Case Management Agency Colorado: How CMAs Control Your Parent's Care

You called your county's Department of Human Services about getting your parent Medicaid home care, and they told you to contact your "CMA." You've never heard of a CMA. You don't know which one covers your parent's county or what they actually do. And nobody seems interested in explaining it.

Here's what you need to know: your regional Case Management Agency is the single most important gatekeeper between your parent and Medicaid-funded long-term care in Colorado. Without the CMA's clinical approval, no amount of financial eligibility matters.

What Happened to the Old System

Until 2024, Colorado's long-term care coordination was handled by a patchwork of local Single Entry Points (SEPs) and Community Centered Boards (CCBs). The problem: many of these organizations also provided direct care services, creating a conflict of interest. The same agency deciding whether your parent needed services was also the agency that got paid to provide them.

To comply with federal mandates for "conflict-free" case management, HCPF (Colorado's Medicaid agency) restructured the entire state into 20 distinct Designated Service Areas, each served by a single contracted Case Management Agency. The new CMAs are prohibited from providing direct care — they only assess, plan, and coordinate.

What Your CMA Actually Does

Your regional CMA is responsible for four critical functions in your parent's Medicaid journey:

Intake and referral. When your parent needs long-term care services, the CMA is the first call. You can submit a referral online through the CMA's web portal, by phone, or through a hospital social worker if your parent is currently hospitalized.

The 100.2 functional assessment. This is the clinical eligibility determination. A CMA case manager conducts an in-person evaluation measuring your parent's ability to perform Activities of Daily Living — bathing, dressing, eating, mobility, toileting, and cognitive function. To qualify for the EBD waiver, HCBS services, or institutional Medicaid, your parent must meet a nursing-facility level of care.

Person-centered service planning. Once clinical eligibility is confirmed, the case manager develops a service plan outlining what care your parent will receive, how many hours per week, and through which providers.

Ongoing care coordination. The CMA conducts annual Continued Stay Reviews to reassess your parent's needs and adjust the service plan. During these reviews, the CMA may also transition your parent from the EBD waiver to Community First Choice for personal care and homemaker services.

How to Find Your CMA

Each of Colorado's 20 Designated Service Areas is served by one CMA. The CMA that covers your parent depends on the county where your parent lives — not where you live. HCPF publishes the complete directory of CMAs and their service areas on its website.

If your parent is currently hospitalized, the hospital's social worker or discharge planner should be able to identify and contact the appropriate CMA directly.

The Assessment: What to Expect and How to Prepare

The 100.2 assessment is conducted in person — usually at your parent's home or in the hospital/facility. The case manager asks your parent about their daily routines, observes their physical capabilities, and assesses cognitive function.

The most common reason families fail the assessment: the parent masks their limitations. Out of pride or habit, aging parents tell the evaluator they can bathe, dress, and manage medications independently — even when they can't. If the case manager takes these self-reports at face value, the result may be a level-of-care denial, leaving your parent without waiver coverage.

What you should do:

• Be present during the assessment. Don't let your parent go through it alone.
• Prepare a written summary of your parent's actual daily limitations — what they can't do, what they need help with, how often they forget medications or fall.
• Have the parent's doctor complete a Professional Medical Information Page (PMIP) before the assessment. The PMIP is a state-required form where the physician certifies the patient's functional limitations. It must be sent directly to the CMA.
• Document specific incidents — falls, medication errors, wandering episodes, kitchen fires — with dates.

The "Streamline Eligibility" System and Its Failures

After the CMA completes the 100.2 assessment, the data is entered into the Bridge database. The system is supposed to automatically transmit a "cert page" (Level of Care document) to the county Department of Human Services, which handles the financial side of the Medicaid application.

This automated transfer is supposed to work. In practice, it frequently doesn't. The electronic communication between Bridge and the county system fails silently, leaving the county technician unaware that clinical eligibility has been confirmed. The technician then sends the family a notice saying they're missing the "100.2 level of care" or "cert page," causing weeks of unnecessary delay.

If this happens to you: call your CMA case manager immediately. Ask them to manually print, sign, and transmit (fax or mail) the physical cert page directly to the county financial technician. Don't wait for the electronic system to self-correct — it often doesn't.

Working With Your CMA

The CMA system is still relatively new, and families report common friction points: unreturned phone calls, reassigned caseworkers mid-process, and long delays between referral and assessment. Document every interaction — date, time, who you spoke with, what was discussed. If your case stalls, escalate to the CMA's supervisor and reference the specific timeline commitments they made.

The Colorado Medicaid Long-Term Care & Asset Protection Guide includes the complete CMA referral checklist, the PMIP preparation steps, the assessment preparation strategy, and the Streamline Eligibility troubleshooting protocol — so you can hold your CMA accountable and move through the system without getting stuck in administrative limbo.

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