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Adult Medicaid Waivers:

Colorado’s developmental disabilities services for adults include the Home and Community Based Services Developmental Disabilities waiver (HCBS-DD), Supported Living Services waiver (HCBS-SLS) and state funded Supported Living Services. Waiver services will waive income up to 300% of the poverty level income to allow individuals to qualify. Once approved, qualifying individuals will receive access to all Medicaid State Plan services. Click here for eligibility determination information.

 

HCBS-DD Services:

Up to 24/7 supports and supervision.

Assistance with all areas of an individual’s life, if needed, with a focus on helping individuals develop independent living skills.

SSI/SSA benefits used to pay required room & board costs, allowing for at least $68 per month personal needs funds.

Assistance with employment, developing work skills, and/or day activity programs.

Transportation as needed.

Dental and vision services provided.

 

HCBS-SLS Services:

Must not require 24/7 paid support; strong reliance on natural support networks.

Participants must be in charge of their own living arrangements.

Services can be selected from a menu including personal care, respite, homemaker, specialized habilitation, supported community connections, employment development and ongoing support, transportation, behavioral services, specialized medical supplies and equipment, massage therapy, movement therapy, hippotherapy, emergency response system, assistive technology, accessibility adaptations, dental, and vision services.

Services are limited to assessed funding levels.

 

State SLS Services:

Same as HCBS-SLS services, but participants are not required to be Medicaid eligible, and will not receive a Medicaid card upon enrollment.

Services are available through a quasi-managed care model; funding is limited to the needs of each individual and by the number of participants enrolled.

 

Case Management facilitates access to any of the three service categories through the establishment of developmental disability eligibility. Once eligible, the Case Manager will meet with the individual in their home to complete the Long Term Care assessment for anyone interested in either the DD or SLS waivers. The assessment is used in Colorado to determine if the individual with developmental disabilities meets the necessary Level of Care criteria to be placed on Medicaid waiting lists for adult services. The Case Manager will also facilitate completion of a Supports Intensity Scale (SIS) evaluation to establish the level of funding that would be available to the person when a funded resource is available. Individuals waiting for State SLS are not required to be eligible for Medicaid Long Term Care, but must be eligible.

 

When an adult is transitioning out of foster care services or a waiver resource becomes available to the next adult on the waiting list, the Case Manager will complete a new Long Term Care assessment and will assist the client with application for Medicaid.

 

The State of Colorado has contracts with numerous Program Approved Service Agencies (PASAs) to provide services to eligible individuals with developmental disabilities; Envision works with many of those agencies to provide services in Weld County. The Case Manager provides information about all qualified service providers in Weld County to the client and their guardian or other supports in their lives, to allow for choice. Individuals have the option to access the full state-wide list of PASAs here.

 

Choice includes the Family Caregiver option available for each of the waivers. The Case Manager facilitates connections between client and service providers to assure both are comfortable with the other. Once the client selects their providers, the Case Manager proceeds with enrollment activities and completion of an Individualized Plan with the client, their supports, and their chosen providers, identifying the needs of the client, how those needs will be met, and by whom. All supports, both paid and otherwise, must be identified.

 

Case Managers provide ongoing monitoring of funded services provided, encouragement and assistance for individuals and families to develop a community support network, and will assist as needed for individuals to maintain eligibility for services.