How to Become a Paid Family Caregiver in Colorado

To become a paid family caregiver in Colorado, enroll the person you care for in Health First Colorado (the state’s Medicaid program), get them approved for home-based services under Community First Choice, and sign on as their attendant through the Consumer-Directed Attendant Support Services (CDASS) model. Your family member controls the care budget and hires you directly; a state-contracted financial management company processes your paychecks. You’ll need to be at least 18, physically capable of the tasks, and cleared through a Colorado Bureau of Investigation background check.

The Main Route: CDASS Under Community First Choice

As of July 1, 2025, Colorado delivers its core home-based attendant services through a single program called Community First Choice (CFC). CFC covers personal care, homemaker services, health maintenance activities, home-delivered meals, medication reminders, emergency response systems, and remote support.¹

Within CFC, the delivery model that lets a family member get paid directly is CDASS. Your family member (or their authorized representative) becomes the employer. They receive a monthly budget based on their assessed needs, decide how to spend it across attendants, and set the schedule and tasks. You become the attendant.²

CDASS is the most common path for family caregivers because it offers the widest flexibility over who is hired and how care is delivered. A Financial Management Services (FMS) provider handles the paperwork: processing your paycheck, withholding taxes, and tracking the budget. Colorado currently contracts with two FMS providers, Palco, Inc. and Public Partnerships, LLC.³

IHSS as an Alternative

In-Home Support Services (IHSS) is a second delivery model. Your family member still selects and supervises their own attendants, including relatives, but they do it through an IHSS-approved home health agency that provides clinical oversight. IHSS can be a better fit when the care plan involves skilled tasks that benefit from agency-level supervision and training. As of July 1, 2025, IHSS for health maintenance activities, homemaker services, and personal care is delivered through CFC.⁴

Whether Your Family Member Qualifies

The person receiving care has to clear three gates before any paid caregiving can happen: Medicaid enrollment, functional and medical need, and financial eligibility.

They must be enrolled in Health First Colorado and meet an institutional level of care. In plain terms, their needs are significant enough that without home-based help, they’d need a nursing home, hospital, or similar facility. Anyone already enrolled in an HCBS waiver and using at least one waiver service per month automatically meets the level-of-care requirement for CFC.¹

Functionally, this usually means help with activities of daily living such as bathing, dressing, eating, or transferring, or with broader tasks like meal preparation and medication management.

Financial eligibility follows Medicaid rules. For 2026, the monthly income cap is $2,982 for a single individual,⁵ which is 300% of the federal SSI benefit rate of $994 per month.⁶ The asset limit is generally $2,000 for a single applicant. When one spouse applies and the other stays in the community, the community spouse can keep significantly more in assets and is not subject to the income cap.

Whether You Qualify as the Caregiver

CDASS attendants are generally expected to be at least 18 and physically able to perform the tasks in the care plan. Under CDASS, the care recipient (or their authorized representative) is responsible for training you on any health maintenance activities before you carry them out.⁷

You’ll also need to pass a Colorado Bureau of Investigation criminal background check. Certain convictions trigger disqualification periods that vary by offense, and a smaller set of serious offenses (including murder, healthcare fraud, and sexual exploitation of a child or at-risk person) permit no exception. Where an exception is possible, the care recipient can request one from the Participant Directed Programs office and, if approved, complete a safety plan.⁸

The Application Steps

The process starts with the care recipient, not the caregiver.

Apply for Health First Colorado. If your family member isn’t already on Medicaid, they can apply through Colorado PEAK, by mail, or in person at their county human services office. Standard processing takes up to 45 days; applications that require a disability determination can take up to 90.
Contact a Case Management Agency (CMA), sometimes called a Single Entry Point agency. The CMA will guide the CFC or HCBS waiver enrollment and schedule the assessment.
Complete the needs assessment. A case manager evaluates functional limitations, medical needs, and care goals, then establishes what services your family member qualifies for.
Choose CDASS. If your family member wants to hire you directly, they select CDASS as the delivery option. The case manager helps develop an Attendant Support Management Plan (ASMP) that lists your tasks and the monthly budget.
Enroll with an FMS provider. Your family member picks Palco or Public Partnerships and receives an employment packet for you to complete.³
Pass the CBI background check. The care recipient must have at least two approved attendants before CDASS services begin.⁷
Start work. Once your packet is processed and the background check clears, you begin providing care and submitting timesheets through the FMS provider.

The slowest part is usually Medicaid enrollment and the assessment, not the caregiver setup. If your family member already has Medicaid and is on a waiver, moving to CDASS goes much faster.

How Much You’ll Be Paid

Rates depend on the delivery model, the tasks performed, your relationship to the care recipient, and whether the work is in Denver County. For October 2025 through July 2026, CDASS pays family members classified as legally responsible caregivers (such as spouses or parents) roughly $24.80 per hour outside Denver County and $26.16 per hour in Denver County. IHSS rates for the same category run about $25.96 and $27.52 per hour respectively.⁹

Rates are set per 15-minute unit and change when the state updates its fee schedule. Legally responsible family caregivers are capped at 2,086 units (about 521 hours) per year per caregiver, which works out to roughly 10 hours a week. Family members who aren’t legally responsible for the care recipient, like adult children or siblings, may qualify for higher rate categories and different unit caps. Your case manager and FMS provider can confirm what applies in your case.

Pay flows through the FMS provider. You submit timesheets, typically electronically, and the FMS provider issues your paycheck, withholds taxes, and tracks spending against the monthly budget. If needs outpace the budget, the care recipient can request an adjustment through their case manager.

Taxes: The Live-In Rule Changes Everything

The single biggest tax question is whether you live in the same home as the person you care for.

If You Live With the Care Recipient

Under IRS Notice 2014-7, Medicaid waiver payments made to a caregiver who lives in the same home as the care recipient are treated as difficulty-of-care payments and can be excluded from gross income. The requirement is that the care recipient’s home is also your home: you reside there and carry out your normal private life there, including things like sharing meals and holidays. Maintaining a separate residence and commuting in to provide care does not qualify.¹⁰

Even when excluded from gross income, these payments can still count as earned income for the Earned Income Tax Credit, which can matter for lower-income caregivers.

If You Don’t Live With the Care Recipient

Payments are taxable income. For 2026, if your family member pays you $3,000 or more in cash wages during the year, Social Security tax (6.2%) and Medicare tax (1.45%) must be withheld. The FMS provider typically handles this automatically.¹¹ You’ll also owe federal and state income tax. Keep records of what you earn and any caregiving-related expenses, and talk to a tax professional if the reporting isn’t clear to you.

Special Situations That Change the Timing

Intellectual and Developmental Disabilities

If your family member has an intellectual or developmental disability and needs around-the-clock support, the Developmental Disabilities (DD) waiver is likely the right fit. It also has a significant waitlist. On average, people wait about eight years before receiving an enrollment slot. Placement on the list is based on the date the person was determined to have a developmental disability by their Community Centered Board, or their 14th birthday if the determination happened earlier.¹²

While waiting, your family member may qualify for the Supported Living Services waiver (currently no waitlist), the State Supported Living Services program, or CFC services directly. These offer fewer services than the DD waiver but can keep paid caregiving in place. Get on the DD waitlist as early as possible.

Veterans

If your family member is a veteran, the VA’s Veteran-Directed Care program is a separate federal option. Eligible veterans receive a flexible budget and hire their own caregivers, including family members. Because it operates independently from Colorado’s Medicaid programs, a veteran who qualifies for both may be able to use them together.¹³

Respite and Training After You Start

Colorado builds some relief into the system. Respite care, temporary substitute caregiving that gives you a break, is available through most HCBS waivers. The format varies: in-home respite, short-term nursing facility stays, group day programs, and, for children, skilled nursing respite and overnight camps.¹⁴

On the training side, the care recipient is responsible under CDASS for teaching you the specific tasks in the care plan, and any training on health maintenance activities has to happen before you perform them. The Case Management Agency can point you to additional resources on things like infection control, promoting independence, and the care recipient’s rights.⁷

The programs exist, the pay is real, and the process is workable, but it takes patience. Starting the Medicaid application and the assessment before care needs become urgent gives you the best shot at avoiding gaps. Your Case Management Agency is the single most useful contact you have: they run the assessment, help choose the right waiver and delivery model, and stay involved once services are in place.

1
Department of Health Care Policy and Financing. Community First Choice Option
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Department of Health Care Policy and Financing. Consumer-Directed Attendant Support Services (CDASS)
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Department of Health Care Policy and Financing. CDASS Policies and Resources
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Department of Health Care Policy and Financing. In-Home Support Services (IHSS)
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Medicaid. January 2026 SSI and Spousal Impoverishment Standards
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Social Security Administration. SSI Federal Payment Amounts
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Department of Health Care Policy and Financing. CDASS Regulations 8.510
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Department of Health Care Policy and Financing. CDASS Background Check Crimes of High Risk Employer Hiring Guide
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Department of Health Care Policy and Financing. CFC Fee Schedule October 2025
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Internal Revenue Service. Certain Medicaid Waiver Payments May Be Excludable From Income
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Internal Revenue Service. Topic No. 756, Employment Taxes for Household Employees
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Department of Health Care Policy and Financing. Waiting Lists and Enrollment
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U.S. Department of Veterans Affairs. Veteran-Directed Care
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Department of Health Care Policy and Financing. Respite