Question 1

Can a family member get paid to be a caregiver in Colorado?

Accepted Answer

Yes. Colorado Medicaid allows many family members — adult children, siblings, grandchildren, nieces and nephews, and in some cases friends or neighbors — to be paid for the personal care they already provide. The most common routes are Consumer Directed Attendant Support Services (CDASS) and In-Home Support Services (IHSS), both of which let the person receiving care choose and direct their own caregiver. Spouses and the legal guardians of a minor child can be paid under IHSS, but generally not under CDASS. Families caring for a child can also look into 2nd Home Community's Parent CNA program.

Question 2

How much do family caregivers get paid in Colorado?

Accepted Answer

Pay is set by an individual budget rather than a fixed statewide wage. Under CDASS the member controls an allocation based on their assessed need and sets the attendant's hourly rate within state limits — commonly in the range of about $16 to $25 per hour. Under IHSS the agency sets the wage. The total monthly amount depends on how many care hours the assessment authorizes, which is driven by the level of help the person needs with bathing, dressing, toileting, transfers, mobility, eating and medication reminders.

Question 3

Do I need a license or certification to be paid?

Accepted Answer

No professional license or CNA certificate is required to be a paid attendant under CDASS or IHSS. You must be at least 18, pass a background check, be legally allowed to work in the U.S., and complete the training the program or agency requires. The person receiving care (or their authorized representative) trains you on their specific needs.

Question 4

Can I get paid for care I already provided in the past?

Accepted Answer

No. Colorado Medicaid pays only for care delivered after enrollment is approved and services are authorized. That is why families are encouraged to start the eligibility process early rather than waiting — every month of delay is unpaid care.

Question 5

What is Health First Colorado?

Accepted Answer

Health First Colorado is Colorado's Medicaid program, administered by the Department of Health Care Policy & Financing (HCPF). It covers doctor visits, hospital care, prescriptions, behavioral health and long-term services and supports. Home and community based services (HCBS) waivers sit on top of Health First Colorado and fund the in-home care that lets people avoid a nursing facility.

Question 6

What is CDASS and how does it work?

Accepted Answer

Consumer Directed Attendant Support Services (CDASS) is a self-directed option for adults on an HCBS waiver. The member receives a monthly allocation and acts as the employer: they hire attendants (often family), set wages, build the schedule and approve timesheets. A Financial Management Services (FMS) company handles payroll and taxes, and a Consumer Direct training program prepares the member or their representative for the employer role.

Question 7

What is IHSS and how is it different from CDASS?

Accepted Answer

In-Home Support Services (IHSS) is also consumer directed, but an IHSS agency is the legal employer of record. The agency handles hiring paperwork, payroll, supervision and backup coverage, and a health professional oversees the care plan. IHSS is a better fit for families who want support and structure; CDASS suits families who want maximum control over wages and scheduling. IHSS also allows spouses to be paid, while CDASS generally does not. You can see how in-home support fits into the bigger picture on 2nd Home Community's home care services page.

Question 8

Which Colorado HCBS waivers cover in-home care?

Accepted Answer

The main adult waivers are Elderly, Blind and Disabled (EBD) for people 65+ or adults with disabilities; Community Mental Health Supports (CMHS); Brain Injury (BI); Spinal Cord Injury (SCI); and Complementary and Integrative Health (CIH). Children may qualify through the Children's HCBS (CHCBS) waiver, the Children with Life-Limiting Illness (CLLI) waiver, or the Children's Extensive Support (CES) waiver. CDASS and IHSS are available through several of these waivers.

Question 9

What is a Case Management Agency and why do I need one?

Accepted Answer

Colorado assigns every waiver applicant to a Case Management Agency (CMA) for their county. The CMA completes the functional assessment, confirms level-of-care need, builds the service plan, and authorizes the hours. Since 2024 Colorado has consolidated case management into a smaller set of regional CMAs, so the agency serving your county may differ from the one families used in the past.

Question 10

What are the income limits for Colorado Medicaid long-term care?

Accepted Answer

Long-term care Medicaid in Colorado uses a monthly income cap tied to 300% of the federal SSI benefit rate — roughly $2,900 to $3,000 per month for a single applicant, adjusted annually. Countable assets are generally limited to $2,000 for an individual, with higher protected amounts for a spouse who remains at home. A primary residence, one vehicle and personal belongings are typically excluded. Exact figures change each year, so confirm current limits with a Care Coordinator or your county office.

Question 11

What if income is over the limit?

Accepted Answer

Being over the income cap does not automatically disqualify you. Colorado allows an income trust — commonly called a Miller Trust or Qualified Income Trust — where income above the cap is deposited each month and used for care. Excess assets can often be spent down on legitimate care costs, home modifications, medical equipment or prepaid funeral arrangements. A five-year look-back applies to asset transfers, so avoid giving away property before applying.

Question 12

What is a level of care assessment?

Accepted Answer

Financial eligibility is only half the test. An assessor also determines whether the person needs a nursing-facility level of care — meaning they need hands-on help with activities of daily living such as bathing, dressing, toileting, transferring, mobility or eating, or need supervision due to cognitive impairment such as dementia. Colorado uses a standardized assessment tool administered by the Case Management Agency.

Question 13

Does the person receiving care need to live with me?

Accepted Answer

No. The care recipient can live in their own home, with the caregiver, or in another private residence in the community. Care provided in a nursing facility or most assisted living settings is billed differently and is not paid through CDASS or IHSS.

Question 14

Can someone on Medicare also use these programs?

Accepted Answer

Yes. Medicare does not pay for ongoing personal or custodial care. People who qualify for both Medicare and Medicaid — often called dual eligibles — commonly use Medicaid HCBS waivers for the daily in-home support Medicare will not cover.

Question 15

How do I apply for Medicaid home care in Colorado?

Accepted Answer

There are three parallel steps: apply for Health First Colorado through PEAK, your county human services office, or with help from a Care Coordinator; contact the Case Management Agency for your county to request a waiver assessment; and once approved, choose your service delivery option (CDASS, IHSS or agency-based care) and enroll your caregiver. Completing the short eligibility questionnaire on this page lets a Care Coordinator identify the right path and start the paperwork with you.

Question 16

How long does approval take?

Accepted Answer

Most families see approval in roughly 45 to 90 days from application to the first authorized service. Financial determination typically takes 30 to 45 days; the functional assessment and service plan add a few more weeks. Missing documents — proof of income, bank statements, identification, medical records — are the most common cause of delay.

Question 17

What documents will I need?

Accepted Answer

Plan on a photo ID and Social Security number, proof of Colorado residency, proof of all income (Social Security award letter, pension, wages), recent bank and retirement statements, life insurance and property records, proof of citizenship or lawful residency, and any medical or diagnostic documentation of the person's care needs.

Question 18

Is there a waiting list?

Accepted Answer

Colorado's adult waivers, including EBD, generally do not carry a statewide waiting list, so approved applicants can begin services once enrollment completes. Some children's waivers and specialized programs do have waitlists. A Care Coordinator can tell you what to expect for your specific situation.

Question 19

What does it cost to get help applying?

Accepted Answer

Completing the eligibility questionnaire and speaking with a 2nd Home Community Care Coordinator is free and carries no obligation. Colorado Medicaid programs themselves have no premium for most waiver members, though some households with higher income may owe a monthly patient payment toward the cost of care.

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