HCBS-DD: comprehensive adult residential and in-home support
The Home- and Community-Based Services Developmental Disabilities waiver is the comprehensive waiver for adults (18+) with intellectual and developmental disabilities.
HCBS-DD covers:
- Residential supports (Host Homes, group residential)
- Personal Care Alternative and personal care
- Family caregiver compensation
- Day services and supported employment
- Behavioral and clinical supports
- Transportation, environmental modifications, and assistive technology
It’s the waiver to look for when a client needs significant ongoing support and may be moving into residential placement.
SLS: lighter-touch in-home support for adults
The Supported Living Services waiver is the lighter companion to HCBS-DD. Same adult IDD population, but designed for clients who live with family or independently and need less intensive support.
SLS covers many of the same service categories as HCBS-DD (personal care, behavioral supports, transportation, employment) but at lower funding caps and without the full residential services. Colorado has historically maintained a waiting list for SLS.
If you’re referring a client who lives at home and needs supplemental support — not residential placement — SLS is the more common fit than HCBS-DD.
CES: children under 18
The Children’s Extensive Support waiver covers children with IDD who have extraordinary support needs and live at home with their families. Eligibility is for children under 18 who would otherwise require institutional care.
CES funds in-home care, respite, behavioral services, and related supports for the family. When the child turns 18, they typically transition to one of the adult waivers (HCBS-DD or SLS) depending on need.
How to choose which waiver fits your client
The Case Management Agency (CMA) for your region handles the functional eligibility determination, using tools like the Supports Intensity Scale (SIS) and clinical judgment. As a referring case manager or family, the practical question is:
- Residential or institutional-level need? → HCBS-DD
- Living at home or independently, supplemental support? → SLS
- Child under 18 with extraordinary needs? → CES
The actual waiver enrollment is handled by the CMA, not the provider agency.
Which waiver does Grace Mountain accept?
We currently serve HCBS-DD only. We do not currently serve SLS or CES clients. If your client is on SLS, your CMA can route you to agencies that accept it.
For HCBS-DD referrals across five Denver-metro counties, Christina takes every new-client call personally. Response within one business day. For the full referral walkthrough, see Referring a Client to a Colorado Host Home.