Colorado Public Legal Library · Citizen Guide
Trauma Care, Discharge Planning & Home-Based Support in Colorado
How Colorado’s trauma system, rehabilitation, discharge planning, Medicaid HCBS, the EBD waiver, Community First Choice, and case management fit together after a serious injury.
Two systems may touch the same patient—but they answer different questions
Colorado’s trauma system governs organized emergency and trauma care. Medicaid HCBS and Community First Choice govern access to qualifying long-term services and supports. The first asks how an injured person is triaged, transported, treated, transferred, and rehabilitated. The second asks whether the person qualifies for community-based services after the acute-care phase.
C.R.S. §§ 25-3.5-701 to 709
Colorado’s Statewide Trauma Care System Act establishes the statutory framework for trauma-system development, designation, coordination, transport/transfer concepts, trauma data, rehabilitation and quality improvement.
6 CCR 1015-4
Colorado’s statewide emergency medical and trauma-care regulations provide the operational framework for trauma-facility designation and system standards.
HCBS EBD
The Elderly, Blind, and Disabled waiver is one Medicaid long-term-services-and-supports pathway for qualifying adults who meet current eligibility and level-of-care requirements.
Community First Choice
CFC now carries selected home- and community-based services that historically appeared under waiver service structures. Current HCPF guidance must be checked before relying on an older waiver service list.
Build the acute-care chronology
Injury and 911
Record the event, emergency call, dispatch, and what information was available before responders arrived.
EMS assessment
Preserve mechanism, vital signs, neurologic findings, field interventions, destination decision and transport times.
Emergency department and trauma activation
Record arrival, triage category, trauma activation, imaging, consultations, procedures and changes in condition.
Transfer decision
If a higher level of care was considered, preserve the transfer request, consultation, acceptance/declination, transport availability and actual transfer time.
Inpatient treatment
Track surgery, ICU care, complications, specialist treatment, functional changes and rehabilitation recommendations.
Rehabilitation and discharge
Preserve functional assessments, equipment needs, caregiver training, therapy goals, discharge destination and post-discharge referrals.
Discharge planning should start with function, not program names
Before asking which benefit pays, identify what the person will actually need in the home.
Personal care
Bathing, dressing, toileting, eating, grooming, continence, skin care and positioning.
Mobility
Transfers, walking, wheelchair use, stairs/ramps, vehicle access, fall risk and equipment.
Supervision
Cognition, medication management, communication, safety awareness, nighttime needs and behavioral support.
Before the person goes home
- Identify the actual discharge destination and who will be physically present.
- Confirm who can safely perform transfers, toileting, bathing, meals, medications and mobility assistance.
- Check entrance access, bathroom access, sleeping arrangements and transportation.
- Confirm ordered durable medical equipment is delivered and fits the home.
- Confirm medications, follow-up care, therapy and home-health arrangements.
- Ask hospital or rehabilitation case management whether Medicaid, HCBS, CFC, home health, or a Case Management Agency referral is appropriate.
- Document any gap between assessed needs and the actual discharge plan.
HCBS EBD and Community First Choice in 2026
The EBD waiver can support qualifying adults in home and community settings. Eligibility is not established merely by age, diagnosis, paralysis, hospitalization or a need for help. Current Health First Colorado eligibility, program targeting criteria, level-of-care requirements, assessment and service authorization must be satisfied.
Five separate questions
What does the person need?
Medical and functional need should be documented independently of benefit eligibility.
What program is the person eligible for?
Eligibility may depend on Health First Colorado status, age/disability category, financial criteria, and institutional level of care.
Which authority covers the service?
A service may be delivered through CFC, an HCBS waiver, the Medicaid State Plan, home health, or another authority.
Is it authorized?
The service must appear in the appropriate person-centered plan and may require prior authorization or another administrative approval.
Can someone deliver it?
Eligibility and authorization do not guarantee that a qualified provider is immediately available.
CFC and an HCBS waiver can coexist
Current HCPF guidance permits eligible members to receive CFC and an HCBS waiver at the same time when requirements are met and services are not duplicative. CFC does not create a new Health First Colorado eligibility category; it is a State Plan benefit for members who satisfy the applicable criteria.
The Case Management Agency is the operational hub
For long-term services and supports, the Case Management Agency is often the practical entry point for assessment, level-of-care determination, service planning and coordination.
- Record the CMA and assigned case manager.
- Record referral and assessment dates.
- Preserve the assessment and level-of-care determination.
- Preserve eligibility notices.
- Keep the person-centered support plan.
- Keep service authorizations and provider referrals.
- Preserve every notice reducing, denying or terminating a service.
- Record the appeal deadline and whether continuation of benefits pending appeal is available.
When services are denied, reduced or terminated
Get the written notice
Do not rely only on a verbal “not covered” or “not eligible” statement.
Identify the exact decision
Eligibility, level of care, service amount, service type, authorization, provider qualification and payment are different issues.
Identify the authority cited
Record the statute, rule, waiver provision, State Plan authority, manual or policy invoked.
Preserve the record used
Keep the assessment, service plan, medical support, functional evidence and communications relied upon.
Calendar the appeal
Record the effective date, appeal deadline, counting rule, filing method and any separate deadline for continuation of benefits.
Current-law source controls
Use the current 2026 statutory text together with current statewide trauma regulations and CDPHE operational materials.
Current regulatory framework for Colorado’s emergency medical and trauma care system and trauma-facility designation.
Use current 2026 Title 25.5. Do not rely on superseded local extracts for current service definitions.
Current HCPF guidance controls the 2025–2026 transition of selected services to CFC and the current operational service map.
Frequently asked questions
Does treatment at a lower-level trauma center prove the patient should have been transferred?
No. Trauma designation helps identify system capabilities, but transfer appropriateness depends on the patient’s condition, timing, available services, clinical judgment, transport feasibility, accepting-facility availability and other facts.
Does a severe disability automatically qualify someone for the EBD waiver?
No. Disability or need is relevant, but current program eligibility and level-of-care criteria still must be satisfied through the applicable administrative process.
Did Community First Choice replace the EBD waiver?
No. CFC and HCBS waivers are distinct authorities and may operate together for an eligible member. What changed is that selected services transitioned from waiver delivery to CFC.
Can someone receive CFC while also enrolled in a waiver?
Current HCPF guidance says yes when eligibility requirements are met and the services are not duplicative.
What is the most important discharge-planning question?
Who will perform each necessary task safely on the first day home? Program eligibility matters, but an unsafe gap in actual care should be identified before discharge whenever possible.
Build one continuity-of-care record
The strongest post-injury file links the acute-care chronology, rehabilitation findings, functional needs, discharge plan, caregiver capacity, Medicaid/CMA assessments, service authorizations, provider availability, denials and appeals—without confusing the legal role of each system.