Lastest Updates (June 2026)
Colorado’s Medicaid program continues to evolve as state leaders work to address budget challenges, implement approved changes, and plan for the future of long-term services and supports.
This page provides the latest information available to Imagine! families about changes that may affect Medicaid-funded services in 2026. Some changes have already been approved and are moving forward, while others are still being discussed or developed at the state level.
We know many families have questions about what these changes mean for their loved one. Our goal is to share clear, accurate information, explain what we know today, and help families understand what to expect as additional details become available.
Because state guidance, timelines, and implementation plans may continue to change, we will update this page as new information is released.
As always, families are encouraged to speak with their case manager or service team about how any changes may apply to their individual situation.
Colorado Budget (Long Bill) Signed
Colorado’s state budget has now been finalized and signed into law. Many of the Medicaid and long-term services and supports (LTSS) changes previously discussed are now moving forward according to their planned implementation timelines.
New Medicaid Commission Begins Work
Colorado has created a temporary Commission on Medicaid to review the future of the Medicaid program and make recommendations to state leaders.
The Commission will meet throughout 2026 and is expected to discuss topics including:
- Medicaid funding and sustainability
- Access to services
- Program administration
- Federal Medicaid changes
- Long-term policy options for Colorado
The Commission is expected to provide recommendations to the Governor and Legislature by December 2026.
Learn more and follow Commission meetings: Colorado Medicaid Commission Meetings & Materials
Medicaid Work Requirements
Federal law requires states to implement Medicaid work requirements by the end of 2026, but these requirements are not currently in effect in Colorado. While details are still being developed, many people with disabilities are expected to qualify for exemptions.
Families do not need to take action at this time. We encourage everyone to keep contact information up to date, read all Medicaid-related communications, and stay informed as additional guidance becomes available.
Imagine! is monitoring developments and will continue sharing updates and resources as more information is released. For more information, click here.
Family Caregiver Medical Services Rulemaking (non HCBS-DD services)
Colorado is currently developing rules related to family caregiver medical services. This is the process that determines how the program will operate, including eligibility requirements, service expectations, and implementation details.
Families, caregivers, and community members are encouraged to review the proposal and provide feedback during the public comment process.
Comments are current open; learn more here: Rulemaking Information and Meeting Materials
New Information Added Below
Several Medicaid updates have been finalized, while others remain in rulemaking. Families are encouraged to review the Service Updates at a Glance chart below for the latest information, including June 2026 updates related to Homemaker services provided by Legally Responsible Persons (LRPs).
What’s Changing in 2026
Beginning this year (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. Not all changes will apply to everyone, and not all changes will move forward on the same timeline.
When changes do apply, they should 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 generally not be available for children under age 6 unless there is an assessed exception. Click here for Community Connector Guidance | For younger children, community activities are expected to be supported by parents or caregivers as part of typical development. Services may still be authorized when there is an exceptional or extraordinary need that goes beyond what is typical. Status: Approved Implementation Date: April 1, 2026 What This Means: Exceptions may be authorized based on assessed need and will be addressed through the individual planning process (CSRs). |
| Community Connector (Service Limits) | Annual service limits are being introduced for Community Connector services. Click here for the fact sheet | The new limit is 1,040 units (approximately 260 hours per year). These limits are not absolute. If needs exceed this amount, case managers can review the situation and request additional services when appropriate. Status: Approved Implementation Date: April 1, 2026 What This Means: The annual limit will be applied during the individual planning process (CSRs). Additional services may be authorized based on assessed need. |
| Community Connector (Rate Reduction) | Payment rates for Community Connector services are being reduced. Click here for the fact sheet | This is a change in how the service is reimbursed—not whether the service is available. Your team will work with you to plan for continuity of support. Status: Approved Implementation Date: April 1, 2026 |
| Homemaker (Legally Responsible Person) | Homemaker services provided by Legally Responsible Persons (LRPs) are changing. HCPF is proposing a limit of 7 hours per week of Homemaker services per member provided by LRPs. Click here to read more Click here for caregiver/attendant options. | This proposal would replace the current policy that allows up to 5 hours per week per LRP (up to two LRPs). The 7-hour limit would apply to the member’s total Homemaker services delivered by LRPs within the household. Additional Homemaker services may still be provided by authorized caregivers who are not LRPs. Status: Proposed Rule Change Expected Implementation Date: July 1, 2026* What This Means: Families using LRP Homemaker services may see changes to how those hours are authorized. Additional support needs may continue to be met through other authorized caregivers and services. |
| HCBS Service Limits | HCBS Service Limits (Personal Care, Homemaker, Health Maintenance) Annual service limits are being introduced for certain HCBS services. Click here for the fact sheet | These are soft caps, not hard limits. If documented needs exceed these limits, case managers can review the situation and request additional services when appropriate. For context: Personal Care: approximately 6.5 hours per day Homemaker: approximately 3 hours per day Status: Approved Implementation Date: April 1, 2026 What This Means: Service limits will be applied during the individual planning process (CSRs). Additional services may be authorized based on assessed need. |
| Weekly Caregiving Hours | A revised schedule has been approved to gradually reduce the number of hours one caregiver can provide per week. | This change applies to hours per caregiver, not total services. Important: This does not limit the total amount of support a person can receive. Additional caregivers may be used if needed. Ramp-down schedule: 84 hours/week beginning July 1, 2026 70 hours/week beginning January 1, 2027 56 hours/week beginning July 1, 2027 Status: Approved Implementation Date: July 1, 2026 What This Means: The weekly hour limit applies to each individual caregiver. Total support hours may be maintained by utilizing multiple caregivers, based on assessed need. |
| Residential Services (IRSS Rates) | Proposed changes to align residential service rates across settings are paused for now. | No changes are expected at this time. We will share updates if this proposal moves forward in the future. |
| Across-the-Board (ATB) Adjustments | A 2% provider rate reduction has been approved for Medicaid services. | This change affects how services are funded across the system. It does not change eligibility or access to services. 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) Status: Approved Implementation Date: July 1, 2026 What This Means: Provider reimbursement rates will be reduced by 2% for most services. This does not impact eligibility or the amount of services individuals can receive. |
| Aligning Cost of Care in the DD Waiver: Post Eligibility-Treatment of Income (PETI) | This proposal requires individuals in the DD waiver to contribute a portion of their income toward the cost of residential services. As of recently, HCPF has shared additional information about how PETI may be implemented. We understand this is an area of strong interest for many families and are linking to the most current information below. View the latest HCPF update Click here for the fact sheet | When implemented, individuals would still retain a portion of their income for personal use. Status: Approved Implementation Date: July 1, 2026 What This Means: Introduces cost-share/co-pay requirements for some DD services |
| Create Group Rates for certain Community First Choice (CFC) and Long-Term Home Health (LTHH) Services | New group service rates are being introduced for some Community First Choice (CFC) and Long-Term Home Health (LTHH) services. Click here for the fact sheet | When one caregiver supports multiple people at the same time in the same setting, services may be billed at a group rate, which is lower per person than individual rates. Status: Approved Implementation Date: January 2027 What This Means: When services are delivered in a group setting, reimbursement may be at a lower per-person rate. Individual services will continue to be available based on assessed need. |
| Auto Enrollment Changes for Youth Transitioning to the DD Waiver | Automatic enrollment into the adult DD waiver will end for youth transitioning from children’s waivers. Click here for the fact sheet | Young people may move to a waitlist or access services through other waivers instead of automatically entering the DD waiver. Emergency and priority situations are not affected. Status: Approved Implementation Date: July 2026 What This Means: Youth transitioning from children’s waivers may no longer be automatically enrolled in the DD waiver and may access services through other pathways. |
| Reducing DD Waiver Churn (Movement On and Off the Waiver) | The state will reduce by 50% the number of people moving into DD waiver spots as they open. Click here for the fact sheet | More individuals may remain on waitlists longer and continue receiving services through their current waiver. Emergency and priority situations are not affected. Status: Approved Implementation Date: July 2026 What This Means: Fewer individuals may transition into the DD waiver as openings occur, and some may continue receiving services through other waivers. |
These are statewide changes and not specific to Imagine!. Not every change will apply to every person or family.
Background: Why These Changes Are Happening
This page focuses on the specific updates families may see in 2026. If you’re wondering why these changes are happening, the information below provides additional context.
Why Changes Are Happening
Colorado’s Medicaid program supports hundreds of thousands of people across the state, including many individuals who rely on long-term services and supports.
At the same time, the cost of providing services has grown faster than available funding. As a result, state leaders are making changes intended to help sustain the Medicaid program over time.
These are statewide decisions that affect many programs and providers across Colorado and are not specific to Imagine!.
Some changes took effect April 1, 2026. Additional changes are scheduled for July 1, 2026 and beyond. Other proposals remain under discussion or continue to evolve.
Because services, waivers, and individual circumstances vary, families may hear about these changes at different times through service planning meetings, case management conversations, advocacy organizations, or provider communications.
Ongoing State Discussions
In addition to the changes already approved, Colorado leaders continue to evaluate the future of the Medicaid program.
A new Commission on Medicaid began meeting in 2026 to review Medicaid funding, program operations, federal policy changes, and long-term sustainability. The Commission will gather input from Medicaid members, families, advocates, providers, and community organizations before making recommendations to state leaders later this year.
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
