Creating a budget is hard, especially when you know you have to cut back on spending.  Anyone who has done it for their own household knows that. It is logical to focus on where you spend the most money, and see if you can make cuts in spending there.  If you spend most of your money on food, you might think: “I don’t need to eat out five meals a week,” or “I can pick up my meals instead of using a delivery service.” Governor Polis used this logical method to create a balance budget, but I believe failed to consider the human cost for what his cuts mean. 

There are many cuts to the FY 2025-26 & 2026-27 Budget Reductions that I cannot speak to.  I do not have the research, or the personal experience, to understand how they will impact the individuals who currently access those programs.  What I can speak to are how the cuts to the programs my daughter has access to will impact her, and our family. 

Lyra is currently on the Children’s Extensive Support (CES) Waiver for Medicaid. “Waiver” simply indicates that she qualifies for Medicaid coverage based on a need other than financial hardship.  Some of the resources she qualifies for though this waiver are:

• CNA care – skilled care for activities for daily living
• Community Connector Services- someone whole helps her go out and work on life skills outside of the home
• Homemaker Services – extra cleaning and maintaining of the spaces the individual uses

While she does qualify for many other services, these are the ones where funding cuts will most directly impact our family and her quality of life.  Let me be clear, I am well aware that my family is very lucky.  We are being impacted much less than many other families within my community.  However, the numbers will show that the “minimal impact” we will experience across these categories is substantial.   

Currently I provide all three of these service for Lyra.  I am a registered CNA.  I am licensed by the State of Colorado and subject to all of the same rules and regulations as any other CNA.  I work for a home health company (All For Kids Home Health), and my only patient is my child.  Given Lyra’s needs, she qualifies for 8 hours/day of CNA care (56 hours/week).  It is vital that Lyra gains skills outside of the home (community connector services), and learns 3how to interact with the community at large.  For those of you who personally know us, you know that we take Lyra everywhere: grocery store, out to eat, the zoo, the aquarium, local rec centers, etc.  It’s important for her understand how to pay for things, how to find items in a store, how to wait your turn to look at a fish, or how to behave in a restaurant.  These are life skills that are significantly harder for Lyra to grasp, and take significantly more practice and patience.  Community Connector services help to give us more opportunities to work on those skills with her. She qualifies of 10 hours/week. 

Lastly, and possibly most difficult for some people to understand, Homemaker services.  Should I be washing Lyra’s clothing, cleaning her dishes, and generally trying to keep a tidy house regardless of Lyra’s needs? Absolutely.  We all work to take care of our homes, and cleaning is part of that.  However, the amount of cleaning and level of clean required for Lyra is above and beyond what is required for an average 10-year-old.  Also, Lyra is not capable of helping with any of these tasks in a meaningful way.  Lyra has significant gastrointestinal issues.  She is also incontinent and wears diapers.  Just like with infants and young toddlers, accidents happen daily.  However, I am cleaning up after a 10 yo, not an infant.  Blow outs take on a whole new meaning when your child is 10.  Also, Lyra struggles with reflux and spits up or vomits daily.  The amount of laundry we do is significant.  Not to mention, cleaning the various bodily fluids off of other surfaces.  While I could technically hire someone else to do this cleaning, recent changes to Medicaid requirements for providers have made it impossible to find someone.  Also, it’s not like I can call them at 2am to come clean her bed and start a load of laundry.  Lyra qualifies for 10 hours/week.

So, let’s put this in a chart and figure out roughly how much financial support we get currently, and how much we will get with the proposed changes. Keep in mind, due to Lyra’s needs, I cannot get another job.  Managing her care is more than a full-time job.  She has over 20 providers that I have to coordinate so she gets everything she needs.  Plus, I have to physically take care of her.

Now, let’s look at the proposed changes:

• Limiting to weekly “caregiving hours” to 8 hours/day (56 hours/week).[1]  – This will include both of my CNA hours and my Homemaker hours. 
• Reduce the number of allowable hours for Homemaker services from 10 hours/week to 5 hours/week[2]
• Reduce the number of allowable hours for Community Connector by half (down to 5 hours/week) and reduce the amount paid per hour.[3]  In a recent conversation with other parents and advocates, it was explained that the reduction in pay per hour was about 30%. 

With these changes, it’s time to look at how the financial support for our family will change.  Since CNA and Homemaker service hours can not exceed 56 hours/week, I will have drop Homemaker services.  I get paid more per hour as a CNA, so Homemaker will be 0.

With the proposed changes, our household will be losing $447 per week of financial support.  What will that look like over the course of a year? 

$447/week  x  52 weeks/year= $23,244 per year of reduced household support for a disabled child

Instead of multiplying $447 by 52 weeks, let us assume that there are at least 21 days (3 weeks) out of the year where I cannot provide those services.  Lyra could be in the hospital, she may have too many appointments one day, or we might do on vacation out of state.  Instead, we say 49 weeks.

$447/week  x  49 weeks= $21,903 per year of reduced household support for a disabled child

Many children qualify for significantly more CNA hours.  Many families are single parent households.  Without even losing CNA hours, our household will lose over $20,000 next year under Governor Polis’ new plan.  Maybe he can help my family figure out where we can cut $21,903 from our household budget to make up for his changes.

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[1] FY 25-26 HCPF Budget Reduction Items Fact Sheet – Update for Nov. 1, page 4

[2] FY 25-26 HCPF Budget Reduction Items Fact Sheet – Update for Nov. 1, page 4

[3] FY 25-26 HCPF Budget Reduction Items Fact Sheet – Update for Nov. 1, pages 4 and 5

Resources:

1. HCPF Budget Reductions Fact Sheet FY 2025-26 & 2026-27 Projected Reductions, Colorado Department of Health Care Policy & Financing, October 31, 2025, https://hcpf.colorado.gov/sites/hcpf/files/FY%2025-26%20HCPF%20Budget%20Reduction%20Items%20Fact%20Sheet-Update%20C.pdf?fbclid=IwY2xjawOC6nFleHRuA2FlbQIxMABicmlkETEya2ZoeFZNQlB3T3NsMDhic3J0YwZhcHBfaWQQMjIyMDM5MTc4ODIwMDg5MgABHlDMphSaEHt8kCc_yfTHpcRp4EN0-tKwsPV-MFK5ZcfcFZhukCf_dsW4GCAF_aem_TX6WeN_eNxRr22XXNewkcw
2. Medicaid Sustainability and Colorado’s LTSS System, https://hcpf.colorado.gov/medicaid-sustainability-and-ltss?fbclid=IwY2xjawOC6mhleHRuA2FlbQIxMABicmlkETEya2ZoeFZNQlB3T3NsMDhic3J0YwZhcHBfaWQQMjIyMDM5MTc4ODIwMDg5MgABHkFS3CoVkJKrnf0UdIRM-TzUFLzFZU4fi03hvZ5azJ0TbPzlTsMy3tkRWh2b_aem_dlTmvhQX-mWUngExHiTkGQ#FactSheets
3. Children’s Extensive Support Waiver, https://hcpf.colorado.gov/childrens-extensive-support-waiver-ces