CES Waiver Colorado: Eligibility, Services, and How to Apply

The Children's Extensive Support (CES) Waiver is a Colorado Medicaid (Health First Colorado) 1915(c) Home and Community-Based Services waiver. It is administered by the Department of Health Care Policy & Financing (HCPF). It serves children under 18 who have a developmental disability, live in the family home, and need intensive behavioral or medical intervention. HCPF describes its purpose as helping children "establish a long-term foundation for community inclusion as they grow into adulthood." Enrolled children also keep all of their non-duplicative Health First Colorado benefits. Source: HCPF CES Waiver page, retrieved July 2026.

Not currently, but the answer has an important second half. As of July 2026, HCPF states that "the only HCBS waiver with an active waiting list is the HCBS Developmental Disability waiver (HCBS-DD)." CES is not on that list. This matters because most of what circulates online about Colorado waiver waits: an eight-year average, the As Soon As Available and Safety Net lists, advice to sign up at age 14. All of that describes the adult HCBS-DD waiver, not CES. However, CES has a codified waitlist protocol that activates automatically at capacity: under 10 CCR 2505-10 Section 8.503.60, when the waiver reaches enrollment capacity, eligible children are placed on a statewide waitlist ordered by application receipt date rather than by severity of need. Enrollment is capped at 5,771 unduplicated participants for the waiver year beginning July 1, 2026. So the absence of a queue today is a reason to apply now, because your application date is what would protect your place later.

A child must be under 18 years of age, have a determined developmental disability (developmental delay counts if the child is under 5), live in the family home, meet the Social Security Administration definition of disability, and meet Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) level of care as determined by the Functional Needs Assessment. The child must also meet the Health First Colorado financial determination for Long-Term Services and Supports. A child cannot be enrolled in two HCBS waivers at the same time. Source: HCPF CES Waiver page.

This is the criterion that decides most CES cases. The child must demonstrate a behavior or have a medical condition requiring direct human intervention that is more intense than a verbal reminder, redirection, or brief observation of status, at least once every two hours during the day, and on a weekly average of once every three hours during the night, beyond what would be age-appropriate. The underlying qualifying patterns include self-endangering behavior or a medical condition that becomes life-threatening without intervention, serious aggressive behavior toward self, others, or property, or constant vocalizations. Document actual events, because the assessment looks at real incidents rather than general descriptions. Confirm the current criteria with your Case Management Agency.

No, and this is the single most common misunderstanding about CES. ABA does not appear on HCPF's current CES service list, and Colorado's Pediatric Behavioral Therapies billing manual explicitly states that it "does not address services available through Home and Community-Based Services (HCBS) waiver programs." ABA is funded through two other routes instead. First, the Health First Colorado state-plan Pediatric Behavioral Therapies (PBT) benefit, for members 20 and younger who meet EPSDT medical-necessity criteria, with prior authorization required before treatment begins. Second, private insurance: CRS 10-16-104(1.4) requires health benefit plans issued or renewed in Colorado to cover assessment, diagnosis, and treatment of autism spectrum disorder, expressly including applied behavior analysis. You do not need the CES waiver to start ABA.

It should not change your child's access to medically necessary ABA, but it does mean tighter paperwork. In March 2026, the HHS Office of Inspector General found that Colorado made at least $77.8 million in improper fee-for-service Medicaid payments for ABA (based on an audit of 2022 and 2023 claims) and asked the state to refund about $42.6 million in federal money. HCPF disputed the size of that estimate but agreed to give ABA providers more billing guidance, and the OIG directed periodic statewide reviews of ABA payments. Separately, Colorado's proposed FY2026-27 budget included Medicaid rate reductions that singled out pediatric behavioral therapy (the PBT/ABA benefit); the Colorado Association for Behavior Analysis, provider organizations, and families have challenged those cuts in court, and the state added new pre- and post-payment review for autism therapy. The practical takeaway for families: PBT is still how ABA is funded, so keep thorough records, confirm your provider's prior authorization (PAR) is current, and save assessment and session documentation in case of review. Sources: HHS OIG report (2026); The Colorado Sun, March 2, 2026.

CES is not a cash award or a scholarship. It funds a defined list of home and community-based services. Per the waiver text effective July 1, 2026, which matches the live HCPF CES page, there are 13: Adaptive Therapeutic Recreational Equipment and Fees, Assistive Technology, Community Connector, Extraordinary Cleaning, Home Accessibility Adaptations, Massage Therapy, Movement Therapy, Primary Caregiver Education, Respite, Specialized Medical Equipment and Supplies, Vehicle Modifications, Wellness Education Benefit, and Youth Day Service. Community Connector is capped at 1,040 units per year with a case-manager exception process. Separately, through Community First Choice (CFC), families can access Personal Care, Homemaker Services, Health Maintenance Activities, Home Delivered Meals, Medication Reminder, PERS, Remote Supports, and Transition Set Up. The CFC transition completed June 30, 2026, so those are no longer available through the waiver itself. Older brochures still list Homemaker and Hippotherapy as CES services. That information is out of date: hippotherapy ended June 30, 2026.

Start with your local Case Management Agency (CMA), which you can find through HCPF's Case Management Agency Directory or its interactive CMA map. The CMA handles intake, the Developmental Disability Determination, the Functional Needs Assessment for level of care, and service planning, and it submits your application to the utilization review contractor within 14 calendar days of your signature. Supporting documentation must be less than 6 months old. Financial eligibility is determined separately from the CMA, historically by your local county human services department. If your child is not yet a Health First Colorado member, contact the CMA or apply online at co.gov/PEAK. You can also call the Member Contact Center at 1-800-221-3943 (State Relay 711). Denials carry appeal rights under 10 CCR 2505-10 Section 8.057. Some older HCPF pages still direct families to a Community Centered Board (CCB), but Colorado's Case Management Redesign took effect July 1, 2024 and you are now served by one CMA in your area regardless of waiver, so start there.

Generally no, though confirm it with your Case Management Agency rather than taking this page's word for it. CES eligibility is based on your child's own income and resources, not your household income. The child's income must be under 300% of the SSI benefit rate per month with countable resources under $2,000. Colorado does this through the TEFRA (institutional deeming) option within the waiver's authority, meaning a child living at home is assessed as if they were in an institution. The financial rules sit at 10 CCR 2505-10 Section 8.100, and Section 8.100.7.A allows time receiving HCBS services to satisfy the institutionalization test. One honest caveat: no current HCPF page states this in plain language. The mechanism is documented across the waiver application (which elects the federal 42 CFR 435.217 deeming group), the state rule, and HCPF's 2017 assessment report, which lists CES as "based on child's income (TEFRA option w/in waiver authority)." Confirm how your household will be counted with your Case Management Agency, and do not assume you earn too much to apply.

CES is for children under 18 with a developmental disability who live in the family home and need intensive behavioral or medical support. CHRP (Children's Habilitation Residential Program) is for children 20 and younger who need out-of-home placement, and it funds 24-hour residential habilitation; co-pay costs vary. SLS (Supported Living Services) is for adults 18 and older living in the community. All three use ICF/IID level of care, and none of the three has an active waiting list as of July 2026. You cannot be enrolled in two HCBS waivers at once. On aging out of CES at 18: do not assume the move into adult services is automatic. HCPF has proposed discontinuing automatic enrollment from CES into the adult HCBS-DD waiver, which would route young adults through the DD waiting list or Reserved Capacity instead. That is a proposal in the comment record, not adopted policy, so raise transition planning with your CMA well before your child turns 18.

Start therapy now rather than waiting on the waiver, because CES would not pay for ABA anyway. If your child is a Health First Colorado member and 20 or younger, ask a provider about a PBT prior authorization under EPSDT medical necessity. If you have private insurance issued or renewed in Colorado, the autism mandate at CRS 10-16-104(1.4) requires coverage of ABA, and the current statute states no age cap and bars dollar limits less favorable than those applied to physical illness. Meanwhile, contact your CMA to begin the CES assessment process. These run in parallel; neither one blocks the other.

Start with our therapy directory by city (Denver, Colorado Springs, Pueblo, Arvada, Centennial, Grand Junction) and our Colorado schools directory. You can also tell our concierge about your child and we will connect you with ABA providers and special needs schools that fit your area, your insurance, and your child's needs. The concierge is free. It does not get you a CES waiver slot and it does not speak to HCPF for you. It helps you build care now while you work through the waiver process with your CMA.