COLORADO
BColorado's system, honestly. A letter grade is a summary, not a verdict on your family — a low grade doesn't mean nothing is available, it means the path is narrower. What's behind it is below.
Do this first
Contact the Case Management Agency for your area and ask for an intake and a functional eligibility determination — this is the same body families used to call a Community Centered Board, and most guidance online still uses the old name. Ask about Community First Choice in the same conversation: CFC is a Health First Colorado benefit rather than a waiver, so it does not require a waiver slot and can start while you wait. For a child under 18 the waiver is Children's Extensive Support, and the waiting list runs in the order applications were received, so the date matters.
Last verified 2026-07-03
HOW WE GRADE COLORADO
Full methodology (v2.1) →Colorado's strongest area is institutional vs. community balance; what pulls the grade down most is self-direction index.
Waitlist Burden
30% of grade83/10039 people waiting per 100,000 residents
Nobody waiting scores 100. 225 per 100,000 scores 0.
Source:KFF State Health Facts, People Waiting for HCBS by Target … (FY2025 (KFF Medicaid HCBS Waiver Program Survey, FY 2025))US Census Bureau Vintage 2025 state population estimates (2025-07)
HCBS Spending Per Capita
25% of grade72/100$544 spent per resident
$200 per resident scores 0. $675 scores 100.
Source:CMS / Mathematica — Medicaid LTSS Annual Expenditures and … (CY2023)
Self-Direction Index
20% of grade67/10067 out of 100 on the self-direction index
Scored directly on its own 0–100 scale.
Source:CMS approved 1915(c) waiver application (2026-08-05)CMS approved 1915(c) waiver application (2026-08-05)
Waiver Program Count & Breadth
15% of grade80/10080 out of 100 on program breadth
Scored directly on its own 0–100 scale.
- No authoritative national roster of 1915(i) adopters exists; scored as absent where unconfirmed.
Source:Medicaid.gov State Waivers List, Authority=1915(c), Status… (Section 1915(c) counts: Medicaid.gov State Waivers List retrieved 2026-08-05. Target populations & 1915(k): KFF Medicaid HCBS Survey 2025 (FY2025). 1915(i): CMS SPA database retrieved 2026-08-05.)KFF Medicaid Home Care (HCBS) in 2025, Appendix Table 2 (Section 1915(c) counts: Medicaid.gov State Waivers List retrieved 2026-08-05. Target populations & 1915(k): KFF Medicaid HCBS Survey 2025 (FY2025). 1915(i): CMS SPA database retrieved 2026-08-05.)KFF Medicaid Home Care (HCBS) in 2025, Appendix Table 1 (Section 1915(c) counts: Medicaid.gov State Waivers List retrieved 2026-08-05. Target populations & 1915(k): KFF Medicaid HCBS Survey 2025 (FY2025). 1915(i): CMS SPA database retrieved 2026-08-05.)
Each factor is scored against a fixed bar, not against the other states, so Colorado's grade moves when Colorado moves. Think we have it wrong? Every number above links to its source — email hello@spectrumpathways.ai and we will correct it in public.
WHAT THINGS ARE CALLED IN COLORADO
Use these exact words when you search, call, or fill out forms — they're what Colorado's own offices use.
- Medicaid here is
- Health First Colorado
- The DD agency is
- Office of Community Living (HCPF)
- You contact
- Case Management Agency (formerly Community Centered Board)
- The plan is
- Person-Centered Support Plan
- Self-direction is
- Consumer Directed Attendant Support Services (CDASS)controlling your own budget and hiring your own people
- A denial arrives as a
- Notice of Action / Long Term Care Noticethe letter that gives you the right to appeal
WHO TO CONTACT, IN ORDER
Five different offices, and they don't talk to each other. Disability services, health coverage, and income each run through a separate agency — applying to one does not start the others. Ask each office for the name of the person you spoke to and write down the date; if something is later denied, that record is what an appeal is built on.
- 1
Developmental disability services
This is the office that decides whether your child is eligible for disability services. Ask for "intake" or "eligibility determination" by name. In Colorado, you contact Case Management Agency (formerly Community Centered Board).
Colorado HCPF Long-Term Services and Supports (Case Management Agencies)
- 2
Health coverage — Health First Colorado
Almost every waiver and personal-care route requires this first, and it is decided by a different office from the one above. Apply in parallel rather than waiting.
- 3
Help at home, and who can be paid for it
Unless you say otherwise, services come the traditional way: the agency picks and pays the providers. Self-direction — where you get a budget and hire your own people — is opt-in almost everywhere and is not offered automatically. Here it is called Consumer Directed Attendant Support Services (CDASS). Ask for it by that name.
- 4
Income — SSI
Federal, so it's the same everywhere: 1-800-772-1213 (TTY 1-800-325-0778). There is no minimum age — you can apply for a newborn. Until 18, the parents' income is deemed to the child, so an early denial is usually about that rather than the child's disability. In many states an SSI award also opens Medicaid automatically — ask when you call.
- 5
If you get told no
Every state has a Protection & Advocacy agency by federal law — free legal help on disability services and appeals. Most families never hear of it, and it is the number to have before a deadline, not after. Yours is Disability Law Colorado.
Disability Law Colorado · 1-800-288-1376
RUNNING IT YOURSELF
In many states you can control the budget and hire your own people — including, sometimes, family. Most families are never told this is an option. Here's what we've verified for Colorado; where we haven't verified an answer we say so — it does not mean the answer is no, and it is worth asking.
Can you control the budget?
Yes — CDASS and In-Home Support Services, under Community First Choice since 1 July 2025
Can a family member be paid to provide care?
Not verified yet — ask, don't assume the answer is no.
Who is legally the employer of the people you hire?
Not verified yet — ask, don't assume the answer is no.
How freely can money move between services?
Not verified yet — ask, don't assume the answer is no.
Can the budget buy things, not just staff time?
Not verified yet — ask, don't assume the answer is no.
Is your case manager independent of your providers?
Not verified yet — ask, don't assume the answer is no.
Your income does not disqualify your child.
Colorado determines waiver eligibility on the individual's own income and medical need; parental income is not counted.
Deadlines reflect this state’s rules as researched; they can change — always confirm the current deadline with your state agency or Protection & Advocacy office before relying on it.
HOW TO GET SERVICES & APPEAL IN COLORADO
- For plan (RAE/MCO) service actions: file internal plan appeal within 60 days
- File request for state fair hearing with the Office of Administrative Courts within 60 calendar days of the Notice of Action date
- State fair hearing before an Administrative Law Judge; Office of Appeals issues final agency decision
KEY AGENCIES & RESOURCES
NOTABLE WAIVERS
DD Waiver (Developmental Disabilities)
SourceAdults with IDD needing comprehensive residential supports.
Waitlist: Long waitlist by order-of-selection date — enroll through your Case Management Agency early.
SLS Waiver (Supported Living Services)
SourceAdults with IDD living with family or independently.
Waitlist: Shorter than DD waiver in many counties.
CES Waiver (Children's Extensive Support)
SourceChildren with IDD and extensive behavioral/medical needs.
Waitlist: Colorado removed the CES enrollment cap — eligible children enroll without waiting.
CHCBS Waiver (Children's Home and Community Based Services)
SourceMedically fragile children; parent income disregarded.
Waitlist: No waitlist.
Medicaid Buy-In for Children with Disabilities
SourceChildren with disabilities in families over income limits.
Waitlist: No waitlist — premium-based.
Full milestone guide
View the Colorado Roadmap →
Six age-based stages — state-correct programs, benefits, and milestones from birth through adulthood.
