Colorado is one of the more flexible states for paying a family member to provide care, and unlike most states, it lets a spouse be a paid caregiver. The state runs most of its paid in-home care through two self-direction options under Health First Colorado, the state's Medicaid program, where the person receiving care chooses and directs their own attendant rather than being assigned an agency worker.

The two options are CDASS and IHSS. Under CDASS, the family member becomes the legal employer of the attendant. Under IHSS, an agency is the employer and the family directs the work. Both let a relative, including a spouse, be paid to provide hands-on care.

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 spouse, adult child, sibling, other relative, or close friend of someone who qualifies for Health First Colorado long-term care, you can likely be paid to provide their care through one of two self-direction options. With CDASS, the care recipient or their Authorized Representative becomes the attendant's employer and a payroll vendor handles taxes. With IHSS, an agency is the employer and the family directs the work, with a 40-hour-per-week cap on paid personal care from a family attendant.

If your loved one is a veteran, check the VA programs first. The VA's caregiver stipend and Veteran-Directed Care often pay as well as or better than Medicaid, and they allow paid spouses.

If your family has enough private assets, a written personal services contract can pay a caregiver now while documenting the arrangement for later Medicaid planning. Colorado enforces a 60-month look-back, so the contract format matters.

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

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

In most states, the first question a family asks, "can I be paid to care for my own husband or wife," gets a flat no under Medicaid. Colorado answers differently. The state delivers most of its Medicaid in-home care through participant-directed services, where the person receiving care chooses, trains, and supervises their own attendant rather than being assigned an agency worker. That attendant is very often a family member, and Colorado does not bar a spouse from the role.

There are two self-direction options, and the practical difference is who the legal employer is:

  • CDASS (Consumer-Directed Attendant Support Services). The member or their Authorized Representative is the employer of record for the attendant. A Financial Management Services (FMS) vendor, chosen by the family and contracted with HCPF, runs payroll, withholds taxes, and tracks the spending against the member's allocation. A Case Management Agency sets the allocation amount based on assessed need. CDASS covers three task categories: personal care (bathing, dressing, grooming, eating), homemaker tasks (light housekeeping, meal preparation, shopping, money management), and health maintenance activities (skilled tasks such as medication administration).
  • IHSS (In-Home Support Services). An IHSS agency is the employer of record, but the member still selects, trains, and supervises their own attendant, who can be a neighbor, friend, or family member. Because IHSS attendants do not have to be licensed health professionals, the family has flexibility over who provides both skilled and unskilled care.

On the spouse question specifically: under CDASS, a family member including a spouse may be hired and paid as the attendant. Under IHSS, a 2014 state law (HB 14-1357) allows a family member, including a spouse, to be a paid attendant for up to 40 hours per week of personal care services. This is the key Colorado advantage.

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. That is a floor, not a ceiling: within the member's allocation, the actual hourly rate the family sets can run higher.

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. Other relatives and friends can also be hired.

What it is: CDASS is a self-direction option where the member or their Authorized Representative is the employer of record. That means the family does the hiring, sets the schedule, and directs the work, while the FMS vendor handles the payroll mechanics, tax withholding, and tracking against the allocation. A Case Management Agency case manager sets the allocation amount based on assessed need.

What it covers: Three task categories: personal care (hands-on help with daily activities), homemaker services (light housekeeping, meal preparation, shopping, money management), and health maintenance activities (skilled tasks such as medication administration and respiratory care).

Eligibility, recipient: As of July 1, 2025, CDASS for these services is available through the Community First Choice Medicaid state plan benefit, and CDASS has historically been available to members on the HCBS waivers for the Elderly, Blind and Disabled (HCBS-EBD), Community Mental Health Supports, and Brain Injury. The member must qualify for Health First Colorado long-term services and supports.

How you get paid: The FMS vendor pays you on a payroll schedule with taxes withheld. Attendant wages must comply with Colorado Department of Labor and Employment standards, including minimum wage and overtime, and cannot fall below the applicable wage floor.

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

2. IHSS: The Agency Is the Employer

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

Who can be paid: A neighbor, friend, or family member, including a spouse, for up to 40 hours per week of personal care services.

What it is: IHSS is a participant-directed option where the member directs their own care but an IHSS agency is the employer of record. The member selects, trains, and supervises the attendant; the agency handles the employment side. Because attendants do not have to be licensed or certified health professionals, families have flexibility over who provides care.

The 40-hour cap: Under the 2014 legislative change (HB 14-1357), a family member, including a spouse, may be a paid IHSS attendant for up to 40 hours per week of personal care services. This cap is specific to IHSS and to family attendants.

The Authorized Representative rule: A member can designate an Authorized Representative to help direct services. The Authorized Representative must be at least 18, the role is unpaid, and the same person cannot be both the Authorized Representative and the paid attendant.

How you get paid: The IHSS agency runs payroll and withholds taxes, at or above the state direct care base wage.

Best for: A family that wants to direct the care but prefers the agency to carry the employer responsibilities, and whose family attendant works within the 40-hour cap.

3. The Programs That Feed CDASS and IHSS

CDASS and IHSS are delivery options, not standalone benefits. The care recipient first has to qualify for Health First Colorado long-term services and supports, and then chooses to receive their personal care through self-direction.

  • Community First Choice (CFC). As of July 1, 2025, CDASS for personal care, homemaker, and health maintenance services runs through CFC, a Medicaid state plan benefit. Because a state plan benefit is an entitlement rather than a capped waiver, eligible members are not subject to the same waitlists that waivers can have.
  • HCBS waivers. Both CDASS and IHSS have historically been available to members on Colorado's Home and Community-Based Services waivers, principally the waiver for the Elderly, Blind, and Disabled (HCBS-EBD), which lets eligible older adults receive services at home instead of in a nursing facility.

The practical point for a caregiver: the program your loved one is enrolled under determines eligibility and what else gets bundled in, but in all cases the care is delivered through CDASS or IHSS, and a family member can be the paid attendant. A Case Management Agency assesses the need and sets the allocation.

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

Who can be paid: A designated Primary Family Caregiver of an eligible veteran, which can be a spouse, adult child, parent, or other family member.

2026 stipend: The PCAFC stipend is calculated from the federal General Schedule GS-4, Step 1 annual rate for the locality where the veteran lives, divided by 12, then multiplied by a level factor. Level One is 0.625, for caregivers of veterans needing personal care assistance; Level Two is 1.00, when the veteran is determined unable to self-sustain in the community. Because the rate depends on the veteran's locality pay area, the stipend differs across Colorado, so confirm your exact figure with your VA Caregiver Support Coordinator.

Veteran eligibility: A service-connected disability rated at 70 percent or higher, a need for in-person personal care, and enrollment in VA health care.

Why it stands out: The stipend allows paid spouses, the Primary Family Caregiver can also receive CHAMPVA health coverage if otherwise uninsured, mental health counseling, and at least 30 days of respite care per year, and PCAFC can be combined with other benefits.

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

5. VA Veteran-Directed Care (VDC)

Who can be paid: Almost any caregiver the veteran chooses, including a spouse and other family.

How it works: The VA determines the veteran's eligibility and sets a flexible monthly budget the veteran uses to purchase in-home personal care and to hire and supervise their own caregivers, with one-on-one case-management support.

Availability in Colorado: Veteran-Directed Care is offered through participating VA medical centers in partnership with Area Agencies on Aging. In the Denver region it is delivered by the Denver Regional Council of Governments (DRCOG) Area Agency on Aging in partnership with the Rocky Mountain Regional VA Medical Center. Availability varies by region, so ask your VA social worker or Caregiver Support Coordinator whether VDC is available at the facility serving your area.

Best for: A Colorado veteran with daily-living needs who wants to pay a spouse or set their caregiver's schedule and rate directly.

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.

2026 maximums (effective December 1, 2025 through November 30, 2026): a single veteran with Aid and Attendance receives up to $2,424 per month ($29,093 per year); a veteran with one dependent up to $2,874 per month ($34,488 per year); two married veterans both receiving Aid and Attendance up to $3,845 per month ($46,143 per year). A surviving spouse with Aid and Attendance receives up to $1,558 per month ($18,697 per year). The 2026 net worth limit is $163,699. Confirm current figures on the VA pension rate page before applying.

Eligibility: A wartime veteran (90 days of active duty including at least one day during a recognized wartime period) or a surviving spouse, who also meets the Aid and Attendance functional criteria (needs help with daily activities, is housebound, is in a nursing facility, or is legally blind), and whose countable income and assets fall under the limit. VA pension carries a 36-month look-back on asset transfers for less than fair market value.

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, and the treatment is fact-specific, so confirm the interaction with a County Veterans Service Officer or HCPF before relying on receiving both at full value.

Best for: A wartime veteran or surviving spouse with income and assets under the limit who needs help with daily activities.

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, arm's-length contract between the care recipient (or their legal representative) and the caregiver, signed before care begins. It should spell out the services, the schedule, a reasonable and customary hourly rate documented against local agency quotes, how and when the caregiver is paid, and a requirement that the caregiver keep daily logs and report the income on their taxes.

Why the format matters: Health First Colorado enforces a 60-month (five-year) look-back on asset transfers. Without a written contract, money that flows from an aging parent to an adult child for care is presumed to be an uncompensated transfer and can create a penalty period when the parent later applies for Medicaid long-term care. The penalty is calculated by dividing the transferred amount by a statewide penalty divisor that HCPF updates periodically; that exact divisor figure changes, so confirm the current rate with HCPF or a Colorado elder-law attorney before relying on it. A properly drafted contract converts the payment into a documented exchange of value.

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

Pathway Pay a spouse? Who is the employer Who pays Best fit
CDASS Yes Member or Authorized Representative Health First Colorado via FMS vendor Family wanting full control of hiring
IHSS Yes (up to 40 hrs/wk) IHSS agency Health First Colorado via agency Family wanting the agency to be employer
VA PCAFC Yes VA (stipend, not wages) VA Eligible veteran's primary caregiver
VA Veteran-Directed Care Yes Veteran (veteran-set budget) VA Veteran wanting to pay a spouse
VA Aid and Attendance Pension paid to veteran Private arrangement VA (pension) Wartime veteran under income/asset limits
Personal services contract No Private arrangement Private funds Family with assets, planning ahead

How to Choose a Colorado Pathway

Start with the care recipient's situation:

  1. Is your loved one a veteran? Check the VA pathways first. PCAFC pays a stipend, Veteran-Directed Care lets you pay a spouse, and Aid and Attendance can help with care costs. Your County Veterans Service Officer helps for free.
  2. Are you a spouse? Good news in Colorado: both CDASS and IHSS allow a spouse to be paid, and so do the VA programs. With IHSS, your paid personal care is capped at 40 hours per week; CDASS does not carry that same family-attendant cap.
  3. Is your loved one on or likely eligible for Health First Colorado? Start by contacting HCPF Long-Term Services and Supports or a Case Management Agency to request an assessment, then decide between CDASS (you become the employer) and IHSS (the agency is the employer).
  4. Do you want full control, or do you want the agency to handle employment? Choose CDASS for control over hiring, scheduling, and the rate within your allocation. Choose IHSS if you would rather the agency carry payroll and employer duties.
  5. Do you have substantial private assets and want to plan ahead? Talk to a Colorado elder-law attorney about a personal services contract.

Not sure which Colorado pathway fits your family? Chat with Brevy's care navigator for a side-by-side comparison based on your situation: whether you are a spouse or another relative, the care recipient's veteran status, and whether they qualify for Health First Colorado.

Tax Considerations

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

  • CDASS and IHSS pay W-2 wages through the FMS vendor or the IHSS agency.
  • VA PCAFC is a stipend, calculated and paid differently from a wage.
  • VA Aid and Attendance is tax-free to the veteran; when the veteran uses it to pay a caregiver, the caregiver receives ordinary taxable income.
  • Personal services contracts pay W-2 or 1099 income depending on how the caregiver is classified.

IRS Notice 2014-7: If you live in the same home as the person you care for and you are paid through a Medicaid program, your wages may be excluded from federal gross income. This applies to many Colorado CDASS and IHSS arrangements and is a common, valuable benefit. Talk to a tax preparer familiar with the rule before filing.

Colorado state income tax: Colorado levies a flat individual income tax, so the same rate applies regardless of income level. The statutory rate is 4.4 percent, but recent tax years have applied temporary reductions (for example a 4.25 percent rate) that vary with the state's TABOR surplus, so confirm the rate in effect for your filing year with the Colorado Department of Revenue. The load-bearing point is that it is flat: caregiver wage income is taxed at that single state rate.

Common Misconceptions

"I cannot be paid to care for my own spouse." In many states that is true, but not in Colorado. Under CDASS, a spouse can be hired and paid as the attendant, and under IHSS a spouse can be paid for up to 40 hours per week of personal care.

"CDASS and IHSS are the same thing." They both let a family member be paid, but the legal employer differs. Under CDASS the member or Authorized Representative is the employer; under IHSS an agency is the employer. That changes who handles payroll and who carries the employer responsibilities.

"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 direct the care and be the paid attendant under IHSS." Not the Authorized Representative role. The Authorized Representative is unpaid and cannot also be the paid attendant.

"I can just start getting paid out of Dad's bank account." Not without a written personal services contract. An informal transfer of a parent's money to a child for care is treated as an uncompensated transfer under Colorado's 60-month look-back and can delay the parent's Medicaid eligibility later.

Frequently Asked Questions

Yes. Colorado is more flexible than most states here. Under CDASS, a family member including a spouse may be hired and paid as the care recipient's attendant. Under IHSS, a 2014 state law allows a spouse or other family member to be a paid attendant for up to 40 hours per week of personal care services. The VA programs (PCAFC, Veteran-Directed Care, and Aid and Attendance) also allow paid spouses.

Both are Health First Colorado self-direction options where the care recipient chooses and directs their own attendant, but the legal employer differs. Under CDASS, the member or their Authorized Representative is the employer of record, and a Financial Management Services vendor runs payroll. Under IHSS, an agency is the employer of record while the family still selects and supervises the attendant.

Pay starts at the state direct care base wage, which is $17.00 per hour statewide effective January 1, 2026, with higher local floors of $19.29 per hour in Denver and $18.17 per hour in Edgewater. That is a floor, not a ceiling: within the member's allocation set by the Case Management Agency, the actual hourly rate can run higher.

For IHSS, attendants are not required to be licensed or certified health professionals, which gives families flexibility over who provides care. CDASS and IHSS attendants do have to meet program requirements and comply with state wage and labor standards. Confirm the current requirements with your Case Management Agency, FMS vendor, or IHSS agency.

The care recipient (or you on their behalf) contacts HCPF Long-Term Services and Supports or a Case Management Agency to request an assessment. Once eligibility and an allocation are set, the family chooses CDASS or IHSS and the attendant is hired and paid through the FMS vendor or the IHSS agency.

  • 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 that feed CDASS and IHSS; Community First Choice, by contrast, 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.

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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.