Mikelle’s life works because of her team—the steady, intelligent, creative, and caring women who show up every day and make it possible for her to live a full and meaningful life in her community.
The other morning, I sat at the kitchen table with a cup of coffee that had gone lukewarm, listening in on the webinar from Healthcare and Public Financing (HCPF), our Medicaid agency, while watching a spring build over the Front Range. Clouds stack slowly, gather weight, darken just enough that you know something is about to change. You can smell it in the air. And, I can smell regret and despair.
Most likely, we’ll notice it in the pay for the hours I work to keep Mikelle’s team together. Maryann, our most experienced team member and leader, is leaving for a new job as a case manager just before the cuts start, which will save us some money.
Some families who provide most of the care for their loved ones will feel the cuts the most. Many have worked 70 to 80 hours a week because they haven’t been able to find the right people for their care team. Starting July 1st, 2026, the hours family caregivers begin to step down incrementally until the end of the year, at which point the maximum billed hours are 56 hours a week.
For us, I haven’t billed more than 40 hours a week in many years. Even when the work went beyond that, I stayed within that limit as was required under the older waiver. I never billed more, and often I billed less.
Lately, I’ve been cutting back my hours on purpose as part of our succession planning. I’m stepping back carefully to make sure the system doesn’t depend only on me.
This takes planning, training, and trust.
Now, just like the storm over the mountains, something is changing beneath us.
I have deep respect for what the Colorado legislature is facing right now. Balancing a budget, especially one where Medicaid is such a big part, is no small task. These are not easy decisions. The advocacy community has also been showing up: families, providers, and organizations are making sure the human side of these decisions stays visible. That matters.
There is also a seriousness in this moment that I appreciate. Because we are learning something important. Some of the rising Medicaid costs were not where many people expected. There were providers, not individuals or families, but providers and systems where overbilling happened. It went on longer than it should have and wasn’t caught in time.
Now, both the
legislature and advocacy groups are asking the right questions.
How did this happen?
How do we fix it?
How do we make sure it doesn’t happen again?
But here at the kitchen table, the question feels a little different. What happens to families like ours while that gets sorted out?
Because we’ve already been carrying more than what shows up on paper. We stretch hours. We cover gaps.
We keep teams together, not because there’s extra funding, but because we can’t let things fall apart. out, we adjust. When schedules shift, we absorb it. When systems don’t work as they should, we quietly make them work anyway.
Two Truths at the Same Time
So, I find myself holding two truths at once. We need accountability. We need systems that work as intended.
And…
The solutions cannot land hardest on the families who have been holding those systems together all along. There isn’t extra here.
There isn’t a margin. There is just a careful balance, built over years, of people, trust, and relationships that make a good life possible.
Scarcity is Upon Us
This winter, the snow didn’t come the way it used to.
Across Colorado, the mountains held less than we’ve ever seen, and already we’re being asked to conserve—to ration water now so there will be enough for drinking, for daily life, and crops.
It is hard not to see the parallels.
A kind of budget drought has settled in.
Out here in the Rockies, we understand both storms and scarcity. Some years test us with too much water, too many fires. Others, like this one, ask us to stretch what we have—carefully, deliberately—so that what matters most endures.
That’s where we are now.
Still holding the line.
Still adjusting.
Still making careful choices so the essentials last. Once again, we will pioneer a new era.
And hoping that as decisions are made, the people making them remember—
Behind every number is a family who has already been conserving, stretching, and doing everything they can to make it work.
And will keep doing their best to support the people they love.
