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Expanding the Substance Use Disorder (SUD) Continuum of Care Waiver

Medicaid and Children's Health Insurance Program (CHIP) Section 1115 waivers allow states to test new approaches to administering Medicaid and CHIP programs beyond what is required by federal statute. These waivers give states flexibility to design and improve their programs to better serve Medicaid and CHIP populations through experimental, pilot, or demonstration projects.

Links to the Federal records are listed below:

5 Year Waiver Demonstration Approved for Colorado's Demonstration

The Centers for Medicare and Medicaid Services approved Colorado’s Expanding the Substance Use Disorder Continuum of Care Section 1115 demonstration waiver (1115 SUD waiver) effective January 1, 2021 through December 31, 2025. This demonstration will run for five years and provide the state with authority to provide high-quality, clinically appropriate treatment to participants with substance use disorders.

Goals of this waiver include:

  • Increased rates of identification, initiation, and engagement in treatment
  • Increased adherence to and retention in treatment
  • Reductions in overdose deaths, particularly those due to opioids
  • Reduced utilization of emergency departments and inpatient hospitals settings 
  • Fewer readmissions to the same of higher level of care where the readmission is preventable or medically inappropriate 
  • Improved access to care for physical health conditions among beneficiaries

CMS 1115 Waiver Documents

CMS 1115 Reports

Stakeholder Forums

HCPF held two stakeholder overview forums virtually in November to review the proposed amendment to the 1115 SUD Waiver, and provided an opportunity for participants to ask questions. These opportunities for the public to attend the forums were held on the following dates and times:

  • November 27, 2023 @ 10am-12pm MT - View slides here. Click for English recording or Spanish recording, both with English ASL included.
  • November 29, 2023 @ 5pm-7pm MT - View slides here. Click for English recording or Spanish recording, both with English ASL included.

This amendment to Colorado’s current 1115 SUD Waiver promotes access to health care as a core component of substance misuse prevention for children, youth and adults, reducing hospitalization and incarceration, and prioritizing physical and behavioral health promotion in Colorado.

Amendment to Colorado's 1115 SUD Waiver Demonstration

HCPF is requesting an amendment to the current 1115 SUD waiver, which would authorize:

  • Continuous eligibility for ages 0-3 and adults leaving a Colorado Department of Corrections (DOC) facility; 
  • Prerelease services for individuals transitioning from correctional facilities; and 
  • Reimbursement for acute inpatient and residential stays in institutes for mental disease (IMD) for individuals diagnosed with a serious mental illness (SMI) or serious emotional disturbance (SED).

1115 SUD demonstration Amendment Request

Submitting Comments

During the public comment period, comments may be submitted via one of the following methods:

  • During one of the Public Hearing Meetings
  • Email to hcpf_1115waiver@state.co.us  
  • Fax to 303-866-4411, Attn:1115 SUD Demonstration Amendment
  • Mail your comments to:
    Colorado Department of Health Care Policy and Financing
    Attn: Public Comment - 1115 SUD Demonstration Amendment
    303 E. 17th Avenue
    Denver, CO 80203

Additional Information

  • You can request a printed copy of the full amendment application and other documents by:
    • Sending an email to hcpf_1115waiver@state.co.us  
    • Faxing your request to 303-866-4411
    • Mailing your request to:
      Colorado Department of Health Care Policy and Financing
      Attn: Public Comment - 1115 SUD Demonstration Amendment
      303 E. 17th Avenue
      Denver, CO 80203
  • Colorado Register Demonstration Notice