Colorado will cut rates for all long-term services and supports, home and community-based services and case management by 2% starting July 1, 2026. The state will also phase in a weekly cap on the hours one caregiver can provide to a single member and limit new enrollments in its Developmental Disabilities (DD) waiver.
Bonnie Silva, director of the Office of Community Living at the Department of Health Care Policy and Financing (HCPF), laid out the package in an April 8, 2026 message on the department's LTSS sustainability page, citing a budget gap that followed the 2025 federal budget law. As of that update, the changes were pending final approval from CMS, the Medical Services Board and the legislature.
The 2% rate cut
The across-the-board decrease applies to all provider rates and case management agency contract rates, including state general fund programs and targeted case management.
The weekly caregiver cap
The cap covers personal care, homemaker, health maintenance activities and long-term home health aide and nursing services. It steps down from 84 hours a week per caregiver for one member on July 1, 2026, to 70 hours on Jan. 1, 2027, and 56 hours on July 1, 2027. HCPF says members' authorized hours and budgets are not cut; the hours must be spread across more caregivers. Provider agencies and CDASS employers can request exceptions, for example for workforce shortages, stabilization periods or end-of-life care. The existing 16-hour daily limit per caregiver stays.
DD waiver changes
Waiver amendments submitted to CMS on March 20, 2026, with a requested July 1 start, would cut transitions from the waiting list onto the DD waiver by 50%. Youth leaving the CES and CHRP children's waivers would no longer move onto the DD waiver automatically; they would be offered the Supported Living Services waiver instead. Emergency and institutional-exit enrollments remain.
Some DD waiver members in residential services would also contribute part of their income toward care under the federal post-eligibility treatment of income method, which does not count family members' income.
Separately, soft caps on some in-home services, including annual limits for homemaker and personal care units, took effect April 1, 2026.
Why this matters for providers and DSPs
Colorado agencies face lower rates while also having to recruit more caregivers to cover hours that one worker can no longer provide. Providers should plan staffing now and use the exception process where members need continuity.