Colorado CES Waiver: Eligibility, Services, and 2026 Changes

Start here: what CES is and whose income counts

The Children's Extensive Support (CES) Waiver is a Health First Colorado (Medicaid) 1915(c) Home and Community-Based Services waiver for children birth through age 17 who live in the family home, or who can return home from an out-of-home placement with CES services, and need behavioral or medical support well beyond what is typical for their age. HCPF's CES page says:

• "A waiver is an extra set of Health First Colorado (Colorado's Medicaid program) benefits that you could qualify for in certain cases. These benefits can help you remain in your home and community."
• "The Children's Extensive Support (CES) Waiver helps children and families by providing services and supports that will help children with a developmental disability establish a long-term foundation for community inclusion as they grow into adulthood."
• "Children who receive services through the CES waiver are also eligible for all Health First Colorado covered services as long as they are not duplicative."

CES looks at the child's income and countable resources, not a parent's household paycheck. The limit is less than 300% of the SSI allowance, with countable resources below $2,000. On money, HCPF's CES page says: "Children must meet the Health First Colorado financial determination for Long-Term Services and Supports eligibility." The state and county make that determination, so ask the CMA to confirm how the numbers apply to your child. Colorado's HCBS rule, 10 CCR 2505-10 § 8.7100.C, states:

• "Members shall meet the Medicaid Assistance eligibility criteria for Long Term Care as stated at Section 8.100."
• "The Applicant’s income must be less than 300% of the current Supplemental Security Income Federal Benefit Rate and countable resources less than $2,000 for a single person or $3,000 for a couple."

Section 8.7101.B adds that "HCBS-CES Waiver Services are available to eligible Individuals in the following State Plan eligibility groups:" "SSI recipients" and "Optional state plan recipients."

Other states use the same child-only income rule through Katie Beckett, TEFRA, or similar waivers. Our Katie Beckett and TEFRA guide compares every state.

Waitlist status: no active CES queue, but capacity is limited

The active statewide queues belong to the adult HCBS-DD waiver, not CES, and they are the source of the “eight-year wait” stories. HCPF's waiting-list page says:

• "The HCBS-DD waiver currently has a statewide waiting list because enrollment capacity is limited by legislative appropriation and waiver authority."
• "In most cases, individuals are on the waiting list for multiple years before receiving a waiver spot."
• "The number of years you are considered to be waiting includes only the years you are 18 years of age or older."

CES still has a ceiling: a federally approved capacity of 5,771 unduplicated participants for the waiver year that began July 1, 2026. Colorado's current CES rule, 10 CCR 2505-10 § 8.7101.B, states: "Individuals who are determined eligible for HCBS-CES Waiver Benefits who cannot be served within the capacity limits of the federally approved waiver, shall be eligible for placement on a waiting list maintained by the Department."

The general HCBS rule, 10 CCR 2505-10 § 8.7100.B, says the HCBS waivers:

• "Shall not constitute an entitlement to services from the Department,"
• "Shall be subject to annual appropriations by the Colorado General Assembly,"
• "May limit the individual waiver program’s enrollment when utilization of the HCBS waiver program is projected to exceed legislative spending authority."

Colorado places eligible applications in the order the utilization review contractor receives them. The waitlist protocol in the CMS-approved CES waiver (CO.4180.R06.08, Appendix B-3) states: "Any client determined eligible for services under the HCBS-CES waiver when services are not immediately available within the federally approved capacity limits of the HCBS-CES waiver, shall be eligible for placement on a single statewide waitlist in the order in which the utilization review contractor received the eligible HCBS-CES waiver application." Where the two differ, § 8.7100.B says: "To the extent that the terms of the federally approved waiver are inconsistent with the provisions of this section, the waiver(s) shall control." Contact your CMA as soon as the program may fit, keep a copy of the completed packet, and confirm the date the packet was received.

Eligibility turns on hands-on support, not a diagnosis alone

A diagnosis by itself is not the test. The CMA's Functional Needs Assessment asks what happens during an ordinary day and night, and what an adult must do to keep the child safe. HCPF's CES page says "Children must meet Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) level of care which is determined by the Functional Needs Assessment" and lists the eligibility group. Children in this program:

• "Are less than eighteen years of age"
• "Have been determined to have a developmental disability which includes developmental delay if under five (5) years of age"
• "Live in the family home"
• "Demonstrate a behavior or have a medical condition that requires direct human intervention, 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. The behavior or medical condition must be considered beyond what is typically age-appropriate."
• "Are determined to meet the Federal Social Security Administration's definition of disability"

The regulation, 10 CCR 2505-10 § 8.7101.B, also counts a child "Residing with biological or adoptive Parent(s), or Legal Guardian, or" "Residing in an out-of-home placement and can return home with the provision of HCBS-CES Waiver Services" with a transition plan the Department approves. It names the conditions behind that behavior or medical need:

• "A significant pattern of self-endangering behavior or medical condition which, without intervention will result in a life-threatening condition or situation,"
• "A significant pattern of serious aggressive behavior toward self, others, or property, or"
• "Constant vocalizations such as screaming, crying, laughing, or verbal threats" that cause caregiver distress. "The term constant is defined as on the average of 15 minutes each waking hour."
• "Significant Pattern is defined as a behavior or medical condition that is harmful to self or others as evidenced by actual events occurring within the past six (6) months."
• "To remain eligible for Waiver Services, the annual Reassessment must demonstrate that in the absence of the existing interventions or preventions provided as Waiver Services, the intensity and frequency of the behavior or medical condition would return to a level that would meet the criteria listed above."

Your CMA, not this page, decides whether the records meet the standard.

What CES covers, plus the 2026 Community Connector change

A service on the CES menu is not automatically approved for every child. It has to match the child's assessed needs and be written into the Person-Centered Support Plan. The current waiver list includes respite, Community Connector, youth day service, primary caregiver education, assistive technology, specialized medical equipment, home and vehicle adaptations, extraordinary cleaning, massage, movement therapy, wellness education, and adaptive recreational equipment. HCPF's benefits glossary defines several of them:

• Respite: "Respite is available for your caregiver on a short-term basis because of the absence or need for relief of those persons normally providing the care. Respite may be provided in the community, in the private residence of the respite provider, or in your home."
• Youth Day: "Youth Day Services provides care and supervision to children 12 - 17 years old while the primary caregiver works (paid or unpaid), volunteers, or seeks employment."
• Primary Caregiver Education: "Primary Caregiver Education services teach parents and other caregivers about a child's disabilities."
• Movement Therapy: "Movement therapy includes music and dance therapy for the habilitation, rehabilitation, and maintenance of behavioral, developmental, physical, social, communication, or gross motor skills."
• Adaptive recreation: "These services include recreational equipment that is adapted specific to the Member’s disability and not items that a typical age peer would commonly need as a recreation item."
• Home and vehicle changes: "There is a combined $10,000 maximum over the 5-year waiver period for the Assistive Technology, Home Accessibility Adaptations, and Vehicle Modifications benefits for the Children's Extensive Support (CES) and Supported Living Services (SLS) waivers. This amount may be exceeded with prior approval."

The CES respite rule in 10 CCR 2505-10 § 8.7546 adds limits:

• "Respite is not a covered benefit for Member 11 years of age and younger during the time the primary caregiver is at work, pursuing continuing education or engaging in volunteer activities."
• "The total amount of respite provided in one support plan year may not exceed an amount equal to 30 day units and 1,880 15-minute units. The Department may approve a higher amount based on a need due to a documented increase in medical or behavioral needs."
• "Respite may not be provided by the Member’s legal guardian, primary caregiver, or Legally Responsible Person."

For Community Connector, HCPF's current policy focuses the service on school-age children and sets an annual limit of 1,040 fifteen-minute units (260 hours), subject to an exception process. OM 26-005 first set a strict age 6 minimum; OM 26-034 (May 2026) revised it:

• "Community Connector services are accessible to children under 6 years of age when the Member has an assessed age-appropriate extraordinary community engagement support need that cannot be appropriately addressed through other services."
• "Community Connector authorization for children under 6 is expected to be uncommon and limited to rare, extreme, or extenuating circumstances."

Operational Memo 26-005 states:

• "The annual unit limit for Community Connector services will be reduced by 50%, from 2,080 units (520 hours) to 1,040 units (260 hours) per Person-Centered Support Plan year."
• "Members with needs that exceed the annual unit limits may work with their CMA to request an exception."
• "You have the right to appeal any adverse action."

The same memo explains why: "Over time, Community Connector has become one of the most frequently used children’s waiver benefits, with about 80% of CES Members accessing it." Under Operational Memo 26-034, the limit takes effect for a member at the next Continued Stay Review and new certification period. A CMA that reduced units at quarterly monitoring solely because of the limit should restore the prior units for the rest of the current certification period and withdraw the related notice. Ask the CMA to review your authorization if that happened. OM 26-034 states: "Under the revised policy, the new annual limit will be implemented only at a Member’s CSR and will take effect at the start of the Member’s new certification period." It adds: "The member and family are to be informed that this withdrawal and temporary hold on the unit limitation applies only to the current PAR certification period." OM 26-034 tells members: "Members may work with their Case Manager to request an exception to the Community Connector unit limit if an exceptional community engagement need is present."

ABA is a separate coverage path

Families often put CES and ABA in the same search because both can involve intensive support. ABA is not on the CES waiver service list. Health First Colorado handles it through the separate Pediatric Behavioral Therapies (PBT) state-plan benefit for members age 20 and younger who meet EPSDT medical-necessity rules. The enrolled clinical provider submits the Prior Authorization Request. HCPF's Pediatric Behavioral Therapies page says:

• "All behavioral therapies will need to be authorized prior to the start of treatment."
• "The contracted Medicaid provider will assess your child, put together a treatment plan, and submit a Prior Authorization Request (PAR) to the Department's Utilization Management (UM) vendor to review for medical necessity."
• "Each approved PAR is valid for up to six (6) months."
• "Behavioral therapy is available to all children currently eligible for Health First Colorado when the service is medically necessary."

Asked whether a child on an HCBS waiver can still get these services, the same page answers: "Yes. All EPSDT services are available to all children receiving Health First Colorado."

A family with a Colorado-regulated commercial plan may have a second route under C.R.S. § 10-16-104(1.4). A Colorado Legislative Council Staff memo on that section says: "All health benefit plans issued or renewed in the state must provide coverage to assess, diagnose, and treat autism spectrum disorder (ASD)." It also says: "Any treatment for ASD must be deemed medically necessary." In either case, ask the ABA provider or insurer about its own authorization process; a CES approval does not approve ABA.

How to apply: start with the right CMA

The first call is to the Case Management Agency that serves your county. HCPF's CES page says: "If you have questions about this waiver, or to learn more about how to apply, contact your local Case Management Agency or the Member Contact Center." Colorado’s Case Management Redesign took effect July 1, 2024, so older pages may still tell families to start with a Community Centered Board (CCB). HCPF’s current process uses one regional CMA for the family, regardless of which HCBS waiver may fit.

If the child is already enrolled in Health First Colorado, the CMA can explain the CES application. If not, the family can contact the CMA or apply through Colorado PEAK. The CMA completes the Functional Needs Assessment and submits the CES packet to the utilization review contractor within 14 calendar days after the parent’s signature. Keep the submission date. If the application is denied, ask about the appeal process under 10 CCR 2505-10 § 8.057.

• CES waiver CO.4180.R06.08, Appendix B-3: "The completed application and a copy of the Functional Needs Assessment that determines the client meets the ICF/MR level of care shall be submitted to the Utilization Review Contractor within fourteen (14) calendar days of the parent's signature."
• Same appendix: "Applicants denied program enrollment shall be informed of the client's appeal rights per 10 CCR 2505-10, Section 8.057."
• 10 CCR 2505-10 § 8.7100: "Utilization Review Contractor (URC) means the Agency contracted with the Department to review the HCBS waiver applications for determination of eligibility based on the additional targeting criteria."
• OM 26-005: "Notice of Action (NOA) is a formal, written statement used to inform a Member of a decision regarding their Medicaid eligibility or covered services."

Comparing Colorado Waivers: CES vs. CHRP vs. SLS

Colorado runs several 1915(c) waivers for people with intellectual and developmental disabilities. Which one fits depends on age, where the person lives, and how much support they need. For the adult HCBS-DD waiver, HCPF's waiting-list page says an individual must:

• "Be determined to have an intellectual and/or developmental disability."
• "Individual must require 24-hour supports to safely live in the community"
• "Be 18 years of age or older."

Personal care and homemaker help sit outside the waivers. HCPF's CES page says: "CFC is not a waiver. It’s a Health First Colorado benefit program designed to work in conjunction with waiver services for members who need long-term care and qualify for these services."

The target criteria in 10 CCR 2505-10 § 8.7101 set the age lines. For CHRP, an individual "Is under 21 years of age." For SLS, an individual:

• "Is 18 years of age or older."
• "Does not require 24-hour supervision on a continuous basis which is reimbursed as an HCBS-SLS service."
• Lives in "A living arrangement, which the individual owns, rents, or leases in their own name," or "The home where the individual lives with the Member’s Family or legal Guardian, or"

Colorado Special Education & Provider Resources

Statutory Sources and Administrative Rule Filings

• Children's Extensive Support Waiver (CES) | Department of Health Care Policy and Financing
• Code of Colorado Regulations 10 CCR 2505-10 8.7000 (HCBS rules, including CES § 8.7101.B and Community Connector § 8.7514)
• Long-Term Services and Supports - Benefits and Services Glossary | Department of Health Care Policy and Financing
• HCPF OM 26-005 Updates to Community Connector Rate, Policy, and Limits in the Children's Extensive Supports (CES) & Children's Habilitative Residential Program (CHRP) Waivers
• HCPF OM 26-034 New Updates to Community Connector Rate, Policy, and Limits in the Children's Extensive Supports (CES) & the Children's Habilitative Residential Program (CHRP) Waivers
• CMA and CCB Agency Directory | Department of Health Care Policy and Financing
• Application for 1915(c) HCBS Waiver: CO.4180.R06.08 (Children's Extensive Support Waiver, approved full text)
• HCBS Developmental Disabilities Waiver Enrollment and Waiting List | Department of Health Care Policy and Financing
• Pediatric Behavioral Therapies | Department of Health Care Policy and Financing
• Legislative Council Staff Memorandum: Colorado Health Insurance Mandates (C.R.S. § 10-16-104(1.4) autism coverage)
• Colorado PEAK Online Medicaid Application Portal

Frequently Asked Questions About the Colorado CES Waiver