In Colorado, home-care Medicaid is won or lost on paper, and the paper moves through three different organizations that do not automatically talk to each other. Health First Colorado is the state’s Medicaid program, overseen by the Department of Health Care Policy and Financing. Your county human services department decides the money. A Case Management Agency decides the services. Nobody chases a missing document on your behalf.
So this page is built around the documents themselves. For each one: what it is, who produces it, what it decides, and what goes wrong when it is late or thin. If you keep a single folder with these items in it, you will move faster than most families in this system.
The waiver that covers older adults and adults with disabilities living at home is the Elderly, Blind and Disabled waiver, universally shortened to EBD. Colorado also operates the Community Mental Health Supports waiver, the Brain Injury waiver and the Complementary and Integrative Health waiver, plus PACE where a program serves the county. Every figure below is stated as of 2026 and should be confirmed with HCPF or your Case Management Agency before you rely on it.
In This Article
- Document 1: The Medical Assistance Application — filed through PEAK or the county
- Document 2: The Level of Care Screen and the Colorado Single Assessment
- Document 3: The Case Management Agency Assignment Letter
- Document 4: The Person-Centered Support Plan and the Prior Authorization Request
- Document 5: The CDASS Enrollment Packet — how a family member gets paid
- Document 6: The Life Insurance File — where Colorado departs, and where it does not
- Frequently Asked Questions
Document 1: The Medical Assistance Application — filed through PEAK or the county
Colorado’s public benefits portal is called PEAK, and it is where a Health First Colorado application normally starts. You can also file on paper at the county human services department, and for long-term care cases many families find the county route produces a named human being to call, which matters more than the convenience of the website.
What this document decides: financial eligibility only. It does not request home care, and filing it does not start a functional assessment. That is the most common Colorado sequencing error — a family completes PEAK, waits, and hears nothing about services because nothing about services was ever asked for.
Assemble before you file: five years of statements for every bank, brokerage and retirement account; deeds and mortgage statements; vehicle titles; life insurance policies with a current in-force illustration and written cash surrender value from the carrier; annuity contracts; burial contracts; and proof of every income source. Colorado, like every state, runs an electronic asset verification check against financial institutions, so undisclosed accounts surface anyway — disclosing them slowly is what causes delay.
Federal timelines apply: 45 days for a decision, up to 90 when a disability determination is required.
Document 2: The Level of Care Screen and the Colorado Single Assessment
Functional eligibility is a separate determination made by a Case Management Agency, not by the county. Colorado historically used an instrument known as the ULTC 100.2 and has been transitioning to an interRAI-based instrument branded the Colorado Single Assessment. Ask your Case Management Agency which instrument is being used on your case as of 2026 and request a copy of the completed assessment — you are entitled to see what was recorded about you.
What this document decides: whether the applicant meets a nursing-facility level of care, which is the gate for every waiver on this page. The assessment scores activities of daily living, instrumental activities, cognition, behavior and medical needs based on an in-person visit.
What goes wrong: an assessment conducted on a good day, with the applicant answering alone, understates need badly. Bring a written incident log — falls with dates, ER visits, medication errors, wandering, weight loss, hours of hands-on help given each day by family. Have the person who actually provides the care present. If the screen comes back below the threshold, ask for the score sheet and the appeal instructions in writing; a physician’s statement addressing the specific low-scored domains is the tool that reverses these.
Document 3: The Case Management Agency Assignment Letter
Colorado restructured its case management system, consolidating what had been Single Entry Point agencies and community centered boards into Case Management Agencies covering defined catchment areas, with the transition landing in 2024. That reorganization is a genuinely Colorado-specific fact and it has a practical edge: if your paperwork predates the change or you moved counties, confirm which agency now holds your case rather than assuming the office you called last year still does.
What this document decides: who your case manager is, and therefore who writes your service plan, authorizes your hours and handles your appeals. It is the single most important phone number in the process.
What goes wrong: cases orphaned between agencies during a boundary change, and families calling a former Single Entry Point agency that no longer covers them. If you cannot get a straight answer, HCPF’s member contact line can identify the correct agency for your address. Get the case manager’s name, direct line and email, and put them at the front of the folder.
| Document | Who Produces It | What It Decides | Common Failure |
|---|---|---|---|
| Medical Assistance application (PEAK or county) | Applicant / county human services | Financial eligibility | Assuming it also requests home care |
| Level of care screen / Colorado Single Assessment | Case Management Agency | Nursing-facility level of care | Assessed alone on a good day |
| Case Management Agency assignment | HCPF / regional CMA | Who writes your plan | Case orphaned after the 2024 restructure |
| Person-Centered Support Plan + PAR | Case manager | Your actual hours | Signing without reading the hour figures |
| CDASS enrollment packet | Member + FMS vendor | Whether family is paid | Assuming a spouse can be hired |
Document 4: The Person-Centered Support Plan and the Prior Authorization Request
The support plan is the document that converts an approved level of care into actual services. It lists each authorized service, the amount, the frequency and the provider. Behind it sits a Prior Authorization Request, the billing instrument that tells providers what they may deliver and be paid for.
What these decide: your hours. Everything else is preliminary.
EBD waiver services in Colorado generally include personal care, homemaker services, adult day services, alternative care facility services, respite for a family caregiver, home modifications such as ramps and grab bars, a personal emergency response system, non-medical transportation, and in-home support services. Home health and skilled nursing come through the Medicaid state plan rather than the waiver.
What goes wrong: families sign the plan without reading the hour figures, then discover the aide comes six hours a week rather than sixteen. Ask for the assessed need in hours and the written basis for the authorized amount. If the amount is reduced or denied, the notice you receive states the appeal deadline — filing quickly enough after an adverse notice generally keeps existing services running during the appeal. Missing that window is the most expensive paperwork mistake in this system.
Document 5: The CDASS Enrollment Packet — how a family member gets paid
Consumer Directed Attendant Support Services, always called CDASS, is Colorado’s self-direction option. The member or an authorized representative becomes the employer of record, receives a monthly allocation, sets the wage within program limits, and hires their own attendants. A Financial Management Services vendor handles payroll, taxes and background checks. Colorado also offers In-Home Support Services, an agency-supported middle ground for people who want to direct care without carrying the full employer role.
The paperwork here is real: an attendant support management training, an employer agreement, an allocation worksheet, attendant hiring packets with background checks, and timesheets on the FMS vendor’s schedule.
Can a family member be paid? Generally yes for an adult child, sibling, grandchild, niece or friend. A spouse generally cannot be paid as an attendant in Colorado — the state follows the national default treating a spouse as a legally responsible relative. Colorado did loosen this temporarily during the federal public health emergency, which is why older internet advice conflicts with current rules. Confirm the 2026 position with your case manager and the FMS vendor before anyone quits a job.
Document 6: The Life Insurance File — where Colorado departs, and where it does not
Where Colorado follows the baseline: the $2,000 countable-asset limit for a single applicant as of 2026; the income cap set at roughly three times the federal SSI benefit rate, in the low-$2,900s per month as of 2026, which makes an income trust necessary for higher-income applicants; the 60-month transfer look-back; the community spouse resource and income allowances; the home equity limit; and estate recovery against the probate estate for recipients 55 and older. Confirm each number with HCPF.
Where Colorado is its own animal: the consolidated Case Management Agency structure, the transition of its assessment instrument, and the maturity of CDASS as a self-direction program with a member-set wage. That wage-setting authority is unusual and it matters — a family that cannot recruit an attendant at the going rate has a lever most states do not give them.
The insurance folder needs three items before any decision: the policy contract, a current in-force illustration, and the carrier’s written statement of cash surrender value. Colorado counts the cash value of permanent life insurance when the combined face value of all policies on the applicant exceeds the small-policy threshold — see how that aggregation rule works. Then work the ladder: a reduced paid-up election lowers cash value while keeping a smaller death benefit; an irrevocable funeral trust converts a countable dollar into an excluded one; a life settlement sells the policy to a licensed buyer for cash, which is then countable and must be spent on care. And sometimes the paperwork answer is to file the policy and leave it alone — a small burial-sized policy, one the at-home spouse still needs, or one on a healthy insured the market would price poorly. Pine Lake Legacy does not purchase policies; the free policy review exists so a family knows the real number. This is not legal, tax or eligibility advice — take it to a Colorado elder law attorney, your CPA, and the state’s insurance division consumer help or the Colorado SHIP counselors.
Frequently Asked Questions
What is the difference between CDASS and IHSS in Colorado?
Both are self-direction models under Colorado’s waivers. CDASS makes the member the full employer of record with a monthly allocation and member-set wages, supported by a financial management vendor. In-Home Support Services keeps an agency in the loop for training, backup staffing and supervision while still letting the member choose the worker. Ask your case manager which fits your family’s capacity.
Can I be paid to care for my parent in Colorado?
Usually yes if you are not their spouse. Under CDASS an adult child, sibling, grandchild, niece or friend can be hired as an attendant and paid through the financial management vendor after a background check. Spouses are generally excluded as legally responsible relatives, a rule that was relaxed temporarily during the public health emergency. Confirm the 2026 rule with your case manager.
Which Colorado agency actually approves the waiver?
Two separate bodies must agree. The county human services department determines financial eligibility for Health First Colorado, and a regional Case Management Agency determines functional eligibility and writes the service plan. The Department of Health Care Policy and Financing oversees both. If either determination is missing, nothing happens, which is why families should track both files separately.
Is there a waiting list for the Colorado EBD waiver?
Availability has varied over time and by region, and the 2024 case management restructure changed who tracks it. Ask your Case Management Agency directly whether there is currently a wait for the Elderly, Blind and Disabled waiver in your catchment area and, if so, roughly how long it is running. Request the answer and your position in writing.
Does a whole life policy block home care in Colorado?
It can. When the combined face value of all life insurance on the applicant exceeds the small-policy threshold, the cash surrender value counts toward the $2,000 countable-asset limit for a single applicant as of 2026. Term insurance without cash value generally does not count. Get the carrier’s written surrender value before deciding between reduced paid-up, a funeral trust, or a settlement.
What happens if my hours are cut?
You will receive a written notice stating the reduction and the appeal deadline. Filing an appeal quickly enough after the notice generally keeps the existing level of service in place while the appeal is decided, which is the difference between a gap in care and none. Ask the case manager for the written basis of the new authorization at the same time you file.
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Related Reading
- Colorado Medicaid Asset Income Limits
- Medicaid Estate Recovery Colorado
- Colorado Insurance Department Consumer Help
- Life Insurance Guaranty Association Colorado
- Life Insurance Counts Medicaid Asset
- Nursing Home Medicaid Spend Down
- What Is Cash Surrender Value
- Home Care Hourly Cost Funding
Pine Lake Legacy does not purchase life insurance policies and does not provide legal, tax, or investment advice. Information provided is for educational purposes only. Eligibility for any option, including life settlements, is not guaranteed and depends on individual circumstances, policy terms, underwriting, and market conditions. Consult independent legal, tax, or financial professionals before making decisions regarding a life insurance policy.