Hello Colorado families,
If you provide care for a loved one through Colorado’s Medicaid program, you may have heard about the new limits on weekly caregiving hours. We want to break down what this means for your family and what steps you might need to take.
What is changing?
Starting July 1, 2026, the state is implementing a phased reduction in the number of paid hours a single caregiver can provide per week. This is part of the state’s efforts to ensure the long-term sustainability of the Medicaid program.
Here is the schedule for the hour reductions:
- July 1, 2026: Limit reduced to 84 hours per week from a single caregiver.
- January 1, 2027: Limit reduced to 70 hours per week from a single caregiver.
- July 1, 2027: Limit reduced to 56 hours per week from a single caregiver.
Important note: This change applies to the hours provided by an individual caregiver, not the total amount of support your loved one can receive. You can still utilize multiple caregivers to meet your family’s assessed needs.
What if my family needs an exception?
The Department of Health Care Policy and Financing (HCPF) recognizes that some families have extraordinary circumstances. They have established an exception process for situations such as:
- Complex or extraordinary care needs requiring continuity of a specific caregiver.
- Workforce shortages making it difficult to find additional caregivers in your area.
- Temporary transition or stabilization periods.
- End-of-life care needs.
How to request an exception:
If you believe your family qualifies for an exception, your provider agency or the Authorized Representative serving as the CDASS employer must submit the request on your behalf. The submission window for the first phase (members receiving more than 84 hours per week) is open from July 1 to July 31, 2026.
We encourage you to speak with your case manager or provider agency right away if you have concerns about how these new limits will impact your family’s care plan. They can help you navigate the exception process or explore options for finding additional caregivers.
Warmly,
The Autism Pathways Team