DD Waiver Colorado: Eligibility, Services, and 2026-27 Changes

The Developmental Disabilities Waiver in Colorado is a Medicaid-funded program that pays for round-the-clock community living, day services, employment supports, and related care for adults with developmental disabilities who would otherwise need an institutional level of care. It is administered by the Colorado Department of Health Care Policy and Financing (HCPF) under federal Section 1915(c) authority.¹²³

Who Qualifies

Eligibility has two parts. On the programmatic side, the applicant must be 18 or older, have a documented developmental disability with onset before age 22, and need access to services and supports 24 hours a day.¹⁴ The person must also meet the Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF-IID) level of care, confirmed through a functional needs assessment. Documentation typically includes evidence of substantial disability before age 22, a neurological condition, and current psychological or adaptive behavior assessments.⁵

Financial eligibility runs through Health First Colorado, the state Medicaid program. Monthly income must be below three times the federal Supplemental Security Income limit. Countable resources are capped at $2,000 for a single person and $3,000 for a married couple. Applicants who earn too much to qualify this way may still get in through the Health First Colorado Buy-In Program for Working Adults with Disabilities.¹ You do not have to be enrolled in Medicaid or receiving SSI to get on the waiting list, but you do have to meet financial requirements when a slot is actually offered.³

What the Waiver Pays For

The waiver is built as a comprehensive package meant to cover a participant’s identified needs. Covered services include:¹⁶

Residential habilitation with 24-hour supervision
Day habilitation, including specialized habilitation and supported community connections
Supported employment and prevocational services
Behavioral services and consultation
Benefits planning
Dental and vision care
Specialized medical equipment and supplies
Non-medical transportation
Peer mentorship and wellness education

Enrollees also keep standard Health First Colorado benefits, so long as they don’t duplicate waiver services, and Community First Choice benefits layer on personal care, homemaker services, home-delivered meals, medication reminders, and personal emergency response systems.¹

A defining feature is that the waiver funds the living arrangement itself. Settings include host homes with one or two residents, individualized settings for one to three people, group settings for four to eight, or the participant’s own home or family home with residential supports delivered there.¹ Families can also form a Microboard, a small nonprofit corporation set up specifically to manage waiver services for one individual, giving the family direct control over hiring and oversight. The person served by a Microboard cannot live with the family under this arrangement.⁷

Each participant’s services are organized through a person-centered service plan built around a formal assessment. The waiver can only pay for needs identified in that assessment, and it cannot duplicate services available through other Medicaid benefits, natural supports, or third-party resources.⁸

How to Apply and Get on the Waiting List

Start by contacting a local Case Management Agency (CMA). HCPF maintains an online directory of CMAs by region.⁹ The CMA conducts the developmental disability determination, then opens a waiting list record. The date of that determination becomes the person’s placement date on the list. For children determined to have a developmental disability before age 14, placement is set to their 14th birthday.³

The waiting list is split into three categories:³

As Soon As Available (ASAA), for people who want enrollment as soon as a slot opens. Within this group, the oldest placement dates come up first.
Date Specific, for people who want enrollment on a particular future date.
Safety Net, for people who don’t need services now but want to hold a place in case things change.

Applicants between 14 and 18 can only sit on the Safety Net list until they turn 18. Turning down an enrollment offer does not erase your original placement date, but your record moves to Safety Net.³

Beyond the regular turnover of slots, enrollments can open through statewide priority situations: emergencies involving homelessness, abuse, or danger; youth transitioning out of children’s waivers or foster care; and people moving out of institutional settings like skilled nursing facilities.³ The General Assembly has also occasionally funded one-time expansions. In July 2021 it authorized 667 additional enrollments.

How Long the Wait Is

The DD waiver is the only home and community-based services waiver in Colorado with an active waiting list. HCPF has historically authorized roughly 10 to 20 new enrollments a month as existing participants leave the program, with an average wait of about seven to eight years.³ The list skews young: 78% of people waiting are between 20 and 39.

What’s Changing in 2026-27

Colorado’s 2026-27 budget, signed into law on May 8, 2026, makes several changes that directly affect the DD waiver and the people on it.¹⁰ They follow executive orders in August and October 2025 that required hundreds of millions of dollars in HCPF budget reductions.¹¹

The waiting list will move more slowly. Effective July 1, 2026, “churn” enrollments are cut in half: the state will enroll one person for every two who leave, rather than one-for-one. Advocacy groups have warned the change could stretch waits to 14 years or longer and have pushed for it to stay temporary.²¹²

Automatic youth transitions are ending. Starting January 1, 2027, young adults aging out of the children’s waivers (CES and CHRP) will no longer be rolled straight into the DD waiver. They will go on the waiting list instead, with exceptions for foster care and emergency situations. Community advocacy pushed the start date back from the originally proposed July 2026.¹¹¹⁰

Some participants will begin paying toward their own care. Starting in summer 2026, the state is applying Post-Eligibility Treatment of Income (PETI) to the DD waiver, requiring certain enrollees to contribute a portion of their income toward the cost of residential services.¹¹ Provider reimbursement rates are cut 2% across the board as of July 1, 2026, and a prior 1.6% increase was reversed.¹³ A 56-hour weekly cap per caregiver for a single member is being phased in, reaching full implementation by July 2027.¹⁴

DD Waiver vs. Supported Living Services

Colorado runs a separate developmental disabilities waiver called Supported Living Services (SLS), and the two are not interchangeable. The DD waiver is for adults who need 24-hour supervision and whose needs can’t be met through other sources; the provider arranges and staffs the living situation. SLS is for adults who can live independently with limited help or who are primarily supported by family, and participants are responsible for their own living arrangements. SLS covers targeted supports like personal care, employment services, assistive technology, home modifications, and professional therapies, with an annual funding cap of roughly $78,000 per participant.⁷¹⁵¹⁶ Both waivers require the same ICF-IID level of care and the same financial eligibility, but SLS is not built to fund round-the-clock care.

Directing Your Own Services

Although the DD waiver centers on provider-managed care, participants can self-direct certain personal care, homemaker, and health maintenance supports through Consumer-Directed Attendant Support Services (CDASS) or In-Home Support Services (IHSS). Both are delivered through the Community First Choice benefits that work alongside the waiver, and both let the participant decide how services are staffed and scheduled rather than relying on a traditional agency model. Enrollees interested in self-direction should ask their CMA or contact the designated training and support contractor.¹⁷

1
HCPF. Developmental Disabilities Waiver (DD)
2
Colorado Sun. Medicaid Budget Cuts Developmental Disabilities Waitlist
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HCPF. IDD Services Enrollments and Waitlists
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Developmental Pathways. DD Medicaid Waiver
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Developmental Disabilities Resource Center. How to Access Services
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Medicaid.gov. Colorado Waiver Factsheet
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Alliance Colorado. Waiver Services
8
Colorado Secretary of State. HCBS-DD Regulations, 10 CCR 2505-10 8.500
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HCPF. Case Management Agency Directory
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Developmental Pathways. Colorado’s 2026 Medicaid Budget: What Changed and What It Means for You
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HCPF. Medicaid Sustainability and LTSS
12
Colorado Developmental Disabilities Council. Community Guide: 2026-27 Medicaid Budget Recommendations
13
Colorado General Assembly. Committee Actions Impacting IDD
14
CPR News. State Budget Medicaid Cuts Caregivers Disability Services
15
HCPF. Supported Living Services Waiver (SLS)
16
HCPF. DD SLS CES Rate Schedules
17
HCPF. Participant Directed Programs