To: Board of County Commissioners
Through: Kathy Smith, Director, Community Resources
Prepared By:
prepared
Courtney Stryker, Division Manager Senior Resources and Veteran Services, Community Resources
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presenter
Presenter: Courtney Stryker, Division Manager Senior Resources and Veteran Services, Community Resources
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Subject:
title
2:00 PM *Senior Resources Homemaker Medicaid Billing Request
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Purpose and Request:
recommended action
The purpose of this request is to seek approval from the Board of County Commissioners for Arapahoe County Senior Resources to apply for and become an approved provider of Homemaker services under the Colorado Community First Choice Medicaid In-Home Support Services (IHSS) program. Approval would allow Senior Resources to bill Medicaid for Homemaker services, thereby diversifying program funding and supporting future program expansion.
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Alignment with Strategic Plan: Good Governance - Understand and respond to community needs, interests, and values.
Background and Discussion: In July 2025 Colorado modified its In-Home Support Services (IHSS) program to transition some services to the Community First Choice (CFC) program. Newly enrolled Medicaid members can now access IHSS directly through CFC instead of through Home and Community-Based Services (HCBS) waiver programs. Current HCBS waiver members who already receive IHSS may continue under their waiver with HCBS but will transition to CFC.
Programs now covered under CFC include:
Health Maintenance Activities (HMA)
Homemaker
Personal Care
Promoting self-direction, relocation out of institutions, and person-centered practices are significant goals of CFC. These goals directly align with our current Homemaker program, supporting self-sufficiency and allowing individuals to remain in their homes as long as possible.
There are currently 245 clients on our existing Homemaker program with 9 staff and 3 administrative staff. All clients on this program are at or below 200% of the Federal Poverty Level. Meaning the majority of them are already on Medicaid or are eligible for Medicaid services like CFC.
This program is currently funded by the Community Services Block Grant (CSBG) and supplemented by County General Funds. CSBG funding remains at risk of reduction or elimination through the 2026 Federal Budget process. By adding CFC through Medicaid we will be able to supplement funding for this program.
The current reimbursement rate for Homemaker under CFC is $6.49 per 15 minutes. Our program sees clients on average for 90 minutes every other week which would be a full reimbursement of $38.94 per visit. This will cover the staff’s time and partially support admin time as well.
There are currently 58 individuals on our waiting list for Homemaker services and the wait time is about 3-4 months. By increasing revenue from Medicaid we will be able to increase current part time staff’s time to help alleviate the waitlist until we are ready to grow the program.
Alternatives: Senior Resources can continue to utilize current funding methods for Homemaker programming including the Community Services Block Grant and County General Funds.
Fiscal Impact: By adding Medicaid to the Senior Resources fiscal portfolio we will be able to supplement current needs for client through external Federal funding and explore future program expansion.
Alignment with Strategic Implementation Strategies: N/A
Staff Recommendation: Community Resources staff recommends approval to apply for Medicaid provider approval to diversify funding for the homemaker program, which remains a high need in our community.
Concurrence: Arapahoe County Finance Department