Colorado Caregiver Hour Limits: The 56-Hour Cap, Soft Caps, and Exception Requests

HCPF Is Capping How Many Hours a Single Caregiver Can Work

Colorado's Department of Health Care Policy and Financing (HCPF) is phasing in strict limits on how many weekly hours any single in-home caregiver — including family members — can be paid through Medicaid. If your parent depends on a single caregiver for most of their care, these caps directly affect your family's care schedule.

The Phased Weekly Hour Cap

Under House Bill 26-1410 and Senate Bill 25-11-06-B, the weekly maximum is stepping down over 12 months:

No caregiver can work more than 16 hours in any single 24-hour day, regardless of the weekly cap.

These limits apply to every delivery model — CDASS, IHSS, and traditional home care agency — and to every caregiver type, whether a family member or a hired professional.

The Spouse Homemaker Cap

Spouses providing paid homemaker services face a separate, much stricter limit: 7 hours per week. This applies specifically to homemaker tasks (light housekeeping, laundry, meal preparation) performed by a legally responsible person. Personal care hours (bathing, dressing, toileting) have their own allocation under the general weekly cap.

Annual Soft Unit Caps

On top of the weekly hour limits, HCPF implemented annual service unit caps effective April 1, 2026:

These are "soft" caps — they can be exceeded with documented medical necessity and CMA approval. The provider agency or CDASS employer should submit an exception request before scheduling services above a cap.

What This Means for Families

If one family caregiver currently provides 80 hours of weekly care, the July 2027 cap cuts their paid hours to 56. The remaining 24 hours either go unfunded or require a second caregiver.

For families in rural Colorado where finding a second trained attendant is genuinely difficult, this can force a choice between unpaid overtime, reduced care, or institutional placement — exactly the outcome the waiver system is designed to prevent.

The overtime problem compounds this. Under FLSA and Colorado wage law, W-2 home care agencies must pay 1.5x for hours over 40 per week or 12 per day. But Medicaid reimburses at a flat per-unit rate with no overtime differential. Many agencies already restrict family caregivers to 40 hours per week to protect their margins, regardless of the state's theoretical cap.

How to Request an Exception

If your parent's care needs exceed the caps, the provider agency or CDASS employer can submit a formal exception request to the CMA case manager. Grounds for an exception include:

• Extraordinary clinical complexity — the parent has medical conditions requiring consistent, specialized attention from a single trained caregiver
• Acute workforce barriers — no additional qualified caregivers are available in your rural area
• End-of-life care — the parent is in hospice or terminal decline

Document everything: medical records, failed recruitment attempts for additional caregivers, physician statements about care continuity requirements.

Planning Around the Caps

The realistic path for most families is building a multi-caregiver schedule before the caps force one:

1. Under CDASS: You control hiring. Start recruiting and training a second attendant now, while the 84-hour cap still gives you breathing room. The FMS provider (Palco or Public Partnerships) handles onboarding and payroll.

2. Under IHSS: Ask the agency to assign a backup caregiver for specific shifts. Many agencies are already planning for the January and July step-downs.

3. Track your hours: Use a weekly caregiver hour log to monitor actual hours against the current cap. Catching overages before they hit claims prevents payment disruptions.

The Aging in Place in Colorado guide includes a caregiver hour log worksheet and a spousal protection planner that accounts for the 7-hour homemaker cap — built for the 2026-2027 phase-in schedule.

See more Colorado guides →