In our last post we introduced Home and Community Based Services or HCBS Waivers in Colorado. In this post we’re going to cover how to apply for HCBS Waivers. HCBS Waivers are designed to give you more choice and decision making capability over your care and to help you avoid institutionalized care such as nursing homes.

If you or a family member need services at home to help live independently, you may qualify for one of Colorado’s HCBS Waivers, which are provided under the Health First Colorado medicaid program. HCBS Waivers can be confusing and this post will help you understand how to apply for a waiver and what eligibility requirements must be met.

Here’s a list of the available waivers in Colorado:

Adult waivers

  • Persons with Brain Injury (BI)
  • Community Mental Health Supports (CMHS)
  • Persons who are Developmentally Disabled (DD)
  • Persons who are Elderly, Blind and Disabled (EBD)
  • Persons with Spinal Cord Injury (SCI)
  • Supported Living Services (SLS)

Children’s waivers

  • Children’s Extensive Support (CES)
  • Children’s Home and Community Based Services (CHCBS)
  • Children’s Habilitation Residential Program (CHRP)
  • Children with Life Limiting Illness (CLLI)

Click on this link to see a chart depicting the children’s HCBS waivers, their targeting criteria, and available services.

To Apply for an HCBS Waiver, Start with a State-Sanctioned Case Management Agency

Application for any one of Colorado’s HCBS Waivers starts with one of Colorado’s 47 contracted Case Management Agencies or your county human or social service office.

In 2017, Governor Bill Hickenlooper signed HB17-1343 into law, which allows Health First Colorado members (Medicaid participants) to choose a Case Management Agency that is separate from their direct service provider. This was done so that the agency that handles applications, assessments, care plans and monitoring of services is not the same agency that provides home health and other community based services. Essentially it removes conflicts of interest and provides better care for Colorado residents who are on HCBS Waivers. In the past, if a person filed a complaint against a provider, it was often the same provider who also was the case manager, making reporting complaints a tangled affair. Now, keeping case management separate allows for more checks and balances, and fair dealings for persons with disabilities.

Three Types of Case Management Agencies for HCBS Waiver Case Management

There are three types of agencies, in addition to your local county human social service office. These different types of case management agencies handle applications, assessments, paperwork and monitoring for specific waivers and their services.

1. Single Entry Point Agencies (SEP)

Single Entry Point Agencies (SEP) provide care planning and case management for the following HCBS Waivers:
  • Children with Life Limiting Illness,
  • Brain Injury,
  • Community Mental Health Supports,
  • Persons who are Elderly, Blind and Disabled and
  • Persons with Spinal Cord Injury.

2. Community Centered Boards (CCB)

Since Community Centered Boards (CCB) are often the only local resource in rural areas, they are allowed to provide targeted case management and services for individuals with intellectual and developmental disabilities.
They are just not allowed to provide both case management and direct services for the same individual, to avoid conflict of interests.
CCBs provide case management and services for the following waivers:
  • Children’s Extensive Support,
  • Persons who are Developmentally Disabled, and
  • Supported Living Services.
One example of a Community Centered Board is The Resource Exchange in El Paso County.

3. Private Case Management Agencies

Private Case Management Agencies provide case management and services for:
  • Children’s Home and Community Based Services
An example of a Private Case Management agency is A Rise Above in El Paso County

4. County Human Social Service office

Your county human social service office provides case management only for the Children’s Habilitative Residential Program Waiver

Which Case Management Agency is Right for Me?

If you know which waivers you may qualify for, click on the above links to be taken to lists of all the Case Management Agencies. You can then reach out to the woman holding young child on her lap while she looks at the computerindividual agency to begin the HCBS Waiver application process. If you’re unsure which agency to start with, contact April Clark at The Independence Center Home Health at (719) 471-8181 x 130. April may be able help you decide the best place to start.

Your Case Management Agency will be your point of contact for your HCBS Waiver application. As part of your application, there will be a Uniform Long Term Care ULTC 100.2 Assessment. Our next post will talk about what you can expect with this assessment.