How to Get Paid as a Family Caregiver in Colorado (2026)

Getting paid as a family caregiver in Colorado usually runs through two self-direction options, and one of them lets a spouse be the paid attendant. Both sit under Health First Colorado, the state's Medicaid program, and let the person receiving care direct their own attendants.1

The two options are CDASS and IHSS. Under CDASS, the member or their Authorized Representative is the attendant's legal employer of record. IHSS adds the support of an agency, and members select and supervise their own attendants, including family members.1

This guide lays out every legitimate way to be paid as a family caregiver in Colorado for 2026: who can be hired under each program, how the pay works, and how to pick the route that fits your family.

The Short Version

If you are a relative or friend of someone who qualifies for Health First Colorado's Community First Choice services, you may be able to be paid to provide their care through one of two self-direction options. With CDASS, the care recipient or their Authorized Representative is the attendant's employer of record. With IHSS, the care recipient directs the attendant they chose with a licensed agency's support. Under both, one caregiver's paid hours are capped.1

If your loved one is a veteran, check the VA programs too. Veteran-Directed Care lets an eligible veteran hire and supervise their own workers, including family and friends, and the VA decides eligibility and the budget.3

If your family has enough private assets, a written personal services agreement can pay a caregiver now while documenting the arrangement for later Medicaid planning. Colorado applies a 60-month look-back and treats pay under an agreement that misses any of its requirements as a transfer without fair consideration, so the format matters.4

The rest of this guide walks through each pathway in detail.

What Makes Colorado Different: Self-Direction and the Spouse Question

The first question many families ask is "can I be paid to care for my own husband or wife?" In Colorado the answer runs through participant-directed services, where the person receiving care directs their own attendants rather than being assigned an agency worker. Members can choose family members, friends, or others as paid caregivers, with some restrictions, and CDASS does not bar a spouse from the role.1

There are two self-direction options, and the practical difference is how much of the employer role the family carries:

• CDASS (Consumer-Directed Attendant Support Services). The member or their Authorized Representative is the attendant's legal employer of record, and a Financial Management Services (FMS) vendor the member chooses processes payroll and withholds federal, state, and local tax. Colorado's two contracted CDASS FMS vendors are Palco, Inc. and Public Partnerships, LLC (PPL).1
• IHSS (In-Home Support Services). The member directs their own attendants, including family members, with the added support of a licensed home care agency.1

On the spouse question specifically: under CDASS, a family member including a spouse may be hired and paid as the attendant, subject to conditions. Because a spouse usually lives with the care recipient, the one that matters most is that a member of the member's household may be paid only to furnish extraordinary care as determined by the Case Manager, documented on the service plan. A spouse who serves as the Authorized Representative cannot also be the paid attendant. If you are your parent's guardian, see whether a guardian can be paid to care for a parent. Homemaker work by a spouse is limited more tightly. For an adult member, a Legally Responsible Person means the spouse, and Colorado's rule limits reimbursement to Legally Responsible Persons for Homemaker services to a maximum of 364 total hours per year, per member. That is one total for the member, not a separate allowance for each Legally Responsible Person, and additional Homemaker hours may be authorized when someone who is not a Legally Responsible Person provides them. Confirm the Homemaker hours authorized with the Case Manager. For IHSS, HCPF says members can choose family members as attendants; ask the Case Manager how the household and Homemaker limits apply to a spouse.1

Whatever the route, attendant pay has a floor. Colorado sets a minimum base wage for direct care workers delivering Home and Community-Based Services, and it applies to CDASS and IHSS attendants. Effective January 1, 2026, that base wage is $17.00 per hour statewide, with higher local floors of $19.29 per hour in Denver and $18.17 per hour in Edgewater to match those cities' local minimum wages.2 Under CDASS the hourly wage is negotiated between the attendant and the member or Authorized Representative, may not exceed the amount the Department establishes, and must meet Colorado labor standards, including minimum wage and overtime.1

The Colorado Paid Family Caregiver Pathways

1. CDASS: The Member Is the Employer

Who pays: Health First Colorado (Medicaid), administered by HCPF, with a Financial Management Services vendor running payroll.

Who can be paid: A family member, including a spouse, hired as the member's attendant, subject to conditions: a member of the member's household may be paid only for extraordinary care as determined by the Case Manager, and the Authorized Representative cannot also be the attendant. Friends and others can also be hired.1

What it is: The member or their Authorized Representative hires, trains, and supervises the attendants and budgets for care within an established monthly and certification-period allocation, while the FMS vendor handles payroll and tax withholding.1

What it covers: Personal care, homemaker, and health maintenance services.1

Eligibility, recipient: CDASS is a covered benefit for members enrolled in Community First Choice, whose state plan amendment took effect July 1, 2025. To use it, the member must be enrolled in Health First Colorado; meet CFC eligibility, including an assessed need for Personal Care, Homemaker, and/or Health Maintenance Activities and an institutional level of care (automatically met if already enrolled in an HCBS waiver); participate in service planning with a Case Management Agency; and want to self-direct all aspects of in-home care. The member must also complete the Attendant Support Management Plan and orientation and show the ability to direct care, or have care directed by an Authorized Representative. A member still receiving CDASS through a waiver who has not yet moved to CFC will be guided through the timing by their Case Manager.1

Hour limits: An attendant may not be reimbursed for more than 16 hours of care per day across all the members they serve, and the weekly limit on one caregiver's hours for a single member steps down from 84 hours (July 1, 2026) to 70 (January 1, 2027) and 56 (July 1, 2027). The CDASS employer can request an exception for a member who meets HCPF's criteria.1

How you get paid: Your hourly wage is negotiated with the member or Authorized Representative, may not exceed the amount the Department sets, and must meet Colorado Department of Labor and Employment standards, including minimum wage and overtime, and the local, state, and federal requirements where the care is provided.1

Best for: A family, including a spouse, that wants full control over hiring and scheduling and is comfortable acting as the employer.

2. IHSS: Self-Direction With an Agency's Support

Who pays: Health First Colorado (Medicaid), administered by HCPF, through a licensed IHSS agency.

Who can be paid: An attendant the member chooses: HCPF says IHSS members select and supervise their own attendants, including family members.1

What it is: IHSS lets the member direct and manage the attendants who provide their personal care, homemaker, and health maintenance services, with the added support of an agency. Colorado's Community First Choice plan describes it as the route for members who wish to choose an attendant and waive the Nurse Practice Act: the member presents a person of their choosing to the agency as a potential attendant. The agency must hold a Class A or B Home Care Agency license in good standing with CDPHE.1

Eligibility, recipient: The same gate as CDASS: enrollment in Health First Colorado, CFC eligibility including an institutional level of care, and service planning with a Case Management Agency.1

Hour limits: There is no service limit on Personal Care or Health Maintenance Activities, but no individual provider is reimbursed for over 16 hours of care per day except in an emergency. Colorado's rule also caps the hours of qualifying services one caregiver can provide to one member in a Sunday-to-Saturday week (84, then 70, then 56 hours, as above), and HCPF says members' authorized hours and budgets will not be cut by it. Exception requests come from the provider agency or CDASS employer; members cannot file one themselves unless they are the CDASS employer.1

How you get paid: IHSS attendants are covered by the state direct care base wage.2

Best for: A family that wants to choose and direct the attendant with the added support of a licensed agency.

3. The Programs That Feed CDASS and IHSS

CDASS and IHSS are delivery options, not standalone benefits: HCPF describes both as service delivery options under Community First Choice. The care recipient first has to be enrolled in Health First Colorado and meet CFC eligibility, which includes an institutional level of care, determined by the state's prescribed level of care eligibility assessment, and an assessed need for Personal Care, Homemaker, and/or Health Maintenance Activities. Health First Colorado enrollment has its own financial rules, so check our Colorado Medicaid eligibility and income limits guide before assuming your loved one does or does not qualify.1

• Community First Choice (CFC). CFC, also known as 1915(k), is an optional Medicaid program that lets states offer select home and community based attendant services and supports to eligible members on the State Plan. HCPF says CFC became active on July 1, 2025.1
• HCBS waivers. HCPF's timeline says waiver members transitioned to CFC from July 2025 through 2026, with waiver actions to remove CFC services from the waivers planned for Fall 2026 through January 2027. A member already enrolled in an HCBS waiver automatically meets institutional level of care, and one still receiving CDASS or IHSS through a waiver will be guided through the move by their Case Manager.1

The practical point for a caregiver: whichever route your loved one came in by, the care is delivered through CDASS or IHSS, a family member can be the paid attendant within the conditions above, and service planning runs through a Case Management Agency.1

4. VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)

Who can be paid: A designated Primary Family Caregiver of an eligible veteran. The caregiver must be at least 18 and either a family member (a spouse, son, daughter, parent, stepfamily member, or extended family member) or someone who lives full time with the veteran, or is willing to if VA designates them. Those are alternatives, so a partner or friend who lives with the veteran can qualify without being related.5

2026 stipend: The PCAFC stipend starts from a monthly base, which is the federal General Schedule GS-4, Step 1 annual rate for the locality where the veteran lives, divided by 12. It is not an hourly wage. 38 CFR 71.40(c)(4)(i) then multiplies that base by a factor, and there are four factors across two schedules, not two. Which one applies depends first on whether the veteran is in the current program under 38 CFR 71.20(a), or is a legacy participant or legacy applicant under 38 CFR 71.20(b) or (c), meaning a household whose connection to PCAFC predates the program's October 1, 2020 restructuring.5

Three rules sit on top of that grid, and a Colorado family can lose money by missing any of them. First, the legacy schedule reaches the full 1.00 on the rating sum alone, with no self-sustain determination required, so a legacy household whose 2019 ratings total 21 or higher should not treat 0.625 as its ceiling. Second, a veteran who meets both the current-program and the legacy criteria is paid whichever of the two amounts is higher. Third, a legacy participant's stipend is held at not less than what the caregiver was eligible to receive the day before October 1, 2020, so long as the veteran still resides at the address on record with PCAFC on that date.5

The legacy schedule is time-limited: it runs for eight years beginning October 1, 2020, and lapses October 1, 2028, after which the current-program factors govern on their own.5

Because the base rate follows the veteran's locality pay area, the stipend differs across Colorado. Ask your VA Caregiver Support Coordinator for two things: your locality's GS-4, Step 1 figure, and which of the five rows above your household falls in. If you are on the legacy schedule and nobody has told you your 2019 rating sum, ask for it.5

Veteran eligibility: VA's first screen has four requirements, and all of them must be true: a VA disability rating (individual or combined) of 70% or higher, a discharge from the U.S. military or a date of medical discharge, a need for at least six months of continuous, in-person personal care, and enrollment in VA health care. A 70% rating alone is not enough, and even the four are a first screen: you and the veteran apply together, and VA decides eligibility through that application.5

Why it stands out: The stipend allows paid spouses, the Primary Family Caregiver can also receive CHAMPVA health coverage if they don't already qualify under another health plan, mental health counseling, and at least 30 days of respite care per year. One step is easy to miss: the stipend is paid only after the caregiver enrolls in direct deposit through the VA customer engagement portal.5

Best for: Families of an eligible veteran where one person provides substantial daily care.

5. VA Veteran-Directed Care (VDC)

Who can be paid: Workers the veteran hires and supervises, including family and friends.3

How it works: VDC serves veterans of any age who are at risk of institutional placement, and their family caregivers. The VA determines the veteran's eligibility and budget; the veteran manages that flexible budget and decides what mix of goods and services best meets their needs. An options counselor at the agency delivering VDC provides assessment and care planning, arranges fiscal management services, and offers ongoing counseling and support.3

Availability in Colorado: In the Denver metro area, Veteran-Directed Care is offered through the Denver Regional Council of Governments (DRCOG) Area Agency on Aging with the Rocky Mountain Regional VA Medical Center, for eligible participants in Adams, Arapahoe, Broomfield, Clear Creek, Denver, Douglas, Gilpin, and Jefferson counties. Elsewhere the approved provider may be an Area Agency on Aging or a Center for Independent Living, so contact your local VA medical center about availability and eligibility.3

Best for: A Colorado veteran at risk of institutional placement who wants to hire a family member or friend and manage their own care budget.

6. VA Aid and Attendance Pension

Who is paid: The veteran or surviving spouse receives the pension directly, and a family caregiver is typically paid out of it under a private arrangement.6

2026 maximums (effective December 1, 2025 through November 30, 2026): VA publishes these as Maximum Annual Pension Rates (MAPRs). A MAPR is a ceiling, not a payment: the pension is the MAPR less the claimant's income for VA purposes, and the monthly rate is that remainder divided by 12, rounded down to the whole dollar. A single veteran with Aid and Attendance has a MAPR of $29,093 per year; a veteran with one dependent $34,488; two veterans married to each other who both qualify for Aid and Attendance $46,143. A surviving spouse with Aid and Attendance and no dependents has a MAPR of $18,697. The net worth limit is $163,699. Confirm current figures on the VA pension rate page before applying.6

Eligibility: A veteran or surviving spouse who qualifies for VA pension with Aid and Attendance and whose income and net worth fall within VA's limits. Non-reimbursable medical expenses (those not covered by insurance) can reduce income for VA purposes, but only the amount above 5% of the MAPR counts. VA pension carries a 36-month look-back on asset transfers for less than fair market value, with a penalty period of up to 5 years.6

How caregivers get paid: The pension goes to the veteran, who then pays the family caregiver, ideally under a written caregiver agreement. Colorado's County Veterans Service Officers help file at no cost; avoid for-profit pension consultants who charge a fee. Aid and Attendance can interact with Health First Colorado long-term care. Under Colorado's Medicaid rule, the Aid and Attendance portion of the pension, as determined by the VA, is not counted as income when deciding eligibility, and it is not used as patient payment to a medical facility other than a State Veterans Home. For a veteran or surviving spouse with no dependents in a State Veterans Home, that portion is used as patient payment, leaving less to pay a caregiver. Federal law can also cut the pension itself to no more than $90 a month after the month of admission for a veteran with neither spouse nor child, or a surviving spouse with no child, whose nursing-facility care Medicaid covers. Confirm the interaction with a County Veterans Service Officer or HCPF before relying on receiving both at full value.7

Best for: A veteran or surviving spouse who qualifies for Aid and Attendance and is within VA's income and net worth limits.

7. Private Personal Services Contract

Who can be paid: Any family member, including an adult child, sibling, or other relative, under a written contract. Spouses are generally not paid this way for Medicaid-planning purposes, because transfers between spouses are treated differently.

What it is: A written personal services agreement between the care recipient and the caregiver. For agreements signed and notarized on or after March 1, 2007, Colorado treats the pay as a transfer without fair consideration unless every requirement is met:4

• The agreement is written, signed, and notarized before any paid service is provided.
• It is signed by the applicant or a legally authorized representative who is not a beneficiary of it.
• It specifies the type, frequency, and time of the services.
• It pays on a regular basis, no less often than monthly, while the services are provided.
• The pay is comparable to the open market, and the applicant carries the burden of proving that.
• A record or log details the services actually rendered, and they do not duplicate services someone else is paid or responsible to provide.4

Why the format matters: Health First Colorado applies a 60-month look-back on asset transfers. A transfer without fair consideration in that window makes the person ineligible for long-term care services for a penalty period, which Colorado computes by dividing the value transferred (less anything received) by the average monthly private-pay cost of long-term care institution care across its regions at the time of application. That cost figure is set by the state, so get the current one from HCPF or a Colorado elder-law attorney. Paying a caregiver for care already given without pay counts as a transfer without fair consideration regardless.4

Best for: Families with enough assets to private-pay a caregiver who also want to preserve eligibility for future Medicaid planning. Work with a Colorado elder-law attorney to draft the contract.

Comparing the Colorado Pathways

How to Choose a Colorado Paid Family Caregiver Pathway

Start with the care recipient's situation.

Tax Considerations

Most Colorado caregiver pay is reportable income, with one valuable federal exception.

• CDASS pay runs through the FMS vendor, which withholds federal, state, and local tax. Under IHSS, ask the agency how your pay and withholding are handled.1
• VA PCAFC is a stipend, calculated and paid differently from a wage.
• VA Aid and Attendance is a VA pension payment, and federal law exempts VA benefits from taxation; that exemption covers the veteran's benefit, not the wages the veteran later pays a caregiver out of it.8
• Personal services contracts pay W-2 or 1099 income depending on how the caregiver is classified.

IRS Notice 2014-7: Qualified Medicaid Home and Community-Based Services waiver payments for personal care may be excluded from your federal gross income, but only for care given in your own home where the care recipient also lives. A caregiver who keeps a separate home where they reside may not exclude the payments.9 The notice is written for section 1915(c) waiver programs, and the IRS does not treat the exclusion as automatic for a non-waiver program such as the section 1915(k) Community First Choice option, under which HCPF describes CDASS and IHSS as service delivery options. Confirm how your own pay is treated with a tax professional before filing.9

Colorado state income tax: Colorado taxes income at a single rate applied to Colorado taxable income, and the rate varies by tax year: 4.4% for tax year 2025 and 4.25% for tax year 2024. Caregiver wage income is taxed at the rate in effect for your filing year, so confirm it with the Colorado Department of Revenue.4

Common Misconceptions

"I cannot be paid to care for my own spouse." Not necessarily in Colorado. Under CDASS, a spouse can be hired and paid as the attendant, though a household member may be paid only for extraordinary care as determined by the Case Manager.1

"CDASS and IHSS are the same thing." They both let a family member be paid, but the setup differs. Under CDASS the member or Authorized Representative is the attendant's legal employer of record and an FMS vendor processes payroll; IHSS adds the support of a licensed home care agency.1

"If Mom has Medicare, I can get paid through Medicare." Medicare does not pay family caregivers. It only covers short-term skilled home health through certified agencies. Paid family caregiving in Colorado comes through Health First Colorado, the VA, or a private contract.

"The same person can be the Authorized Representative and the paid attendant under CDASS." No. An Authorized Representative may not be employed as the attendant for the member they represent and is not paid for the representative role.1

"I can just start getting paid out of Dad's bank account." Not safely. Colorado treats pay under a care agreement that misses any of its requirements, and payment for care already given, as a transfer without fair consideration, which can trigger a penalty period under its 60-month look-back when the parent later needs Medicaid long-term care.4

Where to Get Help in Colorado

Related Terms

• Consumer Directed Services (CDS): The national term for self-directed programs like Colorado's CDASS, where the care recipient directs their own worker and acts as the employer.
• HCBS waiver: The federal authority behind Colorado's waivers; Community First Choice, under which CDASS and IHSS are now delivered, is a state plan benefit.
• Activities of Daily Living (ADLs): The functional basis for authorizing personal care hours across Colorado's programs.
• Nursing Facility Level of Care: The clinical threshold tied to Colorado's HCBS waiver eligibility.

Learn More

Find personalized help getting paid as a family caregiver in Colorado at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.