Turning 18 on the CES or CHRP waiver? Colorado is ending the automatic move to the DD waiver.

What happened

On September 11, Colorado Medicaid (HCPF) brought a rule to its Medical Services Board, MSB 26-07-05-A. Today, when young people on the Children’s Extensive Supports (CES) or Children’s Habilitation Residential Program (CHRP) waivers age out, “they are automatically enrolled in the DD waiver,” in the rule’s own words. The new rule “ends automatic enrollment for CES and CHRP waiver members unless the CES or CHRP waiver member is in Foster Care or experiencing a Crisis.”

The board is scheduled to take its final vote on October 9. HCPF expects the change to start January 1, 2027, pending approval from the federal Centers for Medicare & Medicaid Services (HCPF presentation, Sept. 11). The legislature already built it into this year’s state budget.

The reason is money. The rule says DD waiver costs “have risen at an unsustainable rate.” From 2018-19 to 2024-25, DD enrollment grew from 6,376 people to 9,119, and yearly spending more than doubled, from $422 million to $894 million (HCPF presentation).

Three details matter more than the headline:

Foster care is the exception. A young person served through child welfare who is in an out-of-home placement, or would need one, and who turns 18 within the next year can still enroll in the DD waiver directly (rule section 8.7101.J.8).

The waiting list is long, and your place in it is set early.As of September 1, 2025, 2,749 people were on the DD waiver’s “as soon as available” list, and HCPF says the average wait “decreased from 9 to 7 years” (IDD Strategic Plan, Nov. 2025). Most of them are not going without: 90% already get other Medicaid or state services while they wait (HCPF legislative presentation, Jan. 2026). A person’s place in line is set by the date the case management agency found they have an intellectual or developmental disability, or by their 14th birthday if that came first. The rule says that date “shall not change.”

The choice now has to be an informed one.The rule adds a new requirement called an “Informed Decision”: a documented process in which the young person, or their legal representative, makes their choice “after receiving and understanding accurate, complete, and accessible information about all applicable service options.”

Why it matters to you

If your child is 14 to 17 and on CES or CHRP, the automatic path was the quick route to adult residential care. The DD waiver is the one that “offers 24-hour residential care,” in the rule’s words, and it is the only Colorado waiver with a waiting list (HCPF). Adult host homes and group homes are DD-waiver services (HCPF OM 26-059). So if living away from home could be part of your child’s adult life, even years from now, the waiting list now belongs in the plan.

If you’re a case manager, the transition conversation was already due at least 12 months before a CES member’s 18th birthday (CES waiver). Now it has to end in a documented Informed Decision, and for most families it has to include the waiting list.

Here’s how we read it at Grace Mountain. The old path was automatic, which meant one of the biggest decisions in a young adult’s life was often made by a birthday. The new one is more work, and the wait is real. But it puts the young person’s own choice, made with full information, in the middle of the process. That’s the right place for it. The people we serve keep showing us they can make real choices about their own lives when someone takes the time to lay out the options.

If you’re sketching what adult life could look like for your son or daughter, we’re glad to walk you through how a host home works and how people get there, even if that’s years away. (New to the waivers themselves? Start with HCBS-DD vs SLS vs CES.) Grace Mountain is also beginning the process of becoming benefits specialists, learning to help the people we serve use Social Security effectively. Bring us your questions; where we don’t know yet, we’ll find out with you.

What to actually do this week

1. Confirm your child’s spot on the DD waiting list. Ask your case manager whether your child is on the list and what their “order of selection” date is. That date sets their place in line and doesn’t change if they later move between statuses.
2. Ask for the transition conversation early, with three questions. Does the January 1 change apply to my child, given their birthday? Which adult programs fit them (SLS, Community First Choice)? Does a direct pathway apply, like foster care or a crisis?
3. Tell the board what you think before October 9. The final vote is Friday, October 9, at 9 a.m., 477 D Avenue in Limon (board agenda). To comment, email the board’s administrator at hcpf_medical_services_board@state.co.us.

One thing to skip

Skip the rumor that your child loses every option at 18. The automatic path is ending; the other doors stay open. HCPF’s own presentation says young people leaving CES or CHRP “will continue to have access to” programs like SLS, Community First Choice, and In-Home Support Services, and “may be placed on the DD Waiver waiting list” when needed. Plan early. There’s no need to panic.

Researched with AI assistance; edited by Ian Thomson.