Colorado Children’s HCBS Waivers

What are they?

Children’s HCBS waivers are an extra Medicaid (Health First Colorado) benefit that helps children and youth who meet specific medical and financial criteria receive long-term services at home and in the community.

Colorado currently has three children’s waivers:

  • Children’s Extensive Support (CES)
  • Children’s Habilitation Residential Program (CHRP)
  • Children with Complex Health Needs (CwCHN)

Waiver: HCBS-CES (Children’s Extensive Support)

Who qualifies? 
Children under 18 with a developmental disability (or a developmental delay if under 5) and who require an Intermediate Care Facility for Individuals with Intellectual Disability (ICF-IID) level of care, meaning they require active treatment and ongoing support for IDD, but not hospital-level medical care. Children must meet SSI guidelines for disability and Medicaid financial eligibility, based on the child’s income and resources only.

What services are included?
Adaptive Therapeutic Recreational Equipment & Fees, Assistive Technology, Home/Vehicle Modifications, Extraordinary Cleaning, Massage Therapy, Movement Therapy, Respite Care, Specialized Medical Equipment/Supplies, Youth Day, and more.

Key things to know

  • The child must live in the family home.
  • The child must require direct human intervention, such as a need for constant line-of-sight supervision to ensure safety.
  • Intervention (Support) Frequency: At least once every two hours during the day and, on a weekly average, once every three hours during the night.

Waiver: HCBS-CHRP (Children’s Habilitation Residential Program)

Who qualifies?

Children and youth from birth through age 20 who have an IDD or a Serious Emotional Disturbance (SED) that puts them at risk or in need of an out-of-home placement. SED is defined as a child or adolescent that has a mental, behavioral, or emotional disorder.  Children and youth with IDD or SED must meet the nursing facility or an inpatient psychiatric hospital level of care. They must meet SSI disability and Medicaid financial eligibility requirements, based solely on the child’s income and resources.

What services are included?
Child & Youth Mentorship, Community Connector, Massage Therapy, Movement Therapy, Respite Care, Wellness Education Benefit, Habilitation Services, and Wraparound Services.

Key things to know

  • CHRP focuses on stabilizing children in family or community settings to avoid institutional placement.

As of January 1, 2005, this waiver includes Serious Emotional Disturbance (SED) within the CHRP targeting criteria for waiver eligibility. 

HCBS-CwCHN (Children with Complex Health Needs)

Who qualifies?

  • Children aged 18 or younger with a life-limiting illness who can be safely cared for in the home and who are at risk of institutionalization in a hospital, and/or
  • Children determined to have a significant functional impairment as identified by a Level of Care Eligibility Determination and who require long-term support services at a level comparable to services typically provided in a nursing facility or hospital.

Children must meet SSI guidelines for disability and Medicaid financial eligibility, based on the child’s income and resources only.

What services are included?

Respite Care, Expressive Therapy, Massage Therapy, Wellness Education Benefits, Palliative and Supportive Care Services, Therapeutic Support for Life-Limiting Illnesses: Individual, Family, and Group Counseling, and Bereavement Counseling.

Key things to know

  • The waiver allows medically fragile children to remain at home with comprehensive supports.
  • For children with a life-limiting illness, this allows the family to seek curative treatment while the child is receiving palliative or hospice care. 

Children’s HCBS Waivers and Community First Choice (CFC) 

CFC is a new Medicaid benefit in Colorado that expands access to attendant services for eligible members who meet an institutional level of care and have an assessed need for CFC services. It is for those who prefer to receive personal care and support in their home or community instead of an institutional setting. 

CFC can be used along with children’s HCBS waivers or on its own, and families may choose to receive services through an agency or direct their own care.

For more information about CFC and how to apply, click here.

CFC One-pagers (Jefferson County):

How to Apply for Children’s HCBS Waivers

  1. Make sure your child is eligible (or becomes eligible) for Health First Colorado. If your child is not yet enrolled, apply for Medicaid (Health First Colorado).
  2. Contact your local Case Management Agency (CMA) to request the functional assessment and waiver screening; CMAs handle level-of-care determinations and help coordinate services. Use the CMA Directory  to find yours.
  3. Ask about CFC at the same time. New and current members are assessed for CFC and waiver services together during the transition year.

Where Can I Learn More?

Using the links below, you can visit the Department of Health Care Policy & Financing’s website to learn more about:

Our advocacy team is here to help. If you have questions about Children’s HCBS Waivers or would like to speak with an advocate, Submit an Advocacy Request Here and one of our advocates will follow up with you.