Colorado Medicaid Waiver

What Programs Are Available To Assist People With Disabilities in Colorado?

Is there a Medicaid waiver program in Colorado? Colorado has twelve Medicaid waiver programs- four of which are specifically for individuals with intellectual and/or developmental disabilities.

* WAIVER for PERSONS with DEVELOPMENTAL DISABILITIIES(formerly known as “comprehensive services”) (HCBS-DD)
*SUPPORTED LIVING SERVICES WAIVER (HCBS-SLS)
*CHILDREN WITH AUTISM WAIVER (HCBS-CWA)
*CHILDREN'S EXTENSIVE SUPPORT WAIVER (HCBS-CES)
CHILDREN'S HABILITATION RESIDENTIAL PROGRAM WAIVER (HCBS-CHRP)
CHILDREN'S HCBS WAIVER (CHCBS)
HCBS WAIVER for PERSONS with BRAIN INJURY (HCBS-BI)
HCBS WAIVER for Community Mental Health Supports (HCBS-CMHS)
HCBS WAIVER for PERSONS LIVING WITH AIDS (HCBS-PLWA)
HCBS WAIVER for PERSONS who are ELDERLY, BLIND, AND DISABLED (HCBS-EBD)
HCBS Waiver for Children with Life Limiting Illness (HCBS-CLLI)
HCBS waiver for persons with Spinal Cord Injury (pilot) (HCBS-SCI)

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What state department handles the Medicaid waiver program in Colorado for persons with disabilities? The DIVISION FOR DEVELOPMENTAL DISABILITIES (DDD) - is the State office that provides leadership for the direction, funding, and operation of services to persons with developmental disabilities within Colorado. DDD services are administered under the Office of Long Term Care of the Colorado Department of Human Services (CDHS). Effective April 1, 2014, the administration of the HCBS-DD, HCBS-SLS, and HCBS-CES waivers will transfer to the Department of Health Care Policy and Financing

What programs assist people who have developmental disabilities? The Waiver for Persons with Developmental Disabilities and the SUPPORTED LIVING SERVICES waiver assist adults with developmental disabilities in Colorado. The HCBS CHILDREN WITH AUTISM and CHILDREN'S EXTENSIVE SUPPORT WAIVER assists children with developmental disabilities in Colorado.

What is the best number to call to get started? Main Phone: (303) 866-7450 or 303 866-7904.

Is there a website? https://www.colorado.gov/hcpf or
https://www.colorado.gov/cdhs/ddd

Who Qualifies For Assistance?

What is considered a developmental disability in Colorado? "Developmental Disability" means a disability that is manifested before the person reaches twenty-two years of age, which constitutes a substantial disability to the affected individual, and is attributable to mental retardation or related conditions which include cerebral palsy, epilepsy, autism or other neurological conditions when such conditions result in impairment of general intellectual functioning or adaptive behavior similar to that of a person with mental retardation. (C.R.S. 27-10.5-102 11 (a), as amended).

Are there income limits to receive Medicaid waiver services in Colorado? Clients must meet financial, medical, and program criteria to access services under a waiver. The applicant's income must be less than $2,094.00 (300%, or three times, the Supplemental Security Income allowance) per month and countable resources less than $2,000 for a single person or $3,000 for a couple.

How old do you have to be to start receiving services in Colorado? People with developmental disabilities of all ages may be eligible for one of four of Colorado's Medicaid waivers that provide services and supports for people with developmental disabilities.

Is There a Waiting List For Services?

How long is the waiting list in Colorado? Unfortunately, some of the Medicaid waivers in Colorado have waiting lists. It is difficult to quantify how “long” the waiting lists are, but data shows that people wait an average of 5-7 years from the time they go on the waiting list to the time they enroll into waiver services.

How many people are on the waiting list? Each waiver has an enrollment limit. There is a waiting list for all developmental disability waiver programs in Colorado, The HCBS Waiver for Persons with Developmental Disabilities (HCBS-DD) has a waiting list of 894 people who would accept services immediately if offered. The HCBS-SLS Waiver has a waiting list of 2,405 people who would accept services as soon as available.

How many people are currently receiving services in Colorado? There are 4,420 people being served under The Waiver For Persons with Developmental Disabilities. There are another 3,172 served under the Supported Living Services Waiver.

What assistance is available while you wait? Family Voices Colorado provides help with health insurance plans, communicating with service providers, navigating Medicaid or other public systems, individual health insurance counseling (such as in benefits decision or help with the appeals process). Family Voices can be reached at 1-800-881-8272 or 303-733-3000. Additionally, there are local Arc chapters across Colorado and many other advocacy organizations (Parent to Parent, PADCO, People First, Speaking for Ourselves, CCDC).

Is there priority preference for people who are in crisis? There is priority placement for crisis such as homelessness. Crisis does not guarantee placement, and Requests for Emergency Enrollment are reviewed by the DDD against specific criteria outlined in rules and subject to availability of appropriate services to meet the need.

What Services Are Offered & What Are The Service Limitations?

What services does the Medicaid waiver program offer in Colorado? Services available include: Personal Care services; Homemaker services Home Modifications; Assistive Technology; Behavioral Consultation, Counseling and Line services; Dental services; Day Habilitation, Prevocational and Supported Employment services; Respite services Residential Habilitation and Non-Medical Transportation.

What services are available to people living in the family home in Colorado? Services to people living with family members or provided by paid family members include: Personal Care services; Homemaker services Day Habilitation, Prevocational and Supported Employment and Non-Medical Transportation.

Are There Spending Caps For Services in Colorado? ? There are spending caps for all Colorado developmental disability waivers. The Waiver for Persons with Developmental Disabilities has different spending limits for each service. For example, Dental has a $2,000 Basic services limit per year and $10,000 maximum Major services for the 5 year life of the waiver. The Supported Living Services Waiver is designed with six Support Levels, based on the support needs identified in the Supports Intensity Scale (SIS) and an overall cap in the waiver of $36,400. Each level has a different spending limit. The Children's Extensive Support Waiver has a spending limit of up to $36,400 per Service Plan year.

Does Colorado offer community group homes? Yes, Colorado does offer group homes. There are just under 200 group homes for adults in Colorado. There are also group homes for children through the CHRP Waiver.

Does Colorado offer supported living? Yes

Are there still state owned institutions in Colorado? How many people are living in institutions? Regional Centers (RC) - are administered by the Division for Regional Center Operations (DRCO) under the Colorado Department of Human Services and serve persons with developmental disabilities who have the most intensive needs through Intermediate Care Facilities for individuals with Developmental Disabilities (ICF/IDD). DRCO coordinates service delivery with these three State-owned and operated Regional Centers that provide a number of services including: 24-hour supervision, residential services, day programming, habilitation, medical, training and behavioral intervention, plus short-term emergency/crisis support to the community system. There are three Regional Centers in the State of Colorado that serve individuals with developmental disabilities- The Grand Junction Regional Center, Wheat Ridge, and Pueblo. There are approximately 300 people being served through these Regional Centers.

How Do You Select A Provider?

Do providers work for the state? HCPF and DHS/DDD contracts with 20 non-state private non-profit corporations to act as the single entry point agencies to perform Home and Community Based waiver operational and administrative services including intake, screening, eligibility, enrollment, utilization review and quality assurance. These agencies also operate as Organized Health Care Delivery Systems and contract with other service providers for the provision of services under the HCBS waivers. These local non-governmental non-state entities also provide Targeted Case Management and waiver services through Medicaid Provider Agreements

About how many providers are there in the state? There are about 200 providers in Colorado.

Do you have a choice in providers in Colorado? Yes,along with the 200 providers, family members can also be paid to provide support. The Family Caregiver Act, Senate Bill 08-002, included a statutory definition of Family Caregiver and allows for the delivery of services and supports for persons with developmental disabilities to be provided by a family caregiver. This change makes available the option for services and supports to be provided in the family home and allows for family members to be paid to deliver services and supports.

“Family” is defined as all persons related to the person in services by virtue of blood, marriage, adoption, or common law. Legally Responsible Persons, defined as a parent of a minor child, or the individual’s spouse, may not be paid to provide services to an individual. Legal guardians who do not meet the definition of Legally Responsible Person may be paid to provide services. Family Caregivers must currently be employed by a Program Approved Service Agency (PASA) in order to receive payment for the delivery of services to an individual.

How Do You Become A Provider?

To become a PASA an application for Program Approval must be submitted to DDD and a Medicaid Provider Agreement must be submitted to HCPF to enroll as a Medicaid Provider. There is no fee to become a provider.

Additional Information

Applicants may apply and get on the waiting list for more than one waiver, but may only receive services through one waiver at a time.

Colorado uses the SIS as an assessment tool to identify support needs in the way it was intended and validated by the authors. Colorado also uses scores from the specific sections of the SIS that were found to be statistically relevant for establishing reimbursement rates, level of need, and an upper limit of services (Service Plan Authorization Limit-SPAL) available to clients in HCBS-SLS.

Case Management Services assist a person in accessing necessary services and supports to meet his or her needs. Services include intake, eligibility determination, Service Plan development, arrangement for services, delivery of services, service and support coordination, monitoring, and termination and discharge from services.