Case Management Agency
What is a Case Management Agency?
Single Entry Point (SEP) Agencies provide case management, care planning, and make referrals to other resources for Health First Colorado (Colorado's Medicaid program) members with the following qualifying needs: elderly, blind and disabled, persons living with HIV/AIDS, mental health, brain injury, spinal cord injury, multiple sclerosis, spina bifida, muscular dystrophy, or cerebral palsy, children with a life-limiting illness, and medically fragile children.
What is changing?
If you use Health First Colorado’s (Colorado’s Medicaid program) home and community based services (HCBS), then you should know that important changes are coming to the case management system.
Since 2014, the Department has worked to come into compliance with the federal law that requires case management be provided by an agency that is separate from the agency that provides direct care. By eliminating conflicts of interest, case managers can make objective decisions. This approach is intended to simplify access and remove silos so individuals and families will be able to more easily navigate and find the right programs and services that work for them and will achieve greater consistency of case management services across the state.
To comply with this federal requirement, Colorado's case management system is changing. There will now be one case management agency in each defined service area. Each case management agency will serve everyone within their defined service area, regardless of age, disability type, or HCBS waiver.
Case management agencies have been selected through a legal process to perform case management duties in their defined service areas. Due to this process, the case management agency in Jefferson and Clear Creek Counties will change to Jefferson County Human Services on July 1, 2024.
We are working closely with Colorado Department of Health Care Policy & Financing (HCPF) and Developmental Disabilities Resource Center (DDRC), so this transition is seamless for members and providers. JCHS and DDRC are committed to the continuity of services and minimizing the impact this may have on you or your loved one during the transition.
For more information on these changes, visit My HCBS Case Management webpage and more information will be shared here as available.
More on Case Management Redesign
See more details on Case Management for Long Term Services & Supports Changing in Colorado.