How to Navigate Colorado's DD Waiver System Without a Case Manager

If you're trying to navigate Colorado's DD waiver system without a case manager, you're not doing anything wrong — you're describing the default starting position. Case managers are assigned through Case Management Agencies (CMAs) as part of the waiver enrollment process, which means you have to navigate the intake system before you get the person whose job it is to help you navigate the system. That circular gap is where most families stall.

Here's how to work through the CMA intake, waiver selection, and functional assessment process on your own, step by step.

Understanding the Post-Redesign Structure

Colorado's Case Management Redesign, completed in mid-2024, separated case management intake from service delivery. Before the redesign, Community Centered Boards (CCBs) handled both — they assessed you, enrolled you, and managed your services. Now:

• Case Management Agencies (CMAs) handle intake, functional assessments, the Person-Centered Support Plan, and ongoing service coordination for their designated service areas.
• Community Centered Boards (CCBs) still administer state-funded local programs, but they no longer hold the exclusive gate to waiver intake in most counties.
• HCPF (the state Medicaid agency) administers the waiver programs and sets the rules.

The practical impact: you now have to identify the CMA designated for your county and know that a CMA is what you need for intake. Nobody sends you a letter explaining this.

The Five-Step Self-Navigation Path

Step 1: Confirm Medicaid Eligibility

Before any waiver application, your family member must have active Health First Colorado (Medicaid) coverage. If SSI cash payments are active, Medicaid is automatic under Section 1634. If SSI was denied or hasn't been applied for, you need a separate Medicaid application through Colorado PEAK or your county Department of Human Services.

Working adults can qualify through the WAwD (Working Adults with Disabilities) buy-in program, which covers individuals with disabilities whose countable income after disregards is at or below 450% FPL — $5,985 per month in 2026, with no asset limit.

Step 2: Contact the Right CMA for Your County

Finding your CMA is the first real bottleneck. Colorado has 20 Case Management Agency catchment areas across 64 counties, and coverage areas shifted after the Case Management Redesign. Your options:

• HCPF's Case Management Agency directory: hcpf.colorado.gov/case-management-agency-directory lists the designated CMA by county
• Call HCPF's Member Contact Center at 1-800-221-3943 — they can tell you which CMA serves your county
• Your county DHS can also provide referrals

When you contact the CMA, ask specifically about waiver intake — not general Medicaid questions. The person who answers the phone may not know the waiver process if you don't use the right terms. Say: "I need to start an intake for the HCBS-DD waiver or the SLS waiver for my adult child with a developmental disability."

Step 3: Choose Your Waiver Target

Colorado offers two main HCBS waivers for adults with intellectual and developmental disabilities, and the one you target shapes your entire intake process:

Most families should apply for the SLS waiver first (because there's no waitlist and services can begin once the intake is complete) while also getting on the DD waiver waiting list for the future. These aren't mutually exclusive — you can receive SLS services while waiting for a DD slot.

There's also Community First Choice (CFC), launched July 1, 2025, which moves attendant-type services into a Medicaid state plan benefit. CFC is not a waiver — it has no waiver waiting list, but it still requires a functional level-of-care determination through the applicable pathway. If the primary need is personal care or attendant services, CFC may cover it without entering the waiver system at all, subject to its own eligibility criteria.

Step 4: Complete the PMIP and Functional Assessment

Once you've contacted a CMA and initiated intake, two things happen:

1. Professional Medical Information Page (PMIP) — this is the required medical information page that must be submitted to the CMA before an intake assessment can be scheduled. Prepare for it by documenting your family member's daily support needs in specific, measurable terms. "Needs help bathing" is less useful than "requires physical assistance for transfer into the shower, verbal prompting for each step of the washing sequence, and full supervision to prevent falls — approximately 45 minutes per shower."

2. Colorado Single Assessment (CSA) — Colorado's statewide assessment tool is being rolled out to replace legacy evaluation tools. For newly enrolling members in adult waivers, HCPF uses the Interim Support Level Assessment (ISLA), which extracts functional questions from the CSA and assigns a Support Level that determines the individual's authorized service budget.

What to bring to the assessment:

• All current medical records and diagnoses
• Recent psychological or neuropsychological evaluation (within past 12 months)
• IEP transition documents if the individual is still in school or recently graduated
• A daily activity log showing what support is required, how often, and what happens without it
• Medication list with documented side effects

Step 5: Follow Up Relentlessly

The part nobody tells you: after the intake paperwork is submitted, there's no automated tracking system that updates you on status. CMAs are managing large caseloads, and your intake can sit in a queue without progress if you don't follow up.

Create a tracking system:

• Record the name and direct number of every CMA contact person
• Note every call date, what was discussed, and what the next step is supposed to be
• Follow up at minimum every two weeks during active intake
• If you're placed on the DD waiver waiting list, request written confirmation of your placement date — this date determines your position, and disputes over placement dates are nearly impossible to resolve retroactively

Who This Is For

• Families starting the waiver process for the first time with no existing case manager or CMA relationship
• Parents of young adults transitioning from school-based services who've never interacted with the adult disability system
• Guardians who've been told "call a CCB" and found that the post-Redesign structure no longer works that way
• Families in rural Colorado counties where CMA options are limited and wait times for intake appointments are long

Who This Is NOT For

• Families who already have an active case manager and need to change CMAs — that's a transfer process, not a new intake
• Individuals seeking DVR (vocational rehabilitation) services — DVR has its own intake separate from the CMA waiver system
• Families whose primary need is attendant care only — Community First Choice may be a faster path than the waiver system

The Full Navigation System

The Colorado SSI at 18 & Adult Disability Benefits Guide maps every step of this process in detail — from the CMA county directory and PMIP preparation through the functional assessment, waiver comparison, and appeals timeline. It coordinates the waiver intake with the other four agencies (SSA, HCPF Medicaid enrollment, DVR, and school transition services) so each application builds on the one before it instead of creating gaps between agencies that don't share data.

Frequently Asked Questions

Can I apply for a DD waiver without a case manager?

You can initiate the process — contacting a CMA and starting intake is how you eventually get a case manager assigned. What you can't do is skip the CMA intake step. The CMA is the entry point to the waiver system, and the case manager is assigned as part of enrollment, not before it.

How long does the SLS waiver intake take from first contact to services?

Timelines vary by CMA capacity and how quickly the functional assessment can be scheduled. Having medical documentation, the psychological evaluation, and daily activity logs ready before intake starts can shorten the timeline.

What if my county's CMA has a long wait for intake appointments?

After the Case Management Redesign, use HCPF's directory or Member Contact Center to identify the CMA designated for your county and ask about its intake timeline. Some families in congested Front Range counties have had faster intake timelines with smaller CMAs.

Does getting on the DD waiver waiting list cost anything?

No. Placement on the waiting list is free and happens during the CMA intake process. There's no application fee, no retainer, and no obligation to accept services when your name comes up years later. Getting on the list early is purely strategic — placement dates are used in prioritization, and HCPF reserves limited slots for emergency enrollments; the 2026 HCPF budget also reduced the number of new enrollment slots per year.

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