Last updated: 2026-09-13
Colorado CES Waiver: Eligibility, Services, and 2026 Changes
Use this guide to separate waiver eligibility, service authorization, Medicaid ABA coverage, and the current Community Connector limits before you call a Case Management Agency.
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Statutory Framework and Institutional Income Deeming
The Children's Extensive Support (CES) waiver is a specialized Medicaid Home and Community-Based Services program administered by the Colorado Department of Health Care Policy and Financing under 10 CCR 2505-10 § 8.503 and CMS waiver authority CO.4180.R06.00. The program provides an annual service budget for children under age 18 with severe developmental disabilities or intense medical needs, allowing them to remain in the family home rather than entering an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID). Under federal institutional deeming provisions in 42 CFR § 435.217 and 10 CCR 2505-10 § 8.100.7.A, household parental income and financial assets are completely disregarded during financial eligibility determinations. Qualification is evaluated exclusively against the child's personal monthly income, which cannot exceed 300% of the Supplemental Security Income federal benefit rate ($2,829 per month in 2026), and countable individual liquid resources below $2,000.
Evaluated strictly on the child's individual income and assets.
Set at 300% of the SSI Federal Benefit Rate (2026).
Liquid savings accounts in child's name (ABLE accounts exempt).
The Waitlist Myth vs. The 5,771 Statutory Enrollment Cap
Under Colorado Department of Health Care Policy and Financing regulations, the adult HCBS-DD waiver carries a multi-year waiting list with separate Safety Net and As Soon As Available queues. By contrast, the Children's Extensive Support waiver operates without an active waiting list. Under 10 CCR 2505-10 § 8.503.60, HCPF establishes a statutory capacity ceiling of 5,771 unduplicated children for state fiscal year 2026-27 under CMS waiver agreement CO.4180.R06.00. Should active enrollment reach 5,771 participants, the department activates a statutory waitlist ordered by the date and time the completed packet is logged into the state Bridge portal. Families submit applications through their designated Case Management Agency to register an intake date before statutory capacity is reached.
Clinical Eligibility and the 24-Hour Hands-On Support Standard
Eligibility for CES requires meeting the Intermediate Care Facility for Individuals with Intellectual Disabilities level of care under 10 CCR 2505-10 § 8.503.30. Qualification requires satisfying the statutory extensive support criterion on the Colorado Functional Needs Assessment and the Professional Medical Information Page. Under state guidelines, the child must exhibit behaviors or medical needs requiring direct physical human intervention at least once every two hours during daytime waking hours, and on a weekly average of once every three hours throughout the night. Interventions must exceed verbal cues, redirection, or passive visual monitoring. Qualifying behaviors include severe physical self-injury, ongoing physical aggression toward caregivers, severe property destruction, or medical conditions that turn life-threatening without intervention. Case managers review 14 to 30 day parent tracking logs documenting nighttime incidents; children who sleep through the night without requiring physical intervention fail this requirement and are referred to the standard Children's HCBS waiver.
1. Document Physical Interventions: State evaluators disregard verbal prompting. Note exact physical hands-on actions required to maintain airway, stop elopement, or block self-injurious behavior.
2. Track Nighttime Sleep Disruptions: Record exact timestamps of night waking (e.g., 1:15 AM, 3:45 AM) and the physical adult intervention administered. Continuous 8-hour sleep patterns result in redirection to CHCBS.
3. Document Freshness: Under HCPF rules, medical documentation and behavioral incident logs must be dated within six months of the formal intake assessment.
Waiver Services and the Paid Parent Caregiver / CNA Model
Colorado permits legally responsible persons to provide certain CES services under its current waiver rules, but a Medicaid service rate is not a parent wage. HCPF’s current Community Connector policy sets provider reimbursement at $7.71 per 15-minute unit outside Denver County and $7.83 in Denver County. Beginning April 1, 2026, Community Connector is limited to children age 6 and older and to 1,040 units (260 hours) per support-plan year. A CMA may request an exception when a member’s documented needs exceed that limit. Ask an agency what it pays its employees and which services it can actually authorize; do not use the state rate as a wage quote.
Can a Colorado parent get paid for Community Connector in 2026?
Possibly, but it is not automatic. The first questions are whether Community Connector is in the child’s Person-Centered Support Plan, whether the child has the assessed extraordinary need the service requires, and whether a qualified provider agency can authorize and employ the parent or guardian under the current CES rules. The state’s $7.71 or $7.83 per-unit reimbursement rate is paid to a provider; it does not tell a family what the agency will pay a caregiver. Start with the CMA, then get the agency’s pay and employment terms in writing.
Source: HCPF Operational Memo 26-005; confirm individual authorization with the assigned CMA.
| The service is for | It is not a substitute for |
|---|---|
| One-to-one support for an assessed extraordinary need that substantially exceeds age-typical parental responsibility. | Routine supervision, ordinary parenting tasks, or support a parent would normally provide for a child of the same age. |
| Participation in public community settings that builds skills, natural supports, and greater independence. | Services already supplied through school, including school-based or home-school-based supports. |
| Goals and strategies written into the Person-Centered Support Plan. | Entertainment admission, food, or drink costs; those are specifically excluded from reimbursement. |
Source: Colorado HCPF Community Connector rule materials. A CMA and provider must apply the rule to the child’s individual plan.
- Respite Care (Individual & Group)
- Youth Day Service
- Community Connector (1,040 unit limit)
- Primary Caregiver Education
- Assistive Technology
- Specialized Medical Equipment and Supplies
- Adaptive Therapeutic Recreational Equipment and Fees
- Home Accessibility Adaptations (ramps, lifts)
- Vehicle Modifications (wheelchair lifts, tie-downs)
- Extraordinary Cleaning
- Massage Therapy (licensed CMT)
- Movement Therapy
- Wellness Education Benefit
Community Connector: the 2026 details to check
HCPF’s policy change applies at a member’s Continued Stay Review. A CMA should document the new annual limit or a justified exception in the Person-Centered Support Plan and related authorization.
Applied Behavior Analysis (ABA): Medicaid PBT vs. Private Insurance
Applied Behavior Analysis (ABA) is not a billable service under the CES waiver benefit package. Colorado's Pediatric Behavioral Therapies billing manual explicitly restricts waiver allocations from covering ABA services. Instead, autism therapy is funded through two parallel statutory channels. Health First Colorado covers ABA through the state-plan Pediatric Behavioral Therapies benefit under Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) medical necessity rules for members aged 20 and younger, requiring Prior Authorization Requests (PAR) submitted by enrolled clinical providers. For families with commercial health coverage, C.R.S. § 10-16-104(1.4) mandates that Colorado-regulated private plans provide coverage for autism evaluation and ABA therapy without annual or lifetime dollar caps.
1. Health First Colorado (Medicaid PBT)
Administered under EPSDT for youth aged 20 and younger. Requires clinical provider Prior Authorization Requests (PAR) approved for up to six months per treatment plan cycle.
Read Colorado Medicaid ABA Guide2. Private Insurance Mandate (C.R.S. § 10-16-104)
State law requires state-regulated commercial plans to cover autism diagnosis and ABA treatment without age limits or dollar ceilings less favorable than general health care.
Review Colorado Insurance Mandate Statute (PDF)Case Management Redesign & The Application Process
Do not look for the old Community Centered Boards. Colorado finished a statewide overhaul that consolidated developmental disability agencies into regional Case Management Agencies. Your local CMA is the single doorway for CES enrollment. If you live in Denver, you contact Rocky Mountain Human Services. In Arapahoe and Douglas counties, you call Developmental Pathways. In El Paso County and Colorado Springs, your agency is The Resource Exchange. Your case manager handles your functional assessment and submits your enrollment packet to the state utilization review contractor within 14 calendar days of your signature. If an intake assessment is denied, parents retain formal appeal rights under 10 CCR 2505-10 § 8.057 before state administrative law judges at the Colorado Office of Administrative Courts.
Single entry point for Denver residents.
Intake agency for south metro communities.
Front Range & Pikes Peak regional agency.
Fort Collins & Loveland intake CMA.
Greeley & northern agricultural corridor.
Boulder & Longmont regional CMA.
Connect with Colorado Pediatric Providers
Our parent matching team assists Colorado families in navigating Medicaid PBT prior authorizations, finding contracted ABA clinics in Denver and Colorado Springs, and locating specialized private programs.
Colorado Special Education & Provider Resources
Compare center-based and in-home pediatric therapy teams across Denver County.
El Paso County pediatric specialists, clinical ABA centers, and sensory clinics.
Contracted Health First Colorado pediatric providers and developmental therapists.
Statutory Sources and Administrative Rule Filings
- HCPF: Children's Extensive Support (CES) Waiver Official Manual
- HCPF Operational Memo 26-005: Community Connector changes
- HCPF: Regional Case Management Agency Directory & Map
- Colorado Code of Regulations: 10 CCR 2505-10 § 8.503 (CES Regulations)
- HCPF: IDD Services, Enrollments and Waitlist Reports
- HCPF: Pediatric Behavioral Therapies Benefit (Medicaid ABA)
- Colorado Revised Statutes: C.R.S. § 10-16-104(1.4) (Autism Insurance Mandate)
- Colorado PEAK Online Medicaid Application Portal
Frequently Asked Questions About the Colorado CES Waiver
Frequently Asked Questions
Common questions about this guide
What is the Children's Extensive Support (CES) Waiver in Colorado?
The Children's Extensive Support waiver is a specialized Medicaid 1915(c) Home and Community-Based Services (HCBS) program administered by the Colorado Department of Health Care Policy and Financing (HCPF) under 10 CCR 2505-10 Section 8.503 and CMS authority CO.4180.R06.00. It funds home accessibility modifications, specialized medical equipment, respite care, and community integration for children under age 18 with severe developmental disabilities or extreme medical fragility, enabling them to remain in the family home rather than an institution.
Does the Colorado CES Waiver have a waiting list in 2026-27?
CES does not have an active waiting list today. The widely reported eight-to-ten-year waitlists describe the adult HCBS Developmental Disabilities (HCBS-DD) waiver, not CES. However, under 10 CCR 2505-10 Section 8.503.60, HCPF enforces an unduplicated participant enrollment cap of 5,771 children for waiver year 2026-27. If enrollment reaches this statutory ceiling, the state immediately activates a waitlist ordered strictly by application receipt timestamp rather than clinical severity. Applying early secures an official priority date.
Can parents get paid as family caregivers under the Colorado CES Waiver?
Colorado allows legally responsible persons to provide certain CES services under its current waiver rules, but a state service rate is not a parent wage. For Community Connector, HCPF’s April 2026 policy sets the provider reimbursement rate at $7.71 per 15-minute unit outside Denver County and $7.83 in Denver County. The service has a 1,040-unit annual limit, with an exceptions process when additional need is justified. Ask a prospective provider agency what it pays its employees and which services it can authorize; do not treat the Medicaid rate as a promised wage.
What is the clinical extensive support test for CES eligibility?
Under 10 CCR 2505-10 Section 8.503.30, a child must meet the Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) level of care. Evaluators require documented proof that the child requires direct, physical adult hands-on intervention at least once every two hours during daytime waking hours, and on a weekly average of once every three hours throughout the night. Verbal prompting and redirection do not qualify. Families must document continuous self-injurious behavior, physical aggression, property destruction, or severe medical instability on a 14-to-30-day incident log.
Does the CES Waiver pay for Applied Behavior Analysis (ABA) therapy?
No. Colorado's Pediatric Behavioral Therapies billing manual explicitly bars HCBS waiver funds from paying for Applied Behavior Analysis. ABA is funded through two separate pathways: first, Health First Colorado covers ABA directly under the state-plan Pediatric Behavioral Therapies (PBT) benefit for members 20 and younger meeting EPSDT medical necessity (requiring a Prior Authorization Request); second, C.R.S. 10-16-104(1.4) mandates that Colorado-regulated private health insurance cover autism diagnosis and ABA therapy without annual or lifetime caps.
Does parental household income disqualify a child from CES?
No. Under federal institutional deeming rules (42 CFR 435.217) and 10 CCR 2505-10 Section 8.100.7.A, household parental income and liquid assets are completely disregarded. Eligibility is evaluated exclusively against the child's individual income (capped at 300% of the SSI Federal Benefit Rate, or $2,829 per month in 2026) and countable child resources below $2,000. Families should never self-reject based on household earnings.
How did Colorado's Case Management Redesign change CES intake?
On July 1, 2024, Colorado eliminated legacy Community Centered Boards (CCBs) and transitioned to single-entry Case Management Agencies (CMAs) organized by regional territory. Families apply through their designated regional CMA: Rocky Mountain Human Services (Denver), Developmental Pathways (Arapahoe/Douglas), The Resource Exchange (El Paso/Colorado Springs), Foothills Gateway (Larimer), or Envision (Weld). The CMA must submit the completed Functional Needs Assessment to the state utilization review contractor within 14 calendar days of parental signature.
What happens when a child on CES turns 18 years old?
CES eligibility terminates automatically at age 18. Young adults transition toward adult waiver programs, primarily the adult HCBS Developmental Disabilities (HCBS-DD) waiver or Supported Living Services (SLS). Because HCBS-DD has a substantial waiting list, parents must initiate formal transition planning with their CMA coordinator well before the child's 18th birthday to place their name on the adult waiting list or explore Reserved Capacity pathways.