At RMHP, we’re here to help our members get the quality care that’s right for them. To do this, we work with our members, providers, and a variety of community resource programs. Our goal is to help our members find the care that’s right for their individual needs while helping them maintain their independence as much as possible.
Changes are being made to the case management system in Colorado and RMHP is committed to supporting you and your loved ones through the process. These changes will happen in three phases, making sure there are the right number of case management agencies in Colorado. Case management agencies will now serve all Home and Community-Based Service (HCBS) waivers, so people have one place to go, increasing the quality of case management services. These changes will make it easier to access long-term services and support (LTSS).
Options for Long Term Care Services and Supports
- Home and Community-Based Services (HCBS) Waivers
- 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. Waivers have extra program rules, and some programs may have waitlists.
- Children’s Home and Community-Based Services (CHCBS)
- The CHCBS Waiver is available for children with significant medical needs and who are at risk for institutional care in an acute hospital or skilled nursing facility.
- Intellectual and Developmental Disability (I/DD) and Developmental Delay
- The HCBS I/DD Waiver provides access to 24-hour, seven-day-a-week supervision through Residential Habilitation and Day Habilitation Services and Supports.
- Long-Term Home Health
- Skilled Home Health services are provided to members who require ongoing Home Health services beyond the Acute Home Health period. Prior authorization is required for Long-Term Home Health Services.
- Referrals to Skilled Nursing Facilities
- The CMA provides support to members and families for nursing home admissions when Medicaid is the payor source.
- Home Care Allowance
- A state-funded program that provides assistance to members in their homes.
- Hospital Back-Up (HBU) Program
- HBU is a program within Health First Colorado (Colorado’s Medicaid Program) that supports qualified skilled nursing facilities in providing hospital-level care to clients who are ventilator dependent, have complex wounds, or have medically complex needs.
- Program of All-Inclusive Care for the Elderly (PACE)
- Providers comprehensive health care services to their participants. One of the main objectives of the PACE program is to enable older adults to live in the community as long as medically and socially feasible.
- State General Fund Programs
- State Supported Living Services Program (State SLS)
- Omnibus Reconciliation Act of 1987 Specialized Services Program (OBRA-SS)
- Family Support Services Program (FSSP)
- Case Management Redesign
- Changes are being made to the case management system in Colorado. RMHP is committed to supporting you and your loved ones through the process. Case Management Redesign | Colorado Department of Health Care Policy & Financing
How Do I Apply?
Which Benefits Are Right For Me?
Choosing an HCBS Waiver Flowchart-Adults-January 2017.pdf (colorado.gov)
Choosing an HCBS Waiver (Children) (colorado.gov)
HCBS Adult Waiver and PACE Comparison Chart-April 2023 (colorado.gov)
CO HCBS Children Waiver Chart-March 2023 (colorado.gov)