✴️ LTSS Priority Projects Implementation
Purpose
This page provides a central location for all of the information regarding the priority projects being implemented on July 1, 2025, related to Long-Term Services and Supports (LTSS).
For more than a decade in Colorado, the Department of Health Care Policy and Financing (HCPF) has been working to transform Colorado’s Long-Term Services and Supports (LTSS) system into one that is more person-centered, community-focused, and responsive to the unique needs of each member. This vision is now moving closer to reality through the implementation of several key, priority projects effective July 1, 2025.
Project Implementation Schedule
- Community First Choice (CFC) - July 1, 2025
- Children with Complex Health Needs (CwCHN) Waiver - July 1, 2025
- Individual In-Reach - July 1, 2025
- Interim Support Level Assessment (ISLA) - July 1, 2025
- Long-Term Home Health (LTHH) PAR Restart - July 1 and August 1, 2025
- Nurse Assessor and Skilled Care Acuity Assessment - August 1, 2025
Have Questions?
- General Priority Project Questions email HCBS_Questions@state.co.us
- Submit non member-specific questions
- Include in the subject line the project you are inquiring about
- Project Specific Questions
- CFC and CwCHN - email hcpf_cfc@state.co.us
- ISLA - email sis_sl@state.co.us
- Individual In-Reach Counseling - email hcpf_accessunit@state.co.us
- Nurse Assessor/Acuity Assessment/ PAR Restart - email hcpf_homehealth@state.co.us
- County Contact - Find your county contact information
- Case Management Agency Contact - Find your Case Management Agency contact information
- Member Complaints and Escalations
- Use this form after you have worked with your CMA and/or county without resolution, to ask HCPF for assistance
- Member Call Center 1-800-221-3943
- Provider Call Center 1-833-468-0362
- Care and Case Management (CCM) Call Center 1-888-235-6944
Project Information
Community First Choice (CFC)
Scheduled Implementation - July 1, 2025
Community First Choice (CFC), also known as 1915(k), is an optional Medicaid program that allows states to offer select home and community based attendant services and supports to eligible members on the State Plan, expanding these long-term care services to more Health First Colorado (Colorado's Medicaid Program) members.
Promoting self-direction, relocation out of institutions, and person-centered practices are significant goals of CFC. Members will have the option to self-direct their attendant care services or to receive services through an agency. CFC gives members access to service delivery models that allow them to control their own budget, select and dismiss their attendants, and provide training for the people who provide their care. By expanding these options, members will experience greater choice and control over how they receive services.
Furthermore, the CFC option provides a 6 percentage point increase in Federal matching payments to states for CFC service expenditures. With the authority from Senate Bill 23-289, Colorado is currently working to implement CFC by July 1, 2025.
The Centers for Medicare and Medicaid Services (CMS) approved the CFC State Plan Amendment in December 2024.
- CFC Fact Sheet - February 2025
- Spanish Version - CFC Fact Sheet - February 2025
- CFC Frequently Asked Questions (FAQ) - Updated May 22, 2025
View Community First Choice (CFC) webpage
Questions? - email hcpf_cfc@state.co.us
Children with Complex Health Needs (CwCHN) Waiver
Scheduled Implementation - July 1, 2025
The Children with Complex Health Needs Waiver will be a new waiver for children that encompasses the current Children’s Home and Community Based Services (CHCBS) waiver members and the Children with Life-Limiting Illness (CLLI) waiver members. The services on the new CwCHN waiver will be the same as the current CLLI waiver services, with the addition of the Wellness Education Benefit. Additionally, eligibility will be expanded to capture both the CHCBS and CLLI Waiver populations. Members who currently receive IHSS through the CHCBS waiver will receive the benefit through CFC.
- View CwCHN Waiver Fact Sheet - February 2025
- Spanish Version - CwCHN Waiver Fact Sheet - February 2025
Questions? - email hcpf_cfc@state.co.us
Individual In-Reach
Scheduled Implementation - July 1, 2025
In-Reach includes actively connecting with members who are living in nursing facilities or other institutions and helping them make an informed choice about transitioning out of the nursing home to live at home or elsewhere in the community. All members have the right to be informed about their options to live at home or in the community while still receiving the care and services they need and decide if transitioning is right for them.
In-Reach provides:
- Information about housing supports and other services in the member's community that may be available to them as an alternative to living in the nursing facility
- Answers to any questions or concerns members, their families, or caregivers may have
- Assistance with connecting members with Case Management Agencies, Transition Coordination Agencies, or other organizations that can help set up services to meet the member's specific care needs while living in the community
View Keeping Coloradans in the Community webpage
View Transitions Services webpage
Questions? - email hcpf_accessunit@state.co.us
Interim Support Level Assessment (ISLA)
Scheduled Implementation - July 1, 2025
The Colorado Single Assessment (CSA)-Needs Assessment was designed as a more robust and comprehensive replacement for the Supports Intensity Scale (SIS). However, HCPF has delayed CSA implementation to allow for Colorado’s Case Management ecosystem to stabilize.
HCPF has been working with stakeholders to develop an Interim Support Level Assessment (ISLA) to replace the SIS assessment. The ISLA is based on the components of the CSA which map across to the SIS Support Level Algorithm.
The ISLA will be used to determine the Support Level for adult members newly enrolling on the SLS and DD waivers and interested in using Day Habilitation, Prevocational, Supported Employment services, and/or Residential Habilitation services. The ISLA needs to be completed for members interested in these services who do not currently have a SIS Assessment completed and therefore do not have a Support Level.
HCPF is developing rules to implement the ISLA which includes a new algorithm for the Support Level and will post the algorithm formula table on this webpage in July 2025.
HCPF has been working with trained assessors to conduct a pilot of the assessment from April through June 2025 with the ISLA being implemented July 1, 2025.
Questions? - email sis_sl@state.co.us
Long-Term Home Health (LTHH) PAR Restart
Scheduled Implementation - July 1 and August 1, 2025
The Home Health benefit for Health First Colorado (Colorado's Medicaid program) members provides services from a licensed and certified Home Health Agency (HHA) for members who need Intermittent Home Health Services.
There are two types of home health services:
- Acute Home Health: Skilled Home Health services are provided to members who experience an acute health care need that necessitates skilled Home Health care. Acute Home Health services are allowed without prior authorization for up to 60 calendar days or until the acute condition is resolved, whichever comes first. (If the member is on a Health First Colorado Managed Care Program, prior authorization for acute Home Health may be required by the Managed Care Organization.)
- Long-Term Home Health (LTHH): Skilled Home Health services provided to members who require ongoing Home Health services beyond the Acute Home Health period. Prior authorization is required for Long-Term Home Health Services.
Prior Authorization Request (PAR) Restart for LTHH Nursing PARs is anticipated to go-live August 1, 2025. This includes PARs for Registered Nursing (RN), Licensed Practical Nursing (LPN), and Certified Nursing Aide (CNA) services. This restart date has been moved due to delays with the Nurse Assessor and Skilled Care Acuity Assessment implementation as outlined in Operational Memo OM 25-036. This means providers are not required to submit PARs for medical necessity review by Acentra Health, the current Colorado Utilization Management (UM) vendor until August 1, 2025.
PAR Restart for Pediatric LTHH Therapy PARs is anticipated to go-live July 1, 2025, after a successful soft launch that started February 3, 2025. This includes Physical Therapy (PT), Occupational Therapy (OT), and Speech Therapy/Speech Language Pathology (ST/SLP). This means providers are required to submit PARs for medical necessity review by Acentra Health, the current Colorado Utilization Management (UM) vendor starting July 1, 2025. View Operational Memo OM 25-033.
View Long-Term Home Health webpage
View Colorado PAR Program webpage
Questions? - email hcpf_homehealth@state.co.us
Nurse Assessor and Skilled Care Acuity Assessment
Scheduled Implementation - August 1, 2025
The nurse assessor is a new process that streamlines the way members are assessed and receive recommendations for skilled care services, including Registered Nurse (RN), Certified Nursing Assistant (CNA), and Health Maintenance Activities (HMA). The nurse assessor using the Skilled Care Acuity Assessment (SCAA) will holistically assess members for their skilled care needs.
The skilled nurse assessor will also help educate members about skilled care services and all service delivery options, including self-direction, and ensure members understand the service that will best meet their needs based on their assessment.
The Nurse Assessor and the Skilled Care Acuity Assessment is scheduled for implementation August 1, 2025.
Questions? - email hcpf_homehealth@state.co.us