Frequently Asked Questions

The process for choosing providers is person-centered and determined by the individual.  

If you reach out to your case manager, they can assist you in multiple ways, including:

• Providing a list of providers for the individual to select from; 
• Using the Department of Health Care Policy and Financing (HCPF) “Find a Doctor” tool to search for providers;
• Selecting several providers and then contacting them to determine if they can meet the individual’s needs;
• A combination of any of the above.

Case managers can assist in choosing providers if the individual asks the case manager to make the choice for him or her. Case managers shall ask the individual about his or her preferences for a provider agency and make every effort to choose an agency that matches the preferences.  

Our website was recently redesigned. You can find pages dedicated to our local programming here.

You can also read about our local programming in more detail in our Annual and Mill Levy reports; see our FY22 Report

The Emergency Enrollment Request (EER) process is specific to the HCBS-DD waiver, which is currently the only waiver in Colorado with a waitlist. 

Generally speaking, HCBS-DD enrollments are authorized by the order of selection (OOS) date (otherwise known as an individual’s eligibility date for the I/DD adult waivers).  

The EER process allows individuals to be enrolled out of date order based on an “emergency situation where the health and safety of the person or others is endangered, and the emergency cannot be resolved in another way.”  

The criteria for these exceptions is outlined in 10 CCR-2505-10 8.500.7.F and includes:

1. Homelessness
2. Abuse/neglect
3. Danger to others
4. Danger to self
5. Loss or incapacitation of primary caregiver

Community Centered Boards (CCBs) and Case Management Agencies (CMAs) do not have authority to authorize EERs; instead, they are required to follow the EER process outlined by the Colorado Department of Health Care Policy and Financing (HCPF) to request authorization for an emergency enrollment and must demonstrate that the HCBS-DD waiver, above other support (including other waivers), will meet the emergent needs.  

The following I/DD programs have statewide waitlists, which are managed by the Colorado Department of Health Care Policy and Financing (HCPF), our state Medicaid Agency:

• Home and Community-Based Services Waiver (HCBS-DD) / Developmental Disabilities Medicaid Waiver (DD)

The following programs may have waitlists within their local communities:

• State Supported Living Services Program (State-SLS)
• Family Support Services Program (FSSP)
• Currently, DP does not have a waitlist for State SLS, but we do have one for FSSP.

Individuals can be on a waitlist while on another waiver or in another program.  

Additionally, individuals can be on multiple waitlists. For instance, an individual can be enrolled in HCBS-SLS and waiting As Soon As Possible (ASAA) for the HCBS-DD waitlist. 

Last, but not least, DP offers a locally-funded program called Community Outreach Waitlist that can provide some support to individuals and families while they are waiting. More information can be found here.

Both our federal partners at the Centers for Medicare & Medicaid Services (CMS) and our state Medicaid agency, the Colorado Department of Health Care Policy and Financing (HCPF), put limitations on waiver services.  

Services may be denied if: 

• The amount of total services in a plan year exceed the service limits in the waiver or lifetime limits.
• The amount of total funding in the plan year exceeds any of the spending limits in the waiver.
• The service is not on the approved list of services for the waiver. An example of this is that Movement Therapy is not currently covered under the HCBS-DD waiver but is offered in HCBS-SLS and HCBS-CES. 
• The scope of the intended support does not meet the intended purpose of the waiver service as defined by HCPF. An example of this is that Parent Education on the CES waiver cannot fund a broader course, it needs to be specifically related to the child’s developmental disability.
• The support is specifically listed as one of the exclusions for that waiver service. An example of this is that both computers and service animals are specifically excluded under Assistive Technology. Another example of this is that an individual eleven (11) years of age and younger cannot receive respite during the time the parent works, pursues continuing education, or volunteers, because this is a typical expense for all parents of young children. 

Whenever services are denied, you have the right to appeal through Medicaid (if you are enrolled in an HCBS waiver) or the right to submit a grievance (for state-funded programming). Each year, your case manager should be sharing information on how to appeal denials and can help you navigate the denial process.  Click here for more information on Medicaid Appeal Rights.

Children qualify to receive EI services if they have a significant delay of 25% or more in two or more areas of development or a 33% or more delay in one or more areas of development.  
 
Children also qualify for EI Colorado services if they are diagnosed with a condition that will likely cause a significant delay in development or if they live with a parent who has a developmental disability.  
 
Find more information here
 

The Community Outreach Waitlist Services Program (CO WL) is a unique program created by Developmental Pathways to assist individuals with developmental disabilities/delays and their families who are waiting for state or federally funded services.  

Supports include access to an assigned Coordinator, connection to resources, and support with accessing limited financial assistance through Unmet Needs programming*.  

This program is intended to be a short-term support while individuals work to access other more robust programming.  

*Please note access to funding is limited and not guaranteed.   

Individuals wanting to access the CO WL Program need to go through eligibility determination through the Developmental Pathways Intake Team (Intake@dpcolo.org or 303-858-2260). 

Once determined eligible and placed on a waitlist, individuals are auto-enrolled into the CO WL Program with the exception of children exiting the Early Intervention Program who need to fill out a quick form to indicate interest in continued supports through the CO WL Program. For questions about the CO WL Program contact us at: communityoutreach@dpcolo.org.