Home and Community-Based Service (HCBS) waivers are meaningful resources for adults in Colorado with care needs. HCBS waivers make it possible to acquire care provided in the home or community and can also be used to compensate family members for providing care to a relative in need. HCBS waivers for adults benefit any adult who requires home or local services, such as Medicaid-funded programs supporting these individuals to live independently.
PASCO specializes in offering tailored and comprehensive support for adults with diverse needs. We have shaped our services to align with the Colorado HCBS waiver system. This ensures that HCBS waivers can be used to access the services we provide. We are honored to hold this important role in the community, empowering adults with diverse needs and ensuring the waiver provides support the way it was designed to.
Discover how PASCO can help you or your loved ones thrive with HCBS waivers for adults.
What Are HCBS Waivers for Adults?
HCBS waivers make it possible for adults with disabilities or care needs to receive support at home instead of in a nursing facility or hospital. This Medicaid program is designed to provide services that help people live independently while staying connected to their communities.
These waivers cover a wide range of support services, from medical care to assistance with activities of daily living, ensuring that individuals receive the help they need in a setting that works best for them. They also allow family members who take on caregiving responsibilities to become paid providers, offering financial support to those already dedicating their time and energy to a loved one’s care.
HCBS waivers are used to help adults maintain independence, avoid institutional care, and foster community engagement. People can live in their own home and take part in their community when they might otherwise be stuck in a care facility. HCBS waivers are also designed to help meet diverse care needs, including medical and non-medical assistance.
Types of HCBS Waivers
The types of HCBS waivers available for adults depend on qualifying conditions. Each type of condition receives a waiver designed to provide for a specific set of needs. We will explore the medical waivers available to adults by eligibility, care requirements, and financial criteria.
To give you a clear picture, we will cover:
- Overview: Briefly explain what the waiver is designed for.
- Eligibility Criteria: Outline who qualifies, including age, condition, and residency.
- Level of Care Requirement: Define the level of care needed to be eligible for the waiver (e.g., hospital-level care, nursing home level care, etc.).
- Financial Requirements: Explain income thresholds or other Medicaid-related financial eligibility rules.
1. Brain Injury Waiver
Brain Injury Waivers offer services to adults who suffer from a traumatic or acquired brain injury. The waiver is designed to help brain injury patients live independently. Those eligible must be 16 or older and have a brain injury or related condition that results in needing assistance with daily activities.
Eligibility Criteria:
- Age: Individuals aged 16 and older
- Diagnosis: Traumatic brain injury or related conditions requiring ongoing support.
- Residency: Must reside in a serviceable Colorado county.
Level of Care Requirement:
- Must meet hospital or nursing facility level of care.
- Requires assistance with daily activities such as mobility or cognitive tasks.
Financial Requirements:
- Must qualify for Medicaid based on income and resource limits.
2. Community Mental Health Supports Waiver
Waivers for Community Mental Health Supports assist adults who face mental health challenges. These waivers can be used to access therapy, counseling, and other services that help someone with mental health concerns remain active and independent outside of facility care. Eligibility relies on being 18 or older with a diagnosed condition that impacts daily life that would otherwise require long-term care or residence in a mental health facility.
Eligibility Criteria:
- Age: Adults aged 18+.
- Diagnosis: Documented mental health condition impacting daily living or independence.
Level of Care Requirement:
- Requires psychiatric or long-term care equivalent to a mental health facility.
Financial Requirements:
- Medicaid-eligible based on financial criteria, including income and assets.
3. Elderly, Blind, and Disabled Waiver
Elderly, Blind, and Disabled Waivers are designed for seniors and adults with disabilities who require help with daily living to remain safely at home. Eligibility includes adults 18 and over who are blind or disabled or elders aged 60 and up who qualify for nursing home care and whose income is 300% or more below the Federal Poverty Level (FPL).
Eligibility Criteria:
- Age: Adults aged 18+ who are blind, disabled, or elderly (65+).
- Residency: Must live in a home or community setting.
Level of Care Requirement:
- Must qualify for nursing home level of care.
Financial Requirements:
- Income must be below 300% of the Federal Poverty Level (FPL).
- Assets capped according to Medicaid guidelines.
4. Developmental Disabilities Waiver
The Developmental Disabilities Waiver is designed for adults with significant developmental disabilities that require them to receive comprehensive support. To be eligible, you must be 18 years or older with a diagnosed intellectual disability or other developmental condition and require an institutional level of support.
Eligibility Criteria:
- Age: Adults aged 18+ with documented developmental disabilities.
- Diagnosis: Intellectual disabilities or other developmental conditions.
Level of Care Requirement:
- Must meet the institutional care level of support
- Requires help with critical areas like mobility, communication, or personal care.
Financial Requirements:
- Income and asset limits as determined by Medicaid.
5. Supported Living Services Waiver
The Supported Living Services Waiver is available for those who need non-residential support. This waiver is ideal for adults who live independently but require occasional assistance, often related to a disability. Those eligible are 18 years or older with a diagnosed disability that impacts daily activities but does not require constant care. This may be a functional impairment that requires periodic, occasional, or routine out-of-home assistance.
Eligibility Criteria:
- Age: Adults aged 18+ with disabilities.
- Diagnosis: Conditions that impact daily activities but do not require 24/7 supervision.
Level of Care Requirement:
- Functional impairment requiring periodic assistance.
Financial Requirements:
- Must meet Medicaid eligibility standards, including income limits.
6. Complimentary and Integrative Health Waiver
The Complimentary and Integrative Health Waiver offers access to unique therapies like acupuncture, massage, and other complementary treatments that can empower individuals dealing with health conditions that impact daily life. Those who are eligible are 18 years or older and have a chronic condition that inhibits mobility, which is aided by these complimentary health services.
Eligibility Criteria:
- Age: Adults aged 18+.
- Diagnosis: Spinal cord injury (traumatic or nontraumatic), multiple sclerosis, brain injury, spina bifida, muscular dystrophy, or cerebral palsy with the inability for independent ambulation over the age of 18.
Level of Care Requirement:
- Documented need for integrative health services.
Financial Requirements:
- Medicaid eligibility based on income and resource caps.
How HCBS Waivers Work at PASCO
At PASCO, we make it easy to build a care plan for individuals on HCBS waivers. Whether you already have access to your eligible waivers or you are starting from the beginning, we are here to help. PASCO will walk you through the process from assessing your needs to tailoring waiver benefits into the care services you and your family need.
Here is a step-by-step outline for how PASCO helps you use your HCBS waivers.
1. Initial consultation to assess needs.
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We will meet to discuss your situation and your individual needs. This is a highly personalized consultation in which we lay the groundwork for HCBS waiver eligibility and a customized care plan.
2. Eligibility determination for Medicaid and specific waivers.
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We will explore your eligibility factors to determine which HCBS waivers for adults you can have access to. We will then help you receive approval and secure your eligible waivers.
3. Development of a customized care plan.
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Together, we will develop a customized care plan that combines your waiver-approved services and your personal needs. Our goal is to enhance your independence, comfort, and personal lifestyle at home and in your community.
4. Matching with professional caregivers or training chosen family caregivers.
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We will help you put your care plan into action by matching your service needs with professional caregivers and services.
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We can also help to train chosen family members to provide certain caregiver services and receive compensation through the HCBS waiver system.
Frequently asked questions
Who qualifies for HCBS Waivers for Adults?
HCBS waivers are primarily available to individuals aged 18 and over with specific disabilities, injuries, or care needs. Each waiver type has unique qualification requirements.
What services are covered under HCBS Waivers for Adults?
HCBS waivers cover a wide range of medical and non-medical care services. The specific services available depend on the type of waiver you qualify for.
How do I apply for an HCBS waiver in Colorado?
PASCO can guide you through the HCBS waiver application process from start to finish.
Can a family member be my caregiver under an HCBS waiver?
Yes. HCBS waivers can be used to compensate family caregivers who provide qualified care.
How long does it take to get approved for an HCBS waiver?
On average, it takes about 3 months to receive approval for a qualifying HCBS waiver.
If I am a parent C.N.A. and I apply for an HCBS waiver, will I have to forfeit my C.N.A. program benefits?
No, you will not lose your C.N.A. benefits. The Family C.N.A. program is provided through Colorado’s State Plan Medicaid, so it operates separately from HCBS waivers. Instead of replacing your C.N.A. support, an HCBS waiver offers additional dedicated services that can work alongside your existing benefits to create more comprehensive, wrap-around care.
