I/DD Waivers in Colorado

All states: Medicaid disability services map

Colorado I/DD services at a glance

Last verified against state sources: 2026-10-23.

Who runs I/DD services in Colorado?

Colorado does not have a separate developmental disabilities department. The Department of Health Care Policy and Financing (HCPF), the state Medicaid agency, runs all four I/DD waivers itself through its Office of Community Living. HCPF contracts with 15 regional Case Management Agencies (CMAs), and the CMA for a person's county is the front door for intake, eligibility and service planning.

• HCPF Office of Community Living: writes waiver policy, sets provider rates and pays providers. Colorado's Medicaid program is called Health First Colorado. HCPF's HCBS waivers page lists all of its home and community-based services (HCBS) waivers.
• Case Management Agencies (CMAs): each CMA serves a defined area. Since July 1, 2024 Colorado has used conflict-free case management under House Bill 21-1187, which moved the work of 26 older agencies to 15 CMAs. Each member now has one CMA no matter what their disability or program is. Families can find their CMA by county in HCPF's CMA and CCB Agency Directory.
• Community Centered Boards (CCBs): these local organizations still exist and use local funding to help with I/DD needs that the waivers do not cover.
• Colorado Department of Public Health and Environment (CDPHE): surveys I/DD provider agencies before they can serve waiver members and licenses group homes.

What Medicaid waivers and programs serve people with I/DD in Colorado?

Colorado has four 1915(c) waivers for people with I/DD: two for adults (DD and SLS) and two for children and youth (CES and CHRP). A 1915(c) waiver is a federal Medicaid option that lets a state pay for home and community services instead of institutional care. All four were renewed on July 1, 2024, are due for renewal on July 1, 2029, and were amended effective July 1, 2026.

• Developmental Disabilities (HCBS-DD) Waiver (control number CO.0007): serves adults 18 and older with an intellectual or developmental disability who need access to supports 24 hours a day and meet the level of care for an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID). Income must be under 300 percent of the SSI limit and resources under $2,000 for a single person. Services include Residential Habilitation (individual settings, host homes and group homes), Day Habilitation, Prevocational Services, individual and group Supported Employment, Workplace Assistance, Behavioral Services, Benefits Planning, Non-Medical Transportation, Peer Mentorship, Dental and Vision, and Specialized Medical Equipment and Supplies. It is the only Colorado HCBS waiver with a waiting list. The July 1, 2026 amendment lowered the number of people the waiver can serve in waiver years 3 to 5, and HCPF says no current participant loses services. DD members generally cannot also use Community First Choice, because residential habilitation already covers personal care.
• Supported Living Services (HCBS-SLS) Waiver (control number CO.0293): serves adults 18 and older with an intellectual or developmental disability who live in their own home, a rented home or a family home and do not need 24-hour paid support. Services include Day Habilitation, Prevocational Services, Supported Employment, Respite, Life Skills Training, Mentorship, Behavioral Services, Assistive Technology, Home Accessibility Adaptations, Vehicle Modifications, Non-Medical Transportation and Massage and Movement Therapy. Since July 1, 2026, Extraordinary Cleaning is a standalone service in place of Homemaker. There is no waiting list.
• Children's Extensive Support (HCBS-CES) Waiver (control number CO.4180): serves children from birth through age 17 with an intellectual or developmental disability who live in the family home and need extensive support. It is not designed to provide 24-hour services. Services include Respite, Community Connector, Youth Day Services (ages 12 to 17), Extraordinary Cleaning, home and vehicle modifications, Massage and Movement Therapy, Adaptive Therapeutic Recreational Equipment and Fees, and Primary Caregiver Education. HCPF cut the Community Connector rate to about $7.71 per 15-minute unit and halved its yearly cap from 2,080 to 1,040 units.
• Children's Habilitation Residential Program (HCBS-CHRP) Waiver (control number CO.0305): serves children and youth from birth through age 20 with an intellectual or developmental disability, a developmental delay or a serious emotional disturbance who need a high level of services to stay in the community. It is an alternative to an ICF/IID, a nursing facility or a psychiatric hospital. Services include habilitation in licensed foster homes, group homes or residential child care facilities, Respite, Child and Youth Mentorship, Community Connector and Wraparound. Habilitation is not offered in the family home. HCPF reported more than 494 children enrolled in February 2025, after eligibility grew to include serious emotional disturbance.

All four waivers also include a Wellness Education Benefit. Two related programs serve many of the same people. Community First Choice (CFC), a 1915(k) state plan option active since July 1, 2025, covers Personal Care, Homemaker, Health Maintenance Activities, Remote Supports, Home Delivered Meals, Transition Setup and personal emergency response systems for members of any age who meet institutional level of care, including SLS and CES members. State Supported Living Services (State SLS) and the Family Support Services Program (FSSP) are paid only with state General Fund dollars, not Medicaid, for people who are not on Medicaid or whose needs a waiver does not fully meet. ICF/IID facilities and the state's Regional Centers remain the institutional option.

Does Colorado pay for I/DD services through managed care?

No. HCPF pays I/DD waiver providers fee-for-service from a published rate schedule. Case Management Agencies plan and coordinate services, but they do not pay providers. No health plan sits between the state and I/DD waiver providers.

• Who pays claims: HCPF, as the Medicaid agency, pays enrolled providers at the rates on its DD, SLS and CES rate schedule, with separate rates for Denver County and the rest of the state.
• Who coordinates services: the member's CMA handles eligibility, the support plan and service authorization.
• One narrow exception: the DD waiver runs alongside a 1915(b)(4) selective contracting waiver, approved January 1, 2025, that covers only the Wellness Education Benefit. It does not put members in managed care plans.

Is there a waiting list for I/DD services in Colorado?

Yes, but only for the adult HCBS-DD waiver, because its enrollment is limited by state funding and federal waiver approval. As of September 1, 2025, HCPF reported 2,749 people in As Soon As Available status, meaning they want to enroll as soon as a spot opens. The SLS, CES and CHRP waivers have no waiting list.

• Other DD list statuses: HCPF also counted 3,530 people in Safety Net status and 1,854 on a date-specific list as of the same date. HCPF said about 90 percent of the people in As Soon As Available status were already getting some Medicaid or state-funded services, and that the average wait in that status had fallen from 9 years to 7 years.
• How the order is set: each person's place depends on their Order of Selection Date, which is the date of the CMA's I/DD determination, or the person's 14th birthday if they were determined earlier. HCPF makes offers each month to the people with the oldest As Soon As Available dates, according to its enrollment and waiting list page.
• Reserved capacity: some DD waiver spots are held for emergencies, for people leaving institutions and for youth in the child welfare system.
• Fewer offers from July 1, 2026: HCPF cut by half the enrollments it makes to fill openings left when other members leave the waiver (churn enrollments), which leaves more people on the list. Emergency, institutional transfer and child welfare enrollments are not affected, per HCPF's Medicaid sustainability page.
• State-funded programs: as of September 1, 2025, 47 people were waiting for State SLS and 1,085 for the Family Support Services Program.

The counts come from HCPF's strategic plan update dated November 1, 2025. HCPF reports that over the past 10 years, enrollment in I/DD waivers and programs grew 112 percent and waiting lists fell 61 percent. We did not find a newer count. For a person's place on the list, ask their CMA.

How do people apply for I/DD services in Colorado, and how are budgets set?

People apply through the Case Management Agency for their county. The CMA decides whether the person has an intellectual or developmental disability, checks level of care and Medicaid eligibility, and adds the person to the DD waiting list if needed. Support levels, which drive many provider rates, are set with the Interim Support Level Assessment (ISLA).

• Developmental Disability Determination: the CMA confirms a substantial disability that appeared before age 22.
• Waiver eligibility: ICF/IID level of care from the functional assessment, plus Medicaid financial eligibility (for the DD waiver, income under 300 percent of the SSI limit).
• Joining the DD waiting list: a person can be added from age 14 after a determination, but only in Safety Net or date-specific status until age 18. SSI or Medicaid is not needed to be placed on the list.
• Assessment and support levels: since July 1, 2025, new DD, SLS and CHRP enrollees are assessed with the ISLA, which replaced the Supports Intensity Scale (SIS). The ISLA sets Support Levels 1 to 7 and was aligned with the old SIS support level formula. Members who already had a SIS keep their assigned Support Level.
• Limits on day services: in the DD and SLS waivers, Specialized Habilitation, Supported Community Connections and Prevocational Services share a cap of 4,800 units a year, and day and employment services together are capped at 7,112 units a year.

HCPF plans a fuller Colorado Single Assessment (CSA) and Person-Centered Support Plan. That rollout was paused and is funded for state fiscal year 2026-27, but we did not find a firm start date.

What day and residential services can I/DD providers offer in Colorado?

DD and SLS waiver providers can offer two kinds of Day Habilitation, Prevocational Services and Supported Employment, and CES providers can offer Youth Day Services. DD waiver residential services are Individual Residential Services and Supports (IRSS), including host homes, and Group Residential Services and Supports (GRSS) group homes. Most of these services need Program Approved Service Agency (PASA) approval after a CDPHE survey, and only group homes also need a CDPHE license, according to CDPHE's Medicaid certification guidance.

Day and employment services

• Specialized Habilitation (DD and SLS): skill-building in self-care, socialization and adaptive skills in a setting outside the home. Delivered in person in a group (Tier 2) or by telehealth (Tier 1, billed at the Tier 2 rate). Sheltered workshops are excluded. Billed in 15-minute units at rates tiered by Support Level. PASA approval, no CDPHE license. The research did not find a published staff ratio.
• Supported Community Connections (DD and SLS): support to take part in community life, such as classes, volunteering or retirement activities, alongside people without disabilities. Billed in 15-minute units tiered by Support Level. Tier 3 is one-to-one in person at a separate rate. PASA approval, no CDPHE license. We did not find a published ratio for group settings.
• Prevocational Services (DD and SLS): time-limited services that build general work skills toward competitive integrated employment. They cannot be billed at the same time as Day Habilitation or Supported Employment. Colorado ended subminimum wage employment at the end of 2023. Billed in 15-minute units tiered by Support Level. PASA approval, no CDPHE license. The research did not find a published staff ratio.
• Supported Employment (DD and SLS): job development, job coaching and group supported employment, coordinated with the state Division of Vocational Rehabilitation. Group job coaching is billed in 15-minute units tiered by Support Level. Since July 1, 2026, individual Job Development is paid by outcome and individual Job Coaching is paid in phases from the job retention start date, and Workplace Assistance is a standalone service. PASA approval, no CDPHE license.
• Youth Day Services (CES): day services for CES members ages 12 through 17, limited to 10 hours per calendar day. PASA approval, no CDPHE license. We did not find the billing unit.

Colorado's certified adult day centers are paid through other waivers, not the I/DD waivers. Specialized Adult Day Services centers may serve people whose main diagnosis is I/DD, with a Medicaid ratio of one staff to eight participants under 10 CCR 2505-10 8.7505.

Residential services

• Individual Residential Services and Supports (IRSS, DD waiver): residential habilitation for three or fewer members in one setting, a host home, a Personal Care Alternative setting, or the member's own or family home. A family caregiver can deliver it through a PASA. Paid a daily rate tiered by Support Level (host home Level 1 was $81.90 a day from July 1, 2026). There is no state license for the living setting; the agency needs PASA approval.
• Group Residential Services and Supports (GRSS, DD waiver): group homes for four to eight members, paid a daily rate tiered by Support Level (Level 1 was $207.73 a day from July 1, 2026). The home needs a CDPHE Group Home (Community Residential Home) license and the agency needs PASA approval. CDPHE surveys every three years.
• CHRP Habilitation: provided in licensed foster homes, group homes or residential child care facilities through a foster provider or Child Placement Agency with a Medicaid provider number. The placement is licensed through child welfare, and HCPF handles initial enrollment of CHRP providers.

Since August 1, 2026, DD members whose certification starts on or after July 1, 2026 pay part of their income toward IRSS or GRSS costs. This is called Post-Eligibility Treatment of Income (PETI), and the enrolled agency collects it, not the host home caregiver. Regional Center residents are excluded until further notice.

How are I/DD provider rates set and how do agencies enroll in Colorado?

HCPF publishes a fee schedule with separate rates for Denver County and the rest of the state. Residential, day habilitation, prevocational and group supported employment rates come from a cost model and are tiered by the member's Support Level. Most agencies enroll by getting PASA approval through a CDPHE survey and then enrolling as a Medicaid provider with HCPF.

• Rate method: the cost model covers direct and indirect staffing, facility, administrative and capital costs, and was last rebased in 2018. Rates are tiered by Support Levels 1 to 6. Support Level 7 residential rates are set one person at a time from provider cost information.
• Latest rate change: DD, SLS and CES waiver rates were cut 2 percent across the board on July 1, 2026, a reduction chosen by the Joint Budget Committee on March 31, 2026. For example, GRSS Level 1 fell from $211.97 to $207.73 a day. This followed the reversal on October 1, 2025 of a 1.6 percent increase from July 1, 2025. See HCPF's provider rates and fee schedule page.
• PASA approval: the agency sends a letter of intent and application to CDPHE, passes an initial survey with zero deficiencies, and attaches the resulting certification to its HCPF Medicaid provider enrollment application. CDPHE surveys again every three years. Each service has a specialty code (for example 639 for Specialized Habilitation and 713 for Supported Community Connections).
• Medicaid enrollment: agencies enroll through HCPF's provider enrollment page. Group homes also need the CDPHE Community Residential Home license, and CHRP providers enroll with HCPF directly.
• EVV: electronic visit verification (EVV) applies to visit-based in-home services that I/DD members use, such as CFC personal care and homemaker, CES respite and in-home behavioral services. Providers can use the free state Sandata system or their own system connected to the Sandata aggregator, and claims without a matching EVV record are denied. Residential services in provider-owned settings, day services, office-based behavioral consults and State SLS are exempt, according to HCPF's EVV program manual.

What is changing next for I/DD services in Colorado?

From January 1, 2027, youth aging out of the CES and CHRP children's waivers will no longer move automatically onto the DD waiver unless they are involved in child welfare. For youth with age-out dates on or after that date, Youth Transition enrollment into the DD waiver is open only to youth in the child welfare system, according to HCPF's enrollment and waiting list page. Other youth would need to wait on the DD list by their Order of Selection Date.

Several other changes took effect in 2026 or are still being planned:

• Already in place: the 2 percent rate cut and the waiver amendments on July 1, 2026, the 50 percent cut in DD churn enrollments from July 1, 2026, and DD PETI from August 1, 2026.
• Paused: HCPF has paused a plan to align IRSS rates for host homes and family caregiver homes until the legislature and federal government approve it. HCPF also plans a standardized tool for negotiated DD and CHRP residential rates. Neither has a confirmed date.
• Planned: the Colorado Single Assessment and Person-Centered Support Plan are funded for state fiscal year 2026-27, but we did not find a firm start date.
• New waiting list numbers: HCPF's next strategic plan update was due to the General Assembly on November 1, 2026. As of our last check on October 23, 2026, we had not seen a newer count than September 1, 2025.

Colorado I/DD sources

• HCPF: HCBS Developmental Disabilities Waiver Enrollment and Waiting List
• HCPF: Developmental Disabilities Waiver (DD)
• HCPF: HCBS Waivers
• HCPF: HCBS-DD waiver application, amendment effective July 1, 2026 (CO.0007)
• HCPF: I/DD strategic plan update, November 1, 2025 (data as of September 1, 2025)
• HCPF: DD, SLS and CES July 2026-2027 rate schedules
• HCPF: Medicaid sustainability and LTSS
• HCPF: Case Management Agency directory
• CDPHE: Medicaid certification guidance for HCBS waiver services
• HCPF: Electronic Visit Verification program manual

Related reading

• Disability Services and Independent Living Guide
• Essential Acronyms in Disability Services: A Quick Reference Guide
• Disability Services DayHab has a dilemma - how to solve it
• Developmental Disabilities vs. Mental Health: Key Differences
• I/DD services in every state (map)
• Colorado EVV requirements

Page history

• October 23, 2026: Page rewritten and checked against state sources.

This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.

Ankota provides software for I/DD provider agencies, including EVV, service documentation, goal tracking and billing. If you would like to talk through your program, contact Ankota or read more about Ankota's I/DD software.