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CO HCPF Home and Community Based Services (HCBS) Complementary and Integrative Health (CIH) Manual — Complementary and Integrative (CIH) Waiver Services

ComplementaryandIntegrative(CIH)WaiverServices

activein force · 2026-07-26 – presentas-observed

TheHCBS-CIHwaiverprogramprovidesavarietyofservicestoeligibleMemberswithaspinalcordinjury,braininjury,spinabifida,multiplesclerosis,musculardystrophy,andcerebralpalsywiththeinabilityforindependentambulationasanalternativetoinpatienthospitalandnursingfacilityplacement.Membersmeetingprogrameligibilityrequirementsarecertifiedbythecasemanagementagency/singleentrypointasmedicallyeligibleforthisHCBSwaiverprogram.Thiswaiveroffersallofthefollowingservices:

TierI-Servicesprovidedvirtuallyorin-personinanoutpatientsettingtoincludeparksorothercommunity-basedlocations.Mealprovisionnotrequiredifservicesarenotprovidedinpersonoroverthelunchhour.Servicecanbeprovideduptothree(3)hoursperday.

TierII-Servicesprovidedbetweenthree(3)-five(5)ormorehoursperdayasapprovedbytheCaseManagerandinthecontextoftheMember'shealth,forone(1)ormoredaysperweek.Servicesprovidedinanoutpatientsetting,encompassingbothhealthandsocialservicesneededtoassuretheoptimalfunctioningoftheindividual.Mealsprovidedaspartoftheseservicesshallnotconstituteafullnutritionalregimen"(3mealsperday).Physical,occupationalandspeechtherapiesindicatedintheindividual'splanofcarewouldbeprovidedascomponentpartsofthisserviceifsuchservicesarenotbeingprovidedintheMember'shome..

TierIII-ServicesprovidedoverafulldayasapprovedbytheCaseManagerandinthecontextoftheMember'shealth,forone(1)ormoredaysperweek.Servicesprovidedinanoutpatientsetting,encompassingbothhealthandsocialservicesneededtoassuretheoptimalfunctioningoftheindividual.Mealsprovidedaspartoftheseservicesshallnotconstituteafullnutritionalregimen"(3mealsperday).Physical,occupationalandspeechtherapiesindicatedintheindividual'splanofcarewouldbeprovidedascomponentpartsofthisserviceifsuchservicesarenotbeingprovidedintheMember'shome.TierIAdultDayServicescannotbeprovidedinconjunctionwiththisservice.

AdultDayServices(Specialized)-Servicesprovidedbetweenthree(3)-five(5)ormorehoursperdayasapprovedbytheCaseManagerandinthecontextoftheMember'shealth,forone(1)ormoredaysperweek.Servicesprovidedinanoutpatientsetting,encompassingbothhealthandsocialservicesneededtoassuretheoptimalfunctioningoftheindividual.Mealsprovidedaspartoftheseservicesshallnotconstituteafullnutritionalregimen"(3mealsperday).Physical,occupationalandspeechtherapiesindicatedintheindividual'splanofcarewouldbeprovidedascomponentpartsofthisserviceifsuchservicesarenotbeingprovidedintheMember'shome.TierIAdultDayServicescannotbeprovidedinconjunctionwiththisservice.

ComplementaryandIntegrativeHealthServices-ServicesarelimitedtoAcupuncture,ChiropracticCare,andMassageTherapy.ServicesaretobedeliveredunderdirectionofacareplanapprovedbyaComplementaryandIntegrativeHealthServiceProvider.Thereisayearlycapthatallowsfornomorethan408totalunitsofanycombinationofservices.

HomeModification-Specificmodifications,adaptationsorimprovementsinaneligibleMember'sexistinghomesettingwhich,basedontheMember'smedicalconditionarenecessarytoensurethehealth,welfareandsafetyoftheMember,enablethemembertofunctionwithgreaterindependenceinthehome,arerequiredbecauseoftheMember'sillness,impairmentordisability,asdocumentedontheULTC-100.2formandthecareplanandpreventsinstitutionalizationoftheMember.Thereisalifetimecapof$14,000perMember.

Respite-ServicesprovidedtoaneligibleMemberonashort-termbasisbecauseoftheabsenceorneedforreliefofthosepersonsnormallyprovidingthecare.Theunitofreimbursementshallbeaunitofone(1)dayforcareprovidedinanAlternativeCareFacility.Individualrespiteprovidersshallbillaccordingtoanhourlyrateordailyinstitutionalrate,whicheverisless.

Non-MedicalTransportation-Serviceofferedinordertoenableindividualsservedonthewaivertogainaccesstowaiverandothercommunityservices,activitiesandresources,specifiedbytheserviceplan.Thisserviceisofferedinadditiontomedicaltransportationrequiredunder42CFR431.53andtransportationservicesundertheStatePlan,definedat42CFR440.170(a)(ifapplicable),andshallnotreplacethem.Non-MedicalTransportationislimitedtotwo(2)roundtripsperweek.TripstoandfromAdultDayprogramsarenotsubjecttothiscap.

LifeSkillsTraining-Individualizedtraining,providedinMember'sresidence,thecommunity,orgrouplivingsituations,thatisdesignedanddirectedwithMembertodevelopandmaintaintheabilitytoindependentlysustainhimself/herselfinthecommunity.MustdemonstrateneedfortheserviceinServicePlan:needfortrainingtosustainselfinthecommunity,skillsforwhichtrainingisneededandthatwithoutposesarisktothehealth,safety,orabilitytoliveinthecommunity,withouttrainingindividualcouldnotdeveloptheskillsneeded,withtrainingabilitytoacquiretheseskillswithin365days.LifeSkillsTrainingislimitedtoupto24unitsperdaywithnomorethan160unitsperweek,upto365dayspost-transition.

PeerMentorship-Providedbypeerstopromoteself-advocacyandencouragecommunitylivingbyinstructingandadvisingonissuesandtopicsrelatedtocommunityliving,describingreal-worldexperiencesasexamples,andmodelingsuccessfulcommunitylivingandproblem-solving.MustdemonstratetheneedfortheserviceinServicePlan:needforsoftskills,insight,orguidancefromapeer,withoutservicemayexperienceahealth,safety,orinstitutionalrisk,nootherservicesorresourcesavailabletomeettheneed.PeerMentorshipislimitedto24unitsperdayfor365dayspost-transition.

WellnessEducationBenefit(WEB)-TheWEBisdesignedtoreducetheneedforahigherlevelofcarebyofferingeducationalmaterialsthatprovideMembersandtheirfamilieswithactionabletoolsthatcanbeusedtopreventtheprogressionofadisability,increasecommunityengagement,combatisolationandimproveawarenessofHealthFirstColoradoservices.

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Provenance

Source: hcpf.colorado.gov
Retrieved: 2026-07-26
Edition: 2026-07-26
Content hash: 38fc969f60386471cbb1bf345af92f3d81176a776181ce14c83e155f31530161

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