Submit the completed Initial Program Approval application and required documents to:
Colorado Department of Public Health and Environment
Health Facilities and Emergency Medical Services Division
Building A, Level 2
Attention: Program Approval/Kara Johnson
4300 Cherry Creek Drive South
Denver, Colorado 80246-1530
Please read through the application thoroughly and complete all items. Incomplete applications will not be processed. Applications will not be accepted via email or fax. Please allow 30 business days for DDD review and process the application. After the application has been reviewed the DDD will notify the agency in writing of the application status. Links to the applications and important information about the program approval process are provided below.
Existing Application Links
Colorado Medical Assistance Program – In addition to receiving Initial Program Approval from DDD the agency must enroll in the Colorado Medical Assistance Program and obtain a Medicaid Provider Number. Once the agency receives a Medicaid Provider Number the DDD will issue Medicaid Certification. Agencies can neither provide nor be reimbursed for services without Program Approval and Medicaid Certification. Provider enrollment information and applications are available on the Colorado Department of Health Care Policy and Financing (HCPF) website: Click here
Group Residential Services and Supports – If the agency is applying for Initial Program Approval to provide Group Residential Services and Supports (GRSS) the agency must also contact the Colorado Department of Public Health and environment (CDPHE) at 303-692-2881 to apply for a group home license. CDPHE will not issue a license for a group home until DDD has granted Program Approval. Information is available on the CDPHE website: Click here
Home Care Agency – Agencies applying to provide direct in-home services to persons in SLS or CES must become a licensed Home Care Agency through CDPHE prior to applying for Program Approval. A copy of the license must be attached to the Program Approval application. This applies to any SLS or CES service that involves any of the following activities of daily living:
· Walking or mobility
· Toileting and continence care
· Personal laundry
· Medication assistance
· Companionship Services
· Housekeeping – agencies that provide Housekeeping services only are not required to become a Home Care Agency.
More information about Home Care Agency licensing can be found at the CDPHE website: Click here
*In addition to notifying the DDD and completing the above PASA Change of Information Form, agencies are required to contact HCPF/Xerox and complete the provider update form. Information on the HCPF site states, "Provider information updates and affiliation changes may be made through the Web Portal and are effective within 24 hours. Providers may update the following information: Address, Phone, Fax, Publication Preferences (including Email), Medicare Information and Affiliations. Providers can also send update requests that require State approval; providers should submit the update requests by using the update form below".
When completing a name change, agencies are required to submit to HCPF/Xerox and the DDD a copy of the new W-9 verifying the new name. Please be sure to include the reason for the request or it may be denied. Below is the link to the HCPF form: