HCPF outlines emergency rule changes and soft caps; families say cuts already happening
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Summary
HCPF said it will use emergency rulemaking to implement caregiver limits and related sustainability actions, with feedback open through Jan. 15 and emergency hearing Feb. 13; families and advocates reported that case managers and providers are already applying the new calculator and caps ahead of the April 1 effective date.
The Colorado Department of Health Care Policy & Financing told the Community First Choice Council it is taking rule changes through an emergency rulemaking process to implement caregiver limits and soft, capped service limits required by a governor's October 2025 executive order.
HCPF said a redlined draft of the rules has been posted on its website (since Dec. 19) and the public comment period is open through Jan. 15. The department said it will hold an emergency rule hearing on Feb. 13 and a final hearing on April 10; the rules are described in presentation materials as intended to be effective May 30, 2026, but staff emphasized that some operational pieces need to be in place by April 1 to allow case managers time to complete service planning.
Stakeholders pressed HCPF about implementation. Victoria, who leads an advocacy group of family members, said she and other families ‘‘can guarantee you right now, we have the evidence…that families are already being impacted by implementation of the caps’’ and described service plans that had been adjusted downward before trainings and memos were issued.
HCPF staff responded that the department intends the caps to be "soft caps" with an exceptions process in rule, not a change to hard caps. Speakers from the department’s case management and participant‑directed teams (Kidron Backus and Cassie) said case managers are expected to start using the new direct care services calculator now for relevant revisions but that the caregiver caps and sustainability actions are not effective until April 1. HCPF said it will provide case manager training and provider training in January and expects full caseload revisions to be completed by November 2026.
Stakeholders raised specific operational questions: whether respite qualifies for the difficulty‑of‑care exemption (HCPF will check IRS language), how the 56‑hour caregiver‑cap will be applied to families with multiple waivers, and how documentation for health maintenance activities differs from physician orders. HCPF staff said memos and a reissued direct care services calculator memo will clarify these points and urged members to use an HCPCS grievance form for individual cases in which they believe policy has been misapplied.
HCPF asked stakeholders to submit feedback via its online form and said it cannot alter the numeric limits in rule but will accept input on language.