CDASS Colorado: Get Paid To Care For A Family Member

Yes -- and this is what makes Colorado unusual. Most state Medicaid programs bar spouses from being paid caregivers, but Colorado's CDASS defines a Family Member as anyone related by blood, marriage, adoption, or common law, which includes a spouse. A husband or wife can be the paid attendant for personal care and health maintenance without a special hours cap. There is one limit: because a spouse is a "legally responsible person" under Colorado rules, they cannot be reimbursed for more than 520 hours of homemaker (housekeeping, cooking, shopping) services per year. That cap applies only to homemaker tasks, not to personal care or skilled health-maintenance work. The spouse also cannot serve as the member's Authorized Representative and the paid attendant at the same time. If you want a spouse paid to provide hands-on personal care, CDASS is one of the best options in the country.

CDASS is different from agency care: the member sets each attendant's hourly wage within a monthly dollar allocation approved by the case manager, as long as it meets Colorado's direct-care wage floor. As of January 1, 2026 that floor is $17.00 per hour statewide, with higher local minimums of $19.29 in Denver and $18.17 in Edgewater. In practice, negotiated wages commonly land between $17 and $25 per hour depending on region, the attendant's skill, and the service type -- skilled health-maintenance tasks generally pay more than homemaker work. Because the total budget is fixed, paying a higher hourly rate means fewer scheduled hours, so members balance wage against hours. Attendants are W-2 employees, so the FMS vendor (Palco or PPL) withholds federal and state income tax, Social Security, and Medicare from each check.

Plan for roughly 45 to 90 days from first contact to your first paycheck, though it varies. The main steps are the functional assessment with your Case Management Agency, confirmation of Medicaid long-term-care eligibility, choosing an FMS vendor, and completing attendant onboarding (background check, tax and employment forms) plus the required CDCN training. If the member is not yet enrolled in Health First Colorado, add another 30 to 90 days for the Medicaid application itself -- Colorado notes long-term-care determinations can take up to three months. You can speed things up by gathering documents in advance: proof of Colorado residency and identity, Social Security information, proof of income and assets, and any medical records that support the need for home care. Starting the Medicaid application on Colorado PEAK while you wait for the assessment also saves time.

None of the usual clinical credentials are required. A CDASS attendant does not need to be a Certified Nursing Assistant (CNA), Home Health Aide (HHA), or licensed nurse. The member (or their Authorized Representative) trains the attendant on the specific tasks they need. There are basic requirements before an attendant can be paid: they must pass a criminal-history background check through the FMS vendor, complete federal I-9 and W-4 paperwork, and sign an attendant support agreement. The member and any Authorized Representative also complete training through Consumer Direct Care Network Colorado (CDCN), the state's CDASS training and support contractor, on how to manage attendants, timesheets, and the budget. Attendants must be at least 16 years old; those 16-17 face restrictions such as not operating powered patient-lift equipment. This low barrier is exactly why CDASS works so well for families who have been caregiving informally.

Both are self-direction options under Community First Choice, and both let you hire family, but the amount of responsibility differs. Under CDASS, the member is the legal employer: you recruit, hire, set wages within your allocation, schedule, train, and can dismiss your own attendants, and you pick an FMS vendor to run payroll and taxes. It offers the most control -- including managing skilled health-maintenance tasks -- but also the most administrative work. Under In-Home Support Services (IHSS), a licensed IHSS agency shares the load: you still select and direct your own attendant, but the agency serves as the employer of record and handles more of the oversight, training, and back-office duties. Families who want maximum control and flexibility usually choose CDASS; those who want help carrying the employer responsibilities often prefer IHSS. Your Case Management Agency can walk you through which fits your situation.

Several parties work together. The Department of Health Care Policy and Financing (HCPF) runs the program at the state level. Your Case Management Agency (CMA) assesses your needs, sets your monthly allocation, and renews eligibility each year. You then choose a Financial Management Services (FMS) vendor -- either Palco or Public Partnerships (PPL) -- which acts as the money-and-paperwork engine: it runs attendant background checks, processes timesheets, pays your attendants, withholds and files employment taxes, and tracks your spending against the allocation. Consumer Direct Care Network Colorado (CDCN) is the statewide training and support contractor that teaches members how to manage the program. Importantly, none of these entities choose your attendant or supervise the care -- those decisions stay with you (or your Authorized Representative). You remain the authority over who is hired and how care is delivered.

There is no single statewide hour cap. Instead, your monthly dollar allocation -- set by the case manager based on assessed need -- and the hourly wage you pay together determine how many hours can be scheduled. If you pay a higher rate, the same budget buys fewer hours; a lower rate stretches to more. One rule applies specifically to a legally responsible person (a spouse, or a parent caring for a minor child): they can be reimbursed for no more than 520 hours of homemaker services per year. Personal care and skilled health-maintenance hours are not limited by that rule. Federal overtime also matters -- an attendant working more than 40 hours a week for one member is owed 1.5x pay, which draws down the budget faster, so many families split hours between two or more attendants to make the allocation go further.

No. Enrolling in CDASS does not reduce or replace the member's other Health First Colorado benefits -- doctor visits, hospital care, prescriptions, durable medical equipment, and other covered services all continue. CDASS is simply the self-directed way of delivering the personal care, homemaker, and health-maintenance services the member is already entitled to under Community First Choice. If the member is dually eligible for Medicare and Medicaid, Medicare keeps covering acute and short-term skilled care while Medicaid covers the ongoing personal care through CDASS; the two coordinate without interfering. You can also switch between CDASS and IHSS, or move back to agency-directed care, if your situation changes -- your Case Management Agency handles the transition so there is no gap in services.