We will continue to add and update links here in the coming weeks. You may also want to try the Colorado Resource Directory, created by Family-to-Family Navigator and Family Leadership Training Institute graduate, LaShay Canady.
Child Find / Early Intervention Colorado: 888-777-4041
Colorado has a Child Find system for appropriately identifying infants and toddlers with developmental delays or disabilities, and timelines for making referrals to local early intervention programs at no cost to parents.
Community-Centered Boards (CCBs):
Colorado has 20 CCB organizations serving children and adults with developmental disabilities. They determine eligibility for community-based services and provide case management services. CCB’s also assist individuals with gaining access to Medicaid Waivers. Waiver programs provide additional Medicaid benefits to individuals with special needs.
Colorado Center on Law and Policy (CCLP): 303-573-5669
The Colorado Center on Law and Policy (CCLP) works to promote justice, economic security, access to health care, and sound fiscal policies for the people or Colorado through advocacy, litigation, education, and research.
Colorado Health Care Policy & Financing (HCPF): 303-866-2993
Provides access to cost-effective, quality health care services. The Department administers the Medicaid and Child Health Plan Plus programs as well as a variety of other programs for Colorado’s low-income families, the elderly, and persons with disabilities.
Colorado Home and Community Based Services: Childrens Waivers (HCBS):
Medicaid Waivers: Adult Waivers
Medicaid is a health care program for low income Coloradans. Applicants must meet eligiblity criteria for one of the Medicaid Program categories in order to qualify for benefits. Major program categories include Aid to Families with Dependent Children/Medicaid Only, Colorado Works/TANF (Temporary Assistance for Needy Families), Baby Care/Kids Care, Aid to the Needy Disabled, Aid to the Blind, and Old Age Pension.
Health Care Program for Children with Special Needs (HCP): 303-692-2370
HCP offers support for families with children with special needs and focuses on care coordination and providing specialty clinics throughout the state of Colorado. HCP services are available to children with special needs, regardless of insurance status or family income.
Healthy Communities combines aspects of the Early Periodic Screening Diagnostic and Treatment (EPSDT) outreach and administrative case management program and Child Health Plan Plus (CHP+) outreach into one model that better meets the needs of clients. This outreach and case management model takes into account that many families have one child enrolled in Medicaid while another is enrolled in CHP+. The distinction between Medicaid and CHP+ benefits and services isn’t always clear. Family Health Coordinators are available statewide to help Colorado Medicaid and CHP+ families through the Healthy Communities program.
Healthy Communities focuses on the “life cycle of a client.” That life cycle may involve all of the activities necessary for you or your children to obtain coverage and access to coordinated health care services in appropriate settings called Medical Homes. Family Health Coordinators do the following:
- Generate awareness on the Colorado Medicaid and CHP+ programs;
- Offer information about how to apply for Colorado Medicaid and CHP+ and the availability of face-to-face application assistance;
- Inform families about where to submit applications for processing and eligibility determination;
- Educate families on the value of preventive health care services and how to access benefits at the right settings;
- Link clients to Colorado Medicaid and CHP+ providers who will serve as the client’s Medical Home;
- Provide clients with information and referrals to other community programs and resources; and
- Explain the re-enrollment process to families who continue to be eligible for Colorado Medicaid and CHP+ to eliminate gaps in coverage
The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit provides comprehensive and preventive health care services for Medicaid members age 20 and under along with pregnant adults. EPSDT is key to ensuring that children and youth receive appropriate preventive, dental, mental health, developmental and specialty services.
EPSDT is made up of the following screening, diagnostic, and treatment services:
Comprehensive health and developmental history
Comprehensive unclothed physical exam
Appropriate immunizations (according to the Advisory Committee on Immunization Practices)
Laboratory tests (including lead toxicity testing)
Health Education (anticipatory guidance including child development, healthy lifestyles, and accident and disease prevention)
At a minimum, diagnosis and treatment for defects in vision, including eyeglasses.
At a minimum, dental services include relief of pain and infections, restoration of teeth, and maintenance of dental health, including examinations, cleanings and fluoride treatments.
At a minimum, diagnosis and treatment for defects in hearing, including hearing aids.
Other Necessary Health Care Services
Additional health care services that are coverable under the Federal Medicaid program and found to be medically necessary to treat, correct or ameliorate illnesses and conditions discovered regardless of whether the service is covered in a state’s Medicaid plan. It is the responsibility of states to determine medical necessity on a case-by-case basis (see medical necessity below for more information).
When a screening indicates the need for further evaluation, diagnostic services must be provided.
Necessary health care services must be made available for treatment of all physical and mental illnesses or conditions discovered by any screening and diagnostic procedures.
Colorado also provides through Healthy Communities and other programs:
Information to all Medicaid-eligible individuals under age 20 and under, including adults who are pregnant, that EPSDT services are available and of the need for age-appropriate screenings, well child visits and immunizations;
Provide or arrange for the provision of screening services for all children;
Arrange (through referral) for corrective treatment as determined by child health screenings;
Missed appointment follow-up; and,
Refer for transportation assistance.
Colorado has adopted the American Academy of Pediatrics Bright Futures Periodicity schedule.
Lead screening is a requirement for all Medicaid eligible children at 12 and 24 months or between the ages of 36 and 72 months if not previously tested.
All Medicaid coverable, medically necessary, services must be provided even if the service is not available under the State plan to other Medicaid eligibles. Benefits not listed are not considered to be a state plan benefit and therefore outside of EPSDT coverage and exceptions. No arbitrary limitations on services are allowed, e.g., one pair of eyeglasses or 10 physical therapy visits per year.
Colorado makes the final determination of medical necessity and it is determined on a case-by-case basis. Provider recommendations will be taken in to consideration, but are not the sole determining factor in coverage. Colorado determines which treatment it will cover among equally effective, available alternative treatments.
EPSDT Medical Necessity Does NOT include:
Experimental or investigational treatments;
Services or items not generally accepted as effective; and/or not within the normal course and duration of treatment;
Services for caregiver or providers convenience.
Services for which Colorado has a waiver are also not considered to be state plan benefits, and therefore are not a benefit under EPSDT. Items such as respite, behavioral interventions, in-home support services, and home modifications are examples of waiver services.
EPSDT and Managed Care
All EPSDT requirements must be adhered to for individuals who receive services under managed care arrangements.
Colorado is responsible for medically necessary services not included in the managed care contract.
The Arc of Colorado: 800-333-7690
The Arc builds better lives for persons with intellectual and developmental disabilities and their families by improving connections to schools, work and the community. Can provide an advocate to assist families through the IEP process.
Parent to Parent of Colorado: 877-472-7201
P2P will match parents one on one with each other for support. They connect families of children and adults with special needs by either phone, computer or in person.
PEAK Parent Center: Colorado’s Parent Training and Info Center (PTI): 800-284-0251
Provides information about all types of disabilities, training on a variety of topics and technical assistance on your child’s IEP.
THRIVE Center: 303-632-6840
The THRIVE Center empowers low-income, culturally diverse families to be advocates for their children with disabilities to achieve success in their schools and communities.
JFK Partners: 303-742-5266
JFK promotes the independence, inclusion, contribution, health and well-being of people with special needs, through consumer, community, and university partnerships.
Easter Seals Colorado: 303-233-1666
Easter Seals is dedicated to supporting people with disabilities and their families as they live, learn, work and play in their communities.
El Grupo VIDA: 303-335-9875
Provides information, referrals, and support for Spanish speaking parents.
Ombudsman (Medicaid): 877-435-7123 email: firstname.lastname@example.org
Ombudsman help solve problems with your health care issues (both physical and mental health) for Medicaid Managed Care patients. They also help with health care rights and with grievances and appeals.
The Legal Center for People with Disabilities: 800-288-1376
Specialize in civil rights and discrimination issues. They protect the human and legal rights of people with mental and physical disabilities throughout Colorado.
Assistive Technology Partners: 303-315-1284
ATP assists persons with cognitive, sensory, and/or physical disabilities reach their highest potential at home, school, work and play through the addition of appropriate assistive technologies to their lives.
Colorado Respite Coalition (CRC): 303-619-1437
CRC is community partners who explore, connect, and support community organizations and individuals interested in creating a variety of respite programs.
Single Entry Point (SEP) Agencies provide case management, care planning, and make referrals to other resources for clients with the following qualifying needs: elderly, blind and disabled, mental health, persons living with AIDS, brain injury, spinal cord injury, children with a life-limiting illness, children with a physical disability.