As we prepare for the launch of our new agency, we are keenly aware of the shifting landscape in Colorado’s Long-Term Services and Supports (LTSS). The recent release of HCPF Operational Memo 26-004 signals a significant change for families who rely on the In-Home Support Services (IHSS) and Community First Choice (CFC) models.
For the dedicated family caregivers who have built their lives around providing care, the news of the allowable homemaking hours for Legally Responsible Persons (LRPs) being capped at 5 hours per week is more than just a policy update. It is an additional weight on a career path that is already uniquely challenging. This reduction from the previous 10-hour limit will require many families to rethink their daily routines.
Understanding the Hardship of the Family Caregiver
The term “family caregiver” is one I have spent my career championing. It describes a role that is both a professional commitment and a labor of love. When budget shortfalls lead to draconian limits on these services, the impact is felt most acutely at the kitchen table and the bedside.
We understand that for many of you, this career isn’t just about the tasks listed in a care plan. It is about the stability and dignity of the home environment. Adding limits to a career that is already defined by high acuity and constant advocacy requires a level of resilience that we deeply respect.
What You Need to Know
According to HCPF OM 26-004, these changes are part of a systemwide effort to ensure Medicaid sustainability. Key points include:
- The New Cap: Allowable Homemaker hours provided by an LRP will be reduced to 5 hours per week per member.
- Timeline: These limits will take effect for Level of Care (LOC) Certification dates starting April 1, 2026 meaning you existing authorization will stay in place until your loved one’s next LOC or Continued Stay Review (COR).
- Transition Plan: The cap must be reflected in all Support Plans through a review at the next scheduled Monitoring or Continued Stay Review by November 30, 2026.
Crucially, the memo notes that a limit on caregiving hours does not mean a reduction in services to the Member. However, we recognize that this puts the burden on families to find alternative caregivers to fill the gap. This is a task that is often easier said than done in today’s labor market.
Lessons from History: The 2008 Parallel
This is not the first time Colorado’s Medicaid system has faced severe fiscal headwinds. If you were navigating the system around 2008, you likely remember a strikingly similar pattern. During the global financial crisis, HCPF was forced to implement emergency measures to manage a massive state budget shortfall.
At that time, we saw:
- Utilization Caps: Strict limits were placed on service hours to control expenditures.
- Rate Freezes: Provider reimbursements were held stagnant or cut, putting immense pressure on agency operations.
- Resilience through Scarcity: Despite these difficult measures, the home care community survived by coming together, advocating for the essential nature of these services, and innovating how care was delivered.
We made it through 2008 by focusing on core clinical needs and maximizing the flexibility of the waivers available. That period of hardship eventually led to the advocacy that created the robust IHSS and CDASS programs we see today. History suggests that while these cuts are painful, the home care community is incredibly durable.
Our Commitment to You
At Caregivers First Choice (CFC), my goal is to leverage our years of operational experience to help you navigate these changes. We are building this agency on the principle that family caregivers deserve a partner who understands the nuance of the law and the reality of the work.
We aren’t just starting an agency. We are continuing a lifelong commitment to the families of Colorado. As we move toward our launch in early 2026, we will be here to help you identify alternative staffing solutions and navigate the sustainability initiatives described in HCPF OM 26-004.
The road ahead has its hurdles, but we have navigated these cycles before. Together, we will continue to ensure that home remains the primary place of care for Colorado’s most vulnerable citizens.
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