Single Entry Point
About Single Entry Point
Montrose County serves as the Single Entry Point (SEP) for Montrose, Ouray, and San Miguel counties. SEP assists children and adults remain living safely and independently in the community of their choice when functional and financial eligibility requirements are met . SEP Case Managers complete a functional assessment to determine if an individual meets level of care to receive Long Term Services and Supports (LTSS) through Health First Colorado (Colorado’s Medicaid program). Members who qualify are eligible for in-home services such as assist with bathing, dressing, meals, shopping, and homemaking. Other available services include home modifications, medication reminder and Personal Emergency Response Systems (PERs or commonly referred to as a lifeline), transportation services and more. Services vary depending on the Home and Community Based Services (HCBS) waiver chosen by the member. See below for a list of waivers served through Montrose County and a link to benefits, services, and how to apply.
SEP Case Management supports the following programs:
- Elderly, Blind, and Disabled Waiver (EBD) https://hcpf.colorado.gov/elderly-blind-disabled-waiver-ebd
- Brain Injury Waiver (BI) https://hcpf.colorado.gov/brain-injury-waiver-bi
- Community Mental Health Supports Waiver (CMHS) https://hcpf.colorado.gov/community-mental-health-supports-waiver-cmhs
- Complementary and Integrative Health Waiver (CHI) https://hcpf.colorado.gov/complementary-integrative-health-waiver-cih
Montrose County SEP also supports children (18 and younger) through the following waivers:
- Children’s Home and Community Based Services Waiver (CHCBS) https://hcpf.colorado.gov/childrens-home-and-community-based-services-waiver-chcbs
- Children With Life Limiting Illness Waiver (CLLI) https://hcpf.colorado.gov/children-life-limiting-illness-waiver-clli
Additionally, SEP supports individuals who qualify for Home Care Allowance (HCA). HCA provides cash assistance to individuals five (5) years of age and older with a disability to pay a home care provider. HCA is used to pay for services to help members remain in their homes (such as bathing, dressing, meal preparation, and shopping). Services are provided by a home care provider. Eligibility for HCA is based on financial need and functional capacity.
Financial eligibility is determined by the client’s income and resources. To be financially eligible, the client must be:
- Approved for Supplemental Security Income (SSI)
- Meet all eligibility criteria for the Aid to the Needy Disabled – State Only (AND-SO) program, or
- Have been receiving both Old Age Pension (OAP) and HCA as of 12/31/13 and remain continuously eligible for both benefits.
Functional capacity is determined by a standard assessment of the individual’s capacity to complete daily activities and the frequency that assistance is needed to complete those activities.
HCA cannot be received while receiving Home and Community Based Services (HCBS) and does not come with other Health First Colorado benefits.
Home & Community Based Services
Either be in a nursing home or currently need this level of care
Apply and be approved for Medicaid under Colorado statutes.
Services must be delivered at a cost equal to or less than nursing home cost
Who can make a referral for the waiver programs?
Your physician’s office, your Medicaid eligibility technician, your mental health worker, community options, a friend, family member, or you. Basically, anyone may call our intake line and make a referral on your behalf.
What to Expect
When you first contact Montrose County Adult Services an intake coordinator will either refer you for a face-to-face assessment with a case manager or refer you to other community resources that may better meet your needs. If you are referred for an assessment, the case manager will come to your residence. Among other areas that he / she will discuss with you are your ability to perform daily living activities, your physical and emotional health and any services you are currently receiving. The case manager will send a request to your physician for your diagnosis and medications.
The case manager will base his / her recommendation for long term care based on the information provided and your physicians input. If approved, the Case Manager will verify Medicaid approval.
Remember, you are responsible for applying for Medicaid!
Once you are approved for Long Term Care Services you and your case manager will discuss a plan of care to provide you with the services you require to keep you safely living in the community. Your case manager will continue to monitor your services and your safety in the community and make suggestions and adjustments to your plan of care accordingly.