What I'm Bringing to the Room: Inside a Week of CARE Act Advocacy

Three conversations. One week. The math Colorado's Medicaid Commission hasn't seen.

This week, advocacy moves into three critical, load-bearing conversations: Employment Law: Resolving FAMLI and FMLA preemption questions to preserve the Colorado CARE Act's statutory independence. Colorado Commission on Medicaid: Presenting the actuarial gap behind the caregiver hour cap-where just 33 arrangement failures out of 910,000 family caregivers completely erases state fiscal savings. DORA Regulatory Reform: Engaging the CCRD sunset review track to codify protections for unpaid working caregivers directly into state law.

By Mark Fukae - Director of Advocacy - Professionals Who Care

On July 1, 2026, a Medicaid policy took effect in Colorado that projects $1.1 million in annual savings. The Colorado Medical Services Board's caregiver hour cap - stepping down from 84 hours per week now to a floor of 56 hours per week by July 2027 - was adopted on fiscal sustainability grounds.

Here is the number that did not appear in five hours of testimony at the July 28 Commission meeting.

Using the Department of Health Care Policy and Financing's own minimum clinical cost differential between home and community-based services and skilled nursing facility placement - $33,614 per year - the math is simple:

$1,100,000 ÷ $33,614 = 33.

Thirty-three family caregiving arrangement failures statewide erase the entire projected savings. Not thirty-three thousand. Thirty-three people - out of 910,000 Colorado family caregivers - pushed into institutional placement, and the fiscal case for the hour cap disappears.

This week, CASI founder and Colorado CARE Act architect Mark Fukae carries that number into three rooms: a legal review of the bill's preemption provisions, an audition for a formal Colorado Medicaid Commission presentation slot, and a meeting with the lead analyst on an independent CCRD legislative review.

The Colorado CARE Act - currently at v5.4 - would add family caregiver status as a protected class under the Colorado Anti-Discrimination Act and require employers to engage in a good-faith interactive process before denying flexible work arrangements. It is proposed legislation targeting the 2027 session. Zero general fund appropriation. TABOR-neutral. The bill's design responds directly to what the Medicaid data shows: keeping caregivers employed keeps care recipients home, and home is where the fiscal math works.

Six states have passed caregiver workplace protection laws. More than 200 municipalities have enacted local protections. Colorado is fighting to become the seventh state.

Read the full Dispatch 3 of The Infrastructure We Build on The Revenue Neutral Caregiver on Substack - and sign the petition at chng.it/zHbMzKnBwJ.

Professionals Who Care is a national nonprofit supporting working caregivers through advocacy, community, and policy. Learn more at professionalswhocare.org.