ARPA HCBS Initiative 3.01 - Equity Study


Individuals receiving HCBS in Colorado are more likely to be white and English-speaking than the overall Colorado population and general Medicaid population. The contributing factors driving the inequity are unclear. This project will help us better understand who receives HCBS in Colorado and what services they receive, where the gaps are, and target outreach to ensure Medicaid HCBS appropriately serves all Coloradans who qualify.

The ARPA 3.01 Equity Study project has three phases:


Internal data analysis:

Identify disparities in HCBS by analyzing by race, ethnicity, language, geography, etc., types and amounts of HCBS and State Plan LTSS received outcomes/satisfaction in HCBS, and access to HCBS. Based on the analysis, Department staff are developing a report that identifies disparities across the system. This also includes conducting a literature review to inform the work. The report detailing findings from internal data analysis and literature review will be published.

External stakeholder feedback and recommendations:

The project is conducting stakeholder engagement and will produce a recommendations report. The purpose of this engagement and the recommendations is to create opportunities for the Department to more fully and more equitably serve members and eligible Coloradans with disabilities. The engagement is designed to achieve three outcomes: building and strengthening relationships with community partners, understanding members’ and advocates’ experiences, and identifying community-driven solutions.

Implementation plan:

Once recommendations are gathered, the project team will put together an implementation plan based on the recommendations to begin creating more equity in HCBS.

While the APRA 3.01 Equity Study aims to understand barriers people experience in HCBS and identify community-driven solutions, the project will not be the end of equity work in HCBS. An important part of this project is building new and deepening relationships with organizations and connectors who help underserved communities navigate the landscape of public services. The hope is that these relationships will continue and be incorporated into HCBS-related policy work well into the future.


Project Reports

Equity in Home and Community-Based Services (HCBS)

September 2023

These reports analyze the literature around equity in HCBS as well as equity issues unique to Colorado's HCBS programs. 

Uncovering Community-Driven Strategies and Solutions for Increasing Equity in Awareness and Enrollment in Home and Community Based Services

November 2023

The report details the findings from the learning exchanges that were conducted as part of the ARPA 3.01 HCBS Equity Study. It provides a set of comprehensive recommendations to promote equity, increase awareness, and improve enrollment in HCBS, focusing on building trust, integrating HCBS into the system, establishing accountability structures, and engaging users in materials design. In addition, it outlines how community-driven organizations currently support people in their communities in navigating complex health care systems to get their needs met, driving health equity in their communities.

Network Partners’ Perceptions, Experiences and Solutions to Inequities within the Program

November 2023

This report details the findings from engaging the HCBS network (defined as the Office of Community Living Stakeholder Newsletter listserv) in identifying barriers and solutions to equitable access, enrollment, and utilization of HCBS as one component of the larger equity study. 



Virtual Summit #1 - Creating Equitable Access within Colorado’s Medicaid Home and Community-Based Services (HCBS) 

April 4, 2023

Meeting Background: 

In February 2023, we sent out a survey request, and nearly 350 providers and 140 members and caregivers responded. Your responses are helping us identify barriers and solutions for awareness, enrollment, and use of HCBS services. Thank you!

Now, HCPF and the Office of Community Living want to share those results with you and create a space to brainstorm more solutions based on the data. We also want to provide more background information about where we are headed with equity work within HCBS programs and what you can expect in the coming months and years.

Virtual Summit #2 - Discussing Project Findings and Next Steps to Increase Equity in HCBS

June 6, 2023

Meeting Background: 

Between March and May 2023, nine in-depth learning exchanges were conducted with community-driven organizations throughout Colorado, in addition to interviews with additional community-driven organizations as well as key state-run resource connection programs. Learning exchange partners are bridge builders, who deeply understand the nuances of their community as well as the many complex systems they engage with to get their health needs met, and in many instances, represent historically marginalized and disenfranchised groups from HCBS enrollment despite high prevalence.

HCPF’s Office of Community Living presented the findings from those sessions, including recommendations on how HCBS will work to increase equity by partnering with community-driven organizations. Four representatives from community-driven organizations shared their expertise about how they work to navigate complex systems with their communities.




For more information on the OCL ARPA Equity Study, please contact Tasia.Sinn@state.co.us