In 2025, more than 20 changes to Colorado’s Long-Term Services and Supports (LTSS) system were proposed by the state’s Department of Health Care Policy & Financing (HCPF) to offset federal Medicaid cuts and state budget challenges. These changes have had a big impact on our community, affecting many of the supports that people with disabilities rely on to receive the care they need and engage with their community.
It’s crucial for people with disabilities to stay informed so they can prepare for changes to their services, make alternate plans if needed, and request exceptions to rules when it makes sense. To help, we’ve compiled a list of every change that’s being implemented and what you need to know about each. We’ll be updating this page frequently, so check back often to stay current on the changes that impact you.
Make your voice heard: Through ongoing feedback opportunities, you can share your perspective with HCPF and help shape rules as they go into effect.
- Click here to find open feedback opportunities for the changes listed below.
- Click here to find open public comment opportunities for any actions that require 1915(c) HCBS waiver changes.
- Both pages are updated regularly, so be sure to check back in the future for additional feedback opportunities.
Implemented
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Eliminating the Nursing Facility Minimum Wage Payments
This change ended supplemental, or additional, payments that the government was providing to nursing facilities. The payments helped nursing facilities pay their employees at least $15 an hour when state minimum wage was still below $15 an hour.
The program was expected to end in the state’s 2026-2027 fiscal year. This change ended the program earlier, in August 2025, with Colorado’s state minimum wage rising above $15 an hour in January 2026.
Who was affected? Nursing facilities
When did this change take place? August 2025. Payments did not go out in Spring 2026.
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Delay Presumptive Eligibility for Long-Term Services and Supports
Under this change, HCPF delayed the launch of its new Long-Term Services and Supports (LTSS) Presumptive Eligibility Program by about one year. In other words, instead of beginning in 2026, the new program is expected to begin in July 2027. The new program will apply to adults with disabilities who:
- have submitted a long-term care Medicaid application, and
- appear to be eligible for LTSS
Through the program, these adults will be able to start receiving some LTSS services before their full application has been approved.
Who is affected? Adults with disabilities applying to receive LTSS should be aware that the Presumptive Eligibility program will not begin in 2026. It is now expected to begin July 1, 2027.
When did this change take place? October 2025
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Community Connector: Rate Reduction (January) and Align Community Connector Rate with Supported Community Connections (April)
These changes decreased the pay rate for providers who provide Community Connector Services. These services are accessed through the Children’s Extensive Support (CES) and Children’s Habilitation Residential Program (CHRP) waivers and support children one-on-one to safely access and engage with the community.
The first reduction took effect in January 2026, decreasing the Community Connector pay rate to about $10.51 per 15-minute unit for providers in Denver and $10.23 per 15-minute unit for providers outside of Denver.
The second reduction took effect in April 2026, decreasing the rate to about $7.83 per 15-minute unit in Denver and $7.71 per 15-minute unit outside of Denver.
Due to a separate sustainability action, all provider rates, including rates for Community Connector, were reduced by an additional 2% across the board. Because of this decrease, the pay rate for Community Connector services is now roughly $7.67 per 15-minute unit in Denver and $7.56 per 15-minute unit outside of Denver. See “Across the Board Provider Rate Reductions (1.6% and 2%)” below for additional detail.
Who is affected? Providers of Community Connector services for children on CES or CHRP waivers.
When did this change take place? The first rate reduction took place in January 2026. The second took place in April 2026.
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Across the Board Provider Rate Reductions (1.6% and 2%)
This change:
- Rolled back a 1.6% pay rate increase that providers received in July 2025.
- Implemented an additional 2% pay rate decrease across the board for most Medicaid providers.
Who was affected? Most Medicaid providers, including Case Management Agencies, as well as Consumer-Directed Attendant Support Services (CDASS) members receiving allocations to direct their own care.
When did this change take place? The 1.6% reduction took effect October 1, 2025. The additional 2% reduction took effect July 1, 2026.
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Reduce Developmental Disabilities Waiver Churn Enrollment
This change reduced waiver churn enrollment onto the Developmental Disabilities (DD) waiver by 50%. Previously, for every person who disenrolled from the DD waiver, one person was moved off the waitlist and authorized to enroll in the waiver. Under the change, for every two people who disenroll from the DD waiver, one person is moved off the waitlist and authorized to enroll in the waiver.
Who is affected? Members currently on the DD Waiver waitlist and those seeking to be added to the waitlist in the future.
When did this change take place? July 1, 2026
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Remove Equine Services in Home and Community Based Services
This change removes Adaptive Therapeutic Equine Activities from HCBS waivers.
These services were added as a specialized therapy option under HCBS waivers in 2024, but there were challenges in launching this new option, so it was never fully implemented. Because of that, no Medicaid members were accessing this service under HCBS waivers yet.
This change stops the plan to implement this option for now. Going forward, members will continue to be unable to access these services under HCBS waivers.
Who is affected? Members enrolled in an HCBS waiver who had planned to access this service when implementation was finished should no longer plan to access the service through their HCBS waiver.
When did this change take place? The effective date for this change is July 1, 2026, pending federal approval.
