If you have been following the recent updates from the Department of Health Care Policy & Financing (HCPF), you know that the landscape of long-term care in Colorado is shifting. We recently broke down the impact of the new soft caps on service units here, explaining how to justify your loved one’s need for higher care levels.
But there is another critical change in the January 2026 Sustainability Actions memo that hits even closer to home for family caregivers: The 56-Hour Weekly Cap.
For many of you—parents, spouses, and devoted children—caregiving isn’t a 9-to-5 job. It is a 24/7 commitment. This new rule changes how you are paid for that commitment, but it also creates an opportunity to ask a vital question: Who is part of my village?
What the New Rule Says
To balance the state budget, Colorado Medicaid is implementing a hard cap on the number of hours a single caregiver can be paid for in a week. This cap is slated for Spring 2026 and the impact will be felt far and wide.
- The Limit: A single caregiver may work up to 56 hours per week per member.
- The Reality: There are no exceptions for members requiring 24/7 care.
- The Impact: If your loved one is authorized for 70, 80, or 90 hours of care per week, you—the primary family caregiver—can no longer provide all of those hours yourself.
This leaves a “service gap.” For the hours exceeding 56, a second caregiver must step in.
The “Hour 57” Opportunity: Hiring Who You Trust
We know the idea of a “stranger” coming into your home can be stressful. You know your loved one’s needs better than anyone else—how to manage the G-tube, how to calm the anxiety, and exactly how they like their pillows arranged.
But the 56-hour cap doesn’t mean you have to hire a stranger. Under the In-Home Support Services (IHSS) model, you have the authority to select your own attendants.
Think about the people already in your life who you trust implicitly:
- The adult sibling who comes over for Sunday dinner.
- The neighbor who has known your child since they were a baby.
- The trusted friend who always offers to help but doesn’t know how.
This new rule gives you the ability to turn that informal support into paid employment. Instead of asking for a favor, you can offer them a reliable, paid role in your loved one’s care team. This allows you to take a much-needed break during “Hour 57,” knowing your loved one is with someone who loves them, too.
How Caregivers First Choice Supports Your Village
At Caregivers First Choice (CFC), we make it easy to formalize these relationships. We handle the “boss” stuff so you can focus on the care.
1. We Employ Your Trusted Circle
If you have a friend, neighbor, or relative you want to hire for those gap hours, send them to us. We handle the background checks, the paperwork, the payroll, and the taxes. As an IHSS agency, we become the employer of record, ensuring they are legally compliant and paid on time, while you retain the ability to train them on your loved one’s specific needs.
2. The Wage Ladder Advantage
Asking a friend to help is easier when you can offer them a competitive wage. Unlike other agencies that may pay closer to minimum wage, CFC offers a Tiered Wage Ladder that starts significantly higher than the industry average. This makes the position attractive to your friends and family—it’s not just “help,” it’s a well-paid professional role.
3. The Safety Net: We Have Your Back
We also know that not everyone has a neighbor or relative available to work 15 hours a week. If your circle isn’t available, we are your safety net.
Because we pay our staff professionals well and reward experience, we attract a higher caliber of caregiver—career professionals who are looking for supplemental hours. If you can’t fill “Hour 57” with a friend, we will work with you to recruit, screen, and train a backup attendant who matches your schedule and values. You are never in this alone.
Let’s Build Your Team
The 56-hour cap is a challenge, but it is also a push toward building a sustainable care team so you don’t burn out. Whether it’s your sister, your neighbor, or one of our professional staff members, we ensure that every hour of care is high quality.
Are you ready to build a care team you can trust?
Contact Caregivers First Choice today. Let’s talk about who is in your village and how we can support them.
While I appreciate efforts to help families adapt, the 56-hour caregiver cap disproportionately harms single-parent households and families who rely on one consistent caregiver. Many of us were already reduced to roughly 16 hours per day under prior policies, and this additional cap ignores the realities of medically complex children who require continuity and familiarity in their care.
The idea of building a “village” also assumes that extended family and friends are available, but in reality most already work full-time and cannot absorb additional caregiving hours. For families without access to multiple trusted, available caregivers, this cap creates a snowball effect that will grow into a much larger access problem. Frequent caregiver changes are not just inconvenient; for some children, they are destabilizing and unsafe. Policy discussions need to better reflect these real-world constraints.
Shannon,
Thank you so much for sharing this honest and important perspective. You are absolutely right—policy changes like this disproportionately impact single-parent households and families managing complex medical needs where continuity isn’t just a preference, but a safety requirement.
We understand that for many families, the idea of a ‘village’ effectively doesn’t exist because friends and family are working full-time or simply cannot provide the specialized level of care your child needs. We know that bringing in new caregivers is often destabilizing and that the reality of ‘Hour 57’ is far more stressful than policy discussions often reflect.
While we are bound to operate within these new state regulations, we fully see and validate the heavy burden this places on you. We are committed to advocating for flexibility wherever possible. If you are open to it, please reach out to us directly. We would value the chance to listen to your specific situation and see if there are any creative solutions or ‘safety net’ options we can offer to help you navigate this difficult transition.
Thank you for the thoughtful response and for acknowledging that continuity of care is a safety requirement, not a preference. I truly appreciate that recognition.
I do want to add that for some families of medically complex minor children, “creative solutions” such as onboarding, training, or rotating additional caregivers are not realistic options. Managing multiple therapies each week, homeschooling, and complex care routines already places a significant cognitive and emotional load on parents as is. Adding ongoing caregiver recruitment, training, and supervision often creates more stress and instability rather than support.
Additionally, the expectation that families can rely on extended family or friends to take on more paid caregiving hours on top of their own full time jobs is increasingly unrealistic and, in many cases, effectively obsolete. Most households are already working at capacity just to meet basic living needs.
This is why clear, accessible exception pathways are so important. For children who require consistent, trusted caregivers, flexibility at the policy level is not a convenience it’s necessary to prevent care disruption and harm.
I hope these realities continue to be elevated as the state considers how these caps are implemented.