Colorado's Medicaid program can pay a family caregiver, including a spouse, to provide care at home. Through Consumer-Directed Attendant Support Services (CDASS), that attendant earns at least the statewide $17.00-an-hour base wage in 2026, and respite, VA benefits, and caregiver support sit alongside it.,

If you are caring for an aging parent, a spouse, or an adult child with a disability in Colorado, the hard part is rarely whether help exists. It is knowing what is there and where to start. This guide maps every major caregiver program in the state for 2026, and shows you the first call to make for each one.

You don't have to figure this out alone, and you don't have to fund all of it from your savings.

In This Guide

Colorado Caregiver Programs at a Glance

Program What It Offers Who Qualifies Cost to You
CDASS Member hires and directs an attendant, including a spouse; sets pay within budget Health First Colorado members who meet an institutional level of care, or who are on an HCBS waiver using at least one waiver service a month Free (paid by Medicaid)
IHSS Member selects and supervises attendants, family included, with a licensed agency's support Health First Colorado members who meet an institutional level of care, or who are on an HCBS waiver using at least one waiver service a month Free (paid by Medicaid)
NFCSP caregiver support Respite, counseling, support groups, training Caregivers of adults 60+ or a person with ADRD; respite needs a frail older person Ask your AAA
VA PCAFC Monthly stipend VA has called nontaxable; a spouse can be the caregiver Veteran rated 70%+, discharged, needing 6+ months of in-person care, in VA health care, plus further VA conditions Free (VA benefit)
VA Aid and Attendance Pension up to $29,093/yr for a single veteran; monthly payments added to a VA pension Wartime veteran or surviving spouse who qualifies for VA pension, under the net-worth limit Free to apply (VSO help)

Programs That Pay Family Caregivers

Colorado delivers paid family care through two Health First Colorado (Medicaid) self-direction options, both administered by the Department of Health Care Policy and Financing (HCPF). As of July 1, 2025, both are delivered through Community First Choice (CFC), a Medicaid State Plan benefit, so a newly enrolling family no longer has to secure a Home and Community-Based Services (HCBS) waiver slot first. CFC is not its own Health First Colorado eligibility group. The person receiving care has to meet the financial requirements for full Medicaid benefits, be willing to receive services at home or in the community rather than in an institution, and qualify under one of two paths: eligible for Health First Colorado under the State Plan and meeting an institutional level of care, or enrolled in an HCBS waiver and receiving at least one waiver service per month.

Consumer-Directed Attendant Support Services (CDASS)

CDASS lets a Health First Colorado member (or their Authorized Representative) act as the legal employer of record: they hire, train, and supervise attendants, negotiate each wage (up to a Department maximum), and budget within a monthly allocation. The member chooses a Financial Management Services (FMS) vendor, either Palco or Public Partnerships (PPL), who handles payroll and taxes.

The standout feature: under CDASS, a family member, including a spouse, may be hired and paid as the attendant. Colorado's rule defines a family member as anyone related by blood, marriage, adoption, or common law, and four conditions shape a spouse's plans. First, a member of the household, which is where a live-in spouse lands, may be paid only for extraordinary care as determined by the case manager and documented on the service plan. Second, an Authorized Representative can't be the paid attendant for the member they represent, so if a spouse takes that role, someone else must be the attendant. Third, hours are capped per caregiver, family or not: 16 paid hours a day, plus a weekly limit on one caregiver's hours with one member: 84 hours from July 1, 2026, 70 from January 1, 2027, and 56 from July 1, 2027, with exception requests for members who meet HCPF's criteria. Fourth, a spouse is a Legally Responsible Person, and Homemaker work by one is capped. The 10-hour weekly limit in Colorado's 2025 Community First Choice plan was cut to 5 hours only under an emergency rule that ran through June 12, 2026 and was not approved at final reading; the rule that replaced it limits reimbursement to Legally Responsible Persons for Homemaker services to 364 total hours a year per member, one total for the member. More Homemaker hours may be authorized from someone who is not a Legally Responsible Person, so confirm the hours authorized with the case manager.

In-Home Support Services (IHSS)

IHSS is Colorado's second participant-directed option. HCPF says IHSS members select and supervise their own attendants, including family members, with the support of an agency: the member presents a person of their choosing to an IHSS agency, which must hold a Class A or B Home Care Agency license. Colorado's CFC plan describes IHSS as the route for members who want to choose their attendant and waive the Nurse Practice Act. Under CDASS, by contrast, the member or their Authorized Representative is the legal employer of record. Colorado's IHSS rule says a family member, including a spouse, may be an attendant. A spouse or other relative who shares the member's home is paid only for extraordinary care the Case Manager approves before the care is given. HCPF notes that many members have a legal guardian or power of attorney as their attendant, but the same person cannot be both the attendant and the member's Authorized Representative, so a member who needs one must name someone else.

Hour Caps and Exceptions

CDASS's annual soft caps are 4,750 hours of Health Maintenance Activities, 2,500 hours of Personal Care and 1,125 hours of Homemaker per Person-Centered Support Plan; the Case Manager can request more through HCPF's exception process.

Outside an Emergency Situation (below), a caregiver may exceed the weekly limit only with a pending or approved exception, granted only for one of four criteria:

  • Extraordinary clinical acuity: a documented complex diagnosis causing medical fragility and severe risk of hospitalization or death, with strict contact limits protective equipment can't reasonably mitigate.
  • Workforce access barriers: a rural or frontier area, specialized skills a new caregiver couldn't learn in time, or an uncommon language, after documented failed recruitment.
  • Transition or stabilization: within 30 days of hospital discharge, after a crisis, or while replacing a lost caregiver.
  • End of life: a terminal illness with a physician-documented prognosis of nine months or less, a documented need for continuity with a primary caregiver, and strict contact limits.

Familiarity with a caregiver alone isn't enough; in CDASS the member or Authorized Representative, as employer, submits the request. An Emergency Situation lets a caregiver exceed the daily or weekly limit only when it's unexpected, lasts no more than 7 calendar days, prevents a gap in critical care and is documented in the member's file.

The 2026 Base Wage

Effective January 1, 2026, Colorado sets a statewide minimum base wage for HCBS direct-care workers of $17.00 per hour, with higher local floors of $19.29 per hour in Denver and $18.17 per hour in Edgewater. This applies to workers paid through CDASS, IHSS, and other HCBS programs. Under CDASS, the member and attendant negotiate the rate, at or above that floor and no higher than the Department's maximum.,

For the full guide to paid pathways: How to Get Paid as a Family Caregiver in Colorado.

How to Start CDASS or IHSS

No case manager yet? Start here.

1
Step 1

Confirm Health First Colorado enrollment

CDASS and IHSS are Medicaid benefits, so the person receiving care must be enrolled in Health First Colorado. If they are not yet enrolled or you are unsure, call the Health First Colorado Member Contact Center at 1-800-221-3943 (State Relay 711) or apply at healthfirstcolorado.gov.

2
Step 2

Ask about Community First Choice

Tell the Member Contact Center you want attendant care through Community First Choice (CFC). Institutional level of care means needs that would otherwise require a nursing home, hospital, intermediate care facility, or inpatient mental health facility; a case manager confirms it through an assessment, and a loved one already on an HCBS waiver meets it automatically.

3
Step 3

Choose CDASS or IHSS

Decide who should be the employer. Under CDASS you (or your loved one) hire and manage the attendant directly; under IHSS your loved one selects and supervises the attendant with a licensed agency's support. Both let you hire family, and both rules expressly allow a spouse.,

4
Step 4

Set up payment

For CDASS, select a Financial Management Services vendor (Palco or Public Partnerships) to run payroll and tax withholding. For IHSS, the agency handles it. Your attendant is paid at or above the $17.00-per-hour 2026 base wage.,

Respite Care Programs

Medicaid: Attendant Pay, Not a Respite Benefit

CDASS and IHSS pay an attendant for Personal Care, Homemaker, and Health Maintenance Activities, and HCPF's pages for them don't list respite. So a family caregiver on either is paid as the attendant, not as a respite worker. Respite is a separate service on the Elderly, Blind and Disabled (EBD) waiver; if your loved one is on it, ask the case manager.,

NFCSP Support Through Colorado's Area Agencies on Aging

The National Family Caregiver Support Program (NFCSP), funded by Title III-E of the Older Americans Act, reaches caregivers through Area Agencies on Aging and their contracted providers. It funds information and access help, counseling, support groups, training, respite, and limited supplemental services for adults caring for someone 60 or older, or for someone of any age with Alzheimer's or a related disorder. Respite and supplemental services carry one extra federal condition: the older person must be frail, meaning unable to do two or more daily activities without substantial help, or needing substantial supervision because a cognitive or other mental impairment leads them to behave in a way that poses a serious health or safety hazard to themselves or others. Find your AAA through the Eldercare Locator at 1-800-677-1116, or call Aging and Disability Resources for Colorado (ADRC) at 1-844-265-2372 for options counseling.,,,

For the full respite guide: Respite Care in Colorado.

Free Support Through Colorado's Area Agencies on Aging

If you are not on a Medicaid program, Colorado's Area Agencies on Aging (AAAs) are your front door for caregiver support that isn't tied to a waiver: NFCSP respite, caregiver training, counseling, and support groups.,

CDHS gives two routes: call ADRC at 1-844-COL-ADRC (1-844-265-2372) for options counseling, or use CDHS's Colorado Area Agency on Aging Regions Map and Contacts to reach your local AAA directly. When you reach your AAA, ask specifically for respite, a caregiver support group, one-on-one counseling, or training on a task like safe transfers.,

VA Caregiver Benefits in Colorado

Veterans enrolled in VA health care in Colorado have caregiver programs separate from Medicaid.

VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)

The PCAFC pays a monthly stipend, which VA described as a nontaxable benefit in its 2020 proposed rule, to the Primary Family Caregiver of an eligible veteran, and a spouse can serve in that role. VA lists four requirements, all of which must be true: a 70 percent or higher disability rating, a military discharge or medical discharge date, a need for at least six continuous months of in-person personal care, and enrollment in VA health care. Those are a first screen; 38 CFR 71.20(a) adds conditions VA weighs in the joint application, such as no other person or program already regularly providing that care. The stipend is paid only after the caregiver enrolls in direct deposit through VA's customer engagement portal. The stipend is not a flat national figure: it starts from the OPM GS-4, Step 1 annual rate for the veteran's locality, divided by 12 to give a monthly base, and it is not an hourly wage. 38 CFR 71.40(c)(4)(i) then multiplies that base by a factor, and there is more than one. In the current program the factor is 0.625, or 1.00 if the VA determines the veteran is unable to self-sustain in the community. For a legacy participant or legacy applicant, meaning a household connected to PCAFC before October 1, 2020, the factor comes from the sum of the veteran's 2019 clinical ratings instead, with no self-sustain determination required: 1.00 at a sum of 21 or higher, 0.625 at 13 to 20, and 0.25 at 1 to 12. A veteran who meets both sets of criteria is paid whichever amount is higher, a legacy participant's stipend is held at no less than what the caregiver was eligible for the day before October 1, 2020 while the veteran remains at the address on record, and the legacy schedule lapses October 1, 2028. Because the base is locality-adjusted, a Colorado family should look up their own locality's rate rather than rely on a number quoted for another state, and a legacy household should not treat 0.625 as its ceiling. The full current and legacy rules are in our guide to the VA caregiver stipend (PCAFC).

Veteran-Directed Care (VDC)

Veteran-Directed Care gives a veteran of any age who is at risk of institutional placement a flexible budget, set by the VA, to hire and supervise their own workers, including family and friends. In the Denver metro area it runs through the Denver Regional Council of Governments (DRCOG) Area Agency on Aging with the Rocky Mountain Regional VA Medical Center, covering Adams, Arapahoe, Broomfield, Clear Creek, Denver, Douglas, Gilpin, and Jefferson counties. Elsewhere the provider may be an Area Agency on Aging or a Center for Independent Living, so ask your local VA medical center.

VA Aid and Attendance Pension

Wartime veterans and surviving spouses who meet the functional criteria and have countable assets and income under the net-worth limit ($163,699 in 2026) may receive the Aid and Attendance pension. VA publishes these as annual maximums and pays monthly: the maximum, less countable income, divided by 12. A single veteran with Aid and Attendance receives up to $29,093 per year; a veteran with one dependent up to $34,488 per year. Aid and Attendance is monthly payments added to a VA pension: a veteran or survivor who gets a VA pension may be eligible if they meet at least one of VA's listed requirements, such as needing another person's help with bathing, feeding, and dressing.

Colorado veterans can get free claims help through the County Veterans Service Office that every Colorado county maintains, and its Service Officers specialize in assisting veterans and their family members with claims, applications, and appeals to the VA. The Colorado Division of Veterans Affairs strongly recommends that anyone considering requesting services or submitting an application to the VA contact their County Veterans Service Office first.

Taxes for Colorado Caregivers

These rules decide how much caregiver pay you keep.

IRS Notice 2014-7

IRS Notice 2014-7 lets a caregiver exclude qualified section 1915(c) Medicaid waiver payments from federal gross income when the care is given in the caregiver's own home, where the person receiving care lives; it does not apply if the caregiver has a separate home where they reside. CDASS and IHSS now run under Community First Choice, a 1915(k) option, and the IRS doesn't treat the exclusion as automatic outside a 1915(c) waiver, so confirm with a tax preparer before excluding these wages.,

Colorado State Income Tax

Colorado taxes income at a single rate that varies by tax year: 4.4% for 2025 and 4.25% for 2024. Confirm the rate in effect for your filing year with the Colorado Department of Revenue.

Medicaid Look-Back

Colorado applies a 60-month look-back to asset transfers for long-term-care eligibility. Paying a family caregiver isn't automatically a transfer, but pay under a personal services agreement counts as one unless every Colorado requirement is met, among them a written agreement signed and notarized before any paid care, a signer who isn't a beneficiary, at-least-monthly pay at open-market rates, and a log of the services given. Paying later for care already given always counts as a transfer.

VA PCAFC Stipend

In the preamble to its March 2020 proposed PCAFC rule, VA described the monthly stipend as a nontaxable benefit.

Where to Get Help With Colorado Caregiver Programs

These are the free, official lines behind every program in this guide; ask each counselor for a name and direct number.,,,,

Health First Colorado Member Contact Center Confirms Medicaid enrollment and is the first call to start Community First Choice, CDASS, or IHSS if you don't yet have a case manager. 1-800-221-3943 (State Relay 711) www.healthfirstcolorado.gov
Aging and Disability Resources for Colorado (ADRC) Options counseling on long-term services and supports; reach your local AAA through CDHS's regions map. 1-844-265-2372
DRCOG Area Agency on Aging (Veteran-Directed Care) Veteran-Directed Care for eligible veterans in eight Denver-metro counties. www.drcog.org/area-agency-aging/veteran-support
VA Caregiver Support Line Support and referrals for caregivers of veterans, weekdays 8 a.m. to 8 p.m. Eastern; not a crisis line. 1-855-260-3274 www.caregiver.va.gov
Colorado Division of Veterans Affairs Points you to your County Veterans Service Office for free help with VA claims, including pension. vets.colorado.gov/services/claims

Frequently Asked Questions

Can I get paid to care for my spouse in Colorado?

Yes. Under CDASS, a family member, including a spouse, may be hired and paid as the member's attendant. A spouse in the same household may be paid only for extraordinary care as determined by the case manager, and a spouse who is the member's Authorized Representative can't also be the paid attendant. Every caregiver's paid hours are capped per day and per week, with exceptions for members who meet HCPF's criteria (see Hour Caps and Exceptions). Homemaker work by a spouse has its own tighter limit.

What is the difference between CDASS and IHSS?

CDASS makes the member (or their Authorized Representative) the legal employer: they hire, train, and supervise attendants and negotiate wages within a budget, with a Financial Management Services vendor running payroll. Under IHSS the member still selects and supervises attendants, family included, with a licensed agency's support. Both are service delivery options under Community First Choice.

Do I need an HCBS waiver to start CDASS or IHSS?

Not anymore for new members. As of July 1, 2025, CDASS and IHSS are delivered through Community First Choice (CFC), a Medicaid State Plan benefit. A new enrollee accesses them directly through CFC after meeting an institutional level of care, rather than waiting for an HCBS waiver slot. A waiver is still one of the two ways in, though: someone enrolled in an HCBS waiver who receives at least one waiver service a month qualifies for CFC on that basis alone, and automatically meets the level-of-care test. A member still getting CDASS through a waiver learns from their Case Manager when they move to the new benefit.

How much do CDASS and IHSS pay in 2026?

Effective January 1, 2026, the statewide HCBS direct-care base wage is $17.00 per hour, with higher floors of $19.29 in Denver and $18.17 in Edgewater. Under CDASS the member and attendant negotiate the rate, at or above the base wage and no higher than the Department's maximum.,

Is there respite in Colorado without Medicaid?

Yes. The National Family Caregiver Support Program funds respite through Colorado's Area Agencies on Aging when the older person you care for is frail under federal law. Find your AAA through the Eldercare Locator at 1-800-677-1116, or call ADRC at 1-844-265-2372.,,,

How do I find my regional Area Agency on Aging?

Use CDHS's Colorado Area Agency on Aging Regions Map and Contacts, or call the Eldercare Locator at 1-800-677-1116, which links callers with their local AAA. The ADRC line, 1-844-265-2372, offers options counseling as a separate route.,

Learn More

CaregiverCaregiver Programs: The 50-State GuideA directory of caregiver programs in all 50 states: paid family caregiver pathways, respite, NFCSP grants, and VA benefits. Find your state's complete guide. CaregiverMedicaid Self-Direction and Consumer-Directed ServicesHow Medicaid self-direction lets a family member be your paid caregiver: employer authority, budget authority, the 1915(j) spouse rule, and how to get started. CaregiverThe National Family Caregiver Support Program (NFCSP): A Complete GuideWhat the National Family Caregiver Support Program funds, who is eligible, and how to reach respite and caregiver support through your Area Agency on Aging. CaregiverHow to Get Paid as a Family Caregiver in ColoradoHow to get paid to care for a family member in Colorado in 2026: CDASS self-direction, IHSS, the spouse-pay angle, Community First Choice, and the VA options. CaregiverRespite Care in ColoradoColorado respite care: NFCSP at Area Agencies on Aging, the Medicaid EBD waiver, CDASS and IHSS pay for family caregivers, and VA programs. See who qualifies. CaregiverCaregiver Burnout: Signs, Stages, and How to Get SupportHow to recognize caregiver burnout, why it happens, and what actually helps, from respite care to evidence-based programs like REACH II and Powerful Tools. VA BenefitsVA Aid and Attendance in ColoradoVA Aid and Attendance in Colorado for 2026: who qualifies, annual rates up to $34,488, how to apply, and free help from county veterans service offices. CaregiverSenior Transportation in Colorado: How an Older Adult Who No Longer Drives Gets AroundSenior transportation in Colorado: Area Agency on Aging rides, ADA paratransit, Health First Colorado medical rides, and how to choose the right one.
Your next step Ready to start? Call the Health First Colorado Member Contact Center at 1-800-221-3943 (State Relay 711) to confirm enrollment and ask about Community First Choice, the pathway into CDASS and IHSS. Or chat with Brevy's care navigator for a plan built around your loved one's Medicaid enrollment, veteran status, and whether a spouse or family member will be the paid caregiver.

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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