. Example: if the PHE does end Jan 15th, 2022, changes would happen at the end of January.

Now let’s talk about how to find out if you or your loved one might be impacted when the PHE ends. To start we suggest individuals and/or families do some, if not all these suggestions:

  • Update their contact info in PEAK website
  • Sign up for the HCPF electronic newsletter and social media to get updates in a timely manner
  • Watch for and respond timely to any notices
  • Review these resources and tools online: For members

HealthFirstColorado.com

Facebook.com/HealthFirstColorado.

For partners and stakeholders

co.gov/HCPF/COVID

 

For more on the Public Health Emergency please follow this link: Public Health Emergency Planning

Luke Wheeland

Written by: Luke Wheeland

Director of Community Outreach, Education and Communication

1 Comment
  • Kelly Stahlman Posted November 19, 2021 1:41 pm

    I love this article! Thank you for explaining the whole concept (and legal requirement!) of Maintenance of Effort. It’s a critical component for the entire Medicaid program, especially for children and adults with disabilities.

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