Understanding the Role of Case Management Agencies
July 21, 2026
Throughout this series, one organization has consistently appeared: the Case Management Agency (CMA). This final article explores the vital role CMAs and case managers play in helping Colorado’s long-term services and supports system serve individuals and families.
Part of the “Understanding Colorado’s Long-Term Care System” series
By Amy Becerra, Chief Strategy Officer
Throughout this series, we have explored how Colorado’s long-term services and supports system is structured, how home and community-based services evolved, how Medicaid is funded, and how policy changes move from government decisions into communities.
One organization has appeared again and again: the Case Management Agency, or CMA.
In this final article, I would like to take a closer look at the role CMAs play, the responsibilities case managers carry, and why case management is essential to helping Colorado’s long-term services and supports system work for individuals and families.
What Is a Case Management Agency?
A Case Management Agency helps people access and navigate long-term services and supports through Colorado’s Medicaid system.
These services help individuals with intellectual or developmental disabilities, physical disabilities, aging-related needs, or other qualifying conditions live as independently and fully as possible in their own homes and communities.
The State of Colorado designates CMAs to help eligible individuals and families understand their options, navigate eligibility processes, assess support needs, coordinate services, and develop person-centered plans based on each person’s goals and circumstances.
There are currently 15 CMAs serving 20 regions across Colorado. Rocky Mountain Human Services provides CMA services for Denver and Adams counties.
For many individuals and families, a case manager becomes a primary guide through what can be a complicated and fragmented system. Whether someone is applying for services for the first time, planning for future needs, transitioning from one setting to another, or responding to a change in circumstances, a case manager helps explain the process and coordinate next steps.
No two individuals have the same goals, strengths, relationships, or support needs. That is why good case management begins with understanding the person—not simply the programs or services they may qualify for.
What Does a CMA Do?
Every person’s situation is different, but the role of a CMA remains consistent: helping individuals access appropriate supports while connecting the many parts of the long-term services and supports system.
Depending on a person’s circumstances, a CMA may:
- Conduct intellectual and developmental disability determinations using criteria established by the State of Colorado
- Help determine eligibility for long-term services and supports
- Assess an individual’s strengths, goals, support needs, and level of care
- Develop and update person-centered service plans
- Help individuals and families understand service options, provider choices, and appeal rights
- Coordinate services with providers, counties, hospitals, health plans, schools, behavioral health partners, and community organizations
- Monitor services, health, safety, and changing circumstances over time
- Support people through changes in services, providers, living arrangements, or life stages
- Respond when needs change, services are delayed, or concerns arise
- Document required information and help ensure services remain connected to assessed needs and program requirements
Some individuals may work with a case manager for a short period of time. Others build relationships with case managers and CMAs that continue for many years.
As people’s lives change, case managers help ensure services and supports continue to reflect the individual and not simply the system around them.
Case Management Is Both Personal and Operational
At its best, case management is relationship-based work.
It requires listening, building trust, understanding what matters to the person, and helping individuals and families make informed decisions about their lives.
Case management also plays an important operational role in Colorado’s Medicaid system.
Through assessment, planning, documentation, coordination, and ongoing monitoring, CMAs help ensure services are connected to assessed needs, included in a person-centered plan, delivered as expected, and adjusted when circumstances change.
This creates an important layer of accountability. It supports the appropriate use of Medicaid resources, helps identify concerns before they become crises, and gives the State insight into how policies and services are working in real life.
CMAs therefore operate at the intersection of two responsibilities: supporting each person’s goals and helping the larger system function responsibly. A sustainable system must do both.
What CMAs Don’t Do
Case Management Agencies do not create Medicaid policy. They do not determine state funding levels, establish waiver structures, set provider rates, decide which services Medicaid will cover, or create the eligibility criteria used to determine who qualifies for services.
Those decisions are made through federal law, the Colorado Legislature, the Colorado Department of Health Care Policy & Financing, federal agencies, and other state processes discussed throughout this series.
CMAs also do not create the underlying need for long-term services and supports. They respond to referrals, apply State-established criteria and tools, assess needs, and coordinate services within the rules and frameworks they are given.
While CMAs do not make policy or budget decisions, they are often responsible for putting those decisions into practice.
That means explaining new requirements, updating plans and documentation, adjusting workflows, communicating with providers, and helping individuals and families understand how a change may affect their daily lives.
In many ways, CMAs are where Medicaid policy becomes real life.
Helping People Navigate Change
Policies change. Budgets change. Programs evolve. New federal requirements are issued, State rules are updated, and operational guidance can sometimes change quickly.
When that happens, individuals and families understandably have questions.
What does this mean for my services? Will my provider change? Do I need another assessment? Will my hours be reduced? Who should I call? What happens next?
Case managers are often the people helping individuals and families work through those questions.
They explain new requirements, coordinate with providers and other partners, update service plans when needed, and help people understand what options and rights are available.
This can be a difficult role.
Case managers are expected to maintain trust with individuals and families while also applying complex rules, meeting documentation requirements, navigating multiple technology systems, monitoring health and safety, and explaining decisions or limitations they did not create.
When systems are fragmented or policies change rapidly, that pressure increases. The work moves to the people responsible for implementation—often case managers, supervisors, providers, individuals, and families.
Clear guidance, workable tools, realistic workloads, strong supervision, and time for relationship-based work are therefore essential to the health of the broader system.
Bringing Real-Life Experience Into Policy Conversations
Although CMAs do not make final policy or budget decisions, they bring an important perspective to those conversations.
Because CMAs work directly with individuals, families, providers, counties, hospitals, community partners, and State systems, they can help policymakers understand how proposed changes may work in practice.
They can help identify questions such as:
- Will the new process make sense to individuals and families?
- Can providers and case managers implement it within the proposed timeline?
- Do existing technology systems support the required workflow?
- Will the change simplify the process or create additional steps?
- Could there be unintended effects on access, health and safety, workforce stability, or continuity of services?
This perspective is not resistance to change. It is part of responsible system design.
Early and meaningful engagement with the people responsible for implementation can help identify problems, reduce confusion, improve communication, and create policies that are more workable for everyone involved.
Why Relationships Matter
Long-term services and supports are about much more than programs, assessments, budgets, and policies.
They are about people.
A child learning new skills.
A young adult preparing for greater independence.
An older adult who wants to remain safely at home.
A person rebuilding stability after a significant change in health.
A family trying to understand what comes next.
Behind every assessment, service plan, and policy decision is a person with unique goals, strengths, relationships, and hopes for the future.
Good case management is built on listening, trust, professional judgment, and collaboration. It means understanding what is important to each individual and helping coordinate supports that reflect the life they want to live.
Documentation, monitoring, and accountability are important. But they should support—not replace—the human relationship at the center of case management.
Looking Ahead
This series was created to make Colorado’s long-term services and supports system a little easier to understand.
It is a complex system, shaped by federal and state policy, funding decisions, waiver rules, provider capacity, workforce realities, technology, and the changing needs of the people it serves.
There will always be new policies and challenges to navigate. But the purpose of the system should remain clear: helping individuals receive the support they need to live healthy, meaningful lives in their communities.
Case Management Agencies are an important part of that system.
They help people access services, coordinate across systems, monitor changing needs and health and safety, support person-centered planning, protect member rights, and promote accountability and responsible stewardship of public resources.
A strong long-term services and supports system depends on more than good policy. It depends on the people, relationships, tools, and infrastructure needed to make that policy work.
Thank you for following along with this series. I hope these articles have helped make Colorado’s long-term services and supports system feel a little more understandable and hopefully a little more human and less bureaucratic.
