Key takeaway
Colorado has two strong self-directed Medicaid options — CDASS and IHSS — that pay family members for in-home caregiving. Spouses can be paid under CDASS in many situations, which is unusual nationally. VA Veteran Directed Care also allows spouses.
- Medicaid: Elderly, Blind & Disabled (EBD) Waiver and Community First Choice fund in-home support.
- CDASS: Consumer-Directed Attendant Support Services lets the participant hire family — including spouses, in most cases.
- IHSS: In-Home Support Services allows family caregivers (spouse policy varies).
- Veterans: Aid & Attendance and VA Veteran Directed Care can fund family caregiving (VDC can pay spouses).
- FAMLI: Colorado’s paid family medical leave program provides partial wage replacement for caregiving leave.
Overview
Colorado offers some of the most flexible paid family caregiving options in the country. The state’s Department of Health Care Policy and Financing (HCPF) administers Medicaid (called Health First Colorado) and the HCBS waivers that pay family caregivers.
Two self-direction models — Consumer-Directed Attendant Support Services (CDASS) and In-Home Support Services (IHSS) — let the care recipient hire their own caregiver. Unlike most states, CDASS allows spouses to be paid in many situations, with the exception of legally responsible relatives in certain narrow cases. Colorado also offers FAMLI (Family and Medical Leave Insurance) for short-term wage replacement while caring for a seriously ill family member.
Programs that pay family caregivers in Colorado
| Program (Type) | Care recipient eligibility | Paid family caregiver provisions |
|---|---|---|
| Elderly, Blind & Disabled (EBD) Waiver (Medicaid HCBS) | Age 65+ or 18+ with a disability or blindness; meets nursing-facility level of care; Medicaid financial limits apply. | Funds personal care, homemaker, respite, adult day services, and home modifications. CDASS or IHSS can be selected to allow family caregivers. |
| Community First Choice (CFC) (Medicaid State Plan) | Medicaid-eligible and meets institutional level of care; entitlement (no waitlist). | Provides attendant care services. Can be combined with CDASS or IHSS for self-direction; family caregivers can be hired. |
| Consumer-Directed Attendant Support Services (CDASS) (Self-direction option) | Available to enrollees in EBD, CMHS, SCI, BI, and CHCBS waivers who can self-direct or have an authorized representative. | Participant gets a monthly budget to hire attendants for personal care, homemaker, and health maintenance. Spouses and other family members may be hired in most cases. |
| In-Home Support Services (IHSS) (Self-direction option) | Available to enrollees in EBD, SCI, BI, CHCBS, and CES waivers who need help with ADLs but want self-direction with agency support. | Family members (other than legally responsible relatives in some cases) can be hired through a participating IHSS agency. |
| Aid & Attendance Pension (VA benefit) | Wartime veteran or surviving spouse with limited income/assets and documented ADL need. | Increases monthly pension to help cover care costs; veteran can pay an adult child or relative. |
| Veteran Directed Care (VDC) and FAMLI (VA / State wage benefit) | VDC: veteran meets nursing-home level of care; FAMLI: Coloradan paying into the FAMLI fund with a serious family caregiving need. | VDC: monthly budget to hire any caregiver, including a spouse. FAMLI: up to 12 weeks of partial wage replacement to care for a family member. |
Colorado Medicaid programs
Colorado pays family caregivers primarily through Health First Colorado (Medicaid) HCBS waivers and the Community First Choice (CFC) state plan benefit. The two self-direction options — CDASS and IHSS — sit on top of these and determine how the participant hires and manages caregivers.
Elderly, Blind & Disabled (EBD) Waiver
The EBD Waiver supports older adults and adults with disabilities or blindness who would otherwise need nursing-facility care. Services include personal care, homemaker, respite, adult day services, and home modifications.
- Age 65+, or adults 18+ who are blind or disabled.
- Must meet nursing-facility level of care.
- Income limit generally at or below 300% of the SSI federal benefit rate.
- Participants can opt into CDASS or IHSS to hire family caregivers (including spouses under CDASS in most cases).
Community First Choice (CFC)
CFC is a Medicaid state plan benefit that provides attendant care to Medicaid recipients meeting an institutional level of care. As an entitlement, it has no waiting list.
- Must be Medicaid-eligible and meet institutional level of care.
- Works with CDASS and IHSS for self-direction.
- Available to participants of all ages who qualify.
CDASS — Consumer-Directed Attendant Support Services
CDASS is Colorado’s strongest self-direction option. The participant receives a monthly attendant services budget, hires their own attendants, sets pay rates, and manages schedules. A Financial Management Service handles payroll and taxes.
- Spouses, adult children, and other relatives may be hired in most cases.
- Participant or their representative is the employer of record.
- Available to enrollees in EBD, CMHS, SCI, BI, and CHCBS waivers.
IHSS — In-Home Support Services
IHSS is a hybrid model where the participant selects and trains their attendant, but the attendant is employed by an IHSS agency rather than the participant. It offers more support than full CDASS self-direction.
- Family members can be hired (legally responsible relative rules apply in some cases).
- Agency handles HR, payroll, and back-up coverage.
State-funded supports: FAMLI and Area Agencies on Aging
Colorado offers significant non-Medicaid supports for family caregivers, including the FAMLI paid leave program and respite/training services through 16 Area Agencies on Aging.
Statewide paid leave program funded by payroll contributions. Eligible Coloradans can receive up to 12 weeks of partial wage replacement (up to 16 weeks with pregnancy complications) to care for a family member with a serious health condition.
State-funded respite grants administered by community-based organizations to help families pay for short-term respite care.
Local AAAs across all 64 counties coordinate caregiver education, respite, counseling, and limited supplemental services for unpaid family caregivers.
Who qualifies
- FAMLI: any Colorado worker contributing to the FAMLI fund (most W-2 employees).
- Respite & AAA supports: family caregivers of adults age 60+ or of any age with Alzheimer’s/related dementia.
- Grandparents 55+ raising grandchildren.
Veterans’ programs
Colorado is home to roughly 380,000 veterans. The most relevant VA pathways for family caregivers are Aid & Attendance, Veteran Directed Care, and PCAFC.
Aid & Attendance Pension
A&A is a monthly add-on to the VA pension for wartime veterans or surviving spouses with limited income/assets who need help with daily activities. The veteran can use these funds to pay a family caregiver.
- Qualifying wartime service, limited income/assets, documented ADL need.
- Spouses cannot be paid directly because household income is combined.
Veteran Directed Care (VDC)
VDC provides a monthly care budget the veteran manages to hire caregivers — including a spouse. Several Colorado VAMCs participate, including the Rocky Mountain Regional VA Medical Center.
- Veteran must meet nursing-home level of care.
- Spouses may be paid under VDC.
- Financial management service handles payroll.
Program of Comprehensive Assistance for Family Caregivers (PCAFC)
PCAFC provides a monthly stipend, training, and other supports to the primary family caregiver of an eligible veteran with serious injury or illness.
- Stipend tier depends on the veteran’s assessed needs.
- Apply through the VA Caregiver Support Program.
Long-term care insurance
If the care recipient owns a long-term care insurance policy, benefits may be used to pay a family caregiver, subject to policy terms.
What to check in the policy
- Coverage includes in-home personal care, not just facility care.
- Benefits pay the policyholder directly (cash/indemnity model), enabling payment to a chosen family caregiver.
If the policy only reimburses licensed agencies, the family caregiver may need to work through a Colorado-licensed home care agency that bills the policy.
How to apply in Colorado (step-by-step)
- Identify your most likely path: EBD Waiver with CDASS or IHSS, Community First Choice, VA benefits, FAMLI, or LTC insurance.
- Gather documents: photo ID, Social Security card, proof of Colorado residency, income/asset documentation, medical records, current medications list, and (for veterans) DD-214.
- Start with the right agency:
- EBD/CFC + CDASS or IHSS: contact your local Single Entry Point (SEP) agency or the HCPF Member Contact Center at 1-800-221-3943.
- CDASS specifically: visit CDASS.com or ask your case manager about the CDASS training and Financial Management Service options.
- FAMLI: apply through famli.colorado.gov.
- VA paths: contact the VA Caregiver Support Line at 1-855-260-3274 or your nearest Colorado VAMC.
- LTC insurance: call the insurer to confirm caregiver payment rules and documentation.
- Complete required assessments — functional level of care (ULTC 100.2) and Medicaid financial eligibility.
- If choosing CDASS or IHSS, complete training, choose a Financial Management Service or IHSS agency, and hire your family caregiver.
- Begin services. Submit timesheets, keep care logs, and prepare for annual reassessment.
Colorado paid caregiver FAQs
Can a spouse be paid as a caregiver in Colorado?
Yes. Colorado’s CDASS (Consumer-Directed Attendant Support Services) program allows spouses to be hired as paid caregivers in most cases — one of the more flexible policies in the country. IHSS may also allow spouses depending on the specific waiver. The VA’s Veteran Directed Care program also allows spouses to be paid.
How much do caregivers get paid in Colorado?
Under CDASS, the participant sets caregiver pay within their monthly attendant services budget — typically $15 to $25+ per hour depending on region, complexity of care, and budget. IHSS rates and VA budgets vary.
Can I be paid to care for my parent in Colorado?
Yes. Adult children are routinely hired through CDASS, IHSS, the EBD Waiver, Community First Choice, and VA programs such as Aid & Attendance and Veteran Directed Care.
What is the difference between CDASS and IHSS in Colorado?
CDASS is full self-direction — the participant is the employer of record, sets pay, and manages schedules with a Financial Management Service. IHSS is a hybrid — the participant selects and trains the attendant, but the attendant is employed by an IHSS agency that handles HR and payroll. CDASS gives more control; IHSS gives more agency support.
Can I use FAMLI and CDASS together?
They serve different purposes. FAMLI replaces wages while you take time off work to provide caregiving. CDASS pays you for the caregiving hours themselves. They can complement each other — for example, FAMLI during the assessment/enrollment period while CDASS pay starts after services begin.
