Colorado Medicaid Changes for Family Caregivers: One Page Now Tracks Them All

Key takeaways

• Seven changes are permanent. The Medical Services Board voted them into rule, including the weekly caregiver limit, which drops from 84 hours today to 70 in January and 56 next July.
  
• Eight proposals aren’t final. The biggest would cap paid Personal Care from a parent or guardian at 7 hours a week.
  
• HCPF wants comments this week. Round 2 feedback sessions run Tuesday, October 27 and Wednesday, October 28. Written comments don’t require attending either one.
• We built a tracker that updates every Monday: Colorado LTSS Sustainability Tracker

What is changing in Colorado Medicaid for family caregivers?

As of October 24, 2026, HCPF has 11 sustainability changes in effect and 8 more proposed. The Medical Services Board has made 7 permanent, including the weekly caregiver limit, which steps down to 56 hours by July 2027. None of the 8 proposals (a 7-hour weekly cap on parents’ paid Personal Care among them) is final.

Since the Governor’s August 2025 executive order, HCPF has announced 32 actions to slow spending on Long-Term Services and Supports. Some arrived as operational memos. Some came as emergency rules. Three showed up last week as Google Docs linked from a feedback page.

You shouldn’t need four browser tabs and a law degree to know which ones touch your paycheck. So we built one page that follows every change from proposal to final vote: the Colorado LTSS Sustainability Tracker. Here’s what it shows this week.

What’s already permanent?

A change is permanent once the Medical Services Board adopts its rule on final reading. Seven have.

Four more rules got final votes on October 9: group rates, Private Duty Nursing, DD Waiver youth transitions, and LTSS medical documentation. The results post with the Board’s minutes, likely alongside the November 13 meeting materials. The tracker will update the week they do.

What’s still being decided?

Round 1 (feedback closed in October; HCPF is reviewing):

• Cap paid Personal Care from a parent or guardian of a child at 7 hours a week, with no exceptions
• Remove Personal Care for children from Community First Choice (CFC); the State Plan benefit children would move to doesn’t pay family caregivers
• Lower the Personal Care soft cap to 8,320 units a year (about 40 hours a week, down from about 48)
• Lower the Homemaker soft cap to 1,456 units a year (about 7 hours a week) for every member
• Extend the 7-hour Homemaker limit to all family caregivers, including adult children and siblings, with no exceptions

Round 2 (open for comment now):

• Remove the live-in caregiver exemption from Electronic Visit Verification, so live-in caregivers would GPS clock in and out at home
• Remove Protective Oversight (line-of-sight supervision) and Accompaniment (help at appointments and errands) from Personal Care, with no exceptions, plus new limits on Life Skills Training and Home Delivered Meals
• Remove eight services from certain HCBS waivers, including Community Connector and Extraordinary Cleaning for CES families

HCPF says no final decisions have been made on either round. None of the eight has reached the Board yet.

HCPF’s own preliminary estimates put the eight at about $149.6 million a year in State General Fund if every one passed as written, roughly a third of the $425 million gap. Several overlap, so the real figure would be lower. Each card on the tracker shows its estimate and source.

Why can’t the current growth hold?

Much of the growth is what Colorado set out to do: more families paid to care at home, better wages for direct care workers. The problem is speed. The numbers are HCPF’s. LTSS serves about 8% of Colorado Medicaid members and uses 48% of Medicaid General Fund spending. Medicaid now needs about $425 million more General Fund for FY 2026-27 than forecast; $244 million of that sits in community-based LTSS.

HCPF splits the growth three ways: 45.9% from more services per member, 42.7% from provider rate increases, and 11.4% from enrollment. It also says plainly that growth doesn’t mean members are getting care they don’t need. The tracker graphs all three numbers at the top.

Do comments actually change anything?

They have this year. HCPF’s first Homemaker limit for parents and spouses allowed 5 hours a week per parent. After feedback, the Board set it at 7 hours a week per member.

The weekly caregiver limit moved too. This summer we filed an exception for a caregiver authorized at 112 hours a week; at the June Board meeting, HCPF acknowledged 112-hour weeks aren’t typical. By August 14, the Board had added exceptions for extraordinary clinical acuity, workforce access barriers, transitions, and end of life.

Neither change happened because families stayed quiet.

What to do before Tuesday

1. Read the three Round 2 proposals. They’re linked from HCPF’s sustainability page and from each card on the tracker.
2. Pick one session. Tuesday, October 27, 11 a.m. to 12:30 p.m. MT or Wednesday, October 28, 8:30 to 10 a.m. MT. Both cover the same material.
   
3. Or skip the meeting and write. HCPF’s written feedback form counts the same, and you don’t have to answer every question.
4. Check your own plan. Open the tracker, tap “Affects family caregivers,” and compare the 16 cards against your authorization.
5. Caring for a family member through another agency? Our caregivers hear about each change from us first, with a plan. See how the Zero-Gap Switch moves you to CFC without missing a paycheck.

How the tracker works

Every card shows a status (open for comment, under HCPF review, planned, in effect), its date, the Board’s vote history, HCPF’s savings estimate, and a plain-language line on what it means for you. A Medical Services Board record lists every vote since April, newest first. We check HCPF’s sustainability page, the Board’s agendas and minutes, and HCPF’s memo series every Monday, and the “last checked” date at the top tells you when we last looked.