The Children with Complex Health Needs (CwCHN) waiver is a Health First Colorado (Colorado Medicaid) waiver that provides additional home and community supports for children with significant medical needs. It is designed to help families keep their child safely cared for at home, reducing the risk of needing care in a hospital or nursing facility.
Child is under age 19
Meets the required level of care through an assessment (hospital or nursing facility level of care)
Meets Medicaid financial and disability eligibility rules
Willing to receive services in the home or community
Enrollment and service planning are coordinated through a local Case Management Agency (CMA)
CwCHN services are added on top of regular Health First Colorado coverage and can include respite support. Children enrolled in CwCHN also keep access to standard Medicaid services and may access Community First Choice (CFC) benefits and obtain IHSS. IHSS allows parents to become paid caregivers for their children under this waiver.
In-Home Support Services (IHSS) is an option within Community First Choice (CFC) that gives members more control over how in-home support is delivered. In this model, the member helps guide day-to-day care, including choosing and overseeing attendants, while an IHSS-approved agency supports the service plan and coordination.
IHSS under CFC is used to deliver core in-home supports based on the member’s assessed needs and approved service plan. These commonly include:
Personal care support: hands-on assistance, supervision, or cueing for daily personal needs.
Homemaker support: help with essential household tasks tied to health and safety.
Health Maintenance Activities (HMA): routine health-related tasks that are allowed under Medicaid rules when the member cannot complete them independently.
Independent living core supports: the IHSS model includes required elements intended to support stable, safe services in the home.
What is approved depends on the assessment results and the authorized plan. Not every member receives every type of support.
IHSS is designed to offer more choice in who provides care. In many situations, members can select attendants who are relatives. Some circumstances may also allow a “legally responsible person” to provide certain services when permitted by program rules and specifically authorized in the service plan.
Even though IHSS is member-directed, an IHSS-approved agency plays a supporting role. This can include items such as backup coverage planning, access to nursing oversight when required by the model, and required program supports that help services run safely and consistently.
Confirm you have Health First Colorado with full benefits.
Connect with your local Case Management Agency (CMA). This is the starting point for CFC and IHSS planning.
Complete required assessments to determine:
Whether you meet the CFC level-of-care requirement, and
Whether you have an assessed need for personal care, homemaker, and/or approved health maintenance activities.
Work with your CMA to build an approved service plan that lists the supports you can receive and the amount authorized.
Choose an IHSS-approved agency and set up services (attendants, scheduling, oversight, and backup plans).
Services begin once the plan and provider setup are complete. Ongoing reviews happen at least annually, and sooner if there is a significant change in needs.
A waiver is not required to access CFC; meeting the level-of-care criteria is what matters. However, people enrolled in HCBS waivers generally already meet level-of-care requirements and may be able to use CFC and IHSS alongside their waiver services, depending on their plan and eligibility.
In-Home Respite is short-term care that gives a break to the person who usually provides most of the day-to-day support (often a parent, spouse, or other unpaid caregiver). The goal is to help families maintain stability at home by providing temporary coverage when the primary caregiver needs relief or is unavailable.
Respite is authorized based on the member’s needs and the approved plan, but commonly includes:
Supervision and safety monitoring
Help with daily routines and basic personal needs during the respite shift
Support provided in the home or another approved setting, depending on what the plan allows
What tasks are covered, where respite can be provided, and how it is billed depends on the member’s authorized plan and the program rules connected to that plan.
The member/family works with their case manager to identify the need for caregiver relief.
Respite is added to the approved service plan with the authorized amount.
The family chooses an approved provider/agency, and respite is scheduled according to the plan.
Respite limits vary by program and service plan. The service plan will list the maximum amount allowed for the plan year.
In some cases, a case manager can request approval for respite above the standard cap when the situation supports it and required documentation is completed.
Respite is intended for caregiver relief. Your approved service plan will show exactly how much respite is authorized and any limits that apply.
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