As of July 1, 2012 and for the very first time in history, the state of Colorado has a Medicaid waiver that offers alternative therapies to persons living with a spinal cord injury.
The HCBS for persons with a Spinal Cord Injury (HCBS-SCI)
- The HCBS-SCI program provides assistance to individuals with spinal cord injuries in the Denver Metro area that require long term supports and services in order to remain in a community setting.
- The HCBS –SCI program provides an opportunity to study the effectiveness of Alternative Therapies and the impact the provision of this service may have on the utilization of other HCBS-SCI program and/or acute care services.
- An independent evaluation shall be conducted in the third year of program operation to determine the effectiveness of the Alternative Therapies.
- The program is limited to 67 clients
- This is a “pilot” program and will only last for 3 years
Level of Care: Individuals shall require long-term support services at a level comparable to services typically provided in a nursing facility.
- Individuals shall be 18 years or older
- Individuals shall have a diagnosis of Spinal Cord Injury
- Individuals shall have been determine to have a significant functional impairment
- Individuals shall reside in the Denver Metro Area in one of the following counties:
HCBS-SCI Waiver Services
- Adult Day Services
- Alternative Therapies
- Consumer Directed Attendant Support Services
- Personal Emergency Response System
- Home Modifications
- Homemaker Services
- In-Home Support Services
- Non-Medical Transportation
- Personal Care Services
- Respite Care Services
Waiver services complement and/or supplement the services that are available to participants through the Medicaid State plan and other federal, state, and local public programs as well as the supports that families and communities provide. A client who receives services through the SCI waiver is also eligible for all Medicaid covered services except nursing facility and long-term hospital care.
- Alternative Therapies are limited to Acupuncture, Chiropractic Care, and Massage Therapy.
- Alternative therapies are limited to the clients assessed need for services as determined by the Supervising Physician and documented in the Alternative Therapies Care Plan.
- Alternative Therapies shall be provided in an outpatient setting.
- Clients receiving Alternative Therapies will participate in an independent evaluation to determine the effectiveness of this service.
- The schedule of services recommended by the Supervising Physician in the Alternative Therapies Care Plan cannot include more than four visits per week for any combination of modalities.
- The schedule of services recommended by the Supervising Physician in the Alternative Therapies Care Plan cannot include more than two visits per week of any one modality.
- The utilization of Alternative Therapies may typically begin at a higher level and is expected to decrease as the client progresses.
TO ENROLL, CONTACT YOUR LONG TERM CARE CASE MANAGER. IF THEY NEED CLARIFICATION, THEY CAN CONTACT HEALTH CARE POLICY AND FINANCING.
Tyler Deines or Sarah Hoerle
Adult HCBS Program Administrators
(303) 866-2266 or (303) 866-2669
Tyler.Deines@state.co.us or Sarah.Hoerle@state.co.us
Colorado Department of Health Care Policy and Financing
Long Term Care Benefits Division
WATCH THE VIDEO TO LEARN ABOUT THE HISTORY BEHIND THE SCI WAIVER