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
10. 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
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.
To get started, click the link to request portal access.