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NAVIGATING CARE OPTIONS FOR IDD ADULTS

November 26, 2020/Care Options for IDD Individuals, Family Caregiver, Host Home
Providers/by Evergreen Service Providers


Persons living with Intellectual and Developmental Disabilities (IDD) are
eligible for adult waiver services when they reach the age of 18. They can
transition from the Children’s Extensive Services (CES) waiver or the Children’s
Habilitation Residential Program (CHRP) waiver. For those who have not been
receiving children’s services, they must apply for adult waiver services.

Once the application is approved, the IDD Individual may begin receiving Home
and Community Based Services – Supported Living Services (HCBS-SLS) and/or be
placed on a wait list to receive Home and Community Based Services for the
Developmentally Disabled (HCBS-DD). There are currently more than 3000 persons
on Colorado’s wait list; transition from the list is based on the order in which
the application was received unless special needs or emergency situations create
priorities.

Two Adult Waiver Options

There is a lot to understand about adult service options for persons with IDD
and their families, starting with the two adult waiver options that are
available.

 1. Supported Living Services (HCBS-SLS)

 * Non-residential waiver
 * Services support the Individual’s integration into their community and living
   independently as much as possible in their own home or the family home.
 * Services are available to the Individual on a capped/fixed budget.
 * Individuals can choose the supports/services they need and prioritize how
   they utilize their budget.
 * A variety of services is offered:
 * Community Integration Services
 * Self-Advocacy Services
 * Medical Services
 * Professional Services
 * Technology & Adaptations
 * In-Home Services

 2. Developmentally Disabled (HCBS-DD)

 * Residential / Comprehensive Waiver
 * Individuals covered under this waiver must receive 24/7 residential and
   support services.
 * Uncapped budget, however, many services have fixed limits
 * Persons must receive Residential services, but other services are available
   according to the person’s needs and choices.
 * A variety of services are offered:
 * Residential Services
 * Medical Services
 * Professional Services
 * Community-Based Services

Residential Options

The HCBS-DD Waiver offers two options. The Group Residential Services and
Supports (GRSS) option is based on a group home model where 4 to 8 IDD
Individuals share group living with on-site direct care, and rotating staff to
provide 24/7 care, support, and supervision. The Individual Residential Services
and Supports (IRSS) option offers a choice of four service models.

 1. Host Home Model – Individuals (typically one or two) live with a host family
    or Host Home Provider (HHP) who provides room, board, and direct care
    services in their home. They are vetted, trained, and monitored by a PASA.
 2. Personal Care Alternative (PCA) Model – A home-like, small group setting
    typically accommodates about three people with on-site direct care staff
    available 24/7.
 3. Independent Living Model – One Individual lives independently in their own
    home or apartment with support provided by a Program Approved Service Agency
    (PASA). The amount of in-home support varies according to the Individual’s
    needs but the PASA is on call and available 24/7.
 4. Family Caregiver Model – The IDD Individual can choose to live with a family
    member who provides care and support as a paid caregiver, employed by or
    contracted with a PASA.

Regardless of the residential model chosen, services must be person centered in
that they meet the person’s needs based on their choices, provide the least
restrictive setting the Individual can manage, and allow for choice and control
over the lives they have chosen. This includes engaging in community life,
seeking employment, controlling personal resources, and receiving services in
the community to the same degree as individuals not receiving waiver services.

The Family Caregiver Option

Colorado’s Family Caregiver Act provides broader choices for Individuals who are
already receiving services funded by the Colorado Department of Health Care
Policy and Financing (HCPF) in terms of where and from whom services are
received. Eligible family members who wish to provide care for an IDD family
member must complete training, maintain documentation, and provide care equal to
the requirements HHPs must meet.

The home must meet Housing and Urban Development (HUD) standards including
having:

 * Adequate emergency exits
 * Smoke and carbon monoxide detectors
 * Fire extinguishers
 * Locks on bedroom doors
 * Locks on bathroom doors
 * A key to the home made available to the Individual
 * No use of cameras, door alarms, window alarms, etc. in a way that is invasive
   of privacy

Learn more about the Family Caregiver option and other care models for IDD
Individuals at Developmental Disabilities Resource Center (DDRC), the Family
Caregiver FAQ page on our website, or from the resources below. We’re happy to
help you navigate your options.

 * Developmental Disabilities Waiver (DD):
   https://www.colorado.gov/pacific/hcpf/developmental-disabilities-waiver-dd
 * Supported Living Services (SLS) Waiver:
   https://www.colorado.gov/pacific/hcpf/supported-living-services-waiver-sls
 * Community Centered Boards:
   https://www.colorado.gov/hcpf/community-centered-boards
 * Family Caregiver Guide:
   http://coddc.org/Documents/Family%20Caregiver%20Guide%20(1).pdf
 * Supplemental Security Income (SSI): https://www.ssa.gov/OACT/COLA/SSI.html
 * End the Wait: https://www.alliancecolorado.org/alliancelegpriorities
 * Person Centered Approach:
   https://www.colorado.gov/pacific/sites/default/files/Moving%20Toward%20a%20Person-Centered%20HCBS%20Delivery%20System%20in%20CO%2010-16-14.pdf



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Evergreen Service Providers is a small, non-profit, 501 (c)(3) agency. Based in
Arvada, Colorado, we’ve been serving Individuals with intellectual and
developmental disabilities since 1991.


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