To the Families Who Testified on Colorado Paid Caregiver Hour Limits: Thank You

Key Takeaways

• A Heartfelt Thank You: We owe our deepest gratitude to every parent, spouse, and family caregiver who translated their deeply personal lives into public record to challenge the new caps.
• The Rule Has Passed: On June 12, 2026, the Medical Services Board adopted MSB 26-05-05-B as an emergency measure, initiating a phased reduction of individual weekly paid hours starting July 1, 2026.
• The Vote Was Not Unanimous: A critical dissenting vote signals that the data, themes, and emotional realities raised by families registered as substantive, not just procedural.
• Shifting the Battleground: The statutory cap was predetermined by the legislature in HB 26-1410; the real focus now shifts to holding the state accountable through the implementation and exception processes.

What is the impact of family testimony on the new Colorado paid caregiver hour limits under rule MSB 26-05-05-B?

While the Colorado Medical Services Board adopted the emergency rule on June 12, 2026, public testimony from families fundamentally disrupted the review, exposing severe flaws in workforce assumptions and forcing a non-unanimous vote.

The Board has voted. The rule has passed. I want to break down exactly what changed during the review, where the cracks in the state's logic showed up, and most importantly our radical gratitude to the families who showed up to fight.

Over the past two weeks, the Colorado Medical Services Board received a massive stack of public testimony on MSB 26-05-05-B. This is the highly contested rule that sets strict weekly limits on paid caregiver hours across In-Home Support Services (IHSS), Consumer Directed Attendant Support Services (CDASS), Personal Care, Homemaker services, Health Maintenance Activities, and Long-Term Home Health.

I listened to every minute of the review. But before we get into the policy mechanics, the timelines, or the legal distinctions, I need to start with the only part of this entire process that truly matters.

Thank you.

Thank you to every parent, spouse, and family caregiver who sat down to write. I know what that took. It meant opening up a laptop or phone after a 14-hour day of tube feedings, precise medication schedules, intensive seizure monitoring, and the hundreds of quiet, heavy tasks that never find their way onto an official state care plan. It meant documenting your raw daily life for a public record on a cold administrative deadline, all while the exhausting work that prompted it never paused for a single second.

Submitting that testimony was not a small act. It required immense courage. You refused to let the state treat your specialized, life-sustaining care as casual, unskilled labor. You spoke as specialists who hold years of professional-grade tenure in your own homes. You did it anyway, and your words matter.

What Did the Medical Services Board Decide on Hour Limits?

On June 12, 2026, the Medical Services Board officially adopted the rule as an emergency measure. The resulting policy establishes a step-down structure designed to phase in the weekly individual caregiver limit over the course of a full year. The state’s implementation timeline will roll out in the following sequential tiers:

Phase-In Schedule

• July 1, 2026: Limits begin at 84 hours per week per caregiver per client, and the pre-existing 16-hour daily caregiver limit remains firmly active.
• January 1, 2027: The weekly cap drops to 70 hours per week across all applicable services.
• July 1, 2027: The final statutory limit of 56 hours per week is reached for individual caregivers.

It is incredibly important to note that the vote was not unanimous. One board member voted against adopting the rule. In the world of state bureaucracy, that single dissent carries immense weight. It signals clear validation for our community: it means the deep, structural flaws families highlighted weren't pushed aside as emotional rhetoric, they registered as substantive, undeniable evidence.

We also need to be precise about what the Board was actually deciding. The budget limitations itself was already carved into statute by the Colorado legislature through HB 26-1410, which the Governor signed back in May. The Board’s authority was strictly limited to how to implement the rule, not whether to allow it. This distinction changes our entire strategy moving forward. The legislative battle is settled, but the live ground where we must protect your livelihood is the implementation framework—specifically, mastering the state's exception process.

This distinction changes our entire strategy moving forward. The legislative battle is settled, but the live ground where we must protect your livelihood is the implementation framework, specifically, mastering the state's exception process.

Why Did Your Family Caregiver Testimony Matter to the Board?

When the state sees an authorization, it sees numbers on a spreadsheet. When you testified, you forced them to look at clinical facts, human dignity, and the reality of specialized care. Across the pages of family testimony, a few profound themes emerged with undeniable consistency:

• The Care Does Not Stop at a Cap: Family after family detailed medical needs that run continuously from sunrise until long after the rest of the world is asleep and frequently straight through the night. A policy change cannot alter the number of respiratory checks, diaper changes, or emergency interventions a human body requires. It only changes whether the person doing that exhausting work is fairly compensated or forced into financial instability.
• Continuity is a Clinical Fact, Not a Convenience: One parent provided devastatingly clear documentation: their medically complex, non-verbal child faced systemic hospitalizations nearly every single year for half a decade. Yet, in the five years since that parent became the consistent, paid caregiver, those hospitalizations dropped to exactly once. A family caregiver who can read a subtle change in skin tone or breathing before it becomes an ICU emergency is an irreplaceable clinical specialist, not a scheduling preference.
• You Cannot Hire Caregivers Who Do Not Exist: The entire rule relies on the fundamentally broken assumption that trimming hours from a dedicated family member will easily redistribute that labor to external workers. Families and the Advocacy groups fought back fiercely against this claim. In the vast majority of Colorado, qualified home care workers are simply unavailable. Cutting your hours does not magically conjure up a nursing workforce that does not exist.
• Dignity Belongs in the Conversation: Individual members wrote movingly about their lives, stating clearly that they do not want a rotating cast of strangers rotating through their bedrooms to perform deeply intimate personal care. That is not stubbornness. It is the basic right to privacy and safety that any human being expects, and it sits at the absolute core of true, person-centered care.

Where Do We Go From Here?

We know that a parent with 10 years of life experience knows more than a stranger off the street and we refuse to accept the narrative that your dedication is "unskilled labor." The Department has explicitly confirmed that this policy does not reduce any member's total authorized service hours. Your overall care plan authorizations are based entirely on your independent, assessed medical need and remain completely unchanged. What changes is how many of those hours a single individual caregiver can be paid for, not the total amount of care a member is legally entitled to receive.

This means our next steps are operational, not panicky. We are completely retooling our agency back office to deliver Radical Ease, handling the administrative burdens, building customized hour-tracking report, and preparing your documentation early so your household experiences absolutely zero gaps in care or income.