Colorado Medicaid Assistance

Home Modification Benefit

Home Modification is a Long-Term Services and Supports (LTSS) Health First Colorado (Colorado's Medicaid Program) benefit that allows for specific modifications, adaptations, or improvements in an eligible client’s existing home setting.

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Eligibility is based on the member’s medical condition, and the following requirements.  

Home modifications must: 

1. Be necessary to ensure the health, welfare and safety of the member, and

2. Enable the member to function with greater independence in the home, and

3. Be required due to the client’s illness, impairment or disability, as documented on the ULTC-100.2 form and the care plan; and 

4. Prevents institutionalization of the member. 

Home Modification, adaptations, or improvements may include, but are not limited to:

• Installing or building ramps

• Modifying bathrooms

• Installing grab-bars and other durable medical equipment as part of a larger Home Modification Project

• Widening doorways

• Modifying kitchen facilities

• Installing specialized electric and plumbing systems that are necessary to accommodate medically necessary equipment and supplies. 

There is a $14,000 lifetime maximum for the Home Modification benefit for the Brain Injury waiver, the Community Mental Health Supports waiver, the Elderly, Blind and Disabled waiver and the Spinal Cord Injury waiver. 

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Source: Colorado Dept. of Health Care Policy and Financing

Colorado Home and Community Based Waivers (HCBS)

For Adults

Supported Living Services (SLS) Waiver

The Supported Living Services Waiver provides necessary services and supports for individuals with adults with intellectual or developmental disabilities so they can remain in their homes and communities with minimal impact to individuals' community and social supports. 

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To Qualify:

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Level of Care
Individuals must meet Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF-IID) level of care as determined by the functional needs assessment (as defined in 42 CFR §440.150)

Eligibility Group
​Individuals must be determined by a Community Centered Board (CCB) to have a developmental disability
Individuals must be 18 years or older

Financial
Your income must be less than three times the current Federal Supplemental Security Income (SSI) limit per month. (See SSI website for current information)
For a single person, their countable resources must be less than $2,000 and for a couple it must be less than $3,000.
If you do not meet these financial requirements, you may be eligible through the Health First Colorado Buy-In Program for Working Adults with Disabilities.

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Source: Colorado Dept. of Health Care Policy and Financing

Colorado Home and Community Based Waivers (HCBS)

For Children

Children Extensive Support Waiver (CES)

The Children's Extensive Support Waiver helps children and families by providing services and supports that will help children establish a long-term foundation for community inclusion as they grow into adulthood.

To Qualify:

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Level of Care

• Children must meet Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) level of care which is determined by the Functional Needs Assessment (ICF/IID services are defined in the Code of Federal Regulations:
  42 CFR §440.150)

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 medical or behavioral condition that is so intense that almost constant line of sight supervision is required to keep the child and others safe

• Are determined to meet the Federal Social Security Administration’s definition of disability

Financial

• Children must meet the Health First Colorado financial determination for Long-Term Services and Supports eligibility. Financial determination requirements are outlined in the Colorado Code of Regulations
  10 CCR 2505-10, Section 8.100.

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Source: Colorado Dept. of Health Care Policy and Financing