Budget Update (as of April 1, 2026)
The Joint Budget Committee (JBC) has finalized the Long Bill. It will be considered in the House next week, followed by the Senate.
While major changes are not typical at this stage, amendments can still affect specific details. As a result, the figures outlined below are not final until the Long Bill—and any related budget legislation—are passed by the legislature and signed into law by the Governor.
We understand there is strong interest in confirmed numbers. At this point, the process is still underway, and we will continue to share updates as more information becomes available.
Understanding Upcoming Colorado Medicaid Changes
In recent months, Imagine! has been sharing information about upcoming changes to Colorado’s Medicaid services and what to expect in 2026. As these statewide changes draw closer, families may also be hearing about them through service planning conversations or advocacy partners.
This page brings together what we know right now in one place and invites families to join upcoming informational sessions, revisit Jodi’s December video, and connect with our team for guidance and support as things continue to unfold.
Please note: Because information is evolving quickly, details and timelines may shift. We know some proposed changes are currently paused, others are being revised, and new approaches are being discussed. We will update this page with updated information when we have it.
Why Changes Are Happening
Colorado’s Medicaid program supports many people across the state, including individuals who rely on long-term services and supports. At the same time, the cost of providing these services has grown faster than the funding available. Simply put, there is a limited amount of money to support a very large and growing need.
Because of this, state leaders are making adjustments to how Medicaid services are structured, reviewed, and funded in order to keep the program sustainable over time. These updates are happening statewide and affect many programs and providers; they are not specific to Imagine!.
Some changes are already underway, while others will roll out over the course of 2026. Because of the scope and timing, families may hear about these updates at different points depending on the services they use, the waiver they are on, and when service plans are reviewed.
👉 View the statewide Medicaid summary letter
What’s Changing in 2026
Beginning in 2026, Colorado’s Medicaid program is expected to make a series of updates to long-term services and supports. These potential changes affect services provided through several waivers (including CES, SLS, DD, CHRP, and others), as well as the Community First Choice (CFC) program.
Some updates are expected to begin as early as April 2026, with additional changes rolling out over the course of the year. Others remain under review or may be revised as state and federal decisions continue to evolve. Because of this, not all changes will apply to everyone, and not all changes will move forward on the same timeline.
When changes do apply, they will be discussed with families during regular service planning or monitoring meetings. Families will have the opportunity to review how any updates relate to their services and to talk through options, supports, and next steps with their case manager.
Service Updates at a Glance
Information below reflects current proposals and discussions and may change as decisions are finalized. For the most current statewide information, visit: https://hcpf.colorado.gov/medicaid-sustainability-and-ltss
| Service Area / Change Area | What’s Changing | What Families Should Know |
|---|---|---|
| Community Connector (Age Appropriateness) | Community Connector services will likely no longer be available for children under age 6 unless there is an assessed exception. Click here for Community Connector Guidance | Community activities for children younger than school age are expected to be provided by parents or caregivers. Community Connector services must be authorized based on an age-appropriate assessed exceptional or extraordinary need that substantially exceeds typical parental responsibilities. Status 3/30/2026: Implementation will move forward. Current expected timeline: April 1, 2026 (pending federal approval) |
| Community Connector (Service Limits) | New annual limits will apply (1,040 units / 260 hours). Click here for the fact sheet | If needs appear to exceed these limits, case managers can review the situation and request additional services when appropriate. Current expected timeline: April 1, 2026 (pending federal approval) |
| Community Connector (Rate Reduction) | Payment for Community Connector supports will be decreased. Click here for the fact sheet | This is a change to how the service is reimbursed, not whether the service exists. Providers and case managers will work together to plan for continuity of support. Status 3/30/2026: Implementation will move forward. Current expected timeline: April 1, 2026 (pending federal approval) |
| Homemaker (Legally Responsible Person) | Payment will be capped at 5 hours per week per legally responsible person (previously 10). Click here for caregiver/attendant options. | Up to two legally responsible persons may each provide up to 5 hours per week. This limit is not flexible, but other caregiver options may be explored if more support is needed. Current expected timeline: April 1, 2026 (pending federal approval) |
| HCBS Service Limits | Annual service unit limits will apply to Personal Care, Homemaker, and Health Maintenance Activities. Click here for the fact sheet | When documented needs exceed these limits, case managers can review information and request additional services if appropriate. Current expected timeline: April 1, 2026 (pending federal approval) |
| Weekly Caregiving Hours | The Joint Budget Committee approved a revised schedule for the Caregiver cap ramp-down, as follows: 84 hours effective 7/1/26 70 hours 1/1/27 56 hours 7/1/27 | This does not limit total services available; it limits hours per caregiver. Additional caregivers may be used if needed. Status 4/2/26: Implementation will move forward on a revised schedule. Current expected timeline: July 2026 |
| Residential Services (IRSS Rates) | Payment rates for Individual Residential Services and Supports will be aligned across certain living settings. | This is a rate adjustment only and does not change the benefit or services provided. Status 3/30/2026: Implementation paused; not likely to start prior to 7/1/2026. |
| Across-the-Board (ATB) Adjustments | The Joint Budget Committee approved a 2% across-the-board provider rate reduction to Medicaid. | Exempted from this reduction: 1. Pediatric Behavioral Therapies, which already received a rate reduction to align with an updated benchmark earlier this budget year. 2. NICU and maternal health service codes (these are also exempted from the proposal to align rates with 85% of Medicare) |
| Aligning Cost of Care in the DD Waiver: Post Eligibility-Treatment of Income (PETI) | People in the DD waiver will begin contributing a portion of their income toward the cost of their residential services (beyond room and board), similar to other Medicaid residential programs. Click here for the fact sheet | Right now, people in the DD waiver keep most of their income (after room and board). In the future, they may need to use some of that income to help pay for their services, while still keeping a set amount for personal expenses. This change is meant to make things more consistent and fair across Medicaid programs, and to help sustain funding for long-term services. Current expected timeline: Summer 2026 (pending federal approval) |
| Create Group Rates for certain Community First Choice (CFC) and Long-Term Home Health (LTHH) Services | This change will allow a single Direct Care worker and/or CNA to serve multiple members of the same household or setting simultaneously. Click here for the fact sheet | Group rates will be required when services are provided to multiple members receiving these services from one person at the same time in the same setting. Group rates for these services are expected to be about 20% lower per person than the individual rate. Current expected timeline: January 2027 |
| Auto Enrollment Changes for Youth Transitioning to the DD Waiver | Automatic transitions from children’s waivers (CES and CHRP) into the adult DD waiver will end. Click here for the fact sheet | Young people aging out of children’s services will no longer automatically move into the DD waiver. Instead, they may move to a waitlist or need to access services through other pathways (such as the SLS and/or EBD waivers). Emergency and priority situations are not affected. Current expected timeline: Summer 2026 (pending federal approval) |
| Reducing DD Waiver Churn (Movement On and Off the Waiver) | The state will reduce “churn” enrollments into the DD waiver by about 50%. Click here for the fact sheet | Fewer people will move into DD waiver spots as they open up. More individuals will remain on the waitlist longer and continue receiving services through their current waiver until additional spots become available. Emergency and priority situations are not affected. Current expected timeline: Summer 2026 (pending federal approval) |
These are statewide changes and not specific to Imagine!. Not every change will apply to every person or family.
What’s Not Changing
It may help to know that these updates reflect changes in how services are structured and reviewed, not a shift away from partnership or support.
- Services will not automatically end or disappear.
- Families will continue to play an active role in service planning.
- Opportunities to ask questions, seek clarification, and request support remain in place.
How Imagine! Is Supporting Families
Imagine! is committed to walking alongside families during this transition by:
- Hosting informational sessions to share updates and answer questions
- Offering opportunities for family engagement and advocacy
- Coordinating internally so staff can provide consistent, accurate information
- Partnering with case managers and advocacy organizations
We will continue to share updates as more clarity becomes available.
What Families Can Do Now
You don’t need to take action all at once. Helpful next steps include:
- Letting Imagine! know when you have upcoming service plan or monitoring meetings
- Asking questions when something feels unclear during service planning conversations
- Making sure your family member’s needs are fully discussed and documented
- Reaching out if you’ve already had conversations about changes and would like help thinking through next steps
It’s okay to ask for time, explanation, and support as you navigate this.
Resources & Ways to Learn More
- State overview letter on upcoming Medicaid changes
https://drive.google.com/file/d/1xPE42dMI6kShzHEj1KYnQJO4D5og53nt/view - Colorado Medicaid information webpage
https://hcpf.colorado.gov/medicaid-sustainability-and-ltss - December video from Imagine! leadership
https://imaginecolorado.org/2026-medicaid-changes-what-imagine-families-need-to-know/ - Past Family & Community Informational Sessions
📍 A&I Avenues Building, 1665 Coal Creek Drive, Lafayette
- Thursday, February 19 | 6:00–7:30 PM
- Saturday, February 28 | 10:00–11:30 AM
