The DD Waiver is an HCBS (Home and Community-Based Services) waiver under Health First Colorado. It is designed for individuals with an intellectual or developmental disability who need extensive, ongoing supports that go beyond what standard Medicaid covers. The waiver helps eligible members receive services in home and community settings rather than in an institutional environment.
Eligibility is determined through case management and required assessments. A key requirement is meeting the Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) level of care. This level of care is established through the Functional Needs Assessment, which evaluates functional support needs (not just a diagnosis). Financial eligibility rules also apply, and enrollment may depend on program availability.
ANIMO HomeCare is a Program Approved Service Agency (PASA), meaning we are authorized to provide direct, community-based services for individuals with intellectual or developmental disabilities who are approved for Medicaid waiver supports. When included in an approved DD service plan, ANIMO may provide PASA services such as:
Supported Community Connections
If the member also qualifies for Community First Choice (CFC), ANIMO can support IHSS under CFC. IHSS is a flexible service model that may allow the member (or their representative) to choose their caregiver, including certain relatives when permitted by program rules and authorized in the plan.
Common DD Waiver eligibility requirements include:
Meets Health First Colorado (Colorado Medicaid) eligibility and financial rules
Has an intellectual/developmental disability that meets program criteria (generally established through required disability documentation)
Meets the ICF/IID level of care, determined through the Functional Needs Assessment
Needs a high level of ongoing support that can be provided in the home/community with a service plan
Works with a Case Management Agency (CMA) to complete assessments and develop a service plan
Enrollment depends on program availability and involves a wait list.
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.
Supported Community Connections is a service that helps a person participate in everyday community life with added guidance and structure. It is designed for members who want to build community routines and relationships but need more direct support to do so safely, consistently, and with confidence.
Services are based on the member’s goals and the approved plan, but commonly support:
Joining typical community activities (recreation, classes, clubs, library, volunteering, faith/community events, etc.)
Building practical “community participation” skills during real activities (communication, following routines, navigation, decision-making, appropriate social interaction)
Safety support in the community (awareness, redirection, staying with the group, safe choices)
Developing natural supports (connections with people, programs, and places the member can continue using over time)
Planning and practicing steps needed to participate successfully (preparing, practicing expectations, reinforcing progress)
The member/family discusses goals and barriers with their case manager.
Supported Community Connections is added to the approved service plan with an authorized amount.
Services are provided by an approved agency and scheduled according to the plan.
This service is focused on community inclusion and skill-building, not basic personal care or household tasks.
Activities must connect to the member’s goals and the approved plan.
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