To become a caregiver in Colorado, you first decide whether you want to provide skilled medical care or non-medical personal care, then clear a standard set of eligibility checks (age, work authorization, criminal background check, TB screening, and CPR), complete the training that matches your path, and apply through a licensed home care agency. Family members caring for a loved one on Medicaid can take a different route and get paid directly through a consumer-directed program, no agency required.
Pick Your Path: Skilled Care or Non-Medical Care
Colorado licenses home care agencies in two classes, and the class dictates what the caregivers who work there can do. A Class A agency delivers skilled healthcare through licensed nurses, certified nursing assistants, and therapy professionals, and may also provide personal care. A Class B agency provides only non-medical personal care such as bathing, dressing, meal preparation, and light housekeeping.1Colorado Department of Public Health and Environment. Home Care Agencies
The federal line between the two is the same. Skilled care means medically necessary services that only licensed medical personnel can provide or supervise, like wound care, physical therapy, or catheter management. Custodial (non-medical) care is daily living assistance that a non-licensed person can safely provide.2Centers for Medicare & Medicaid Services. Custodial Care vs. Skilled Care Your path determines training, pay, and scope of work, so settle this before you start spending money on certifications.
Baseline Eligibility Everyone Must Meet
Before any Colorado agency will hire you, you need to clear a short list of requirements that apply across both paths.
Age and Work Authorization
You must be at least 18 and authorized to work in the United States.
Fingerprint Background Check
Every prospective caregiver passes a fingerprint-based criminal background check through the Colorado Bureau of Investigation. The state-level check runs $38.50 to $39.50 through the Colorado Applicant Background Service, plus a fingerprinting surcharge of $16.50 to $19.50, so budget around $55 to $59 out of pocket.3Colorado Bureau of Investigation. Fees and Forms Information An employer-required FBI nationwide check adds more. Convictions involving crimes against persons or financial exploitation are generally disqualifying.
TB Screening
The CDC recommends TB screening for all healthcare personnel at hire, including those working in home-based settings. Screening includes a risk assessment, a symptom evaluation, and a TB test (blood or skin).4Centers for Disease Control and Prevention. Clinical Testing Guidance for Tuberculosis – Health Care Personnel Most Colorado agencies want this done before your first client visit.
Physical Capability
Caregiving is physical work. You’ll lift, reposition, and transfer clients regularly, and agencies often verify your capacity through a functional assessment during hiring. If you have limitations, raise them early so the agency can decide whether accommodation is possible.
CPR and First Aid
A current CPR and First Aid certification is standard at virtually every Colorado agency, regardless of class.
The Skilled-Care Path: Becoming a CNA
If you want to work for a Class A agency providing skilled care, you need Certified Nursing Assistant certification. Colorado requires a state-approved nurse aide training program of at least 75 hours total, including a minimum of 16 hours of pre-clinical instruction and at least 16 hours of classroom training. After the program, you take a written knowledge exam and a clinical skills evaluation. Passing both places you on Colorado’s nurse aide registry, maintained through the Department of Regulatory Agencies, which employers check before hiring.
CNA programs run through community colleges, vocational schools, and some nursing facilities across the state. Tuition typically runs from a few hundred dollars up to around $1,500, separate from background check and exam fees. Nursing homes and larger home health agencies sometimes sponsor training in exchange for a work commitment, which can take the cost off your plate entirely.
The Non-Medical Path: Agency Training
Non-medical caregivers have lighter formal requirements but still need documented training before working independently. Beyond CPR and First Aid, most agencies require modules on infection control, safe body mechanics for transfers and repositioning, basic personal care techniques, and emergency response. Each session is documented with a certificate of completion, which the agency keeps on file for regulatory audits.
You don’t need to finish this training before you apply. Many Class B agencies provide or arrange it during onboarding. What you do need in hand when you apply: a government-issued photo ID, your Social Security number, a detailed employment history, professional references, and your residential address history. Showing up organized moves things along.
Applying Through a Licensed Agency
Individual caregivers in Colorado don’t apply for a state-issued caregiver license or register directly with a state department. You apply to a licensed home care agency, and the agency handles the regulatory side. The Colorado Department of Public Health and Environment (CDPHE) licenses the agencies themselves under the Class A/Class B framework.1Colorado Department of Public Health and Environment. Home Care Agencies
Expect two to four weeks from application to first client assignment. The agency submits your background check, verifies your training credentials, and may run its own skills assessment. Once you clear, you’re enrolled in scheduling and payroll. For Medicaid-funded services, that also means enrollment in Electronic Visit Verification, covered further down.
Getting Paid to Care for a Family Member
If you want to care for a relative who’s on Medicaid, Colorado has two consumer-directed programs that let you be paid without going through an agency: Consumer-Directed Attendant Support Services (CDASS) and In-Home Support Services (IHSS). Both allow the care recipient, or an authorized representative, to hire, train, and supervise their own attendants, including family members.5Department of Health Care Policy and Financing. Consumer-Directed Attendant Support Services (CDASS)6Department of Health Care Policy and Financing. In-Home Support Services (IHSS)
Who the Care Recipient Must Be
The person receiving care must be enrolled in Health First Colorado (the state Medicaid program) and must meet an institutional level of care, meaning their needs would otherwise warrant placement in a nursing home or similar facility.7Department of Health Care Policy and Financing. Community First Choice Option Many recipients access these services through Colorado’s Community First Choice option, which the state has been implementing through June 2026. Anyone already on an HCBS waiver automatically meets the level-of-care threshold.6Department of Health Care Policy and Financing. In-Home Support Services (IHSS)
Financial eligibility for Medicaid long-term care in Colorado is generally capped at 300% of the federal SSI benefit rate. For 2026, the SSI individual benefit is $994 per month, which puts the income ceiling at $2,982 per month.8Social Security Administration. SSI Federal Payment Amounts for 2026 Asset limits apply too, and a financial assessment confirms eligibility.
How to Start
Confirm which Medicaid program or waiver your family member is enrolled in, then contact the Department of Health Care Policy and Financing (HCPF) or the recipient’s case manager to request enrollment in CDASS or IHSS. The case manager coordinates the level-of-care assessment if one hasn’t been done. Once approved, the recipient selects you as the caregiver, and a Financial Management Services (FMS) provider handles payroll, taxes, and workers’ compensation.
How Your Pay Gets Taxed
Caregiver pay is taxable in most situations, but two federal rules can meaningfully reduce the bite for family caregivers.
FICA Exemptions Between Family Members
When a family member employs you directly as a household employee, certain relationships are exempt from Social Security and Medicare (FICA) taxes. For 2026, wages for caring for your spouse, your parent, or as a child under 21 working for a parent are not subject to FICA or federal unemployment tax. One exception: if a parent cares for a grandchild under 18 (or a grandchild with a condition requiring adult care), and the employing parent is divorced, widowed, or has a spouse unable to provide care, FICA does apply.9Internal Revenue Service. Household Employer’s Tax Guide Federal income tax withholding generally isn’t required for household employees unless the employee requests it and the employer agrees.
The Medicaid Waiver Payment Exclusion
Under IRS Notice 2014-7, Medicaid waiver payments to a caregiver who lives in the same home as the care recipient can be excluded from gross income entirely. The IRS treats these as “difficulty of care” payments under Section 131 of the Internal Revenue Code.10Internal Revenue Service. Certain Medicaid Waiver Payments May Be Excludable From Income The exclusion applies to payments under Home and Community-Based Services waiver programs authorized by Section 1915(c) of the Social Security Act. The hard requirement is shared residence. Respite care or care outside the recipient’s home doesn’t qualify. Multiple caregivers living in the same household with the recipient can each exclude their payments.
For family caregivers in CDASS or IHSS who live with their loved one, this is a significant benefit. Work with your FMS provider and a tax professional so your W-2 reflects the exclusion correctly.
Wages, Overtime, and Visit Verification
Colorado’s minimum wage for 2026 is $15.16 per hour, well above the federal $7.25.11Colorado Department of Labor and Employment. Labor Standards and Statistics It applies to home care workers regardless of employer type, and some municipalities set higher local minimums.
Federal rules generally require domestic service workers to receive time-and-a-half for hours over 40 in a week.12U.S. Department of Labor. Fact Sheet 79B – Live-in Domestic Service Workers Under the FLSA Live-in caregivers employed directly by a family may be exempt from overtime, but home care agencies cannot claim the exemption and must pay overtime for all hours over 40. The Department of Labor proposed changes in 2025 that could affect federal wage and overtime protections for home health aides; those rules may or may not be final by the time you’re reading this.
If you provide Medicaid-funded personal care or home health services, you’ll use Colorado’s Electronic Visit Verification (EVV) system, required under the federal 21st Century Cures Act and implemented at 10 CCR 2505-10.13Legal Information Institute (LII). Colorado Code of Regulations 10 CCR 2505-10-8.001 – Electronic Visit Verification (EVV) EVV records when you arrive, when you leave, what services you provide, and where the visit takes place, through a mobile app, phone check-in, or manual entry. Take it seriously: providers must report known or suspected falsification within two business days, and Colorado law imposes civil penalties of at least $5,500 per false Medicaid claim.14Justia Law. Colorado Revised Statutes Title 25.5 – Section 25-5-4-305 – False Medicaid Claims – Liability for Certain Acts Honest mistakes happen, but patterns of inaccurate reporting draw audits fast.