DD Waiver Colorado: Eligibility, Costs, and 2026 Changes

The Colorado DD waiver is a Medicaid-funded program that pays for round-the-clock community-based services for adults with developmental disabilities, including housing, day programs, employment support, and behavioral care.¹ It is administered by the Colorado Department of Health Care Policy and Financing (HCPF), and the single biggest thing to know before applying is that the waiting list currently averages seven to eight years.²

Who Qualifies

Two sets of requirements apply: one about disability and needs, the other about finances.

On the disability side, the applicant must be 18 or older, have a documented developmental disability with onset before age 22, and require access to services and supports 24 hours a day.¹³ The person must also meet the Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF-IID) level of care, which is established through a functional needs assessment. Documentation typically includes evidence of a substantial disability present before age 22, a neurological condition, and current psychological or adaptive behavior evaluations.⁴

Financial eligibility runs through Health First Colorado, the state’s Medicaid program. Monthly income must be less than three times the federal Supplemental Security Income (SSI) limit. Countable resources are capped at $2,000 for a single person and $3,000 for a married couple.¹ Working adults who exceed those limits may still qualify through the Health First Colorado Buy-In Program for Working Adults with Disabilities. Financial eligibility is verified when a slot is offered, not when the person joins the waiting list.

What the Waiver Pays For

The DD waiver is designed as a full package, funding both direct services and the living arrangement itself. Covered services include:¹⁵

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

Enrollees keep their standard Health First Colorado benefits as long as those don’t duplicate waiver services. Community First Choice (CFC) benefits run alongside the waiver, covering personal care, homemaker services, home-delivered meals, medication reminders, and personal emergency response systems.¹

Residential Living Options

The waiver funds several housing formats:¹

Host homes, with one to two individuals living with a host family or caregiver
Individualized settings, with one to three people and dedicated support staff
Group settings, with four to eight residents and staff support
The participant’s own home or family home, with residential supports provided in that setting

Families can also form a Microboard, a small nonprofit corporation set up to manage waiver services for a single individual. A Microboard gives the family direct control over hiring, training standards, and quality oversight, though the person served by the Microboard cannot live with the family under this arrangement.⁶

Self-Directed Care

Participants who want more control over their day-to-day supports can use Consumer-Directed Attendant Support Services (CDASS) or In-Home Support Services (IHSS). These options let individuals choose their own mix of personal care, homemaker, and health maintenance supports instead of receiving them through a traditional agency.⁷ Both run through Community First Choice benefits alongside the waiver.

How to Apply

Applications go through a local Case Management Agency (CMA), which can be found in HCPF’s online directory.²⁸ The CMA conducts a developmental disability determination using the documentation and assessments described above.⁴

Once the determination is complete, the CMA opens a waiting list record. Being on Medicaid or SSI is not required to get on the list. The date of the developmental disability determination becomes the placement date, which is what governs when a slot is offered. For children found to have a developmental disability before age 14, the placement date is set to the 14th birthday.²

The Waiting List

The DD waiver is the only home and community-based services waiver in Colorado with an active waiting list. Roughly 2,800 people are on it, and 78% of them are between 20 and 39 years old.⁹² Historically, HCPF has authorized about 10 to 20 enrollments per month as existing participants leave the program.

Applicants choose one of three categories:

As Soon As Available (ASAA): for people who want a slot as soon as one opens; the oldest placement dates are called first.
Date Specific: for people who want to enroll on a particular future date.
Safety Net: for people who don’t currently need services but want to hold their place in case circumstances change.

Applicants between 14 and 18 can only sit on the Safety Net list until they turn 18. Declining an enrollment offer does not erase the original placement date; the record just moves to Safety Net.²

Slots can also open outside the normal cycle for statewide priority situations, including 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. The General Assembly has occasionally funded one-time expansions; 667 extra enrollments were authorized in July 2021, for example.²

2026 Changes That Affect the Wait and Costs

Colorado’s 2026-27 budget, signed into law on May 8, 2026, made several changes that directly affect people applying for or already using the DD waiver.¹⁰

The most consequential change for anyone on the waiting list: effective July 1, 2026, routine enrollments were cut by 50%. Instead of enrolling one person for every one who leaves the program, the state now enrolls one for every two. Advocacy groups have warned this could push wait times to 14 years or longer.⁹¹¹

Beginning January 1, 2027, youth aging out of the Children’s Extensive Support (CES) and Children’s Habilitation Residential Program (CHRP) waivers will no longer be automatically enrolled in the adult DD waiver. They will be placed on the waiting list instead, with exceptions for foster care and emergency situations.¹²¹⁰

Cost sharing is also changing. Starting in summer 2026, Post-Eligibility Treatment of Income (PETI) applies to the DD waiver, requiring some participants to contribute a portion of their income toward residential services.¹² Provider reimbursement rates dropped 2% across the board on 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. SLS Waiver

Colorado runs a second developmental disabilities waiver, Supported Living Services (SLS), and the two are easy to confuse. The DD waiver is for adults who need 24-hour supervision and whose needs can’t be met by other sources; the provider arranges and staffs the living situation. The SLS waiver is for adults who can live independently with limited help or who are supported primarily by family; participants handle their own living arrangements and use SLS for targeted supports like personal care, employment services, assistive technology, home modifications, and professional therapies.⁶¹⁵ SLS carries an annual funding cap of roughly $78,000 per participant and is not built for round-the-clock care.¹⁶ Both waivers use the same ICF-IID level-of-care standard and the same financial eligibility rules, but they serve fundamentally different levels of need. SLS does not have an active waiting list.

1
HCPF. Developmental Disabilities Waiver (DD)
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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
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HCPF. Participant Directed Programs
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HCPF. Case Management Agency Directory
9
Colorado Sun. Medicaid Budget Cuts Developmental Disabilities Waitlist
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Developmental Pathways. Colorado’s 2026 Medicaid Budget: What Changed and What It Means for You
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Colorado Developmental Disabilities Council. Community Guide: 2026-27 Medicaid Budget Recommendations
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HCPF. Medicaid Sustainability and LTSS
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Colorado General Assembly. Committee Actions Impacting IDD
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CPR News. State Budget Medicaid Cuts Caregivers Disability Services
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HCPF. Supported Living Services Waiver (SLS)
16
HCPF. DD SLS CES Rate Schedules