Written by a parent, not a doctor. Nothing here is medical advice.

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Colorado program

Colorado's waiver for a medically fragile child

Extra Medicaid support for a medically fragile child who needs hospital-level or nursing-home-level care at home.

What it is

Extra Medicaid support for a medically fragile child who needs hospital-level or nursing-home-level care at home.

Some children need substantial care at home. The local Case Management Agency assesses their needs for this waiver. Parents’ income does not count, but the child’s finances and available enrollment still matter.

Eligibility rules
  • The Case Management Agency decides whether your child needs hospital-level or nursing-home-level care at home, or has a life-limiting illness. Heavy care at home is the reason to ask for that assessment.
  • The local Case Management Agency assesses the required care level or life-limiting-illness criteria and coordinates the financial eligibility review.
What you get
  • Waiver services for an eligible child who needs hospital or nursing-facility care.
What the coverage includes
  • This is waiver 0450.R04.00. Services follow the child's assessed care needs.
If you decide to apply
  1. Ask the hospital social worker whether a Children with Complex Health Needs waiver assessment is worth discussing with your local Case Management Agency.
  2. Bring a description of your child's daily care and ask the oncology team for supporting medical records.

Local Case Management Agency, with help from the hospital discharge planner · Official page ↗

After you ask
  • The hospital discharge planner can help identify your local Case Management Agency. It confirms the referral route, current openings and assessment schedule.
Good to know

The Case Management Agency can explain the services and any wait before you rely on waiver support. An assessment does not reserve a place.

Other details
  • The former CHCBS waiver ended June 30, 2026. CwCHN waiver 0450.R04.00 has an approval term of July 1, 2025 through June 30, 2030, with an amendment approved June 16, 2026.
  • Only your child's own income and savings count: under $2,982 a month and $2,000 in savings (2026). (the rest repeats details.eligibility)
Official sources
Ask your social worker

“Would our child’s care needs fit the complex-care waiver, and what help and restrictions would it bring? If an assessment is worthwhile, could you help arrange it?”

Why I’m asking: I need to understand what support could make caring for my child at home possible.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Ask for the referral before discharge and keep the assessment appointment.

Your social worker

The hospital discharge planner makes the referral; the county assessor visits.

The care team

The doctor describes what the child needs at home.

Who decides
The county long-term-care team assesses the level of care; the state runs the waiver.
Ask your social worker
“Can you refer us for a functional assessment for the Children with Complex Health Needs waiver, and tell us whether there is a wait?”

How to apply

First step: Ask the hospital discharge planner or the county long-term-care team for a functional assessment.

  1. Ask the hospital discharge planner to make the referral for a functional assessment before discharge.
  2. Ask the county whether there is a waiting list and how long it is, in writing.

Where it starts: Ask the county for a functional assessment for the Children with Complex Health Needs waiver. In Jefferson County the referral line is 303-271-4216, which advertises a callback within 72 hours.

What to gather

  • The doctor's description of the care the child needs at home

How long: Unknown. A Jefferson County line advertises a callback within 72 hours; that is a callback, not a decision.

What a yes looks like

An assessment visit, then a service plan naming what is approved.

What a no looks like, and the next move

Ask whether the no was on level of care or on finances, and ask for the appeal date.

Watch out

  • The old children's waiver ended in June 2026. Ask for the Children with Complex Health Needs waiver by name.
  • Places and the waiting list are unknown. Ask the county what the wait is, in writing.
  • Whether parents' income counts here was not established.

Dates that change this

2026-07-01: The Case Management Agency confirms current places, waiting-list rules and service limits. The 2026 child-finance screen is income below $2,982 monthly and resources below $2,000; parental income is not counted. (not yet confirmed against the final rule)

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

Waiver services for a medically fragile child aged 0 to 18 who meets hospital or nursing-facility level of care.

Covers: Waiver services on top of the state plan for a child who meets the level of care · A care assessment through the local Case Management Agency, with a separate financial review.

Legal protection: The old children's waiver ended on June 30, 2026: this is the current door, not the old one

What it costs the family: The agency reviews the child's income and resources without counting parental income; current service and enrollment terms need agency confirmation.

The eligibility facts, as published

Age
0 to 18
Age max exclusive
19
Level of care
Hospital or nursing-facility level of care assessed by the local Case Management Agency.
Income
Parents' income is not counted. The child's countable income must be below $2,982 a month and resources below $2,000 under the published 2026 screen.
Residency
Colorado

The trap: Whether this waiver counts the parents' income was not established. Nobody should tell you it does or it does not until the county says so in writing. The waiting list and the number of places are also unknown, and a missing count is not the same as an open door.

Where I read this

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