These videos give an overview of the various Home and Community-Based Services (HCBS) available in Colorado for providers who want to learn how to start or operate an HCBS agency in the state. Each video explains the purpose of the service, provider requirements, licensing process, and how the program functions in Colorado. Use these videos to better understand the responsibilities, standards, and steps involved in becoming or working with approved HCBS providers in Colorado. Explore each section to find the service that best matches your goals or area of interest.
Respite Care
RESPITE CARE SERVICES PROVIDER IN COLORADO
PROVIDING TEMPORARY RELIEF FOR CAREGIVERS WHILE ENSURING CONTINUITY OF SUPPORT FOR INDIVIDUALS WITH DISABILITIES OR CHRONIC CONDITIONS
Respite Care Services in Colorado offer short-term relief to primary caregivers by providing temporary care and supervision for individuals with disabilities, complex health needs, or age-related challenges. These services are available through Colorado Medicaid’s Home and Community-Based Services (HCBS) Waivers, including the Elderly, Blind, and Disabled (EBD) waiver, Supported Living Services (SLS) waiver, Children’s Extensive Support (CES) waiver, and others.
1. GOVERNING AGENCIES
Agency: Colorado Department of Health Care Policy and Financing (HCPF)
Role: Administers Medicaid and HCBS waivers that authorize and reimburse Respite Care Services
Agency: Colorado Department of Public Health and Environment (CDPHE)** (if medical or personal care is involved)
Role: Licenses agencies that provide skilled or hands-on care in the home
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Ensures federal compliance with Medicaid-funded respite services
2. RESPITE CARE SERVICE OVERVIEW
Respite Care Services provide planned or emergency short-term care to individuals when their regular caregiver is unavailable or in need of a break. Services can be provided in-home, in the community, or in a licensed setting depending on the waiver and individual’s needs.
Approved providers may deliver:
In-home supervision and companionship
Personal care support (bathing, dressing, feeding, toileting)
Safety monitoring and mobility assistance
Basic ADL support and meal preparation
Community outings or structured activities (if approved)
Documentation of time and services provided
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register your business with the Colorado Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
If providing personal care or health-related assistance, obtain a Class B Home Care Agency license from CDPHE
Enroll as a Medicaid provider through the Gainwell Technologies Provider Portal
Employ trained respite staff or caregivers with appropriate background checks
Carry general liability and workers’ compensation insurance
Maintain HIPAA-compliant documentation systems
4. PROVIDER ENROLLMENT PROCESS
Step 1: Register your business and apply for an NPI
Step 2: Apply for a Class B license (if applicable) through CDPHE
Step 3: Enroll in Medicaid via the Gainwell Technologies Provider Enrollment Portal
Step 4: Connect with Case Management Agencies (CMAs) to begin receiving service authorizations
5. REQUIRED DOCUMENTATION
Articles of Incorporation or business registration
IRS EIN Letter
NPI confirmation
CDPHE Class B license (if applicable)
Medicaid provider ID
Policy & procedure manual including:
Client intake and eligibility confirmation
Consent forms and caregiver instructions
Task and time logs for each respite session
Emergency contact protocol and safety procedures
Confidentiality, abuse prevention, and grievance policies
Staff supervision and training documentation
Incident reporting procedures and service verification tools
6. STAFFING REQUIREMENTS
Role: Respite Caregiver / Direct Support Professional (DSP)
Requirements:
High school diploma or GED (recommended)
Background check and TB screening
CPR/First Aid certification (required if providing personal care)
Experience working with individuals with disabilities or chronic conditions preferred
Role: Program Supervisor (for agencies)
Requirements:
Oversight of staff, scheduling, and service documentation
Experience in caregiving, home health, or human services
Training Requirements for All Staff:
HIPAA, confidentiality, and client rights
Person-centered care principles
Safety and infection control
Abuse prevention and emergency response
Documentation and time-tracking procedures
7. MEDICAID WAIVER SERVICES
Respite Care is reimbursed under:
HCBS-EBD (Elderly, Blind, and Disabled) Waiver
HCBS-SLS (Supported Living Services) Waiver
HCBS-CES (Children’s Extensive Support) Waiver
HCBS-DD (Developmental Disabilities) Waiver
Other Medicaid waivers that include respite in the participant’s plan
Approved providers may deliver:
Planned or emergency in-home or community-based respite
Non-medical supervision and personal assistance
Care continuity while relieving the primary caregiver
Coordination and communication with CMAs and case managers
8. TIMELINE TO LAUNCH
Phase: Business Formation
Timeline: 1–2 weeks
Phase: Licensing with CDPHE (if applicable)
Timeline: 45–90 days
Phase: Medicaid Enrollment via Gainwell
Timeline: 30–60 days
Phase: Referral Activation and Staff Onboarding
Timeline: Ongoing
9. CONTACT INFORMATION
Colorado Department of Public Health and Environment (CDPHE) – Facility Licensing
Phone: (303) 692-2800
Website: https://cdphe.colorado.gov
Colorado Department of Health Care Policy and Financing (HCPF)
Email: hcpf_hcbs_questions@state.co.us
Website: https://hcpf.colorado.gov
Colorado Medicaid Provider Enrollment (Gainwell Technologies)
Website: https://portal.co.gov
WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — COLORADO RESPITE CARE SERVICES PROVIDER
We help caregivers, home care agencies, and service professionals establish Medicaid-compliant Respite Care Services across Colorado’s HCBS waiver system.
Scope of Work:
Business registration (LLC, EIN, NPI)
CDPHE Class B license support (if applicable)
Medicaid provider enrollment and waiver onboarding
Policy & procedure manual for respite care, supervision, and compliance
Templates for shift logs, incident reports, and caregiver notes
Website, domain, and email setup
Staff credentialing trackers and emergency protocols
Client intake packet, consent forms, and grievance tools
Audit preparation tools and referral networking strategies
Residential Care
RESIDENTIAL SERVICES PROVIDER IN COLORADO
OFFERING SAFE, STABLE HOUSING WITH PERSONALIZED SUPPORT FOR INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES
Residential Services in Colorado provide 24-hour or part-time support to individuals with intellectual and developmental disabilities (IDD) in licensed or certified community-based living settings. These services are delivered under the Home and Community-Based Services for Persons with Developmental Disabilities (HCBS-DD) Waiver, administered by the Colorado Department of Health Care Policy and Financing (HCPF) and coordinated through Case Management Agencies (CMAs) and Community-Centered Boards (CCBs).
1. GOVERNING AGENCIES
Agency: Colorado Department of Health Care Policy and Financing (HCPF)
Role: Manages HCBS-DD waiver and sets reimbursement and compliance standards for residential services
Agency: Colorado Department of Public Health and Environment (CDPHE)**
Role: Licenses facilities operating as Group Homes, Host Homes, and Intermediate Care Facilities (ICFs)
Agency: Colorado Department of Early Childhood (CDEC)** (for child residential programs)
Role: Oversees care for individuals under 21 (when applicable)
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Ensures federal compliance with Medicaid and HCBS residential service requirements
2. RESIDENTIAL SERVICE OVERVIEW
Residential Services support individuals in a supervised living environment that fosters independence, choice, and community integration. Services vary in intensity from intermittent supervision to 24/7 care and are based on individualized plans.
Approved providers may deliver:
Daily living assistance (ADLs/IADLs)
Medication administration and health oversight
Meals, hygiene support, and transportation
Life skills development and safety monitoring
Community participation and recreational activities
Support with financial, social, and emotional well-being
Coordination with behavioral, medical, and therapy services
Common models include:
Group Homes (3–8 residents, 24/7 care)
Host Homes (individuals live with contracted caregivers)
Independent Living with drop-in support
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Colorado Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
Obtain residential facility licensure from CDPHE (e.g., Group Home license)
Enroll as an HCBS-DD Waiver Residential Services Provider via the Gainwell Technologies Provider Portal
Comply with HCBS Settings Rule for community integration and resident rights
Maintain fire, health, and safety standards for all residential settings
Ensure staff meet training and background check requirements
4. PROVIDER ENROLLMENT PROCESS
Step 1: Apply for residential program licensure through CDPHE
Submit site plans, policies, and staffing model
Undergo facility inspection and environmental health review
Step 2: Enroll in Medicaid via Gainwell Technologies
Select HCBS-DD Waiver and indicate Residential Habilitation/Support Services
Step 3: Coordinate with Community-Centered Boards (CCBs) and Case Management Agencies (CMAs) for referrals and service authorizations
5. REQUIRED DOCUMENTATION
Articles of Incorporation or proof of business registration
IRS EIN Letter
NPI confirmation
CDPHE residential license (Group Home, Host Home, etc.)
Colorado Medicaid provider ID
Policy & procedure manual including:
Admissions and discharges
Resident rights and grievance process
Health services coordination and medication administration
Daily routine schedules and goal tracking
Emergency preparedness and evacuation plans
Staff training and supervision records
Incident reporting and abuse prevention protocols
Fire and safety inspection logs
6. STAFFING REQUIREMENTS
Role: Direct Support Professional (DSP)
Requirements:
High school diploma or equivalent
Background check, CPR/First Aid certification
Training in IDD, ADLs, safety, and emergency response
Role: Residential Supervisor / House Manager
Requirements:
Oversight of daily operations, scheduling, and compliance
Experience in IDD services or human services field
Training Requirements for All Staff:
Person-centered care and community inclusion
Medication administration (QMAP certified, if applicable)
Crisis prevention and de-escalation
Abuse prevention and HIPAA compliance
Annual refreshers and CEU tracking
7. MEDICAID WAIVER SERVICES
Residential Services are reimbursed under:
HCBS-DD (Developmental Disabilities) Waiver
May be supplemented by behavioral, nursing, and day services
Approved providers may deliver:
24/7 or intermittent supervision
Assistance with daily living, health, and safety
Community access and inclusion activities
Support aligned with the Individualized Service Plan (ISP)
8. TIMELINE TO LAUNCH
Phase: Business Formation
Timeline: 1–2 weeks
Phase: CDPHE Licensing
Timeline: 60–90 days (includes site inspection)
Phase: Medicaid Enrollment
Timeline: 30–60 days
Phase: Staffing and Referral Readiness
Timeline: Ongoing
9. CONTACT INFORMATION
Colorado Department of Health Care Policy and Financing (HCPF)
Email: hcpf_hcbs_questions@state.co.us
Website: https://hcpf.colorado.gov
Colorado Department of Public Health and Environment (CDPHE)
Phone: (303) 692-2800
Website: https://cdphe.colorado.gov
Colorado Medicaid Provider Enrollment (Gainwell Technologies)
Website: https://portal.co.gov
WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — COLORADO RESIDENTIAL SERVICES PROVIDER
We help organizations and care professionals launch licensed Residential Services that meet all Medicaid and HCBS-DD requirements in Colorado.
Scope of Work:
Business registration (LLC, EIN, NPI)
CDPHE residential license application support
Medicaid enrollment and HCBS waiver onboarding
Policy & procedure manual for housing operations, supervision, and documentation
Templates for daily logs, care plans, and medication records
Website, domain, and email setup
Staff credentialing trackers and emergency response tools
Client intake packet, consent forms, and roommate agreements
Incident reporting systems and audit preparation tools
Referral networking with CCBs, CMAs, and family advocacy groups
Supported Employment
SUPPORTED EMPLOYMENT SERVICES PROVIDER IN COLORADO
EMPOWERING INDIVIDUALS WITH DISABILITIES TO ACHIEVE COMPETITIVE EMPLOYMENT IN THEIR COMMUNITIES
Supported Employment Services in Colorado assist individuals with disabilities in finding, obtaining, and maintaining meaningful, competitive employment in integrated community settings. These services are authorized under Colorado’s Home and Community-Based Services (HCBS) waiver programs and the Colorado Medicaid system, promoting independence, financial self-sufficiency, and full community participation.
1. GOVERNING AGENCIES
Agency: Colorado Department of Health Care Policy and Financing (HCPF)
Role: Oversees Medicaid HCBS waivers and approves Supported Employment service providers
Agency: Colorado Division of Vocational Rehabilitation (DVR)
Role: Coordinates employment services and vocational rehabilitation supports for individuals with disabilities
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight to ensure Supported Employment services meet HCBS and Medicaid compliance standards
2. SUPPORTED EMPLOYMENT SERVICE OVERVIEW
Supported Employment Services help individuals prepare for, secure, and maintain employment through a person-centered, goal-driven approach.
Approved providers may deliver:
Job development, including customized job search and employer engagement
Resume building, interview coaching, and employment readiness training
On-the-job skills training and coaching
Workplace accommodation support and advocacy
Ongoing monitoring to ensure job retention and satisfaction
Career advancement support
Benefits counseling (in coordination with appropriate agencies)
Service models include Individual Supported Employment (one-on-one job support) and Group Supported Employment (small group employment in community businesses).
All services must align with the participant’s person-centered service plan and the principles of Colorado’s Employment First initiative.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Colorado Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
Complete enrollment as a Medicaid provider through Colorado’s Gainwell Technologies portal
Maintain liability insurance
Develop policies and procedures that promote competitive, integrated employment
Ensure staff have experience and/or certification in vocational rehabilitation, supported employment, or disability services
4. HCPF PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Request Supported Employment Services application materials from HCPF
Attend a provider orientation session (recommended)
Application and Documentation Submission:
Submit business registration, organizational chart, staffing qualifications, and service descriptions
Provide person-centered employment planning forms, sample job coaching procedures, and employer partnership documentation
Submit background check procedures, proof of insurance, and emergency response policies
Program Readiness Review:
HCPF evaluates service models, participant engagement strategies, and compliance with HCBS requirements
May conduct interviews or readiness audits for new providers
Approval & Medicaid Enrollment:
After approval, finalize Medicaid enrollment through Gainwell Technologies
Configure service billing codes for Supported Employment through Colorado’s MMIS
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License
IRS EIN confirmation
NPI confirmation
General liability insurance documentation
HCPF-Compliant Policy & Procedure Manual including:
Participant intake, employment planning, and goal setting
Job development and customized employment strategies
On-the-job coaching and follow-up support procedures
Client rights, confidentiality, and HIPAA compliance policies
Emergency procedures and workplace safety protocols
Staff credentialing, background checks, and ongoing training logs
Incident reporting, service documentation, and Medicaid billing systems
6. STAFFING REQUIREMENTS
Role: Employment Services Program Manager
Requirements: Bachelor's degree in vocational rehabilitation, special education, social work, or related field preferred; experience supporting individuals with disabilities; background check clearance
Role: Job Coach / Employment Specialist
Requirements: High school diploma or GED required; experience in job development and job coaching; CPR/First Aid certification recommended; background check clearance
All staff must complete:
Training on person-centered employment planning and Employment First principles
Confidentiality, abuse prevention, and workplace safety training
Medicaid HCBS services documentation and compliance training
Annual continuing education on best practices in employment support services
7. MEDICAID WAIVER SERVICES
The following Colorado Medicaid Waivers authorize Supported Employment Services:
Developmental Disabilities (DD) Waiver
Supported Living Services (SLS) Waiver
Brain Injury (BI) Waiver (for supported employment services as part of a broader rehabilitation plan)
Elderly, Blind, and Disabled (EBD) Waiver (in some cases, for younger adults)
Approved providers may deliver:
Individual Supported Employment
Group Supported Employment
Self-employment support and business development coaching (where authorized)
8. TIMELINE TO LAUNCH
Phase: Business Formation and Initial Setup
Timeline: 2–3 weeks
Phase: HCPF Provider Enrollment and Readiness Review
Timeline: 60–90 days
Phase: Staff Hiring, Training, and Service Model Development
Timeline: 30–45 days
Phase: Medicaid Billing System Setup and MCO Contracting (if needed)
Timeline: 45–60 days
9. CONTACT INFORMATION
Colorado Department of Health Care Policy and Financing (HCPF)
Website: https://hcpf.colorado.gov
Colorado Division of Vocational Rehabilitation (DVR)
Website: https://dvr.colorado.gov
Colorado Medicaid Provider Enrollment Portal (Gainwell Technologies)
Website: https://colorado-hcpf.portal.force.com/ProviderEnrollment/s/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — COLORADO SUPPORTED EMPLOYMENT PROVIDER
WCG helps employment service agencies and entrepreneurs launch Medicaid-compliant Supported Employment Services under Colorado’s HCBS Waiver programs.
Scope of Work:
Business registration and EIN/NPI setup
HCPF Medicaid provider enrollment and documentation support
Development of Supported Employment Policy & Procedure Manual
Staff credentialing templates and participant intake forms
Medicaid billing and service authorization setup
Website, domain, and email setup
Participant employment goal setting and tracking packet
Employer engagement strategy templates
Incident reporting and quality assurance tracking systems
Community networking and employment partnership development strategies
Personal Care
PERSONAL CARE SERVICES PROVIDER IN COLORADO
ASSISTING INDIVIDUALS WITH DAILY LIVING ACTIVITIES TO MAINTAIN INDEPENDENCE IN THEIR HOMES AND COMMUNITIES
Personal Care Services in Colorado support individuals with disabilities, chronic conditions, or age-related limitations by providing non-medical assistance with Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). These services are offered through Colorado Medicaid, particularly under Home and Community-Based Services (HCBS) Waivers, including the Elderly, Blind, and Disabled (EBD) waiver, Brain Injury (BI) waiver, and Community Mental Health Supports (CMHS) waiver.
1. GOVERNING AGENCIES
Agency: Colorado Department of Health Care Policy and Financing (HCPF)
Role: Administers Medicaid and HCBS waiver programs, including authorization and reimbursement of Personal Care Services
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight to ensure Personal Care Services meet HCBS rules and person-centered planning standards
2. PERSONAL CARE SERVICE OVERVIEW
Personal Care Services are designed to help individuals remain safely in their homes by assisting with routine daily tasks they cannot complete independently. Services are provided based on a person-centered service plan and must be authorized by a Case Management Agency (CMA).
Approved providers may deliver:
Bathing, dressing, grooming, and hygiene assistance
Mobility support and transferring
Medication reminders (non-administration)
Meal preparation and assistance with eating
Light housekeeping related to personal care
Laundry and linen changes
Toileting and incontinence care
Documentation of hours and tasks completed
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Colorado Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
Obtain a Class B Home Care Agency License from the Colorado Department of Public Health and Environment (CDPHE)
Enroll as a Medicaid provider through the Gainwell Technologies Provider Portal
Employ or contract trained Personal Care Workers (PCWs)
Carry liability and workers’ compensation insurance
Maintain compliance with HIPAA, safety, and HCBS documentation protocols
4. PROVIDER ENROLLMENT PROCESS
Step 1: Obtain Class B Home Care Agency License (CDPHE)
Submit application including emergency plans, policies, and staff training procedures
Pass licensing inspection and receive state certification
Step 2: Enroll as a Medicaid Provider
Apply through the Gainwell Technologies Provider Enrollment Portal
Select provider type: Personal Care (under Class B services)
Step 3: Coordinate with Case Management Agencies (CMAs)
Build referral relationships and receive service authorizations based on approved plans
5. REQUIRED DOCUMENTATION
Articles of Incorporation or proof of business registration
IRS EIN Letter
NPI confirmation
CDPHE Class B Home Care Agency License
Medicaid provider approval
Policy & procedure manual including:
Intake forms and eligibility verification protocols
Daily task logs and service verification sheets
Participant rights and grievance procedures
Confidentiality and HIPAA compliance policies
Emergency preparedness and abuse prevention
Staff orientation, training, and supervision documentation
Incident reporting forms and review procedures
6. STAFFING REQUIREMENTS
Role: Personal Care Worker (PCW)
Requirements:
High school diploma or GED (recommended)
Background check and TB clearance
CPR/First Aid certification (recommended)
Experience or training in ADL/IADL support
Role: Agency Supervisor
Requirements:
Oversight of staff scheduling, supervision, and quality assurance
Familiarity with Medicaid compliance and documentation
Training Requirements for All Staff:
HIPAA and client confidentiality
Abuse prevention and mandated reporting
Infection control and safety procedures
Documentation and service delivery expectations
Annual training refreshers and ongoing competency evaluations
7. MEDICAID WAIVER SERVICES
Personal Care Services are reimbursed under:
HCBS-EBD (Elderly, Blind, and Disabled) Waiver
HCBS-BI (Brain Injury) Waiver
HCBS-CMHS (Community Mental Health Supports) Waiver
Other waivers with documented need for ADL/IADL assistance
Approved providers may deliver:
Scheduled, authorized in-home care based on a person-centered service plan
Documentation and time logs for each shift
Coordination with case managers and waiver teams
8. TIMELINE TO LAUNCH
Phase: Business Formation
Timeline: 1–2 weeks
Phase: CDPHE Class B Licensing
Timeline: 45–90 days
Phase: Medicaid Enrollment
Timeline: 30–60 days
Phase: Staffing and CMA Referral Setup
Timeline: Ongoing
9. CONTACT INFORMATION
Colorado Department of Public Health and Environment (CDPHE) – Facility Licensing
Phone: (303) 692-2800
Website: https://cdphe.colorado.gov
Colorado Department of Health Care Policy and Financing (HCPF)
Email: hcpf_hcbs_questions@state.co.us
Website: https://hcpf.colorado.gov
Colorado Medicaid Provider Enrollment (Gainwell Technologies)
Website: https://portal.co.gov
WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — COLORADO PERSONAL CARE SERVICES PROVIDER
We assist caregiving agencies, entrepreneurs, and healthcare professionals in launching compliant Personal Care Services under Colorado’s HCBS Medicaid waiver programs.
Scope of Work:
Business registration (LLC, EIN, NPI)
CDPHE Class B Home Care Agency license application support
Medicaid provider enrollment and billing setup
Policy & procedure manual for personal care, supervision, and safety
Templates for shift logs, training checklists, and incident reports
Website, domain, and email setup
Staff credentialing trackers and supervision tools
Client intake packet, consent forms, and grievance protocols
Incident reporting systems and audit preparation tools
Referral networking with hospitals, CMAs, and community partners
Durable Medical Equipment
DURABLE MEDICAL EQUIPMENT (DME) SERVICES PROVIDER IN COLORADO
SUPPLYING ESSENTIAL MEDICAL EQUIPMENT TO SUPPORT FUNCTIONAL INDEPENDENCE AND QUALITY OF LIFE FOR MEDICAID MEMBERS
Durable Medical Equipment (DME) Services in Colorado provide individuals with long-term medical conditions or disabilities access to reusable equipment that supports daily living and medical needs at home. These services are reimbursed under the Colorado Medicaid State Plan, as well as certain Home and Community-Based Services (HCBS) Waivers such as the Elderly, Blind, and Disabled (EBD), Supported Living Services (SLS), and Children’s Extensive Support (CES) waivers. DME must be medically necessary, prescribed by a physician, and approved by Health First Colorado (Medicaid).
1. GOVERNING AGENCIES
Agency: Colorado Department of Health Care Policy and Financing (HCPF)
Role: Oversees DME coverage under Medicaid and authorizes providers and reimbursements
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Sets federal standards for Medicaid-covered DME and supplier compliance
2. DME SERVICE OVERVIEW
DME includes medical devices and supplies prescribed for repeated use that are necessary to treat a medical condition or aid in daily functioning. Services may include evaluation, delivery, instruction, repairs, and maintenance.
Approved providers may deliver:
Wheelchairs (manual or power), walkers, and canes
Hospital beds, pressure-relieving mattresses, and lifts
Oxygen equipment and respiratory supplies
Communication devices and augmentative equipment
Blood pressure monitors, diabetic supplies, and feeding pumps
In-home delivery, equipment setup, and user training
Equipment repairs and documentation of medical necessity
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Colorado Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
Obtain applicable Colorado business licenses and Board of Pharmacy license (if supplying oxygen or pharmaceuticals)
Meet Medicare Supplier Standards (required for Medicaid alignment)
Enroll as a Colorado Medicaid DME Provider through the Gainwell Provider Portal
Have systems for tracking prescriptions, delivery, inventory, and documentation
Maintain liability insurance and HIPAA-compliant records
4. PROVIDER ENROLLMENT PROCESS
Step 1: Complete Business Formation and Licensing
Register entity and obtain DME-specific licensing (Board of Pharmacy, if required)
Step 2: Enroll with Colorado Medicaid
Apply via the Gainwell Technologies Medicaid Provider Portal
Choose “DME Provider” as provider type and submit required credentials
Step 3: Prepare for Medical Necessity Reviews
Build internal processes to track physician orders, prior authorizations, and delivery logs
5. REQUIRED DOCUMENTATION
Articles of Incorporation or business registration
IRS EIN Letter
NPI confirmation
Board of Pharmacy License (if supplying oxygen, pharmaceuticals, or enteral nutrition)
Colorado Medicaid provider enrollment confirmation
Policy & procedure manual including:
Intake and prescription verification protocols
Medical necessity documentation forms
Delivery, training, and setup documentation
Maintenance and warranty records
Equipment tracking and replacement policies
HIPAA compliance and consumer rights
Complaint resolution and return policy
Staff credentialing and customer service training logs
6. STAFFING REQUIREMENTS
Role: DME Technician / Delivery Specialist
Requirements:
Experience in medical equipment delivery and user training
Background check, HIPAA training, and safety protocol knowledge
Role: Intake Coordinator / Billing Specialist
Requirements:
Knowledge of Medicaid DME billing, modifiers, and prior authorization
Familiarity with ICD-10, CPT/HCPCS codes, and documentation review
Training Requirements for All Staff:
HIPAA, confidentiality, and data security
Infection control and cleaning procedures for equipment
Product-specific setup and demonstration
Customer service and consumer safety education
7. MEDICAID WAIVER SERVICES
DME is reimbursed under:
Colorado Medicaid State Plan (standard DME benefit)
HCBS-EBD (Elderly, Blind, and Disabled)
HCBS-SLS (Supported Living Services)
HCBS-CES (Children’s Extensive Support)
Other waivers where DME is medically necessary and included in the Service Plan
Approved providers may deliver:
Purchase or rental of authorized equipment
In-home delivery, setup, and user education
Repair, maintenance, and replacement services
Documentation and claims submissions as required by Health First Colorado
8. TIMELINE TO LAUNCH
Phase: Business Formation
Timeline: 1–2 weeks
Phase: Licensing and Insurance Setup
Timeline: 2–4 weeks
Phase: Medicaid Enrollment (Gainwell Technologies)
Timeline: 30–60 days
Phase: Referral Activation and Claims Readiness
Timeline: Ongoing
9. CONTACT INFORMATION
Colorado Department of Health Care Policy and Financing (HCPF)
Email: hcpf_durablemedicalequipment@state.co.us
Website: https://hcpf.colorado.gov
Colorado Medicaid Provider Enrollment (Gainwell Technologies)
Website: https://portal.co.gov
Colorado Board of Pharmacy (for oxygen or pharmaceutical suppliers)
Website: https://dpo.colorado.gov/Pharmacy
WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — COLORADO DURABLE MEDICAL EQUIPMENT (DME) PROVIDER
We help entrepreneurs, pharmacies, and medical supply businesses launch Medicaid-compliant DME services in Colorado, from licensing and setup to claims and referral workflows.
Scope of Work:
Business registration (LLC, EIN, NPI)
Board of Pharmacy and business license support
Medicaid DME enrollment and HCPF policy alignment
Policy & procedure manual for intake, delivery, and documentation
Templates for prescription verification, delivery logs, and training forms
Website, domain, and email setup
Staff credentialing trackers and equipment maintenance logs
Client intake packet, consent forms, and warranty documentation
Incident reporting systems and audit preparation tools
Referral networking with clinics, hospitals, and case managers
Skilled Nursing
NURSING SERVICES PROVIDER IN COLORADO
DELIVERING SKILLED, INDIVIDUALIZED HEALTHCARE TO MEDICAID MEMBERS IN HOME AND COMMUNITY SETTINGS
Nursing Services in Colorado provide essential medical care and oversight to individuals with chronic illnesses, disabilities, or complex medical needs. These services are delivered in-home or community-based settings and are covered under Colorado Medicaid, including Home and Community-Based Services (HCBS) Waivers such as the Elderly, Blind, and Disabled (EBD) waiver, the Brain Injury (BI) waiver, and Children’s HCBS Waivers.
1. GOVERNING AGENCIES
Agency: Colorado Department of Health Care Policy and Financing (HCPF)
Role: Authorizes and reimburses Medicaid-funded nursing services and ensures alignment with waiver programs
Agency: Colorado Department of Public Health and Environment (CDPHE)
Role: Licenses Class A and Class B home care agencies and enforces regulatory standards
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal guidance on Medicaid reimbursement and HCBS compliance
2. NURSING SERVICE OVERVIEW
Nursing Services support waiver participants through ongoing health assessments, treatment administration, care planning, and monitoring. These services must be ordered by a physician and outlined in the participant’s individualized care plan.
Approved providers may deliver:
Skilled nursing visits (wound care, injections, catheter care, etc.)
Medication setup, administration, and monitoring
Chronic condition management (e.g., diabetes, seizures, respiratory care)
Health assessments and reassessments
Delegation and oversight of non-licensed staff (as needed)
Education for participants and families
Documentation of all nursing interventions and outcomes
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Colorado Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
Obtain a Class A or Class B Home Care Agency license from CDPHE
Class A: Skilled medical services including nursing
Class B: Non-medical services only (nursing not included)
Enroll as a Medicaid Nursing Services Provider via the Gainwell Technologies Medicaid Provider Portal
Employ licensed RNs and/or LPNs with appropriate supervision
Maintain liability and malpractice insurance
4. PROVIDER ENROLLMENT PROCESS
Step 1: CDPHE Home Care Agency Licensing
Submit application for Class A licensure, including policies, clinical supervision, and safety protocols
Undergo facility inspection and complete background checks
Step 2: Medicaid Enrollment with Gainwell
Apply through the Colorado Medicaid Provider Web Portal
Submit NPI, licensure documents, and staffing information
Step 3: Network with CMAs and Referring Entities
Coordinate with Case Management Agencies (CMAs) and hospitals for referrals
5. REQUIRED DOCUMENTATION
Articles of Incorporation or business registration
IRS EIN Letter
NPI confirmation
CDPHE Class A license
Colorado Medicaid provider ID
Policy & procedure manual including:
Intake and physician order verification
Care planning and skilled nursing documentation templates
Medication administration logs and delegation protocols
Incident reporting and critical event management
Infection control and emergency procedures
Client rights, consent forms, and HIPAA compliance
Staff credentials, CEUs, and supervision documentation
6. STAFFING REQUIREMENTS
Role: Registered Nurse (RN)
Requirements:
Active Colorado RN license
Experience in home health or long-term care preferred
CPR certification, background check, TB clearance
Role: Licensed Practical Nurse (LPN)
Requirements:
Licensed in Colorado
Works under RN supervision per care plan
Role: Clinical Supervisor (required for Class A agencies)
Requirements:
Colorado RN with supervisory experience
Oversight of documentation, assessments, and team training
Training Requirements for All Staff:
HIPAA and confidentiality
Abuse prevention and reporting
Medication safety and infection control
Documentation standards and emergency protocols
Ongoing CEUs for license renewal
7. MEDICAID WAIVER SERVICES
Nursing Services are reimbursed under:
HCBS-EBD (Elderly, Blind, and Disabled) Waiver
HCBS-BI (Brain Injury) Waiver
Children’s HCBS Waivers (e.g., CHCBS, CLLI)
State Plan Home Health (if skilled nursing is prescribed outside waiver)
Approved providers may deliver:
Direct nursing care based on approved hours and physician orders
Monitoring of medical conditions and health status changes
Coordination with primary care and specialist providers
Documentation aligned with waiver requirements and audits
8. TIMELINE TO LAUNCH
Phase: Business Formation
Timeline: 1–2 weeks
Phase: CDPHE Class A Licensing
Timeline: 60–90 days
Phase: Medicaid Enrollment
Timeline: 30–60 days
Phase: Staff Onboarding and Referral Network Development
Timeline: Ongoing
9. CONTACT INFORMATION
Colorado Department of Public Health and Environment (CDPHE) – Health Facilities Licensure
Phone: (303) 692-2800
Website: https://cdphe.colorado.gov
Colorado Department of Health Care Policy and Financing (HCPF)
Email: hcpf_hcbs_questions@state.co.us
Website: https://hcpf.colorado.gov
Colorado Medicaid Provider Enrollment (Gainwell Technologies)
Website: https://portal.co.gov
WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — COLORADO NURSING SERVICES PROVIDER
We help registered nurses, home care agencies, and healthcare entrepreneurs launch compliant Nursing Services under Colorado Medicaid and HCBS Waiver programs.
Scope of Work:
Business registration (LLC, EIN, NPI)
CDPHE Class A Home Care Agency license application support
Medicaid provider enrollment and billing guidance
Policy & procedure manual for skilled nursing delivery and compliance
Templates for care plans, nurse visit logs, and delegation forms
Website, domain, and email setup
Staff credentialing trackers and CEU documentation tools
Client intake packet, consent forms, and emergency procedures
Incident reporting systems and audit preparation tools
Referral networking with hospitals, CMAs, and case managers
Habilitation Services
DAY HABILITATION SERVICES PROVIDER IN COLORADO
EMPOWERING INDIVIDUALS WITH DISABILITIES THROUGH SKILL-BUILDING, COMMUNITY ACCESS, AND PERSONAL GROWTH
Day Habilitation Services in Colorado support individuals with intellectual and developmental disabilities (IDD) by offering structured daytime programs that focus on life skills development, socialization, and increased independence. These services are authorized under the Home and Community-Based Services for Persons with Developmental Disabilities (HCBS-DD) Waiver and the Supported Living Services (SLS) Waiver, overseen by the Colorado Department of Health Care Policy and Financing (HCPF).
1. GOVERNING AGENCIES
Agency: Colorado Department of Health Care Policy and Financing (HCPF)
Role: Administers HCBS waivers and sets standards for Day Habilitation services and provider participation
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight to ensure services meet person-centered HCBS requirements
2. DAY HABILITATION SERVICE OVERVIEW
Day Habilitation Services are community-based or site-based programs that offer structured activities to help individuals with IDD acquire, improve, and retain self-help, socialization, and adaptive skills.
Approved providers may deliver:
Life skills training (e.g., hygiene, cooking, communication)
Community integration activities (e.g., volunteering, recreation)
Self-advocacy and personal goal-setting support
Safety training and behavioral support (if authorized)
Social and peer interaction opportunities
Documentation of daily attendance and progress toward goals
Service delivery models may include:
Specialized Habilitation (SH): Structured support in a facility-based setting
Supported Community Connections (SCC): Services delivered in integrated, community-based settings
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register your business with the Colorado Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
Enroll as a Medicaid Day Habilitation Provider through the Gainwell Technologies Provider Portal
Ensure facility meets accessibility and safety standards (for site-based programs)
Comply with HCBS Settings Rule for community inclusion and individual choice
Maintain liability insurance and a secure documentation system
4. PROVIDER ENROLLMENT PROCESS
Step 1: Business registration and NPI setup
Step 2: Apply for Medicaid enrollment through the Gainwell Provider Portal
Select HCBS waiver program and Day Habilitation as service type
Step 3: Submit policy manual, resumes, service descriptions, and training materials
Step 4: Coordinate with Case Management Agencies (CMAs) for participant referrals
5. REQUIRED DOCUMENTATION
Articles of Incorporation or proof of business registration
IRS EIN Letter
NPI confirmation
Medicaid provider ID
Policy & procedure manual including:
Intake procedures and individual profile forms
Person-centered activity planning templates
Daily logs, attendance tracking, and goal documentation
Community access safety protocols
Staff-to-participant ratio policy
Emergency preparedness and incident response plans
Participant rights and grievance procedures
Staff training records and background checks
6. STAFFING REQUIREMENTS
Role: Direct Support Professional (DSP)
Requirements:
High school diploma or equivalent
Background check, CPR/First Aid certification
Experience supporting individuals with disabilities preferred
Role: Program Coordinator / Site Supervisor
Requirements:
Supervisory or program management experience
Familiarity with HCBS regulations and community-based programming
Training Requirements for All Staff:
Person-centered planning and service delivery
Community safety and transportation protocols
HIPAA and client rights
Abuse prevention and mandated reporting
Documentation and data collection procedures
Annual refreshers and continuing education tracking
7. MEDICAID WAIVER SERVICES
Day Habilitation is reimbursed under:
HCBS-DD (Developmental Disabilities) Waiver
HCBS-SLS (Supported Living Services) Waiver
Approved providers may deliver:
Specialized Habilitation (SH) — structured, facility-based services
Supported Community Connections (SCC) — integrated, community-based skill-building
Customized programming aligned with the participant’s Individualized Service Plan (ISP)
Transportation services (if included in authorization)
8. TIMELINE TO LAUNCH
Phase: Business Formation
Timeline: 1–2 weeks
Phase: Medicaid Enrollment via Gainwell
Timeline: 30–60 days
Phase: Staff Hiring and Facility Preparation (if applicable)
Timeline: 2–4 weeks
Phase: Referral Activation and Program Launch
Timeline: Ongoing
9. CONTACT INFORMATION
Colorado Department of Health Care Policy and Financing (HCPF)
Email: hcpf_hcbs_questions@state.co.us
Website: https://hcpf.colorado.gov
Colorado Medicaid Provider Enrollment (Gainwell Technologies)
Website: https://portal.co.gov
WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — COLORADO DAY HABILITATION SERVICES PROVIDER
We help disability professionals and organizations launch Medicaid-compliant Day Habilitation programs that promote independence and community access across Colorado.
Scope of Work:
Business registration (LLC, EIN, NPI)
Medicaid provider enrollment and waiver program setup
Policy & procedure manual for activity planning, documentation, and compliance
Templates for goal tracking, daily logs, and incident reports
Website, domain, and email setup
Staff credentialing trackers and training documentation
Client intake packet, consent forms, and service agreements
Incident reporting systems and audit preparation tools
Referral networking with CMAs, schools, and day program partners
Adult Health Services
ADULT DAY SERVICES PROVIDER IN COLORADO
PROMOTING SOCIAL ENGAGEMENT, DAILY SUPPORT, AND SUPERVISED CARE FOR ADULTS IN A COMMUNITY-BASED SETTING
Adult Day Services in Colorado offer structured, non-residential programs that provide supervision, assistance with daily living, and social engagement for adults who are elderly or have disabilities. These services are reimbursed under Colorado’s Medicaid Home and Community-Based Services (HCBS) Waivers, including the Elderly, Blind, and Disabled (EBD) waiver and the Brain Injury (BI) waiver.
1. GOVERNING AGENCIES
Agency: Colorado Department of Health Care Policy and Financing (HCPF)
Role: Authorizes and reimburses Adult Day Services through Medicaid and HCBS waivers
Agency: Colorado Department of Public Health and Environment (CDPHE)
Role: Licenses Adult Day Care Facilities and ensures compliance with state health and safety regulations
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight to ensure Adult Day Services meet HCBS standards
2. ADULT DAY SERVICE OVERVIEW
Adult Day Services support individuals who may need supervision or assistance during the day while allowing them to return home in the evenings. These programs provide person-centered care that promotes independence and social inclusion.
Approved providers may deliver:
Assistance with activities of daily living (ADLs)
Medication administration and health monitoring (under nursing supervision)
Social, recreational, and therapeutic activities
Meals and snacks according to dietary needs
Supervision and safety monitoring
Transportation to and from the center (if included in service plan)
Documentation of attendance and individual progress
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Colorado Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
Obtain an Adult Day Care Facility license from the Colorado Department of Public Health and Environment (CDPHE)
Enroll as a Medicaid provider through the Gainwell Technologies Medicaid Provider Portal
Maintain compliance with HCBS settings rule, including community integration and participant choice
Ensure facility meets accessibility, safety, and staffing standards
4. PROVIDER ENROLLMENT PROCESS
Step 1: Facility Licensing through CDPHE
Submit floor plan, safety procedures, staffing plans, and emergency policies
Pass inspection and receive Adult Day Facility license
Step 2: Medicaid Enrollment with HCPF
Apply through the Gainwell Provider Portal
Submit business documentation, license, and service description for HCBS Adult Day Services
Step 3: Coordinate with Case Management Agencies (CMAs)
Establish referral network with local CMAs for HCBS waiver participants
5. REQUIRED DOCUMENTATION
Articles of Incorporation or business registration
IRS EIN Letter
NPI confirmation
CDPHE Adult Day Facility license
Colorado Medicaid provider ID
Policy & procedure manual including:
Admission criteria and intake procedures
Daily activity schedules and individualized service plans
Staff supervision and training logs
Medication administration and documentation policies
Participant rights and consent forms
Emergency preparedness and incident reporting procedures
Nutrition, infection control, and cleanliness protocols
Community integration activities and transportation logs
6. STAFFING REQUIREMENTS
Role: Program Director
Requirements: Experience in health or human services, supervisory skills, familiarity with HCBS rules
Role: Activity Coordinator / Direct Care Staff
Requirements:
High school diploma or GED
Background check and CPR/First Aid certification
Experience working with older adults or individuals with disabilities preferred
Role: Nurse (if providing medication administration or health monitoring)
Requirements: Colorado RN or LPN license
Training Requirements for All Staff:
Adult day care operations and person-centered planning
HIPAA and participant rights
Medication administration and infection control
Emergency response and abuse prevention
Ongoing staff development and annual reviews
7. MEDICAID WAIVER SERVICES
Adult Day Services are reimbursed under:
HCBS-EBD (Elderly, Blind, and Disabled) Waiver
HCBS-BI (Brain Injury) Waiver
Other Medicaid-funded long-term care programs based on assessed need
Approved providers may deliver:
Half-day or full-day structured care
Activity-based programming and skill-building
Nursing support (if authorized)
Meals, transportation, and documentation as required by waiver guidelines
8. TIMELINE TO LAUNCH
Phase: Business Formation
Timeline: 1–2 weeks
Phase: Facility Licensing with CDPHE
Timeline: 60–90 days
Phase: Medicaid Enrollment (Gainwell Portal)
Timeline: 30–60 days
Phase: Facility Readiness and Referral Activation
Timeline: Ongoing
9. CONTACT INFORMATION
Colorado Department of Health Care Policy and Financing (HCPF)
Email: hcpf_hcbs_questions@state.co.us
Website: https://hcpf.colorado.gov
Colorado Department of Public Health and Environment (CDPHE)
Phone: (303) 692-2800
Website: https://cdphe.colorado.gov
Colorado Medicaid Provider Enrollment (Gainwell Technologies)
Website: https://portal.co.gov
WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — COLORADO ADULT DAY SERVICES PROVIDER
We help healthcare professionals and organizations launch licensed, Medicaid-compliant Adult Day Programs to support aging and disabled populations in community-based settings.
Scope of Work:
Business registration (LLC, EIN, NPI)
CDPHE Adult Day Care Facility license application support
Medicaid provider enrollment and HCBS compliance guidance
Policy & procedure manual for programming, staffing, and safety
Templates for activity logs, incident reports, and intake forms
Website, domain, and email setup
Staff credentialing trackers and training documentation
Client intake packet, consent forms, and emergency protocols
Incident reporting systems and audit preparation tools
Referral networking with CMAs, hospitals, and local aging services
Assistive Technology
ASSISTIVE TECHNOLOGY SERVICES PROVIDER IN COLORADO
ENABLING INDEPENDENCE AND FUNCTIONAL ACCESS THROUGH PERSONALIZED TECHNOLOGY SOLUTIONS FOR MEDICAID MEMBERS
Assistive Technology (AT) Services in Colorado provide individuals with disabilities access to specialized devices, tools, and training to support daily living, mobility, communication, and safety. These services are available through select Home and Community-Based Services (HCBS) Waivers, including the Supported Living Services (SLS) waiver, Children’s Extensive Support (CES) waiver, and Developmental Disabilities (DD) waiver.
1. GOVERNING AGENCIES
Agency: Colorado Department of Health Care Policy and Financing (HCPF)
Role: Oversees Medicaid waivers that authorize Assistive Technology services and monitors provider compliance
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Ensures that AT services meet federal HCBS requirements for medical necessity and person-centered planning
2. ASSISTIVE TECHNOLOGY SERVICE OVERVIEW
Assistive Technology includes any item, device, software, or system that increases, maintains, or improves the functional capabilities of individuals with disabilities. Services may include assessment, training, customization, and repair of AT devices as authorized in the individual’s service plan.
Approved providers may deliver:
AT assessments and evaluations
Purchase, rental, or customization of approved devices
Setup, installation, and user training
Repairs and maintenance (as authorized)
Documentation of functionality and service utilization
Coordination with interdisciplinary teams and care managers
Examples of eligible assistive technology:
Communication devices (e.g., AAC devices)
Environmental control units (e.g., smart switches)
Mobility and positioning devices (e.g., adapted seating)
Hearing, vision, or cognitive support tools
Specialized computer software and hardware
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Colorado Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
Enroll as a Medicaid Waiver Provider through the Gainwell Technologies Provider Portal
Obtain approval from HCPF for Assistive Technology as a service type
Employ or contract qualified professionals (e.g., Assistive Technology Professionals - ATPs, occupational therapists, or speech-language pathologists)
Carry general liability insurance and have HIPAA-compliant documentation procedures
4. PROVIDER ENROLLMENT PROCESS
Step 1: Register as a business and acquire NPI
Complete business formation and IRS registration
Apply for Type 2 NPI for organizational enrollment
Step 2: Apply through the Gainwell Medicaid Provider Portal
Select appropriate waiver programs and service type: Assistive Technology
Submit documentation of qualifications, resumes, and service description
Step 3: Coordinate with Case Management Agencies (CMAs)
Work with case managers and interdisciplinary teams to receive referrals and service authorizations
5. REQUIRED DOCUMENTATION
Articles of Incorporation or proof of business registration
IRS EIN Letter
NPI confirmation
Medicaid provider enrollment approval
Policy & procedure manual including:
AT intake and evaluation forms
Purchase justification templates and prior authorization tracking
Delivery, installation, and training documentation
Consent forms and HIPAA privacy compliance
Device inventory, maintenance logs, and repair protocols
Incident reporting and problem resolution process
Staff credentialing and continuing education documentation
6. STAFFING REQUIREMENTS
Role: Assistive Technology Specialist / Consultant
Requirements:
Certification as an ATP or licensed OT, SLP, or PT with AT experience
Familiarity with HCBS guidelines and device customization
Role: Installation Technician / Support Trainer
Requirements:
Technical proficiency with adaptive devices
Background check and HIPAA training
Training Requirements for All Staff:
HIPAA and participant confidentiality
Person-centered planning and AT documentation
Infection control (for in-home installations)
Emergency and incident response protocols
7. MEDICAID WAIVER SERVICES
Assistive Technology is reimbursed under:
HCBS-SLS (Supported Living Services) Waiver
HCBS-CES (Children’s Extensive Support) Waiver
HCBS-DD (Developmental Disabilities) Waiver
Approved providers may deliver:
Technology assessments and planning
Purchase, installation, and training on use of devices
Device maintenance and repair
Coordination with caregivers, therapists, and CMAs
Reporting and justification for Medicaid audit readiness
8. TIMELINE TO LAUNCH
Phase: Business Formation
Timeline: 1–2 weeks
Phase: Medicaid Enrollment (Gainwell Portal)
Timeline: 30–60 days
Phase: Staffing and Referral Network Development
Timeline: 2–4 weeks
Phase: Service Authorization and Delivery Readiness
Timeline: Ongoing
9. CONTACT INFORMATION
Colorado Department of Health Care Policy and Financing (HCPF)
Email: hcpf_hcbs_questions@state.co.us
Website: https://hcpf.colorado.gov
Colorado Medicaid Provider Enrollment (Gainwell Technologies)
Website: https://portal.co.gov
WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — COLORADO ASSISTIVE TECHNOLOGY SERVICES PROVIDER
We assist technology consultants, therapists, and disability service providers in launching Medicaid-compliant Assistive Technology services under Colorado’s HCBS waiver programs.
Scope of Work:
Business registration (LLC, EIN, NPI)
Medicaid waiver provider enrollment and compliance setup
Policy & procedure manual for evaluations, equipment delivery, and training
Templates for AT assessments, service logs, and purchase justifications
Website, domain, and email setup
Staff credentialing trackers and licensing documentation
Client intake packet, consent forms, and troubleshooting tools
Incident reporting systems and audit preparation tools
Referral networking with CMAs, schools, therapists, and support teams
Behavioral Health
BEHAVIORAL HEALTH SERVICES PROVIDER IN COLORADO
DELIVERING MENTAL HEALTH AND BEHAVIORAL SUPPORT TO PROMOTE STABILITY, WELL-BEING, AND COMMUNITY PARTICIPATION
Behavioral Health Services in Colorado support individuals with mental health needs, behavioral challenges, or co-occurring intellectual/developmental disabilities. These services are funded through Colorado Medicaid, the Behavioral Health Administration (BHA), and specific Home and Community-Based Services (HCBS) Waivers, such as the Children’s Extensive Support (CES) waiver, Supported Living Services (SLS) waiver, and Developmental Disabilities (DD) waiver.
1. GOVERNING AGENCIES
Agency: Colorado Department of Health Care Policy and Financing (HCPF)
Role: Oversees Medicaid funding for behavioral and mental health services through the state plan and HCBS waivers
Agency: Colorado Behavioral Health Administration (BHA)
Role: Regulates behavioral health providers and integrates services across systems
Agency: Colorado Department of Regulatory Agencies (DORA)
Role: Licenses behavioral health professionals (e.g., LPCs, BCBAs, LCSWs, Psychologists)
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Ensures federal compliance with HCBS behavioral services and Medicaid coverage
2. BEHAVIORAL HEALTH SERVICE OVERVIEW
Behavioral Health Services include assessment, intervention, monitoring, and support for individuals experiencing emotional, cognitive, or behavioral difficulties. Services are individualized and may include therapy, behavior plans, and family or caregiver training.
Approved providers may deliver:
Functional behavioral assessments (FBA)
Development and implementation of Behavior Support Plans (BSP)
Individual or group therapy (CBT, DBT, trauma-informed care, etc.)
Skills development and behavior stabilization
Caregiver coaching and staff training
Crisis de-escalation strategies and intervention planning
Documentation of behavior goals, outcomes, and data
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register your business with the Colorado Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
Enroll as a Medicaid behavioral health provider via the Gainwell Technologies Provider Portal
Be licensed or certified through DORA as one of the following:
Licensed Professional Counselor (LPC)
Licensed Clinical Social Worker (LCSW)
Licensed Psychologist
Board Certified Behavior Analyst (BCBA)
Registered Psychotherapist (as applicable)
If offering services under a waiver, obtain HCBS waiver provider approval through HCPF
Carry liability and malpractice insurance
Maintain HIPAA-compliant documentation systems
4. PROVIDER ENROLLMENT PROCESS
Step 1: Acquire appropriate professional licensure or certification
Step 2: Enroll in Colorado Medicaid through the Gainwell Provider Portal
Step 3: If delivering waiver-based services, complete HCBS waiver enrollment with HCPF
Step 4: Network with Case Management Agencies (CMAs) and Regional Centers for referrals
5. REQUIRED DOCUMENTATION
Articles of Incorporation or proof of business registration
IRS EIN Letter
NPI confirmation
DORA licensure/certification
Medicaid provider ID
HCBS waiver enrollment approval (if applicable)
Policy & procedure manual including:
Intake and consent forms
Behavioral assessment and plan templates
Progress notes and treatment documentation
Confidentiality and HIPAA compliance policies
Emergency and crisis protocols
Client rights and complaint procedures
Staff credentialing and CEU logs
Incident reporting and audit readiness materials
6. STAFFING REQUIREMENTS
Role: Behavioral Health Clinician (LPC, LCSW, Psychologist, BCBA, etc.)
Requirements:
Active license with DORA
Experience working with individuals with behavioral health or IDD needs
CPR certification and background check
Role: Behavioral Technician / Paraprofessional (if applicable)
Requirements:
Supervised by licensed clinician
Background check, training in behavior management and de-escalation
Training Requirements for All Staff:
HIPAA and confidentiality
Positive behavior supports and person-centered planning
Crisis management and mandated reporting
Cultural competence and trauma-informed care
Annual CEUs and clinical supervision documentation
7. MEDICAID WAIVER SERVICES
Behavioral Health Services are reimbursed under:
Colorado Medicaid State Plan (standard outpatient behavioral health)
HCBS-CES (Children’s Extensive Support) Waiver
HCBS-SLS (Supported Living Services) Waiver
HCBS-DD (Developmental Disabilities) Waiver
Community Mental Health Supports (CMHS) Waiver
Approved providers may deliver:
Evidence-based therapies and behavioral interventions
Family and caregiver training and consultation
Crisis intervention planning
Documentation aligned with Individual Service Plans (ISPs) and waiver requirements
8. TIMELINE TO LAUNCH
Phase: Business Formation
Timeline: 1–2 weeks
Phase: Licensure and Credentialing
Timeline: 2–4 weeks (varies by profession)
Phase: Medicaid Enrollment via Gainwell
Timeline: 30–60 days
Phase: Waiver Enrollment and Referral Setup
Timeline: Ongoing
9. CONTACT INFORMATION
Colorado Department of Health Care Policy and Financing (HCPF)
Email: hcpf_hcbs_questions@state.co.us
Website: https://hcpf.colorado.gov
Colorado Behavioral Health Administration (BHA)
Website: https://bha.colorado.gov
Colorado Department of Regulatory Agencies (DORA) – Licensing
Website: https://dpo.colorado.gov
Colorado Medicaid Provider Enrollment (Gainwell Technologies)
Website: https://portal.co.gov
WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — COLORADO BEHAVIORAL HEALTH SERVICES PROVIDER
We support clinicians, therapists, and behavior specialists in launching Medicaid-compliant behavioral health practices across Colorado’s waiver and Medicaid systems.
Scope of Work:
Business registration (LLC, EIN, NPI)
DORA licensure and Medicaid provider enrollment support
HCBS waiver provider application guidance
Policy & procedure manual for behavioral care delivery and compliance
Templates for treatment plans, assessments, and daily notes
Website, domain, and email setup
Staff credentialing trackers and CEU documentation tools
Client intake packet, consent forms, and clinical protocols
Incident reporting systems and audit preparation tools
Referral networking with CMAs, schools, and community mental health partners
Home Modification
HOME MODIFICATION SERVICES PROVIDER IN COLORADO
IMPROVING SAFETY, ACCESSIBILITY, AND INDEPENDENCE THROUGH STRUCTURAL ADAPTATIONS FOR MEDICAID MEMBERS AT HOME
Home Modification Services in Colorado provide physical changes to a person’s primary residence to promote independent living, reduce safety risks, and support aging or disability-related needs. These services are offered through Colorado Medicaid's Home and Community-Based Services (HCBS) Waivers, including the Elderly, Blind, and Disabled (EBD), Supported Living Services (SLS), and Children’s Extensive Support (CES) waivers. All modifications must be medically necessary, cost-effective, and included in the participant’s Service Plan.
1. GOVERNING AGENCIES
Agency: Colorado Department of Health Care Policy and Financing (HCPF)
Role: Authorizes, reimburses, and regulates Home Modification Services under Medicaid HCBS Waivers
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Ensures federal compliance with Medicaid-funded environmental accessibility adaptations
2. HOME MODIFICATION SERVICE OVERVIEW
Home modifications are permanent or semi-permanent physical changes made to a person’s home to enhance accessibility and allow them to remain safely in the community. Services must be recommended by a qualified professional and approved through the waiver participant’s care plan.
Approved providers may deliver:
Installation of ramps, grab bars, stair lifts, and handrails
Widening of doorways and accessible flooring
Roll-in showers, shower benches, and bathroom grab bars
Kitchen adaptations for reach and safety
Light switch and outlet relocation
Environmental control units (ECUs) when functionally necessary
Project planning, cost estimating, and documentation of outcomes
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Colorado Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
Obtain Colorado contractor license (if performing structural work)
Carry general liability and workers’ compensation insurance
Enroll as a Colorado Medicaid Home Modification Provider through the Gainwell Provider Portal
Employ qualified professionals (e.g., contractors, accessibility consultants, or OTs for consultation)
Demonstrate compliance with Americans with Disabilities Act (ADA) standards
4. PROVIDER ENROLLMENT PROCESS
Step 1: Gainwell Medicaid Enrollment
Apply through the Colorado Medicaid Provider Web Portal
Select service type “Home Modification” and provide licensing, credentials, and insurance documents
Step 2: HCPF Authorization Readiness
Ensure capability to receive service authorizations through the Bridge system and communicate with Case Management Agencies (CMAs)
Step 3: Bid Submission Process
Participate in bid process upon receiving a service request
Submit scope of work, cost estimates, and timeline in accordance with HCPF guidelines
5. REQUIRED DOCUMENTATION
Articles of Incorporation or business registration
IRS EIN Letter
NPI confirmation
Contractor license and liability insurance
Medicaid provider ID
Policy & procedure manual including:
Intake and home assessment procedures
Project scope and bid submission templates
ADA compliance references and checklist
Documentation of before/after conditions and justification
Consumer rights and consent forms
Safety protocols and job site management plans
Warranty terms and post-installation quality review forms
6. STAFFING REQUIREMENTS
Role: Home Modification Contractor / Technician
Requirements:
Experience in ADA-compliant construction and accessibility adaptations
Colorado contractor license
Background check and insurance coverage
Strong documentation and communication skills
Optional Role: Occupational Therapist (consulting)
Requirements: Colorado OT license; assists with functional justification and environmental assessments
Training Requirements for All Staff:
ADA standards for accessibility
Working with vulnerable populations in home settings
HIPAA and confidentiality
Incident documentation and safety planning
7. MEDICAID WAIVER SERVICES
Home Modifications are reimbursed under:
HCBS-EBD (Elderly, Blind, and Disabled) Waiver
HCBS-SLS (Supported Living Services) Waiver
HCBS-CES (Children’s Extensive Support) Waiver
Other waivers if the modification is documented as necessary in the Service Plan
Approved providers may deliver:
One-time or infrequent modifications to enhance accessibility
Cost-effective solutions reviewed and approved by CMAs
Coordination with case managers, families, and therapists
Written documentation for completion, inspection, and payment
8. TIMELINE TO LAUNCH
Phase: Business Formation
Timeline: 1–2 weeks
Phase: Contractor Licensing and Insurance
Timeline: 2–4 weeks
Phase: Medicaid Enrollment with Gainwell
Timeline: 30–60 days
Phase: CMA Referral Networking and Bid Preparation
Timeline: Ongoing
9. CONTACT INFORMATION
Colorado Department of Health Care Policy and Financing (HCPF)
Email: hcpf_hcbs_questions@state.co.us
Website: https://hcpf.colorado.gov
Colorado Medicaid Provider Enrollment (Gainwell Technologies)
Website: https://portal.co.gov
WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — COLORADO HOME MODIFICATION SERVICES PROVIDER
We help contractors, accessibility specialists, and home improvement professionals become certified Medicaid Home Modification providers in Colorado’s waiver programs.
Scope of Work:
Business registration (LLC, EIN, NPI)
Contractor licensing and liability insurance compliance
Medicaid provider enrollment and CMA coordination setup
Policy & procedure manual for project planning, execution, and compliance
Templates for bids, project logs, and warranty forms
Website, domain, and email setup
Staff credentialing trackers and ADA compliance references
Client intake packet, consent forms, and before/after documentation tools
Incident reporting systems and audit preparation tools
Referral networking with CMAs, OTs, and hospitals
Supported Living
SUPPORTED LIVING SERVICES PROVIDER IN COLORADO
PROMOTING INDEPENDENCE AND COMMUNITY INTEGRATION FOR ADULTS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES
Supported Living Services (SLS) in Colorado offer individualized assistance to adults with intellectual and developmental disabilities (IDD) who live independently or with family. These services are authorized under the Home and Community-Based Services (HCBS) SLS Waiver, administered by the Colorado Department of Health Care Policy and Financing (HCPF) and coordinated through Case Management Agencies (CMAs).
1. GOVERNING AGENCIES
Agency: Colorado Department of Health Care Policy and Financing (HCPF)
Role: Administers the HCBS-SLS waiver and sets rules for provider participation and reimbursement
Agency: Colorado Department of Public Health and Environment (CDPHE)** (as applicable)
Role: Licenses service providers if medical or personal care services are offered
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Ensures waiver services align with federal person-centered and HCBS standards
2. SUPPORTED LIVING SERVICE OVERVIEW
Supported Living Services help individuals manage daily activities, participate in their communities, and develop life skills while residing in non-licensed settings (e.g., their own homes or with family).
Approved providers may deliver:
Personal care and hygiene support
Homemaker services and meal prep assistance
Medication reminders and health support
Life skills training (money management, cooking, etc.)
Transportation to appointments, work, or community activities
Community access and social participation
Oversight and documentation based on individualized plans
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register your business with the Colorado Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
Enroll as a provider under the HCBS-SLS Waiver via the Gainwell Technologies Medicaid Provider Portal
If providing personal care, obtain a Class B Home Care Agency license from CDPHE
Employ staff trained in supporting individuals with IDD
Carry general and professional liability insurance
Implement HIPAA-compliant documentation and quality assurance systems
4. PROVIDER ENROLLMENT PROCESS
Step 1: Complete business registration and obtain NPI
Step 2: Apply for CDPHE Class B license (if providing personal care/homemaker services)
Step 3: Enroll as an HCBS-SLS waiver provider via the Gainwell Medicaid Provider Portal
Step 4: Establish referral relationships with Case Management Agencies (CMAs) and Regional Centers
5. REQUIRED DOCUMENTATION
Articles of Incorporation or proof of business registration
IRS EIN Letter
NPI confirmation
CDPHE Class B license (if applicable)
Medicaid provider ID
Policy & procedure manual including:
Intake and service authorization verification procedures
Individualized service planning and documentation templates
Staff supervision, training, and emergency protocols
Incident reporting and abuse prevention
Participant rights, HIPAA compliance, and consent forms
Community integration tracking and transportation policies
Audit readiness checklists and quality monitoring tools
6. STAFFING REQUIREMENTS
Role: Direct Support Professional (DSP)
Requirements:
High school diploma or equivalent
Background check and TB clearance
CPR/First Aid certification
Experience supporting individuals with IDD preferred
Role: Program Supervisor / Agency Administrator
Requirements:
Human services or social work background
Familiarity with HCBS documentation, person-centered planning, and IDD supports
Training Requirements for All Staff:
Client rights and dignity
Person-centered service delivery
Abuse prevention and mandatory reporting
Medication reminders and ADL/IADL assistance
Documentation and emergency response procedures
7. MEDICAID WAIVER SERVICES
Supported Living Services are reimbursed under:
HCBS-SLS (Supported Living Services) Waiver
Approved providers may deliver:
In-home and community-based services focused on functional independence
Individualized support aligned with each participant’s plan
Non-medical personal assistance and life skills coaching
Daily progress tracking and service coordination with CMAs
8. TIMELINE TO LAUNCH
Phase: Business Formation
Timeline: 1–2 weeks
Phase: CDPHE Licensing (if applicable)
Timeline: 30–90 days
Phase: Medicaid Enrollment via Gainwell
Timeline: 30–60 days
Phase: Staffing and Referral Activation
Timeline: Ongoing
9. CONTACT INFORMATION
Colorado Department of Health Care Policy and Financing (HCPF)
Email: hcpf_hcbs_questions@state.co.us
Website: https://hcpf.colorado.gov
Colorado Department of Public Health and Environment (CDPHE)
Phone: (303) 692-2800
Website: https://cdphe.colorado.gov
Colorado Medicaid Provider Enrollment (Gainwell Technologies)
Website: https://portal.co.gov
WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — COLORADO SUPPORTED LIVING SERVICES PROVIDER
We support agencies and direct support professionals in launching and operating fully compliant Supported Living Services under Colorado’s HCBS-SLS Waiver.
Scope of Work:
Business registration (LLC, EIN, NPI)
Medicaid enrollment and waiver-specific application support
CDPHE Class B license assistance (if required)
Policy & procedure manual for care delivery, supervision, and compliance
Templates for service logs, progress notes, and person-centered plans
Website, domain, and email setup
Staff credentialing trackers and supervision logs
Client intake packet, consent forms, and emergency contact protocols
Incident reporting systems and audit preparation tools
Referral networking with CMAs, day programs, and Regional Centers
Homemaker Services
HOMEMAKER SERVICES PROVIDER IN COLORADO
SUPPORTING DAILY LIVING AND SAFETY AT HOME FOR INDIVIDUALS WHO ARE ELDERLY, DISABLED, OR MEDICALLY FRAGILE
Homemaker Services in Colorado provide assistance with essential household tasks to individuals who are unable to safely maintain their homes due to age, disability, or chronic illness. These services are authorized under Colorado Medicaid's Home and Community-Based Services (HCBS) Waivers, including the Elderly, Blind, and Disabled (EBD) waiver, Brain Injury (BI) waiver, and Community Mental Health Supports (CMHS) waiver.
1. GOVERNING AGENCIES
Agency: Colorado Department of Health Care Policy and Financing (HCPF)
Role: Oversees Medicaid waiver programs, authorizes Homemaker Services, and reimburses qualified providers
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight and ensures Homemaker Services comply with HCBS regulations
2. HOMEMAKER SERVICE OVERVIEW
Homemaker Services assist waiver participants with non-medical tasks to support a clean, safe, and livable home environment. These services may be delivered on a scheduled basis as outlined in the individual’s approved service plan.
Approved providers may deliver:
General light housekeeping (sweeping, vacuuming, mopping)
Laundry and linen changing
Dishwashing and kitchen cleanup
Bathroom sanitation
Meal preparation (non-specialized)
Bed making and organizing personal areas
Routine documentation of completed tasks
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register your business with the Colorado Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
Carry general liability insurance and, if employing staff, workers’ compensation coverage
Enroll as a Homemaker Services Provider through the Gainwell Technologies Medicaid Provider Portal
Maintain staff background checks and HIPAA compliance protocols
Have a system in place for verifying service delivery and task completion
4. PROVIDER ENROLLMENT PROCESS
Step 1: Register Business and Acquire NPI
Establish business entity, obtain EIN, and apply for NPI (Type 2)
Step 2: Medicaid Enrollment through Gainwell
Apply via the Colorado Medicaid Provider Web Portal
Select “Homemaker” as the provider type and submit necessary documentation
Step 3: Connect with Case Management Agencies (CMAs)
Coordinate with regional CMAs to receive referrals for participants authorized to receive homemaker support
5. REQUIRED DOCUMENTATION
Articles of Incorporation or business registration
IRS EIN Letter
NPI confirmation
Liability insurance documentation
Medicaid provider approval
Policy & procedure manual including:
Client intake and authorization verification
Task checklist and service documentation forms
Staff training records and supervision protocols
Participant rights, consent forms, and HIPAA policies
Complaint resolution and incident reporting procedures
Emergency contact protocol and safety guidelines
Service scheduling and completion logs
6. STAFFING REQUIREMENTS
Role: Homemaker / Direct Support Staff
Requirements:
High school diploma or equivalent (recommended)
Background check and TB screening
CPR/First Aid certification (preferred)
Ability to perform physical cleaning tasks and communicate clearly with clients
Role: Program Supervisor (for agencies)
Requirements:
Experience in home care service delivery and staff supervision
Knowledge of Medicaid documentation and service tracking
Training Requirements for All Staff:
Infection control and home safety practices
Abuse prevention and mandatory reporting
Confidentiality and client rights
Documentation standards and professionalism
Annual refreshers in safety and ethical conduct
7. MEDICAID WAIVER SERVICES
Homemaker Services are reimbursed under:
HCBS-EBD (Elderly, Blind, and Disabled) Waiver
HCBS-BI (Brain Injury) Waiver
HCBS-CMHS (Community Mental Health Supports) Waiver
Other waivers where non-medical home assistance is identified in the care plan
Approved providers may deliver:
Authorized homemaking services as outlined in the participant’s care plan
Task-specific services with verification of time and completion
Communication with CMAs and waiver case managers for updates and reporting
8. TIMELINE TO LAUNCH
Phase: Business Formation
Timeline: 1–2 weeks
Phase: Medicaid Enrollment via Gainwell
Timeline: 30–60 days
Phase: Staff Hiring and CMA Referral Setup
Timeline: 2–4 weeks
Phase: Client Intake and Service Activation
Timeline: Ongoing
9. CONTACT INFORMATION
Colorado Department of Health Care Policy and Financing (HCPF)
Email: hcpf_hcbs_questions@state.co.us
Website: https://hcpf.colorado.gov
Colorado Medicaid Provider Enrollment (Gainwell Technologies)
Website: https://portal.co.gov
WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — COLORADO HOMEMAKER SERVICES PROVIDER
We help cleaning service providers, caregivers, and home care entrepreneurs launch compliant Homemaker Services under Colorado’s Medicaid waiver programs.
Scope of Work:
Business registration (LLC, EIN, NPI)
Medicaid provider enrollment and HCBS compliance support
Policy & procedure manual for task tracking, safety, and service delivery
Templates for homemaker checklists, visit logs, and supervision forms
Website, domain, and email setup
Staff credentialing trackers and incident reporting logs
Client intake packet, consent forms, and grievance process
Referral networking with CMAs, discharge planners, and housing agencies
Audit preparation tools and quality improvement templates
Case Management
CASE MANAGEMENT SERVICES PROVIDER IN COLORADO
NAVIGATING LONG-TERM SERVICES AND SUPPORTS (LTSS) TO ENSURE INDIVIDUALIZED CARE AND COMMUNITY INTEGRATION
Case Management Services in Colorado help individuals with disabilities, chronic conditions, and age-related needs access and coordinate Home and Community-Based Services (HCBS) and other Medicaid supports. Under Colorado’s Medicaid redesign, Case Management is transitioning to a conflict-free model, meaning individuals receiving services must work with case managers not affiliated with direct service providers. Services are authorized by the Colorado Department of Health Care Policy and Financing (HCPF) and delivered through Case Management Agencies (CMAs).
1. GOVERNING AGENCIES
Agency: Colorado Department of Health Care Policy and Financing (HCPF)
Role: Oversees Medicaid and HCBS waiver programs, authorizes case management agencies, and sets compliance standards
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight for Medicaid-funded case management and ensures HCBS compliance
2. CASE MANAGEMENT SERVICE OVERVIEW
Case Management Services help individuals assess their needs, create person-centered plans, coordinate services, and monitor outcomes. This includes ensuring that services are accessible, appropriate, and aligned with the individual’s goals.
Approved providers may deliver:
Comprehensive assessments and level of care determinations
Development and implementation of person-centered service plans
Referral to HCBS waiver and non-waiver resources
Ongoing monitoring of service delivery and progress toward goals
Crisis response planning and reassessments
Documentation and data entry into the state case management system (e.g., Bridge)
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Colorado Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
Apply and be designated as a Case Management Agency (CMA) by HCPF
Demonstrate separation from direct service provision (conflict-free criteria)
Employ qualified case managers with experience in HCBS, social work, or human services
Maintain HIPAA-compliant recordkeeping and secure electronic documentation systems
Carry general liability and professional insurance
4. PROVIDER ENROLLMENT PROCESS
Step 1: Review HCPF Case Management Redesign Requirements
Familiarize yourself with the HCPF CMA Readiness Tool and regional realignment plans
Step 2: Apply for CMA Designation
Submit application, conflict-free attestation, organizational chart, and staff resumes to HCPF
Step 3: Enroll as a Colorado Medicaid Provider
Apply through the Gainwell Provider Web Portal
Submit NPI, ownership details, policies, and procedures
Step 4: System Onboarding and Training
Complete HCPF training modules and Bridge system onboarding
5. REQUIRED DOCUMENTATION
Articles of Incorporation or business registration
IRS EIN Letter
NPI confirmation
CMA designation from HCPF
Colorado Medicaid provider ID
Policy & procedure manual including:
Intake and eligibility verification forms
Person-centered service planning templates
Monitoring and reassessment schedules
Confidentiality and client rights policies
Complaint and grievance resolution procedures
Crisis planning protocols
Staff training requirements and supervision documentation
Quality assurance and compliance review tools
6. STAFFING REQUIREMENTS
Role: Case Manager
Requirements:
Bachelor’s degree in social work, nursing, psychology, or related field (or equivalent experience)
Knowledge of HCBS services and Medicaid eligibility
Background check and system access approval
Person-centered planning training (provided by HCPF)
Role: Supervisor / Clinical Reviewer (if applicable)
Requirements:
Clinical or advanced human services background
Oversight of plan approvals, reassessments, and documentation audits
Training Requirements for All Staff:
HCPF-required modules (person-centered planning, critical incident reporting, etc.)
HIPAA and confidentiality
Bridge case management system use
Ongoing CEUs and quarterly refreshers
7. MEDICAID WAIVER SERVICES
Case Management Services are required for participants in:
HCBS-EBD (Elderly, Blind, and Disabled) Waiver
HCBS-DD (Developmental Disabilities) Waiver
HCBS-SLS (Supported Living Services) Waiver
HCBS-CES (Children’s Extensive Support) Waiver
HCBS-CMHS (Community Mental Health Supports) Waiver
Children with Life-Limiting Illness (CLLI) and other Medicaid LTSS programs
Approved providers may deliver:
Intake and eligibility screening
Person-centered service planning and authorizations
Crisis intervention and referrals
Ongoing monitoring and care team coordination
Required data entry and audit-ready documentation
8. TIMELINE TO LAUNCH
Phase: Business Formation
Timeline: 1–2 weeks
Phase: CMA Application and HCPF Review
Timeline: 60–90 days
Phase: Medicaid Enrollment and System Access
Timeline: 30–45 days
Phase: Staff Hiring and Bridge Training
Timeline: 2–4 weeks
9. CONTACT INFORMATION
Colorado Department of Health Care Policy and Financing (HCPF)
Email: hcpf_cmrd@state.co.us
Website: https://hcpf.colorado.gov
Gainwell Technologies – Provider Web Portal
Website: https://portal.co.gov
WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — COLORADO CASE MANAGEMENT SERVICES PROVIDER
We guide providers through the application, enrollment, and readiness process to become approved Case Management Agencies under Colorado’s Medicaid redesign.
Scope of Work:
Business registration (LLC, EIN, NPI)
HCPF Case Management Agency (CMA) application support
Policy & procedure manual for eligibility, planning, and monitoring
Templates for care plans, assessments, and progress tracking
Website, domain, and email setup
Staff credentialing trackers and Bridge training guidance
Client intake packet, consent forms, and complaint protocols
Incident reporting systems and audit preparation tools
Referral networking with providers, hospitals, and county programs
Transportation Assistance
TRANSPORTATION ASSISTANCE SERVICES PROVIDER IN COLORADO
ENSURING ACCESS TO HEALTHCARE, EMPLOYMENT, AND COMMUNITY LIFE FOR INDIVIDUALS WITH DISABILITIES AND CHRONIC CONDITIONS
Transportation Assistance Services in Colorado provide non-medical, non-emergency transportation for individuals enrolled in Home and Community-Based Services (HCBS) waivers. These services help ensure that participants can access medical appointments, employment, day programs, community activities, and essential errands, supporting independence and community integration.
1. GOVERNING AGENCIES
Agency: Colorado Department of Health Care Policy and Financing (HCPF)
Role: Oversees Medicaid HCBS waivers and provider enrollment for Transportation Assistance Services
Agency: Colorado Department of Transportation (CDOT) (in coordination with regional programs)
Role: Provides oversight on transportation safety and accessibility standards
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight to ensure compliance with Medicaid HCBS requirements for transportation services
2. TRANSPORTATION SERVICE OVERVIEW
Transportation Assistance Services provide access to:
Non-emergency medical appointments
Employment and vocational programs
Day habilitation and day programs
Grocery shopping, pharmacies, and other essential errands
Recreational and social community activities
Approved providers may deliver:
Scheduled and demand-response transportation
Door-to-door and curb-to-curb services
Accessible transportation for individuals using wheelchairs or mobility devices
Escort assistance for participants requiring supervision
All services must be authorized in the participant’s person-centered service plan and meet safety, accessibility, and service quality standards.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Colorado Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
Complete enrollment as a Medicaid transportation provider through Gainwell Technologies
Maintain commercial vehicle insurance and general liability insurance
Obtain Colorado Motor Carrier permits (if required for larger operations)
Develop policies for trip scheduling, driver safety, vehicle maintenance, and emergency response
Ensure vehicles meet ADA accessibility requirements if transporting individuals with mobility impairments
4. HCPF PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Request Transportation Assistance Services provider application packet from HCPF
(Recommended) Attend Medicaid HCBS provider orientation sessions
Application and Documentation Submission:
Submit business documentation, insurance certificates, and proof of vehicle compliance
Provide driver background check and training policies
Submit sample scheduling protocols, participant intake forms, and emergency procedures
Program Readiness Review:
HCPF reviews provider readiness, including safety protocols, vehicle accessibility, and trip verification processes
Site inspections or vehicle audits may be conducted if required
Approval & Medicaid Enrollment:
Upon approval, complete provider enrollment through Gainwell Technologies
Configure transportation service billing codes under the appropriate HCBS waiver programs
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License
IRS EIN confirmation
NPI confirmation
Commercial auto and liability insurance
Policy & Procedure Manual including:
Participant intake and trip scheduling procedures
Driver safety standards and emergency protocols
ADA compliance and accessible transportation procedures
Incident response, vehicle maintenance schedules, and inspections
Confidentiality, HIPAA compliance, and participant rights policies
Staff credentialing, driver background check records, and training logs
Medicaid billing, trip verification, and authorization tracking systems
6. STAFFING REQUIREMENTS
Role: Transportation Services Manager
Requirements: Experience in transportation logistics or human services transportation; background check clearance
Role: Drivers / Transportation Assistants
Requirements: Valid Colorado driver’s license; background check clearance; CPR/First Aid certification (recommended); defensive driving certification (preferred)
All staff must complete:
Training on passenger assistance, wheelchair securement (if applicable), and ADA compliance
Emergency response and breakdown protocols
HIPAA confidentiality and participant rights protection training
Annual refresher courses on transportation safety and incident documentation
7. MEDICAID WAIVER SERVICES
The following Colorado Medicaid Waivers authorize Transportation Assistance Services:
Elderly, Blind, and Disabled (EBD) Waiver
Supported Living Services (SLS) Waiver
Developmental Disabilities (DD) Waiver
Brain Injury (BI) Waiver
Community Mental Health Supports (CMHS) Waiver
Children’s Extensive Support (CES) Waiver (for children needing specialized transport)
Approved providers may deliver:
Scheduled and on-demand transportation to approved service locations
Transportation for community integration activities
Specialized transportation for individuals with mobility or behavioral support needs
8. TIMELINE TO LAUNCH
Phase: Business Formation and Insurance Setup
Timeline: 1–2 weeks
Phase: HCPF Provider Application and Readiness Review
Timeline: 60–90 days
Phase: Staff Hiring, Vehicle Preparation, and Training
Timeline: 30–45 days
Phase: Medicaid Enrollment and Billing Configuration
Timeline: 45–60 days
9. CONTACT INFORMATION
Colorado Department of Health Care Policy and Financing (HCPF)
Website: https://hcpf.colorado.gov
Colorado Department of Transportation (CDOT)
Website: https://www.codot.gov
Colorado Medicaid Provider Enrollment Portal (Gainwell Technologies)
Website: https://colorado-hcpf.portal.force.com/ProviderEnrollment/s/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — COLORADO TRANSPORTATION ASSISTANCE PROVIDER
WCG supports transportation service agencies and entrepreneurs in launching Medicaid-compliant Transportation Assistance Services under Colorado’s HCBS Waiver programs.
Scope of Work:
Business registration and EIN/NPI setup
HCPF Medicaid provider enrollment and documentation support
Development of Transportation Services Policy & Procedure Manual
Staff credentialing templates and trip verification forms
Medicaid billing and claims system setup
Website, domain, and email setup
Participant transportation intake forms and scheduling systems
Vehicle maintenance tracking and safety audit templates
Emergency response planning and incident management systems
Community referral networking and marketing strategy development
Home Health
HOME HEALTH SERVICES PROVIDER IN COLORADO
DELIVERING SKILLED NURSING AND THERAPEUTIC CARE TO MEDICAID MEMBERS IN THE COMFORT OF THEIR OWN HOMES
Home Health Services in Colorado provide medical, rehabilitative, and personal care to individuals recovering from illness, managing chronic conditions, or requiring support to avoid institutional placement. These services are reimbursed under the Colorado Medicaid State Plan and may also be accessed through certain Home and Community-Based Services (HCBS) Waivers, including the Elderly, Blind, and Disabled (EBD) waiver and Children’s HCBS Waivers.
1. GOVERNING AGENCIES
Agency: Colorado Department of Health Care Policy and Financing (HCPF)
Role: Oversees Medicaid reimbursement and policy for home health services
Agency: Colorado Department of Public Health and Environment (CDPHE)
Role: Licenses Class A Home Care Agencies that provide skilled medical services
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal guidance for Medicaid-covered home health services
2. HOME HEALTH SERVICE OVERVIEW
Home Health Services offer short-term or long-term skilled care in a client’s home as prescribed by a physician. Services are designed to prevent hospitalization, promote recovery, and support health at home.
Approved providers may deliver:
Skilled nursing visits (e.g., wound care, medication administration, IV therapy)
Physical, occupational, and speech therapy
Certified nursing aide (CNA) support for ADLs
Medical social work and care coordination
Health status assessments and care plan updates
Education for patients and families
Documentation of outcomes and physician communication
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register your business with the Colorado Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
Obtain a Class A Home Care Agency license from CDPHE
Meet Medicare Conditions of Participation (if seeking dual certification)
Enroll as a Home Health Agency Provider via the Gainwell Medicaid Provider Portal
Employ qualified licensed and certified professionals (RN, PT, OT, etc.)
Carry general liability, professional liability, and workers’ comp insurance
4. PROVIDER ENROLLMENT PROCESS
Step 1: CDPHE Class A Home Care Agency License
Submit application, clinical policies, and safety protocols
Pass inspection and background screening
Step 2: Medicaid Enrollment via Gainwell
Apply through the Colorado Medicaid Provider Enrollment Portal
Submit license, business documents, and staff qualifications
Step 3: Referral Network Development
Coordinate with hospitals, physician offices, and CMAs for referrals and authorizations
5. REQUIRED DOCUMENTATION
Articles of Incorporation or business registration
IRS EIN Letter
NPI confirmation
CDPHE Class A Home Care Agency license
Medicaid provider ID
Policy & procedure manual including:
Admission and physician order verification process
Skilled nursing, therapy, and aide documentation templates
Infection control and emergency response plans
HIPAA compliance and patient confidentiality protocols
Supervision and quality assurance plans
Incident reporting and change of condition protocols
Client rights, consent forms, and service agreements
Staff credentialing, CEUs, and supervision documentation
6. STAFFING REQUIREMENTS
Role: Registered Nurse (RN)
Requirements:
Colorado nursing license
Skilled nursing experience
CPR certification, background check, and TB screening
Role: Home Health Aide / CNA
Requirements:
Active CNA license in Colorado
Supervised by RN
ADL support training
Role: Therapist (PT, OT, SLP)
Requirements:
State licensure and experience in home care
Training Requirements for All Staff:
Infection control, HIPAA, and safety training
Abuse prevention and emergency response
Documentation and plan of care protocols
Annual CEUs and in-service training
7. MEDICAID WAIVER SERVICES
Home Health Services are reimbursed under:
Colorado Medicaid State Plan
HCBS-EBD (Elderly, Blind, and Disabled) Waiver
HCBS-BI (Brain Injury) Waiver
Children’s HCBS Waivers (e.g., CHCBS, CLLI)
Approved providers may deliver:
Skilled intermittent care per physician orders
ADL support by certified aides (if ordered)
Therapy and case coordination
Timely documentation for billing and oversight
8. TIMELINE TO LAUNCH
Phase: Business Formation
Timeline: 1–2 weeks
Phase: CDPHE Licensing Process
Timeline: 60–90 days
Phase: Medicaid Enrollment via Gainwell
Timeline: 30–60 days
Phase: Staff Onboarding and Referral Activation
Timeline: Ongoing
9. CONTACT INFORMATION
Colorado Department of Public Health and Environment (CDPHE) – Facility Licensing
Phone: (303) 692-2800
Website: https://cdphe.colorado.gov
Colorado Department of Health Care Policy and Financing (HCPF)
Email: hcpf_hcbs_questions@state.co.us
Website: https://hcpf.colorado.gov
Colorado Medicaid Provider Enrollment (Gainwell Technologies)
Website: https://portal.co.gov
WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — COLORADO HOME HEALTH SERVICES PROVIDER
We help nurses and healthcare organizations launch fully licensed, Medicaid-compliant Home Health Agencies across Colorado’s waiver and Medicaid programs.
Scope of Work:
Business registration (LLC, EIN, NPI)
CDPHE Class A Home Care Agency licensing assistance
Medicaid enrollment and HCBS waiver alignment
Policy & procedure manual for clinical care, safety, and compliance
Templates for physician orders, nursing notes, and therapy plans
Website, domain, and email setup
Staff credentialing trackers and CEU documentation
Client intake packet, consent forms, and emergency procedures
Incident reporting systems and audit preparation tools
Referral networking with hospitals, physicians, and CMAs
Meal and Nutrition
MEAL AND NUTRITION SERVICES PROVIDER IN COLORADO
PROMOTING HEALTH, INDEPENDENCE, AND QUALITY OF LIFE THROUGH NUTRITIONAL SUPPORT FOR INDIVIDUALS WITH DISABILITIES AND CHRONIC CONDITIONS
Meal and Nutrition Services in Colorado ensure that individuals enrolled in Home and Community-Based Services (HCBS) waiver programs have access to safe, nutritious meals that meet their health and personal needs. These services promote wellness, prevent malnutrition, and support individuals’ ability to remain in their homes and communities.
1. GOVERNING AGENCIES
Agency: Colorado Department of Health Care Policy and Financing (HCPF)
Role: Oversees Medicaid enrollment, authorization, and reimbursement for Meal and Nutrition Services
Agency: Colorado Department of Public Health and Environment (CDPHE)
Role: Regulates food safety standards and issues licenses for commercial kitchens and food preparation facilities
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight ensuring Meal and Nutrition Services meet HCBS person-centered requirements
2. MEAL AND NUTRITION SERVICE OVERVIEW
Meal and Nutrition Services provide participants with nutritious meals tailored to their medical, dietary, and cultural needs.
Approved providers may deliver:
Home-delivered meals (hot, frozen, or shelf-stable)
Congregate meals at community centers (where authorized)
Specialized meal plans for dietary conditions (e.g., diabetic, low-sodium, pureed diets)
Nutritional counseling and education (when authorized)
Meal preparation assistance within the participant’s home (as authorized)
All services must be based on the participant’s person-centered plan and be nutritionally adequate to meet USDA Dietary Guidelines or physician-ordered dietary modifications.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Colorado Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
If preparing meals, obtain a Retail Food Establishment License from CDPHE or local health department
Maintain general liability and food service liability insurance
Develop safe food handling, meal preparation, and delivery protocols
Ensure compliance with state food safety regulations and HCBS waiver service standards
4. HCPF PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Request Meal and Nutrition Services provider application packet from HCPF
Attend a Medicaid HCBS waiver provider orientation (recommended)
Application and Documentation Submission:
Submit business documentation, insurance verification, kitchen licensing (if applicable), and staffing plans
Provide sample menus, food safety policies, and meal delivery scheduling protocols
Submit documentation of food handler certifications and emergency response plans
Program Readiness Review:
HCPF reviews menu adequacy, dietary compliance, safety policies, and participant intake processes
Facility inspections may be conducted if meals are prepared in a provider-operated kitchen
Approval & Medicaid Enrollment:
After state approval, finalize Medicaid provider enrollment through Colorado’s Gainwell Technologies Provider Portal
Select and configure appropriate meal service billing codes
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License
IRS EIN confirmation
NPI confirmation
Food Service License (if preparing meals)
Liability insurance coverage
Policy & Procedure Manual including:
Participant intake, dietary assessment, and menu planning
Meal preparation, storage, packaging, and delivery protocols
Food safety and sanitation policies
Emergency meal provision and contingency planning
Client rights, confidentiality, and grievance procedures
Staff training logs and background check records
Incident reporting, infection control, and quality assurance procedures
Medicaid billing, meal verification, and service authorization tracking systems
6. STAFFING REQUIREMENTS
Role: Meal Services Program Manager / Supervisor
Requirements: Experience in food service management or nutrition services; food safety certification; background check clearance
Role: Food Preparers / Delivery Staff
Requirements: Food handler permit, background check clearance, CPR/First Aid certification (recommended)
Role: Registered Dietitian Nutritionist (RDN) (optional for specialized dietary planning)
Requirements: Active RDN license in Colorado, if offering nutritional counseling
All staff must complete:
Food safety and sanitation training
HIPAA confidentiality and participant rights training
Emergency procedures and incident reporting training
Annual continuing education on food service and HCBS waiver compliance
7. MEDICAID WAIVER SERVICES
The following Colorado Medicaid Waivers authorize Meal and Nutrition Services:
Elderly, Blind, and Disabled (EBD) Waiver
Supported Living Services (SLS) Waiver (for adults with developmental disabilities)
Community Mental Health Supports (CMHS) Waiver
Brain Injury (BI) Waiver
Spinal Cord Injury (SCI) Waiver (Denver Metro Area)
Approved providers may deliver:
Home-delivered meals meeting special dietary needs
Congregate meal services (in some cases with approval)
Emergency meals during service disruptions
Nutrition education (only if authorized)
8. TIMELINE TO LAUNCH
Phase: Business Formation and Food Service Licensing
Timeline: 2–3 weeks
Phase: HCPF Provider Application and Readiness Review
Timeline: 60–90 days
Phase: Staff Hiring, Training, and Menu Planning
Timeline: 30–45 days
Phase: Medicaid Enrollment and Claims Configuration
Timeline: 45–60 days
9. CONTACT INFORMATION
Colorado Department of Health Care Policy and Financing (HCPF)
Website: https://hcpf.colorado.gov
Colorado Department of Public Health and Environment (CDPHE)
Website: https://cdphe.colorado.gov
Colorado Medicaid Provider Enrollment Portal (Gainwell Technologies)
Website: https://colorado-hcpf.portal.force.com/ProviderEnrollment/s/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — COLORADO MEAL AND NUTRITION SERVICES PROVIDER
WCG supports providers and entrepreneurs in launching Medicaid-compliant Meal and Nutrition Services under Colorado’s HCBS Waiver programs.
Scope of Work:
Business registration and EIN/NPI setup
Food service licensing support and Medicaid documentation assistance
Development of Meal and Nutrition Policy & Procedure Manual
Staff credentialing templates and dietary intake forms
Medicaid billing setup and claims configuration
Website, domain, and email setup
Participant intake and nutritional assessment packets
Menu planning templates and meal delivery schedules
Emergency planning and quality assurance tracking tools
Community networking and healthcare partnership strategies
Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements.