COLORADO SPRINGS, Colo. (KOAA) — Colorado has begun cutting the number of hours Medicaid will pay caregivers, with the first reduction taking effect July 1 and additional cuts phased in over the next year. Families can apply for an exception to the new caps, but one father says that process is anything but simple.
Ronnie Broyles is fighting to maintain full-time care for his daughter, Victoria. He says 5 registered nurses have refused to take her case because of her level of medical complexity.
He said he worries about finding extra care and doesn't want his daughter, who is medically fragile, to be put at risk.
When the Joint Budget Committee approved a 56-hour caregiving cap in March, Broyles said he had to shift his focus to pursuing an exception.
He has all his ducks in a row with thousands of medical records to prove her need, like statements from pediatricians and providers.
"This goes to say that a reduction in approved hours would be a risk to her and that she should have a permanent exception to the hour caps," Broyles said.
To qualify, he must submit documentation proving Victoria requires around-the-clock care. He is skeptical the state will grant the exception.
"I don't think they're just simply going to willingly give the exception because the only way they save money is if they don't give it, and they're under mandate from the governor to save money," Broyles said.
Bonnie Silva, director of the Office of Community Living at the Department of Health Care Policy and Financing, said the cap is primarily about caregiver burnout, not cost savings.
"This change, while it is projected to save money, it is actually a very conservative small projection of fiscal savings. The primary reason for the 56 hour caregiver cap is member health, safety and well-being," Silva said.
According to the Department of Health Care Policy and Financing, the projected savings from implementing a cap on family caregiver services, the number is $794,117 in savings in this fiscal year of July 1, 2026 to June 30, 2027. They said it is projected to grow to $3,094,895 in the next fiscal year.
Silva said the department has received 50 to 100 exception requests since July 1 and wants eligible families to use the process.
"We just want to be really clear, there's no incentive for us to not have this exceptions process operated appropriately, and for people who meet the criteria, we absolutely want them to leverage it," Silva said.
Broyles said he has been waiting for a response from the department since early July. He does not know when a decision will come.
"So I could get the exception approved today. I could get it approved tomorrow, it could be a week," Broyles said.
If the exception is denied, Broyles said he is prepared to take legal action.
"I'm going to litigate it. I'm going to litigate the state because I have all the medical evidence justifying the exception and they've got nothing a a piece of legislation buried in an ominous budget bill signed by the governor," Broyles said.
Exceptions, if granted, last up to a year. Silva said it is dependent on the need.
Broyles said he will keep fighting regardless of the outcome.
"I have every reason to get up every morning and work all day. Because she needs the best quality of life she can get," Broyles said.
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