Care Coordination

Care Coordination Fact Sheet

Care coordination means that all of your providers work with each other. These providers could be your doctor, behavioral health provider, or your social worker. They want to make sure you get the treatment you need to stay healthy. There are real problems that could affect your health. These problems include not having a way to get to your treatment, lack of healthy food, or living in an unsafe setting. Your care coordinator can help you find local resources like food, clothing, utility help, transportation, and housing. Your care coordinator can also talk to the people involved with you and your family, like your child’s school, or the Department of Human Services.

If you are interested in finding a care coordinator in your area, please call 888-502-4186.

Long-Term Services and Supports (LTSS) Medicaid helps people who need ongoing medical or social support.  To be able to use this support, a Member must qualify with their income and medical issues.   If you want to learn more, go to the website, https://www.colorado.gov/hcpf/long-term-services-and-supports-programs.

For information regarding programs for individuals with physical or developmental disabilities, visit https://www.colorado.gov/hcpf/programs-individuals-physical-or-developmental-disabilities.

Home and community-based services (HCBS) provide extra Medicaid benefits for Members who meet certain standards. These waivers provide chances for Members to receive treatment in their own home or a local setting. These programs serve a wide-range of Members, such as seniors, people with mental illness, intellectual or developmental disabilities, blindness, or physical disabilities. To qualify, Members must meet income, medical, and home and community based treatment standards.

To help choose between the programs that could be open to you, please see the links listed below.  These tools are designed to be used with the help of a Case Manager or your Advocate.

• Choosing an HCBS Waiver for Adults
• Choosing an HCBS Waiver for Children

You can learn more about these home and community-based services through the Department of Health Care Policy and Financing.

Creative Solutions: Creative Solutions (CS) helps Health First Colorado Medicaid members who are children and youth ages 17 years and younger and their families navigate complex health situations and crises. Creative Solutions (CS) process is appropriate when the member needs assistance beyond Health Colorado, Inc.’s ability to provide support. At that point various parties may request Creative Solutions support.

Complex Solutions: Complex Service Solutions (CSS) helps Health First Colorado Medicaid members who are adults ages 18 years and older to address issues with community placement and other complex health needs and situations. After exhaustive collaboration with the member’s community support team, Health Colorado or the Case Management Agency (CMA) may request CSS support from Health Care Policy & Financing (HCPF).