The shortage
A workforce leaving faster than it can be replaced.
rural Coloradans will be 65 or older by 2035.
CRHC, Snapshot of Rural Health in Colorado, 2026of Colorado's remaining healthcare workers have considered leaving.
CRHC Snapshot 2025new nurses Colorado needs every year to keep pace.
CRHC Snapshot 2025The gap is widest in direct care
The 2023 Colorado Talent Gap analysis put the shortfall at 72% for registered nurses and 88% for licensed practical nurses. For certified nurse aides, the role that does the most hands-on care and has the shortest path to certification, the gap was 76%.
That last number is the hopeful one, because a CNA credential takes weeks rather than years. The hard part has never been the length of the training. It is whether any training exists close enough to get to.
Why now
Colorado is halving paid family-caregiver hours.
Across Personal Care, Homemaker, Health Maintenance Activities, and Long-Term Home Health, the weekly hours a paid family caregiver can be reimbursed for are dropping in three steps, from a 112-hour baseline to 56 by July 2027. There is an exceptions process, but the direction is set.
Families who have been covering that care themselves will need certified caregivers to make up the difference, and those caregivers have to live close enough to actually show up.
That is the clock we are working against.
Where the need concentrates
Shortage on top of shortage.
Rural Colorado does not have one gap. It has several, layered on top of each other, and together they compound.
| Measure | Rural / frontier Colorado | Statewide |
|---|---|---|
| Mental Health HPSA designation | All 52 counties (2026) | n/a |
| Dental HPSA designation | 70% of rural counties | 35% |
| Medicaid / CHP+ share of payer mix | 34.7% | 30% |
| Medicare share of payer mix | 22% | 16.5% |
| Residents per mental-health provider | 320 | 210 (urban) |
| Children per pediatrician | 2,336 | 1,207 (urban) |
| Counties with no nursing home | 20 (2026) | n/a |
Source: Colorado Rural Health Center, Snapshot of Rural Health in Colorado, 2025, except the rows marked 2026, which come from the 2026 edition.
The San Luis Valley
Five San Luis Valley counties (Alamosa, Conejos, Costilla, Rio Grande, and Saguache) are federally designated Medically Underserved Areas, with further shortage designations stacked on top. That is exactly why the Valley is one of our three Year 1 regions.
Who this is for
The first person this helps is the caregiver.
A credential means steady work close to home, whether that is caring for a family member, a friend, or patients at a facility in their own town. Next is the community itself, which gains a trained caregiver who stays. These are the places they go on to work.
- Rural and critical-access hospitals
- Skilled nursing facilities and long-term care
- Assisted living and memory care communities
- Hospice and palliative care providers
- Home health and home-care agencies
- Community health centers and rural health clinics
- County human services and Area Agencies on Aging
- School districts and CTE pathways
- Workforce centers and state training-to-career programs
- Families caring for a loved one at home