How to Get Paid to Care for a Family Member in Colorado

Can You Get Paid to Care for a Family Member in Colorado?

The Short Answer

Possibly, yes.

Colorado Medicaid offers participant-directed options that can give eligible members greater control over certain home and community-based services. Through CDASS and other participant-directed arrangements, an eligible member may be able to direct authorized attendant services and manage an attendant relationship rather than receiving all care through a traditional home-care agency.

Colorado's CDASS framework is used within applicable Home and Community-Based Services programs and Community First Choice. Services can include certain personal care, homemaker and health-maintenance services, depending on the member's program and authorization.

The important distinction is this: Colorado Medicaid does not simply pay someone because they are a family member who provides care. The person receiving care must first qualify for the applicable Medicaid program and service, and the caregiver arrangement must meet the program's rules.

What Is CDASS in Colorado?

CDASS stands for Consumer-Directed Attendant Support Services. It is a Colorado Medicaid service-delivery option that gives eligible members greater control over certain attendant services.

Instead of having all care arranged through a traditional agency, participant direction allows the member to have greater involvement in selecting and managing attendants. Depending on the applicable program and authorization, CDASS can include services such as:

• Personal care
• Homemaker services
• Health maintenance activities

Colorado HCPF identifies CDASS as a participant-directed option within applicable HCBS programs.

This is why you may see people searching for terms such as consumer directed personal assistance program Colorado or consumer directed personal care Colorado, even though Colorado's official program name is Consumer-Directed Attendant Support Services.

What Does "Consumer-Directed" Mean?

Consumer-directed care means the person receiving services has greater control over how certain authorized services are delivered. Instead of simply accepting whoever an agency assigns, an eligible member participating in a consumer-directed model can have a greater role in managing the caregiver arrangement.

Depending on the program, this can include:

• Selecting an attendant
• Directing authorized services
• Managing the attendant relationship
• Monitoring care
• Working with the Financial Management Services organization
• Managing the approved service arrangement

The exact responsibilities depend on the program and the individual's circumstances.

Can a Family Member Be a Paid Caregiver in Colorado?

A family member may be able to provide paid services, depending on the specific program, service and relationship.

Colorado's participant-directed system allows eligible members to direct certain services and, when permitted, hire attendants. Colorado HCPF has specifically described circumstances in which a member using CDASS can hire a caregiver as an attendant when the member can direct services or has an Authorized Representative.

However, there is no single rule that says every family member can automatically be paid. The answer can depend on:

• The Medicaid program
• The HCBS waiver or service category
• The service being provided
• The member's age
• The member's functional needs
• The caregiver's relationship to the member
• Whether the member can self-direct
• Whether an Authorized Representative is required
• Caregiver qualifications
• Training requirements
• Background-check requirements
• Applicable service limits

This means the first question should not simply be: "Can my family member get paid?" A better question is: "Which Medicaid-funded services does my family member qualify for, and can those services be participant-directed?"

Can a Parent Get Paid to Care for a Disabled Child in Colorado?

A parent may be able to provide certain Medicaid-funded services, depending on the program and service involved. But a disability diagnosis by itself does not automatically mean that a parent can receive Medicaid payment. The child must meet the requirements for the applicable Medicaid program and service, and the service must be authorized.

Colorado Medicaid has participant-directed service options that can allow caregivers to remain paid attendants in certain circumstances. Colorado HCPF has specifically described situations involving young people transitioning from children's programs into adult HCBS services where participant-directed models can allow caregivers to remain paid attendants.

If you are caring for a disabled child, the important questions are:

1. Which Medicaid program is my child enrolled in?
2. Which services are authorized?
3. Can those services be participant-directed?
4. Can I provide those services as the parent?
5. Are there caregiver restrictions for this particular service?
6. What documentation is required?

Can a Spouse Be Paid to Care for a Spouse in Colorado?

Possibly, depending on the program and service.

Colorado's caregiver rules should not be reduced to a blanket statement that every spouse can or cannot be paid. Spousal caregiver rules can depend on the specific Medicaid program, service and applicable caregiver requirements.

If you are caring for your spouse, ask the case manager to determine:

• Which Medicaid program applies
• Which services are authorized
• Whether those services can be participant-directed
• Whether a spouse may provide that specific service
• Whether additional restrictions apply
• What caregiver requirements must be completed

This is important because caregiver rules can differ by service.

Which Colorado Medicaid Programs Can Involve Consumer-Directed Care?

Colorado's participant-directed system operates across multiple Medicaid programs and Home and Community-Based Services. Depending on the individual's circumstances, CDASS may be available through programs involving:

• Elderly, Blind and Disabled (EBD)
• Brain Injury (BI)
• Supported Living Services (SLS)
• Community Mental Health Services (CMHS)
• Community First Choice
• Other applicable HCBS programs

The specific services available depend on the individual's eligibility, program enrollment and authorized service plan. Colorado HCPF's current materials continue to identify CDASS as a participant-directed service option within Colorado's HCBS system.

Colorado Elderly, Blind and Disabled Waiver

The Elderly, Blind and Disabled (EBD) waiver is one of Colorado's Home and Community-Based Services programs. It is designed for qualifying individuals who meet the applicable Medicaid and functional requirements.

For an individual to receive HCBS services, eligibility is not determined solely by a diagnosis. The person must meet the applicable Medicaid requirements and level-of-care criteria. This is why it is important to document what the person actually needs help with every day.

Does a Diagnosis Automatically Qualify Someone for Paid Caregiving?

No.

A diagnosis is important, but a diagnosis alone does not necessarily establish eligibility for a particular Medicaid caregiver program. A person may have:

• Autism
• Dementia
• Alzheimer's disease
• Parkinson's disease
• Multiple sclerosis
• Cerebral palsy
• A traumatic brain injury
• An intellectual or developmental disability
• A physical disability
• Another chronic or disabling condition

and still need to meet additional Medicaid and program requirements.

What matters is the functional impact of the condition. For example: Does the person need help bathing? Can they dress themselves safely? Do they need help using the bathroom? Can they prepare meals? Can they take medications safely? Do they need supervision? Do they have difficulty walking or transferring? Do they have cognitive or behavioral needs? Do they require assistance to remain safely at home? These are the types of everyday care needs that help explain the actual caregiving situation.

Colorado Medicaid Looks Beyond the Diagnosis

Think about the difference between: "My mother has dementia." and: "My mother has dementia and now needs assistance bathing, dressing, preparing meals, managing medications, navigating appointments and remaining safe because she frequently becomes confused and attempts to leave the home."

The second statement communicates the person's actual care needs. That is why caregivers should document the day-to-day impact of a condition rather than relying only on the medical diagnosis.

What Types of Care Can Be Self-Directed?

Depending on the Medicaid program and authorization, participant-directed services can include areas such as:

Personal Care

This may involve assistance with activities such as:

• Bathing
• Dressing
• Grooming
• Toileting
• Eating
• Mobility
• Transfers
• Other authorized personal-care activities

Homemaker Services

This can include certain household support activities connected to the person's care needs.

Health Maintenance Activities

Certain health-related activities may also be available when authorized under the applicable program and rules.

Colorado's CDASS materials identify personal care, homemaker and health-maintenance services among the services that may be delivered through consumer direction.

How Does Colorado Medicaid Pay a Family Caregiver?

Colorado Medicaid does not operate as a simple reimbursement system where a family member submits a bill for everything they do. There is an authorization and service-delivery process.

Generally, the person receiving care must:

1. Qualify for the applicable Medicaid program.
2. Meet the applicable functional requirements.
3. Have qualifying services authorized.
4. Use an approved service-delivery model.
5. Meet the requirements for participant direction when applicable.
6. Establish the caregiver arrangement.
7. Follow required timekeeping and documentation procedures.

Under a participant-directed model, Financial Management Services can handle important administrative responsibilities associated with the caregiver arrangement.

Does Colorado Have One Set Caregiver Pay Rate?

No.

Be cautious about websites claiming that Colorado Medicaid simply pays every family caregiver a specific hourly rate. Rates can vary by:

• Medicaid program
• Service
• Location
• Authorization
• Current state policy
• Participant-directed arrangement

Colorado has made changes to CDASS rates over time. HCPF issued an operational memo (OM 25-062) regarding a 1.6% rate decrease affecting certain CDASS benefits effective October 1, 2025, part of broader state budget reductions tied to federal tax law changes. Separately, Colorado has established a statewide minimum base wage for direct care workers providing qualifying HCBS services, including CDASS — currently $17.00 per hour effective January 1, 2026, up from the $15.00 per hour rate first introduced in 2022. Local minimums are higher in some areas: $19.29 per hour in Denver and $18.17 per hour in Edgewater.

That means caregiver payment information should always be checked against the current Colorado program rules. Do not make financial decisions based on an outdated hourly rate found online.

Are Caregiver Hours Unlimited?

No. Authorized services and hours are subject to program rules and the individual's service plan. The amount of care a person receives can depend on:

• Functional need
• Assessment results
• Authorized services
• Program requirements
• Service limits
• Current Medicaid policy

This is another reason documentation matters. If your family member's needs have increased, you want to be able to clearly communicate what has changed and how that change affects daily care.

Who Manages the Caregiver?

One of the biggest differences between traditional home care and consumer-directed care is control. With a traditional agency model, the agency generally handles the employment relationship and assigns caregivers. With consumer-directed care, the eligible member can have greater responsibility for directing the caregiver arrangement. That can include:

• Selecting an attendant
• Directing services
• Managing the caregiver
• Monitoring care
• Following the approved service plan
• Working with the Financial Management Services organization

What Is an Authorized Representative?

An Authorized Representative (AR) can assist when the Medicaid member cannot independently direct their services. This can be important when the person receiving care has circumstances that make self-direction difficult or impossible.

An Authorized Representative may help with responsibilities associated with directing services, subject to Colorado's rules. Colorado HCPF has specifically stated that when an Authorized Representative is used in CDASS, the Authorized Representative and attendant cannot be the same person.

If your family member cannot manage the program independently, ask whether an Authorized Representative is appropriate.

What Are Financial Management Services?

Participant-directed care does not mean that the family has to manage every payroll and employment function by itself. Financial Management Services, or FMS, support administrative responsibilities associated with participant-directed care. Depending on the arrangement, this can include:

• Payroll
• Tax-related administration
• Employment paperwork
• Timekeeping
• Other administrative responsibilities

The specific FMS organization and process depend on the program.