Colorado’s Family Caregiver Hour Limit Reaches Its Final Vote June 12. Here’s What’s at Stake.

Key Takeaways

• Strict Weekly Caps: Starting July 1, 2026, Colorado will begin phasing in a hard cap on paid hours for individual family caregivers, eventually dropping to a maximum of 56 hours per week by July 2027.
• Daily Max Hours: No individual caregiver can be compensated for more than 16 hours of care within a single 24-hour day across any combination of services.
• Complex Exception Hurdles: While an exception pathway exists for extraordinary clinical complexity or workforce access barriers, it places a heavy administrative burden entirely on families, case managers, and agencies.
• Critical Operational Gaps: The current draft lacks protections for long-term family relationships, leaves "specialized skills" undefined, and fails to guarantee independent appeal rights for Medicaid members.

What is the Colorado family caregiver hour limits rule?

It is a Department of Health Care Policy and Financing (HCPF) policy phasing in a strict cap on weekly paid hours for Medicaid home care providers. By July 2027, individual caregivers will be limited to 56 hours per week unless they qualify for an approved state exception.

If you rely on a family member to help you stay safely at home, a new Colorado rule is coming that will directly affect how many hours they can be paid to care for you. The rule isn't final yet, but it's close. And while some parts have improved since it was first proposed, there are still serious gaps that families deserve to know about before this takes effect.

We've been following this rule closely and engaged in the state's stakeholder process. Here's what it says, what's changed, what's still missing, and what you can do.

How do the Colorado family caregiver hour limits phase in?

Starting July 1, 2026, Colorado's Department of Health Care Policy and Financing (HCPF) will begin phasing in a cap on how many hours a single caregiver can be paid to provide home care to one person per week. The state is implementing this Colorado Medicaid home care cap across three distinct phases:

Why does this HCPF family caregiver rule matter for Colorado families?

For many families in Colorado, the person providing care isn't a hired stranger. It's a parent, a sibling, an adult child, or a spouse, someone who has learned over years exactly how to communicate with their loved one, how to manage their specific medical needs, and how to keep them safe at home.

The state's stated goal is to prevent caregiver burnout and spread work across a broader workforce. That's a reasonable thing to care about. But the rule as written treats every caregiver situation the same way. Whether the care is straightforward personal care assistance, or around-the-clock support for someone with complex medical needs.

When the cap drops to 56 hours a week, some families will need to find a second caregiver to cover the remaining hours. For families where that's workable, it may be fine. For families where the member's needs are highly specific, where trust and familiarity are part of what keeps them safe, or where qualified caregivers simply aren't available locally, the gap between what the rule allows and what the family actually needs can become a real crisis. We reject the institutional assumption that family care is "unskilled labor." Your life experience is professional tenure, and it deserves to be protected.

How do you apply for an IHSS or CDASS caregiver exception process?

The rule does include a way to request an exception to the 56-hour cap. For most families receiving IHSS services or Community First Choice services, the process starts with your provider agency, who submits the request to your Case Manager first. Your Case Manager must review and approve it before it goes to the state. This is intended to be a collaborative effort. 

If you're self-directing your care through the CDASS caregiver exception process, you or your Authorized Representative take on that same role. The state then makes the final call.

The request can be approved if your situation meets one of four categories:

These categories are an improvement over the first version of this rule, which was narrower. The state also made some other helpful changes: the emergency exception window was extended from 24 hours to 7 days, the 30-day advance notice requirement for submitting exceptions was softened with a "when appropriate" qualifier, and caregivers are now explicitly protected from being considered out of compliance while an exception request is being reviewed.

Those are real improvements, and they do matter.

What is missing from the Colorado Medicaid home care cap policy?

Despite those improvements, there are gaps in this rule that we believe will cause real harm to real families. We want to be direct about them, cutting through the typical bureaucratic noise:

• Long-term family caregivers have no dedicated pathway: If a family member has been providing care for years, someone who knows every detail of their loved one's routine, communication style, and medical history, there is no exception category that recognizes that relationship as something worth protecting on its own terms. The rule treats continuity as a secondary consideration, not a right.
• "Specialized skills" is never defined: One of the workforce barrier criteria allows an exception if the member requires skills not available locally. But the rule never gives examples of what counts. Does trach care qualify? Seizure management? Ventilator support? Families and agencies are left to guess, and the Department has wide discretion to say no without explanation.
• The exception process puts the burden entirely on families and agencies: Submitting a full exception request requires clinical documentation, proof of recruitment efforts, risk assessments, staffing summaries, and more. For a small agency or a self-directing family, assembling all of that in 30 days or less, in an emergency — is a significant ask. There's no acknowledgment in the rule that this burden falls unevenly on the people least equipped to carry it.
• Members don't have their own appeal rights: If an exception is denied, the provider agency has appeal rights. The member (the person whose care is actually at stake) does not have a clearly defined path to appeal independently. That's a meaningful gap in a system that is supposed to center the member's needs.
• What happens to members during a payment hold is not addressed: If an agency is found out of compliance and payments are suspended, nothing in the rule explicitly protects the member's services from being interrupted. The financial consequence falls on the agency, but the person at home still needs care.

What you can do right now

The Medical Services Board is scheduled to review and vote on this rule on June 12, 2026. That means the window to influence the final text closes in days, not weeks. Here's how to use the time you have.

• Make your voice heard before June 12th, 2026
  The Board accepts testimony in several ways, and you don't need to be a policy expert or speak in formal language. A brief, honest account of how this rule affects your family is more powerful than any technical argument.
• Written testimony (recommended if you can't attend):
  Email your testimony to hcpf_medical_services_board@state.co.us. To ensure Board members receive it before the meeting, your email must arrive by 5:00 p.m. on Thursday, June 11. Written testimony received after that deadline will be shared with Board members after the meeting, not before.
• In-person testimony at the June 12 meeting:
  You can testify in person at the meeting. Sign-up closes when the meeting begins, so arrive early. Total testimony time on this rule is capped at 35 minutes across all speakers, so the earlier you sign up the better.
• Remote testimony by phone or computer:
  If you can't attend in person, you can testify live by phone or video during the meeting. Sign up in advance using the Medical Services Board testimony form at the link below. Remote speakers are called after in-person testimony is complete.

  Sign up for remote testimony

Protect your care plan regardless of what the Board decides

Whether or not the rule changes before it passes, these steps matter now:

• Talk to your Case Manager about how the 56-hour limit may affect your current care authorization.
• Ask your provider agency whether they plan to submit an exception request on your behalf and what documentation they'll need from you.
• Document your caregiver's specialized knowledge and skills in writing today. Don't wait until you're filing an exception request under pressure.

Our commitment to families

At Caregivers First Choice, we work specifically with families where a loved one is the caregiver. We understand what's at stake when a rule like this lands without enough nuance. We will continue to monitor this rulemaking, support families through the exception process, and advocate for changes that reflect the reality of how family caregiving actually works.

If you have questions about how this rule affects your specific situation, reach out to us. We're here.

Sources:

• Revision to Home Health Services, Home and Community-Based Services Provider Agency Requirements and HCBS Benefits and Services Requirements
• Cap on Weekly Caregiving Hours
• Medicaid Sustainability and Colorado's LTSS System