A new presumptive eligibility (PE) program, which is scheduled to go live in January of 2026, will provide immediate access to some Long-Term Services and Supports (LTSS) services. This program will be initiated through a referral form using self-declaration of eligibility, followed by application verification.
The new presumptive eligibility program will allow an adult who meets eligibility criteria to receive a defined set of LTSS benefits and services during the PE period while their Long-Term Care Medicaid application is processed.
Watch LTSS PE Stakeholder Video >
LTSS PE Stakeholder Video Presentation - August 2024
LTSS PE Frequently Asked Questions
How is Colorado able to offer LTSS PE?
Colorado’s 1115 waiver is being expanded to operate as a more comprehensive waiver, and LTSS PE is one of the programs being added. LTSS PE will operate separately from the existing Substance Use Disorder (SUD) benefits under the 1115 waiver.
What will the eligibility criteria be for LTSS PE?
Online applications will be reviewed and approved by the Department or its contractors. Adults who meet the following criteria may be eligible:
Self-declare to meeting Long Term Care Medicaid and HCBS eligibility requirements, and
Be determined to be experiencing defined crisis situations
Crisis criteria may include factors such as being a danger to self/others, a recent loss or incapacitation of caregiver, and/or recent acute medical or mental health episode
What services will be provided under LTSS PE?
A small selection of unique services aimed to help someone during a crisis will be provided. Current services under consideration include personal care, homemaker, respite, home delivered meals, a personal emergency response system (PERS), transition coordination, and long-term home health and other State Plan benefits.
Will LTSS PE affect current enrollment processes?
During the PE period, we anticipate that the Long Term Care (LTC) Medicaid financial eligibility process and Home and Community Based Services (HCBS) enrollment process will remain unchanged.
What is happening now?
- The Department of Health Care Policy and Financing (HCPF) is pleased to share that Colorado is requesting the Centers for Medicare and Medicaid Services (CMS) extend the current 1115 “Expanding the Substance Use Disorder (SUD) Continuum of Care” Waiver. HCPF is proposing an extension to the current SUD demonstration, implementing all pending amendments, and including presumptive eligibility for LTSS. Accordingly, HCPF is proposing to rename the demonstration, “Comprehensive Care for Colorado.”
- The renewal is available for review on the 1115 Waiver website
- Additional information is available on the Expanding the Substance Use Disorder Continuum of Care Waiver webpage
- July 2024: Since receiving authority through House Bill 24-1229 to pursue PE for LTSS, HCPF is presenting the program to various stakeholder groups and gathering feedback to help finalize program details.
Stakeholder Engagement
Upcoming meetings and ways to participate:
- LTSS PE - Get Updates About This Upcoming Program
January 16, 2025 - 11 a.m. to 12 p.m.
Register to attend via Zoom- Join us to learn more about the new Long-Term Services and Supports Presumptive Eligibility (LTSS PE) program. We'll present program updates and provide the opportunity for questions.
Completed Meetings:
- LTSS PE Program Updates Session
October 16, 2024- During this session, we provided updates and additional details about the new LTSS PE program scheduled to be implemented in January 2026.
- Recording
- LTSS PE Questions and Answers Session
September 4, 2024- Have questions about the new LTSS PE program? This was a time to ask questions about the upcoming LTSS PE program scheduled to be implemented in January 2026
- Have questions about the new LTSS PE program? This was a time to ask questions about the upcoming LTSS PE program scheduled to be implemented in January 2026
Contact Us
Submit LTSS PE questions or feedback using the LTSS Stakeholder Feedback Form or email HCPF_LTSSPE@state.co.us
The LTSS PE Feedback Log will be used to list the questions and feedback we have received.
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