Northwest Colorado Options for Long-Term Care
Northwest Colorado Options for Long-Term Care (NWCOLTC) is a regional program that is administered by Garfield County Department of Human Services. NWCOLTC serves the following nine counties: Garfield, Eagle, Pitkin, Rio Blanco, Moffat, Routt, Summit, Grand and Jackson.
Northwest Colorado Options for Long Term Care Programs – Medicaid
All Medicaid programs through Northwest Colorado Options for Long Term Care (NWCOLTC) have a financial and functional eligibility component. An individual must be both financially and functionally eligible in order to receive services under any of these programs. The financial eligibility component is completed by the county eligibility staff in the county where the recipient resides. The functional eligibility is determined by NWCOLTC. Functional eligibility assessments address individual function on a day-to-day basis. The individual must be determined to meet the criteria for institutional level of care.
Children’s Home and Community-Based Service Program (CHCBS)
A waiver program for children who are functionally impaired, birth through 17 years of age who are medically fragile and are at risk of institutionalization in a hospital or nursing facility and would not otherwise be eligible for Medicaid due to parental income and/or resources.
Home Care Allowance Program (HCA)
A special non-entitlement allowance for the purpose of helping an individual purchase unskilled in-home services to assist that individual in remaining in his or her own home.
Home- and Community-Based Services for Persons with Brain Injury (HCBS-BI)
A waiver program that provides services in the home and/or community to individuals (16 to 64 years of age) with a traumatic brain injury or other related brain injury diagnosis.
Home and Community Based Services for the Elderly, Blind and Disabled (HCBS-EBD)
A waiver program that provides services in the home and/or community to individuals who are 18 years of age and older who are elderly, blind and/or physically disabled. An individual who is eligible for the program would require nursing facility care without the provision of HCBS-EBD services.
Community Mental Health Services Waiver (CMHS)
A waiver program for persons who are diagnosed with a major mental illness and who are at risk of institutionalization in a hospital or nursing facility.
Nursing Facility Care
Assessment services for persons living in the community or a nursing facility who are accessing Medicaid as a pay source for nursing facility care.
Services:
Waiver services (dependent on the type of waiver, individual needs and availability) can include:
Personal care, homemaker, adult day services, electronic monitoring, medication management, consumer directed attendant support services (CDASS), in home support services (IHSS) respite care, home modification, and alternative care facility.
Northwest Colorado Options for Long Term Care Programs – Non-Medicaid
Non-Medicaid services
These programs do not have a financial eligibility component, but are dependent on availability of funds. There is a functional eligibility component.
Caregiver Support Program
Provides funding for respite care, equipment and educational opportunities for the caregiver of a person who is 60 years of age or older, and for caregivers who are over the age of 60. 970-824-5646 or 1-877-963-8731.
Senior Equipment and Services Program
Provides financial assistance to persons who are 60 years of age or older to help them purchase services or equipment that will enhance the safety and/or independence of that individual. 970-824-5646 or 1-877-963-1639.
Aging and Disability Resources for Colorado (ADRC)
Provides telephone information and referral, telephone contacts to connect recipients to appropriate resources, assistance with applications and access to funding for seniors (over age 60) and disabled adults.
Dear Long-Term Service and Supports Members,
The Department of Health Care Policy & Financing (HCPF) is the state agency that oversees Health First Colorado (Colorado’s Medicaid program). HCPF acknowledges the current challenges that may be impacting both you, as a member receiving Long-Term Services and Supports (LTSS), as well as the community of providers that support you. We are concerned about reported delays in accessing case management and direct services and are acting with urgency to address them.
Case Management Agencies are a critical partner to HCPF. They are the lynchpin for supporting people with disabilities to navigate, enroll, and manage services to live and thrive in their communities. Unfortunately, there are three different challenges impacting all of our valued case management agency partners at the same time and their related services to you. These include: increased county partner workloads due to both a record number of Medicaid and Supplemental Nutrition Assistance Program (SNAP) requests as well as the impact of the end of the federal public health emergency; the implementation of a new IT system used by all case management agencies; and a case management program redesign. In the coming months, the related innovations and modernizations will create a better system for members, providers and case management agencies. But the impact of all three occurring at once – which was not intended – is causing short term challenges to member program eligibility, provider reimbursement, case management agency processing and member service response time.
Case management agencies are not to blame for these challenges. The dedication and resilience demonstrated by case management agencies, counties and providers in navigating these complex changes has been commendable. We are very appreciative of their shared efforts to serve our members and to solve transition-related issues with us during this time.
We want to assure you that HCPF is aware of and addressing these issues on multiple levels and with a sense of urgency, in support of our members, providers, counties and case management agencies. We remain dedicated to collaboration with case management agencies, providers and members to navigate the current challenges to ensure you and your families are supported.
Sincerely,
Bonnie Silva
Director
Office of Community Living
Department of Health Care Policy and Financing