A waiver is an extra set of Health First Colorado (Colorado's Medicaid program) benefits that you could qualify for in certain cases. These benefits can help you remain in your home and community. Waivers have extra program rules and some programs may have waitlists.
The Children's Extensive Support (CES) Waiver helps children and families by providing services and supports that will help children with a developmental disability establish a long-term foundation for community inclusion as they grow into adulthood.
Children who receive services through the CES waiver are also eligible for all Health First Colorado covered services as long as they are not duplicative.
Who Qualifies?
Level of Care
- Children must meet Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) level of care which is determined by the Functional Needs Assessment (ICF/IID services are defined in the Code of Federal Regulations: 42 CFR ยง 440.150)
Eligibility Group
Children in this program:
- Are less than eighteen years of age
- Have been determined to have a developmental disability which includes developmental delay if under five (5) years of age
- Live in the family home
- Demonstrate a behavior or have a medical condition that requires direct human intervention, more intense than a verbal reminder, redirection or brief observation of status, at least once every two hours during the day and on a weekly average of once every three hours during the night. The behavior or medical condition must be considered beyond what is typically age-appropriate.
- Are determined to meet the Federal Social Security Administration's definition of disability
Financial
- Children must meet the Health First Colorado financial determination for Long-Term Services and Supports eligibility. Financial determination requirements are outlined in the Colorado Code of Regulations 10 CCR 2505-10, Section 8.100.
Benefits and Services
- Adaptive Therapeutic Recreational Equipment and Fees
- Assistive Technology
- Community Connector
- Home Accessibility Modifications and Adaptations
- Homemaker
- Massage Therapy
- Movement Therapy
- Primary Caregiver Education
- Respite
- Specialized Medical Equipment and Supplies
- Vehicle Adaptations
- Youth Day
How to Apply
If you have questions about this waiver, or to learn more about how to apply, contact your local Case Management Agency or the Member Contact Center.
Stakeholder Engagement
The Department of Health Care Policy and Financing (HCPF) will be hosting 3 virtual meetings to discuss planned changes in regulations for the Community Connector service and how it will be affected. HCPF is seeking feedback from members and their families, advocates, Program Approved Service Agencies (PASA), and Case Management Agencies (CMA).
Next meeting:
December 4, 2024 from 2:30 to 4:00 p.m.
Join via Phone: (Toll Free) 1-402-628-0170 PIN: 314 767 378#
Meeting Materials:
Other Useful Links
- Health First Colorado and CHP Plus Grievance Form (includes case management agency complaints)
- HCBS Waivers Page
- View Waiver Charts
- Find HCBS Service Providers
- View HCBS Public Comment Opportunities
- HCBS Settings Final Rule
- Rate schedule for this waiver
- Billing manual
- Home and Community Based Services for Persons with Developmental Disabilities (HCBS-DD) Waiver
- Home and Community Based Services Supported Living Services (HCBS-SLS) Waiver
- Other Long-Term Services and Supports Programs