24CA1602 Boyd v CDHS 07-03-2025
COLORADO COURT OF APPEALS
Court of Appeals No. 24CA1602 City and County of Denver District Court No. 23CV32959 Honorable Jon J. Olafson, Judge
Cory Boyd,
Plaintiff-Appellant,
v.
Colorado Department of Human Services, Colorado Department of Health Care Policy and Financing, Adams County Department of Human Services, and Rocky Mountain Human Services,
Defendants-Appellees.
JUDGMENT AFFIRMED
Division II Opinion by JUDGE SCHUTZ Román, C.J., and Fox, J., concur
NOT PUBLISHED PURSUANT TO C.A.R. 35(e) Announced July 3, 2025
Colorado Legal Services, Claire Dickson, Katherine Gladson, Denver, Colorado, for Plaintiff-Appellant
Philip J. Weiser, Attorney General, Aaron Pratt, Second Assistant Attorney General, Keenan E. Lorenz, Assistant Attorney General, Denver, Colorado, for Defendant-Appellee Colorado Department of Human Services
Philip J. Weiser, Attorney General, Felice Haas, Senior Assistant Attorney General, Brian N. Morrow, Senior Assistant Attorney General, Denver, Colorado, for Defendant-Appellee Colorado Department of Health Care Policy and Financing Heidi M. Miller, County Attorney, Christina Pettus, Assistant County Attorney, Brighton, Colorado, for Defendant-Appellee Adams County Department of Human Services
Hall & Evans, L.L.C., Alexandria L. Bell, Denver, Colorado, for Defendant- Appellee Rocky Mountain Human Services ¶1 Plaintiff, Cory Boyd, appeals the district court’s order granting
the motion to dismiss his complaint against defendants, Colorado
Department of Human Services (Department), Colorado Department
of Health Care Policy and Financing (HCPF), Adams County
Department of Human Services (Adams County); and Rocky
Mountain Human Services (Rocky Mountain). We affirm the district
court’s judgment.
I. Benefits Overview
¶2 Under the Colorado Public Assistance Act (the Act), individuals
with a disability may qualify for Home Care Allowance (HCA)
benefits by establishing that they are “functionally impaired.” § 26-
2-122.3(1)(b)(III), C.R.S. 2024. The HCA program is administered
by the Department. § 26-2-122.3(1)(b), (2); Barela v. Beye, 916 P.2d
668, 672 (Colo. App. 1996) (“The [HCA] is a non-entitlement
program designed to serve those clients with the lowest functional
abilities and the greatest need for paid care.”); Dep’t of Hum. Servs.
Rule 3.570.11.A.3, 9 Code Colo. Regs. 2503-5. HCA recipients
receive monthly cash assistance that they may use to obtain home
care services such as dressing, hygiene, meal preparation,
shopping, travel, and assistance with other daily activities. § 26-2-
1 122.3(1)(b)(I)(B), (1)(b)(III). To qualify for HCA benefits, recipients
must have a functional impairment and meet certain financial
requirements. § 26-2-122.3(1)(b). The amount of a recipient’s
benefits is based on the degree of their functional impairment and
their financial circumstances.
¶3 The Department contracts with a case management agency to
perform the initial assessment of a recipient’s functional
impairment, and thereafter an annual reassessment of their current
functional impairment. The local county annually reassesses a
recipient’s income to determine their continuing financial eligibility.
¶4 The Act precludes individuals from simultaneously receiving
HCA and home- and community-based services (HCBS) benefits,
which is a Medicaid program administered by HCPF. See § 26-2-
122.3(1)(b)(II) (“Persons eligible to receive home- and community-
based services pursuant to [the Act] . . . shall not be eligible for
[HCA benefits].” Thus, if a recipient’s annual functional assessment
reveals that they are eligible for HCBS benefits, they cannot receive
HCA benefits. Id.; Dep’t of Hum. Servs. Rule 3.570.11.A.2.b, 9
Code Colo. Regs. 2503-5. An individual may then apply for HCBS
benefits. HCBS benefits are based on whether an applicant
2 qualifies for at least one Medicaid waiver, each of which is designed
to allow particular categories of impaired individuals to access
various types of services.
¶5 One of the Medicaid waivers is the Elderly, Blind, and Disabled
(EBD) waiver, which provides services for those who are elderly,
physically disabled, blind, or HIV positive. Medicaid benefits are
also available for those who qualify for a Community Mental Health
Support (CMHS) waiver, which provides services for persons who
have been diagnosed with a mental, behavioral, or emotional
disorder. See Colo. Dep’t of Health Care Pol’y & Fin., Community
Mental Health Supports Waiver (CMHS), https://perma.cc/P9K3-
FQ96. Under both the EBD and CMHS waivers, recipients may
receive Consumer Directed Attendant Support Services (CDASS),
which include personal care for bathing, dressing, or eating; health
related activities; and homemaker services, such as housekeeping,
meal preparation, and laundry. See Colo. Dep’t of Health Care Pol’y
& Fin., Consumer-Directed Attendant Support Services (CDASS),
https://perma.cc/LSZ9-4D5D. Unlike the direct cash benefit that
HCA provides to recipients, HCBS benefits are paid directly to the
service provider.
3 ¶6 The applicable regulations recognize that there may be a
period of transition between a determination that a person is
functionally eligible for HCBS services and formal approval for
HCBS benefits under one or more of the waiver programs. To allow
for the completion of the necessary evaluations and transition
between these programs, a recipient’s eligibility for HCA benefits
may be extended for three months from the date they are
determined functionally eligible for HCBS benefits so long as the
delay in transition is not within the recipient’s control. Dep’t of
Hum. Servs. Rule 3.570.11.A.2.b, 9 Code Colo. Regs. 2503-5.
II. Boyd’s Benefits
¶7 In September 2021, Boyd qualified to receive HCA benefits in
the form of a monthly $472 cash payment. He used these funds to
pay a friend to serve as his caregiver, assist him with household
management, and complete the paperwork related to his public
benefits and finances.
¶8 In August 2022, Rocky Mountain determined that Boyd was
no longer eligible for HCA benefits after he twice failed to complete
his annual reassessment. See Dep’t of Hum. Servs. Rule
3.570.17.C.3, 9 Code Colo. Regs. 2503-5 (the case management
4 agency or county shall deny or discontinue an HCA recipient if a
recipient has twice refused to schedule a reassessment within a
consecutive thirty-day period).
III. Procedural History
A. Administrative Proceedings
¶9 In September 2022, Boyd filed an administrative appeal
against Adams County and Rocky Mountain challenging the
termination of his HCA benefits for failing to schedule a
reassessment (first appeal). The Department’s office of appeals set
the matter for a hearing in December. That same month, Rocky
Mountain also completed Boyd’s assessment and determined that
he met the level of care requirements for an HCBS-EBD waiver.
¶ 10 In October, Rocky Mountain notified Boyd that his HCA
benefits would terminate by the end of the month. In response,
Boyd filed a second appeal, challenging the effective date of when
his HCA benefits would terminate. The office of appeals opened a
second appeal rather than consolidating the two appeals.
¶ 11 To receive HCBS benefits, Boyd was also required to provide a
professional medical information page (PMIP) from his service
provider to confirm his functional eligibility. The Department had
5 requested a PMIP from Boyd in August 2022, but he did not submit
it until November 2022. In the PMIP, the medical professional
confirmed that Boyd had a significant mental health diagnosis and
that he qualified for the HCBS-EBD waiver. At that point, Rocky
Mountain certified that Boyd was eligible for benefits under the
HCBS-EBD waiver.
¶ 12 In December 2022, the hearing for the first appeal took place
before an administrative law judge (ALJ). On February 7, 2023, the
ALJ in the first appeal issued an initial decision finding that Boyd’s
“eligibility for Medicaid Medical Assistance is not in dispute in this
case.” Based on testimony from Melissa Emery, a Rocky Mountain
representative, the ALJ found that certain benefits Boyd received
under HCA were not available under the HCBS-EBD waiver directly,
but that such service may be covered through the CDASS program.
Emery also acknowledged that it would take about a month to
complete the application and training process required to receive
these benefits. To allow sufficient time for that transition, the
Department extended Boyd’s HCA benefits through the end of
December. The ALJ also determined that Boyd “met functional
eligibility for HCBS long term care on November 10, 2022, and the
6 three-month grace period provided in § 3.570.11.A was triggered on
that date.”
¶ 13 During the administrative proceedings, the HCPF office of
appeals stated that the Department alone has jurisdiction over HCA
matters and instructed the parties to file any exceptions with the
Department’s office of appeals if they disagreed with the decision
regarding Boyd’s HCA benefits. Conversely, the same
communication directed the parties to file any exceptions
concerning the determination of HCBS benefits with the HCPF office
of appeals.
¶ 14 In February 2023, the ALJ in the second appeal dismissed the
claim because the matter was resolved in the first appeal. Boyd
filed exceptions with the Department’s and the HCPF’s offices of
appeals. He did not challenge the ALJ’s determination about his
HCBS eligibility. Rather, Boyd’s appeal focused on challenging the
effective date of the termination of his HCA benefits, whether he
qualified for the three-month extension of his HCA benefits, when
the three-month extension should commence, and whether a
Maintenance of Effort (MOE) payment was due for December 2022.
7 ¶ 15 In March 2023, the Department’s office of appeals vacated the
order dismissing the second appeal, reinstated it, and issued a
remand order on the basis that “the [initial ALJ decision] and record
were forwarded only to the Office of Appeals at [HCPF].” That same
month, HCPF remanded the first appeal back to the office of
administrative appeals. In July, the ALJ in the first appeal issued a
decision on remand, which was materially similar to the initial
decision from February 2023.
¶ 16 In September, the HCPF office of appeals issued a final
decision on the issue of when Boyd became eligible for HCBS
benefits. The following month, the HCPF office of appeals issued an
amended final agency decision vacating its initial final agency
action because HCPF had taken no adverse action against Boyd.
Rather, the HCPF office of appeals concluded, the Department had
the sole authority to address issues related to the termination of his
HCA benefits. It appears Boyd did not file any exceptions to HCPF’s
amended final agency decision.
8 ¶ 17 In November 2023, however, Boyd filed exceptions to the
Department’s final agency action.1 Therein, he asserted that the
HCA appeal process violated various federal laws and the Due
Process Clauses of the United States and Colorado Constitutions.
See U.S. Const. amends. V, XIV; Colo. Const. art. II, § 25. In
support of these arguments, Boyd contended that he is not eligible
for HCBS benefits under the EBD waiver. Relatedly, Boyd asserted
that his HCA benefits were terminated on the erroneous premise
that he qualified for an HCBS-EBD waiver, but that he has no
effective means of challenging the termination of his HCA benefits
because HCA does not have jurisdiction to address his HCBS
eligibility.
¶ 18 In January 2024, the Department’s office of appeals issued its
final agency action affirming the hearing officer’s decision that Boyd
was no longer eligible to receive HCA benefits once it was
determined that he was eligible for HCBS benefits. The
Department’s office of appeals also confirmed the extension of
1 As explained more fully in the following section, these exceptions
were not filed until five weeks after Boyd filed his complaint in the district court, and a week after he filed his amended complaint, which was the subject of the defendants’ motions to dismiss.
9 Boyd’s transition period of HCA and MOE benefits through
December 2022.2 As to Boyd’s statutory and constitutional
challenges to the HCA administrative process, the Department’s
office of appeals concluded that it lacked jurisdiction to address
such arguments. See Dep’t of Hum. Servs. Rule 3.587.2.A.2, .C.7,
9 Code Colo. Regs. 2503-5 (“The ALJ has no jurisdiction or
authority to determine issues of constitutionality or legality of
department rules.”).
B. District Court Proceedings
¶ 19 On October 10, 2023 — after the HCPF office of appeals issued
its initial final action but before it amended the final action (and
before the Department office of appeals’ final action) — Boyd filed
the district court complaint at issue on appeal, naming the
Department, HCPF, Rocky Mountain, and Adams County as
defendants.
¶ 20 Boyd later filed an amended complaint, which sought various
forms of declaratory and injunctive relief. Boyd did not file a claim
2 In its answer brief on appeal, Adams County represents that it
paid these sums in February 2024. In his reply brief, Boyd does not contest this representation. See Dep’t of Hum. Servs. Rule 3.531.D, 9 Code Colo. Regs. 2503-5 (addressing MOE benefits).
10 under C.R.C.P. 106(a)(4) for judicial review of the Department’s and
HCPF’s final decisions. Instead, he asserted claims that he
characterized as follows: (1) The defendants violated the HCA
statute by terminating his HCA benefits after finding him eligible for
HCBS benefits when, he contends, he was not eligible; (2) the
Department and HCPF violated the Act by failing to create an
administrative means to appeal the termination of HCA benefits
when the termination is triggered by a conclusion that the
individual is functionally eligible for HCBS benefits and by failing to
issue a final agency decision within ninety days; (3) Rocky
Mountain and HCPF violated the Act and Medicaid regulations by
finding that Boyd was eligible for Medicaid before he finished the
PMIP and by failing to establish an administrative appeal process to
accommodate issues involving a termination of HCA benefits that is
triggered by a finding of eligibility for HCBS benefits; and (4) the
Department and HCPF violated his right to due process by failing to
establish an appellate process that provides him with a pre-
termination hearing and final agency action before the termination
of his HCA benefits.
11 ¶ 21 While based on different legal theories, each of Boyd’s claims
is predicated on his assertion that he is not eligible for HCBS
benefits, even if he is eligible for HCBS benefits he would not receive
all the services he currently obtains using his HCA cash benefit,
and he has no meaningful administrative remedy to challenge the
conclusion that he is eligible for HCBS benefits.
¶ 22 The defendants moved to dismiss the complaint under
C.R.C.P. 12(b)(1) or C.R.C.P. 12(b)(5), claiming that (1) the district
court lacked subject matter jurisdiction over the claims due to the
absence of a final administrative decision; (2) Boyd lacked standing
to bring the complaint because he could not demonstrate an injury
in fact after he conceded during the administrative proceedings that
he is eligible for HCBS benefits; and (3) Boyd had failed to state a
viable claim for relief.
¶ 23 In July, the district court issued an order granting the
defendants’ motion to dismiss, finding and concluding as follows:
• When Boyd’s complaint was filed, there was no final
agency action from either the Department’s or HCPF’s
office of appeals, and therefore, the claim was barred
12 because Boyd failed to exhaust his administrative
remedies.
• Boyd failed to allege an injury in fact because under the
Act’s express language, Boyd’s right to receive HCA
benefits terminated once he was deemed functionally
eligible for HCBS benefits.
• Because Boyd did not have a legally protected interest in
receiving HCA benefits, he did not suffer an injury.
IV. Issues on Appeal
¶ 24 Boyd contends that the district court erred by finding and
concluding that he failed to exhaust his administrative remedies.
Boyd also challenges the district court’s ruling that he lacked
standing to bring a claim because he was determined to be
functionally eligible for HCBS benefits and was therefore statutorily
barred from receiving HCA benefits. We conclude that Boyd’s
failure to exhaust his administrative remedies deprived the district
court of subject matter jurisdiction and therefore address this
dispositive issue first.
13 V. Exhaustion of Administrative Remedies
A. The District Court’s Ruling
¶ 25 The district court determined that Boyd failed to exhaust his
administrative remedies. The court grounded this holding solely on
the fact that when Boyd filed his complaint, neither the
Department’s nor the HCPF’s office of appeals had issued final
decisions on the two appeals. Specifically, the court held, “While it
now appears that the administrative process has been completed,
that was not the case at the time of the filing of this dispute.
Because this dispute, as filed by Plaintiff Boyd, was filed before the
conclusion of the administrative process, this court lacks
jurisdiction.” Having reached this conclusion, the court did not
expressly address other aspects of the parties’ exhaustion
arguments, including whether Boyd had an adequate administrative
remedy to challenge the termination of his HCA benefits or
relatedly, whether any of the exceptions to exhaustion apply.
B. The Parties’ Contentions
¶ 26 Boyd argues that the court erred by failing to acknowledge
that it could consider the merits of the parties’ contentions because
the Department’s and HCPF’s offices of appeals entered final
14 decisions before the district court ruled on the motion to dismiss.
Turning then to the broader exhaustion issues, Boyd contends the
district court failed to recognize that his claims were subject to one
or more of the exhaustion exceptions and were therefore not barred.
Boyd argues that the net effect of the agencies’ and the court’s
rulings deprived him of his due process right to an affective
administrative remedy to challenge the termination of his HCA
benefits.
¶ 27 The defendants take differing positions on the district court’s
exhaustion holding, but the Department acknowledges that the
court may well have erred by applying the doctrine notwithstanding
that final agency actions were filed before the dismissal order’s
entry.
¶ 28 We begin by addressing the legal principles underlying the
exhaustion doctrine before addressing the parties’ contentions.
C. Standard of Review
¶ 29 We review a question of law, such as whether the requirement
of exhaustion of administrative remedies applies, de novo. Liberty
Bankers Life Ins. Co. v. First Citizens Bank & Tr. Co., 2014 COA 151,
¶ 15. The failure to exhaust administrative remedies deprives a
15 court of subject matter jurisdiction. State v. Golden’s Concrete Co.,
962 P.2d 919, 923 (Colo. 1998). Therefore, the issue can be raised
at any time, whether by the parties or the court. See People in
Interest of M.S., 2017 COA 60, ¶ 13 (“Although this issue was not
initially raised by the parties, we may address it sua sponte because
it concerns the court’s subject matter jurisdiction.”).
D. Exhaustion Legal Principles
¶ 30 “The doctrine of exhaustion of administrative remedies serves
as a threshold to judicial review that requires parties in a civil
action to pursue available statutory administrative remedies before
filing suit in district court.” New Design Constr. Co. v. Hamon
Contractors, Inc., 215 P.3d 1172, 1178 (Colo. App. 2008) (citing
Golden’s, 962 P.2d at 923). “The doctrine promotes important
policy interests, including the efficient use and conservation of
judicial resources, by ensuring that courts intervene only if the
administrative process fails to provide adequate remedies.” Thomas
v. Fed. Deposit Ins. Corp., 255 P.3d 1073, 1077 (Colo. 2011).
¶ 31 Inherent in the exhaustion doctrine is the requirement that a
party must pursue available administrative remedies to a final
agency action. Grant Bros. Ranch, LLC v. Antero Res. Piceance
16 Corp., 2016 COA 178, ¶ 20 (“If ‘complete, adequate, and speedy’
administrative remedies are available, a party generally must
exhaust these remedies before filing suit in district court.” (quoting
City & Cnty. of Denver v. United Air Lines, Inc., 8 P.3d 1206, 1212
(Colo. 2000))).
¶ 32 There are limited exceptions to the exhaustion doctrine.
United Airlines, 8 P.3d at 1213. The recognized exceptions include
— as relevant here — circumstances in which (1) it is “‘clear beyond
a reasonable doubt’ that further administrative review by the
agency would be futile because the agency will not provide the relief
requested,” Golden’s, 962 P.2d at 923 (quoting Colorado v. Veterans
Admin., 430 F. Supp. 551, 558 (D. Colo. 1977)); (2) the claims
involve issues “of law that the agency lacks the authority or
capacity to determine,” such as constitutional issues, United
Airlines, 8 P.3d at 1213; (3) the agency lacks jurisdiction to decide
the issue, Horrell v. Dep’t of Admin., 861 P.2d 1194, 1197 (Colo.
1993); (4) the available administrative remedies are inadequate,
Monez v. Reinertson, 140 P.3d 242, 249 (Colo. App. 2006); or (5)
when the policy reasons for the doctrine would not be served by
requiring the party to exhaust all administrative remedies. id.
17 E. Application
¶ 33 Boyd argues that the district court erred by dismissing his
complaint on the grounds that final agency decisions had not yet
been entered when the complaint was filed, noting that final agency
actions were received before the district court ruled on the motions
to dismiss. Adams County disagrees with this contention on the
grounds that Boyd conceded his eligibility for HCBS benefits and
never properly appealed that determination but does not analyze
the impact of the final agency action received after the litigation was
filed. HCPF does not address the district court’s exhaustion ruling.
The Department concedes that the district court may have erred in
light of the fact that the final agency decisions were received prior to
the entry of the dismissal order, but it does not discuss the breadth
of this exception, instead arguing that any error was harmless
because Boyd lacked standing to assert a claim once Rocky
Mountain determined he was functionally eligible for HCBS
¶ 34 We agree with Boyd that our appellate courts have held that “a
premature petition for judicial review in a district court — like a
premature filing of a notice of appeal to this court — does not
18 warrant the dismissal of the action” absent a showing that a party
was prejudiced by the premature filing. 1405 Hotel, LLC v. Colo.
Econ. Dev. Comm., 2015 COA 127, ¶ 33; see also Musick v.
Woznicki, 136 P.3d 244, 246 (Colo. 2006) (“[A district] court is not
divested of jurisdiction when a party files a premature notice of
appeal of a nonfinal judgment.”). But, while recognizing the
application of this rule in limited circumstances, the supreme court
has also cautioned as follows:
[A]n administrative agency is without authority to change, alter or vacate an order while review proceedings are pending in the district court, even as an inferior court is without authority to vacate or modify a judgment after writ of error has issued out of this court directed to such judgment.
Colo. State Bd. of Med. Exam’rs v. Lopez-Samayoa, 887 P.2d 8, 14
(Colo. 1994) (quoting Colo. Anti-Discrimination Comm. v. Cont’l Air
Lines, Inc., 355 P.2d 83, 86 (Colo. 1960)). No party acknowledges or
discusses these competing principles.
¶ 35 Nevertheless, even if we assume without deciding that the
limited exception recognized in 1405 Hotel applied here because no
party has identified any prejudice that they suffered as a
consequence of the premature filing, that does not fully answer the
19 question of whether Boyd otherwise exhausted his administrative
remedies. We turn now to the broader exhaustion questions.
1. Boyd Failed to Timely Dispute His Eligibility for HCBS Benefits
¶ 36 Boyd did not dispute his eligibility for HCBS benefits during
the administrative appeal regarding the termination of his HCA
benefits. Indeed, the hearing officer found that Boyd’s “eligibility for
Medicaid Medical Assistance is not in dispute in this case.”
¶ 37 Nonetheless, on appeal Boyd declares that it was undisputed
in the administrative proceedings that he did not qualify for the
HCBS-EBD waiver. In support of this contention, he relies largely
on the PMIP application that was signed by his treatment provider.
In the PMIP, however, Boyd’s treatment provider stated that he
qualified for the HCBS-EBD waiver. At the hearing before the ALJ,
Boyd’s counsel cross-examined Emery about the applicability of the
HCBS-EBD waiver, but Boyd provided no countervailing medical
evidence or testimony that he did not qualify for the HCBS-EBD
waiver. Moreover, Boyd never even addressed his eligibility for the
CMHS waiver and CDASS program.
¶ 38 Because the initial decision to terminate Boyd’s benefits was
based on Rocky Mountain’s assessment and the PMIP, Boyd had
20 the opportunity in his HCA appeal to challenge the factual and legal
basis for this conclusion, but he failed to do so.
¶ 39 Boyd also contends that he filed exceptions to this finding, but
the record does not support this contention. Having failed to timely
object in the administrative proceedings, Boyd was barred from
raising the issue in this litigation. See People ex rel. Woodard v.
Brown, 770 P.2d 1373, 1375 (Colo. App. 1989) (contentions not
raised or addressed in administrative proceedings should not be
considered on appeal).
¶ 40 Perhaps recognizing this deficiency, on November 13, 2023,
Boyd filed a notice of exceptions to the ALJ’s decision on remand.
But both of Boyd’s exceptions, and the decision to which they were
directed, were not entered until after Boyd filed this litigation and
his amended complaint. Even if the January 2024 final agency
action from the Department’s office of appeals could be deemed to
cure the nonfinality of the decisions issued prior to the filing of the
district court action, Boyd’s post-litigation exceptions could not be
used to add issues that were not raised in the administrative
proceedings before he filed the operative complaint in the district
court. See Lopez-Samayoa, 887 P.2d at 14. Thus, Boyd failed to
21 timely challenge the Department’s conclusion that his HCA benefits
terminated when he was found functionally eligible for HCBS
2. Boyd’s Failure to Apply for HCBS Benefits
¶ 41 Critically, Boyd does not dispute that he failed to file an
application for HCBS benefits before filing his complaint.3 Thus,
HCPF was unable to make a final determination of whether he
qualified for HCBS benefits under the HCBS-EBD waiver, the CMHS
waiver, or some other Medicaid waiver that would have authorized
him to receive some or all of the services he currently receives using
the HCA benefit. Thus, the agency with expertise on the issue of
Boyd’s eligibility for HCBS benefits has not yet been afforded the
opportunity to determine whether Boyd qualifies for one or more
Medicaid waivers, including the HCBS-EBD waiver.
¶ 42 Against this backdrop, we have an administrative
determination made by Rocky Mountain, based on its initial
assessment of Boyd’s functional capacity and the subsequent PMIP
3 At the May 2024 hearing on the motion to dismiss, Boyd did not
dispute that he had not applied for any HCBS waiver program. And at oral argument held on June 3, 2025, the parties agreed that Boyd still has not filed for HCBS benefits.
22 prepared by Boyd’s physician, that Boyd qualifies for the HCBS-
EBD waiver. Likewise, we have a final assessment made by Adams
County that Boyd is financially eligible for HCBS benefits. In
making these determinations, Rocky Mountain and Adams County
acted as agents of the Department and HCPF. Thus, we perceive no
reason why Boyd could not contemporaneously apply for HCBS
benefits — with the corresponding right to appeal any adverse
determination made by HCPF — while at the same time pursuing
his appeal to the Department challenging the termination of his
HCA benefits. That scenario would have allowed the two
departments to resolve the controlling questions within their
authority: The Department would have decided whether Boyd was
eligible for HCA benefits, and HCPF would have decided whether he
qualifies for specific HCBS benefits. Instead, Boyd chose to
summarily reject the conclusion that he qualifies for HCBS benefits,
without applying for HCBS benefits with HCPF, the agency charged
with deciding whether he was ultimately qualified for one or more of
the HCBS waivers. Thus, we conclude, Boyd failed to exhaust an
“available statutory administrative remed[y] before filing suit in
district court.” New Design, 215 P.3d at 1178.
23 ¶ 43 We recognize that in the district court and on appeal, Boyd
argues that he in fact was not eligible for HCBS benefits, and
particularly the HCBS-EBD waiver. At the same time, the
defendants argue that Boyd was eligible for the HCBS-EBD and
CMHS waivers. Moreover, HCPF also notes that many of the home-
based services that Boyd currently receives under HCA would also
be available to him under the CDASS program, which would be
available if Boyd qualifies for either an HCBS-EBD or CMHS waiver.
¶ 44 Boyd argues that he should be afforded a hearing in the
district court to resolve any factual disputes regarding his eligibility
for the HCBS-EBD and CMHS waivers, and the types of services
available to him under these programs. But that demand
contradicts the central purpose of the exhaustion doctrine — a
party must first exhaust available remedies in the administrative
proceeding before filing a district court action. Grant Bros, ¶ 20
(“The administrative exhaustion doctrine ‘enables the agency to
make initial determinations on matters within its expertise and to
compile a record that is adequate for judicial review’ so as to
‘prevent piecemeal application of judicial relief and to conserve
judicial resources’” (quoting Golden’s, 962 P.2d at 923)).
24 F. The Exhaustion Exceptions
¶ 45 Boyd attempts to justify his failure to exhaust his
administrative remedies by arguing that at least one exhaustion
exception applies. We therefore consider the various exceptions.
1. Administrative Review Would Be Futile
¶ 46 Boyd argues that further administrative proceedings before the
Department and HCPF would be futile. More specifically, Boyd
argues that he is on the horns of a dilemma in the administrative
arena because when he attempts to contest his eligibility for HCBS
benefits, the Department or its agent informs him that it is unable
to determine whether he qualifies for HCBS benefits because that
determination is ultimately made by HCPF. On the other horn,
Boyd argues that HCPF has stated that it does not have the
authority to review whether he is eligible for HCA benefits. Thus, he
contends, the administrative process does not afford him a
meaningful opportunity to challenge the conclusion that he is no
longer eligible for HCA benefits because he qualifies for HCBS
benefits. Boyd argues this violated his rights to due process. See
Goldberg v. Kelly, 397 U.S. 254, 260 (1970) (due process requires
that an agency providing public assistance benefits must afford
25 recipients a pretermination hearing before terminating their right to
benefits).
¶ 47 But instead of applying for the HCBS waiver program, Boyd
attempted to challenge the termination of his HCA benefits by
appealing to HCPF. As HCPF correctly noted, it does not have the
authority to determine whether Boyd qualifies for HCA benefits.
Boyd could have avoided this situation by timely applying for HCBS
benefits. Had he done so, he would have an answer from the
appropriate agency, HCPF, determining whether he qualified for
HCBS benefits.
¶ 48 We acknowledge that the Department provided Boyd with
notice of termination of his HCA benefits based on the
determination that he was functionally eligible for HCBS benefits
before there was a definitive ruling from HCPF that he in fact
qualified for HCBS benefits. Thus, we are not entirely
unsympathetic to Boyd’s argument. A person receiving Medicaid
benefits is generally entitled to a pretermination hearing that
complies with due process before such payments can be
discontinued. See Monez, 140 P.3d at 248 (citing Goldberg, 397
U.S. at 260). It creates administrative burdens for a person who
26 receives notice that they are no longer eligible for HCA benefits to
have to appeal that decision while — simultaneously — applying for
one of the HCBS waivers before a final determination can be made
on their HCBS eligibility. This process creates potential
uncertainties and delays while the two agencies finally resolve the
eligibility questions.
¶ 49 But the regulatory scheme contemplates and accommodates
the potential delays between the time that a person is deemed
functionally and financially eligible for HCBS benefits and the date
an applicant receives a final decision on their application for an
HCBS waiver. Dep’t of Hum. Servs. Rule 3.570.11.A.2.b, 9 Code
Colo. Regs. 2503-5 (“Clients who are determined eligible for
HCBS . . . may remain on HCA for up to three (3) months while they
transition to HCBS if the delay in transition is not within the
client’s control.”).
¶ 50 That is what the three-month extension of HCA benefits is
intended to remediate. Id. This case is illustrative. The initial
notification that Boyd was functionally eligible for HCBS benefits
and therefore no longer functionally eligible for HCA benefits
occurred in September 2022. But the cessation of Boyd’s HCA
27 benefits was delayed until December 2022. This period should have
afforded adequate time for Boyd to appeal the denial of his HCA
benefits, apply for HCBS benefits, and if denied, appeal that
decision to HCPF. Cf. Goldberg, 397 U.S. at 268 (approving a
seven-day period from notice of proposed discontinuance of benefits
within which to request a hearing). Indeed, Boyd cites no evidence
that contradicts Emery’s testimony that he could have completed
the eligibility requirements for an HCBS waiver and CDASS
assistance in slightly over a month. But for reasons that are
unexplained, Boyd never even filed an application for HCBS
¶ 51 Thus, the perceived dilemma that Boyd complains about was
one of his own making and therefore cannot qualify as an exception
to the exhaustion doctrine.
2. Jurisdiction, Authority, Capacity, and Policy
¶ 52 Boyd argues that the Department’s and HCPF’s statements
during the underlying administrative proceedings evidence that any
further administrative proceedings would be futile because the
Department and HCPF lack the authority, jurisdiction, and capacity
to resolve his claims. For the same reasons, he contends that
28 making him pursue further remedies would be against public
policy. But Boyd grounds these arguments on statements made by
the two agencies in response to the claims and arguments he
presented in the administrative proceedings. That is, HCPF stated
that it did not have the authority to address the denial of his HCA
benefits, and the Department stated that it did not have the
authority to decide his contention that he does not qualify for HCBS
benefits. These were correct responses to the issues that Boyd
presented below. See § 26-1-105(3), C.R.S. 2024 (“The
[Department] shall be responsible for the administration of human
services programs as set forth in part 2 of this article.”); § 25.5-1-
201(1)(a), C.R.S. 2024 (the HCPF shall administer the Colorado
Medical Assistance Act).
¶ 53 As explained, Boyd did not present the appropriate question to
the proper agency. A central question is whether Boyd could
actually qualify for HCBS benefits. Boyd failed to take the first
necessary step to answering that question: He failed to file an
application. Had he done so, HCPF would have determined whether
he qualified for HCBS benefits. By failing to take this necessary
first step, Boyd deprived the appropriate agency of the ability to
29 meaningfully assess these issues. Because these failures were
caused by his inaction, Boyd cannot argue that the administrative
process would be futile.
3. Constitutional Issues
¶ 54 Finally, Boyd argues that his claims that the administrative
requirements violate his due process rights present constitutional
issues that the Department and HCPF are not qualified to resolve.
See Dep’t of Hum. Servs. Rule 3.587.2.A.2,. C.7, 9 Code Colo. Regs.
2503-5 (“The ALJ has no jurisdiction or authority to determine
issues of constitutionality or legality of department rules.”). Boyd is
correct that the Department and HCPF lacked the authority to
decide these issues. But the constitutional argument Boyd makes
— that the appeal process does not provide him an effective forum
to address his eligibility for HCBS benefits — is based on the
“dilemma” that he created by failing to file an application for HCBS
benefits. As explained previously, if Boyd had applied for HCBS
benefits with HCPF, we would have an informed decision about
whether he does in fact qualify for HCBS benefits, and the nature of
the benefits he would obtain thereunder. Thus, exhaustion of
Boyd’s administrative remedies may well have rendered the claimed
30 constitutional deficiencies obsolete. Therefore, we conclude that the
exception does not apply.
VI. The Parties’ Remaining Contentions
¶ 55 Boyd also claimed that he was prejudiced by the Department’s
and HCPF’s failures to issue a final agency action within ninety
days. But on appeal, Boyd does not meaningfully develop this
contention in a manner independent of his general objections to the
inefficiencies of the appellate process. Therefore, we do not address
the issue further. See Antolovich v. Brown Grp. Retail, Inc., 183
P.3d 582, 604 (Colo. App. 2007) (“We will not address these
underdeveloped arguments.”).
¶ 56 In response to the motions to dismiss, Boyd argued that he
was entitled to HCA benefits through January 2023, but such a
claim was not asserted in his amended complaint, so we do not
address it further. Boyd also notes in passing that he should have
received MOE payments, but Boyd does not dispute that MOE
payments are discretionary and may not be appealed, or that the
Adams County paid his awarded benefits in February 2023. So we
also do not address this contention. See Dep’t of Hum. Servs. Rule
31 3.531.D, 9 Code Colo. Regs. 2503-5 (“Appeals shall not be allowed
for MOE payment adjustments.”).
¶ 57 Because we affirm the district court’s judgment that Boyd
failed to exhaust his administrative remedies — albeit on additional
grounds than those relied on by the district court — we need not
address the defendants’ alternative arguments that Boyd lacked
standing to bring the asserted claims or that Boyd’s claims failed to
state a cognizable claim for relief.
VII. Disposition
¶ 58 The judgment is affirmed.
CHIEF JUDGE ROMÁN and JUDGE FOX concur.