By Matt VanAuken, DP Chief Executive Officer & Executive Director
Budgets are about numbers, but for the individuals and families we support, they’re about something much more personal: the supports that make daily life possible. This year, Colorado faced the difficult task of cutting more than $1 billion from its budget, and the impact on disability services was significant. On May 8, Governor Polis signed that budget into law. Here’s what you need to know.
Why This Budget Was Especially Difficult
People who receive Long-Term Services and Supports (LTSS), things like in-home help, day programs, and residential care, make up about 5 to 6% of Colorado’s Medicaid members. Yet their services account for roughly 45% of total Medicaid spending, because these supports are intensive and deeply individualized. In other words, a relatively small group of people utilizes a disproportionately large share of resources. That’s not a problem to fix. It’s a reality to fund. That gap has made it increasingly difficult for the state to keep pace, and it will continue to drive hard decisions for years to come.
What Changed in the 2026 Budget
- A new assessment tool is on the way. Colorado is moving forward with the Colorado Single Assessment (CSA), designed to give the state a clearer, more complete picture of each person’s support needs. We’re hopeful this will lead to more accurate, individualized assessments and fairer decisions over time.
- New limits on certain services and individual caregivers. New rules will place soft caps on the number of hours of certain Community First Choice services a person can receive. Limits will also be placed on individual caregivers’ hours, affecting both children and adults. These rules were revised multiple times in response to feedback from families and advocates, and we’re glad the state was listening.
- Changes to the Developmental Disabilities waiver. Several things are shifting here. Policy changes will result in slowing new member enrollment as well as ending the automatic enrollment from certain children’s waivers to the adult Developmental Disabilities. Based on concerns from the community, this change has been pushed back to January 1, 2027, giving individuals and families we support more time to prepare. A new income-based cost-sharing rule called PETI (Post Eligibility Treatment of Income) will require some members to contribute to the cost of their services based on their income.
- A 2% reduction in provider reimbursement rates. Most Medicaid providers, including direct support professionals (DSPs) like in-home support staff, day program employees, etc., as well as case managers, will receive 2% less for their services. This reduction also affects Early Intervention providers, who work with babies and toddlers ages 0 to 3 experiencing developmental delays.
- Annual eligibility reviews for Early Intervention (EI). Children enrolled in Early Intervention will now be reviewed each year to confirm they still qualify for services, a change from the less frequent reviews previously required.
We Hear You
Many families, self-advocates, and providers have shared their frustration with us, not just about the changes themselves, but about how often the rules shifted throughout the process. That frustration is completely understandable, and it has been felt across the board, including by DP’s own case managers and our partners at the state level.
DP actively engages in state budget advocacy each year. This past session we submitted public comments on these changes, met directly with legislators, legislative staff, and Colorado Department of Healthcare Policy and Financing (HCPF), and advocated alongside community partners, individuals, and families we support. The decisions that had to be made were incredibly challenging, and DP worked to ensure decision makers understood the impact this would have on the individuals we support, their families, our case managers, and providers — all while pushing to minimize harm within a constrained budget environment.
It’s also worth understanding how many voices shape these decisions: elected officials, federal Medicaid administrators, volunteer board members, and state agency staff. These are complex, multi-layered decisions, and there are no simple answers.
Find additional context on what made this year’s budget cycle so challenging in our posts on Colorado’s Budget Process for 2026 and What HR1 Means for Colorado.
Questions?
If you have questions about how these changes may affect your specific services, please reach out to your DP case manager. They are your best resource for understanding what this means for you and your family.
We’re In This Together
I want to say a sincere thank you to the individuals and families we support, to self-advocates, providers, case managers, and our state and community partners, for continuing to show up, speak out, and fight for people with disabilities even when the path forward feels unclear.
I also want to say something directly: how we treat each other matters. The people working on these issues at the state level, whether at HCPF, serving on a board, or sitting on a committee, care deeply about this community. They are our partners, working through an incredibly difficult situation alongside us. Disagreement is okay. Frustration is valid. But we are a community built on dignity and respect, and that has to extend to how we engage with one another, even in moments of deep disagreement.
Let’s keep showing up with the grace and humanity we fight for every day on behalf of the people we support.