Home Health Program

The Home Health benefit for Colorado Medicaid clients provides services from a licensed and certified Home Health Agency (HHA) for clients who need Intermittent Home Health Services. Home Health Services include:

• Skilled Nursing (provided by a Registered Nurse or Licensed Practical Nurse)
• Certified Nurse Aide (CNA) services (may also be referred to as a Certified Nursing Assistant or Home Health Aide)
• Physical Therapy (PT)
• Occupational Therapy (OT)
• Speech/Language Pathology (SLP) services (or Speech Therapy)

There are two types of home health services:

1. Acute Home Health: Skilled Home Health services provided to clients who experience an acute health care need that necessitates skilled Home Health care. Acute Home Health services are allowed without prior authorization for up to 60 calendar days or until the acute condition is resolved, whichever comes first. (If the client is on a Medicaid Managed Care Program, prior authorization for acute Home Health may be required by the Managed Care Organization.)
2. Long-term Home Health: Skilled Home Health services provided to clients who require ongoing Home Health services beyond the Acute Home Health period. Prior authorization is required for Long-Term Home Health Services.

Medicaid Clients who:

• Require Home Health Services for the treatment or amelioration of an illness, injury, or disability, which may include mental illness;
• Are unable to perform the health care tasks for him or herself, and he or she has no Family Member/Caregiver who is willing and able to perform the skilled tasks;
• Require services that cannot appropriately or effectively be received in an outpatient treatment office or clinic or for which the client’s residence is the most effective setting to accomplish the care required by the client’s medical condition; and
• The services meet medical necessity criteria and are provided in a manner consistent with professional practice.

• Home Health Agencies FAQs
• Client FAQs

Personal Care Tool Documentation is located on the Benefit Collaborative web page

Personal Care EPSDT Benefit Coverage Standard

• Open Letter to Stakeholders May 2014
• September 30, 2013
• August 29, 2013
• August 13, 2013
• July 26, 2013

• Volunteer Home Health Agencies for PAT Testing
• Listening Log Feedback -  Revised PAT
• CNA List of Services - Skilled & Unskilled
• Stakeholder Feedback - Recommended PAT Revisions

• Training for Use of the REVISED PAT
• Revised PAT Presentation