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Мережа прямої допомоги споживачам у Колорадо
In-Home Support Services (IHSS)
Consumer Direct Care Network Colorado (CDCO) serves as the Training and Support contractor for IHSS. We guide individuals through training and provide program guidance.
We work collaboratively with the IHSS agencies, case management agencies, and Colorado Department of Health Care Policy & Financing (HCPF) to ensure individuals successfully enroll as IHSS members.
Eligibility
To use IHSS, you must:
- Be enrolled in Health First Colorado (Colorado’s Medicaid program)
- Meet eligibility for the CFC program, including:
- Having an assessed need for Personal Care, Homemaker, and/or Health Maintenance Activities
- Meeting an institutional level of care
- If you are already enrolled in an HCBS waiver, you automatically meet institutional level of care
- Participate in service planning with your Case Management Agency (CMA)
If you’re still receiving CDASS through a waiver and haven’t yet transitioned to CFC, your Case Manager will guide you through the timing and next steps.
Learn more about CFC Eligibility and Services and connect with your Local Case Management Agency to get started.
Not yet enrolled in Health First Colorado?
8 кроків до зарахування
There are eight steps to enrolling in the IHSS program:
1. Enroll in Community First Choice
- IHSS is available to members through Community First Choice (CFC).
- Learn more about Community First Choice (CFC).
- Contact your Local Case Management Agency to start the process.
2. Meet with your Case Manager
- Meet with your case manager to discuss why IHSS is right for you compared to other options.
- Looking for your case management agency? Find it using the Colorado Department of Health Care Policy & Financing (HCPF) case management agency directory.
- When you meet with your case manager, you will complete an assessment of your care needs and additional enrollment paperwork.
- After completing the assessment process, your case manager will provide you a list of IHSS agencies in your area. or you may review the HCPF IHSS Provider List for approved agencies in your area.
3. Begin to complete required IHSS forms
Below are forms required to enroll into IHSS:
- Physician Attestation of Consumer Capacity is completed by your (the member’s) physician and helps determine what supports you need to be safe in your home and community. The physician also determines if you require an Authorized Representative (AR). This form is required at initial enrollment and any documented change in your condition. An additional form is required for ARs. It is important to know that a person can be an AR or attendant, but not both.
- The Direct Care Services Calculator is a tool used by the case manager to indicate the number of hours of attendant services a member needs for each covered service (Personal Care, Homemaker, and Health Maintenance Activities).
The IHSS Shared Responsibilities Plan is required for all members. This form should not be completed before you have your Physician’s Attestation form completed. The Shared Responsibilities Plan is completed by you (or your AR) and your chosen IHSS agency during initial enrollment and any documented change in your condition.
4. Select your IHSS agency
- Choose the IHSS agency that is the best fit for you. You may contact them and ask questions about their services.
- After picking an IHSS agency, your case manager will check that it is accepting new members. If they are not, work with your case manager to choose another agency or look into other service options.
- Your case manager will send your chosen IHSS agency a referral and your enrollment paperwork.
5. Enroll with your IHSS agency
- Your IHSS agency will review your referral and contact you to set up an intake assessment.
- Attend your intake assessment and share with your agency your needs and desires for care.
- After your intake assessment, your IHSS agency will create a care plan and send it to your case manager for approval.
6. Case Manager approves care plan and completes the Prior Authorization Request (PAR) Process
- Your case manager will review and approve your care plan. They will work with your IHSS agency to make corrections if needed.
- If additional information is needed, your case manager will contact you.
- After your case manager approves your care plan, they will enter your PAR in HCPF’s system called the interChange (also called Bridge). A PAR has information about your authorized services, service hours, and certification period for IHSS.
7. IHSS agency begins staffing and orientation
- Your IHSS agency will hire your attendants. As the employer, your agency is responsible for your attendants, but you are welcome to participate in the selection and interview process.
- Attend your IHSS agency’s orientation.
- Work with your IHSS agency to train your attendants.
8. Services begin
- Once your attendants are hired and trained, your IHSS agency will set up their work schedule and begin services.
- If at any time an attendant cannot come to work or doesn’t show up, your IHSS agency is responsible for sending a backup attendant.
- Stay in communication with your IHSS agency to manage your attendants and get ongoing support. If you are struggling to work with your agency, you can contact Consumer Direct for Colorado (CDCO) or HCPF at HCPF_PDP@state.co.us або 303-866-5638.
- After services begin, CDCO is always available to help answer questions about IHSS. As the Training and Support contractor, we have many resources available to help you navigate IHSS!
IHSS Program Guide – CFC & Waiver
The IHSS Program Guide is your comprehensive materials to understanding the roles of everyone in the IHSS program. This training tool will provide you with answers to many of your questions about IHSS.
Форми IHSS
Ресурси ІСЗН
HCPF Resources
If you have any issues related to Electronic Visit Verification (EVV), enrollment, taxes or other topics, you can send feedback directly to the Colorado Department of Health Care Policy & Financing’s (HCPF) Participant-Directed Programs (PDP) Unit.
Список агентств
Visit the In-Home Support Services Provider List on the DHCPF website.
Послуги медіації
Послуги медіації для учасників та кейс-менеджерів
Consumer Direct Care Network Colorado (CDCO) helps mediate concerns about the services Health First Colorado (Medicaid) Members receive through In-Home Support Services (IHSS). If Members are unable to work with their Case Manager to achieve the care they believe is needed, Members and Authorized Representatives (AR) have the option to utilize the mediation process.
Mediation services are provided by CDCO as part of the Information and Assistance Services offered to Members and ARs. Mediation through CDCO can assist with facilitating discussions and conversations about disagreements in the care plan and authorized services.
Requests for mediation can be submitted by the Member, an AR, Case Managers, or the provider agency. The Member or AR must consent to mediation. When requested, reasonable accommodations will be provided for people with disabilities by notifying CDCO prior to the scheduled mediation call.
After the mediation session, CDCO will issue recommendations only, not a definitive decision. The Member retains all legal appeal rights for decisions made by the Case Management agency. The Case Manager will be responsible for finalizing the decision for services, when authorized, as a result of the mediation.
Mediation Request Form – November 2024
Mediation Process
- The person requesting mediation completes the Mediation Request form and sends it to CDCO.
- CDCO will process the referral to mediation and contact the Case Manager within one business day to collect information.
- CDCO will contact the Member or AR to collect information and to request consent to participate in mediation.
- CDCO will contact the IHSS Provider Agency to collect information.
- CDCO will set up a mediation call with all the people involved and provide reasonable accommodations when requested.
- After listening to information from all the participants during the mediation call, CDCO will provide a recommendation for services and notify the IHSS Agency.
- The Case Manager will issue a Health First Colorado notice of action with the decision, and new or revised services that may be authorized, and information on the Member’s right to appeal.
Відео IHSS
Consumer Directed Services
Standard Precautions
Огляд IHSS
Introducción a IHSS
Case Manager Role in IHSS
Puesto de gestor de casos a IHSS
Agency Role in IHSS
El rol de una agencia a IHSS
Запобігання шахрайству
Fraud prevention, education, and reporting are among Consumer Direct Care Network’s most important responsibilities.
It is also your responsibility to recognize the signs of fraud. Learn about your rights and responsibilities in preventing and reporting fraud in this fraud prevention video.
Reporting Fraud
To report suspected fraud to the Department of Health Care Policy & Financing, visit its Fraud, Waste, and Abuse website.
Дзвони.
855-375-2500
Report Online
https://hcpf.colorado.gov/how-report-suspected-fraud