Colorado VNA (CVNA) in Northern Colorado has been providing Medicaid Home and Community-Based Services (HCBS) services for over thirty years. Like many organizations that care for HCBS patients, our organization is struggling to care for these patients because the reimbursement is too low, well below our costs. In recent years, with the increase in home health care regulations; the cost to provide homemaking and personal care services has risen significantly. It is because of the gap between reimbursement and costs that CVNA is working to find other agencies to take on some of our patients. Additionally, CVNA will be kicking off a fundraising campaign to seek support from caring donors passionate about helping Colorado residents remain in their homes. The following is an overview of how CVNA came to this decision to decrease our HCBS census as well as a description of what other states are doing with HCBS.