Caring for your child is something you do because you’re their parent. But the hours you spend caring for them, helping with bathing, meals, medications, and other daily needs, can affect your ability to work outside the home.
As a parent of an autistic child, I know how quickly appointments, therapies, school meetings, and everyday care can become part of your family’s normal routine. You may not realize that Colorado has programs that may allow a family member to be paid for providing certain types of care at home.
One option is In-Home Support Services (IHSS). Through Health First Colorado, your child may qualify for you to become a paid caregiver. Colorado’s program works differently from the IHSS program you may have heard about in other states.
Here’s what Colorado families should know about IHSS, including who qualifies, how caregiver pay works, how to apply, and how IHSS compares with other options such as CDASS.
Key Takeaways
- Colorado's IHSS program allows eligible Health First Colorado members to receive certain services at home.
- Family members, including parents in some circumstances, may be able to provide paid care.
- IHSS can include homemaker, personal care, and health maintenance activities, depending on the member's assessed needs.
- Colorado expanded access to IHSS through Community First Choice (CFC) beginning July 1, 2025. If you want help with the next step, you can get started with Alpaca Health.
What Is IHSS in Colorado?
In-Home Support Services, or IHSS, is a Health First Colorado service allowing eligible members to receive certain long-term care services in their home or community.
IHSS may include homemaker services, personal care, and health maintenance activities. Community First Choice currently utilizes IHSS as one of its service-delivery options.
What makes IHSS unique is that it’s more than receiving home care through a traditional agency. The members or their authorized representatives have more involvement in selecting and directing attendants. An approved IHSS agency handles responsibilities such as employment and payroll.
Parents should know that certain family members may be paid to provide authorized care when program requirements are met. However, being your child’s parent doesn’t automatically mean every hour of caregiving is reimbursable. The services and hours are approved based only on your child’s assessed needs.
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How Colorado’s IHSS Differs From the California Program
California’s IHSS is a different program.
In Colorado, IHSS is part of the Health First Colorado system available through Community First Choice for eligible members. Participating families work with Colorado’s long-term care system and an approved IHSS agency. California's program follows its own application and caregiver enrollment process.
That’s why it’s important to use Colorado-specific information when checking eligibility, authorized services, and caregiver pay.
Who Qualifies for IHSS in Colorado?
Eligibility for IHSS in Colorado is two-fold: your child must qualify for the service, and the person providing paid care must meet caregiver requirements.
Your child’s eligibility
Your child must qualify for Health First Colorado. They also need to meet the applicable requirements for long-term services and supports. The approved services and hours are based on an assessment of the help they need with everyday life and health-related tasks.
An autism diagnosis isn’t enough to determine how many hours of IHSS a child receives. The assessment looks at the care your individual child requires.
Your eligibility as the caregiver
If your child qualifies for IHSS, you may be able to become their paid attendant. IHSS permits members or authorized representatives to identify someone they want as a caregiver, including a family member in certain situations.
Caregivers must be at least 16 years old and demonstrate that they can safely perform the tasks included in the care plan. The IHSS agency hires the caregiver and handles employment responsibilities, while the member or authorized representative helps direct day-to-day care.
The person serving as your child's authorized representative cannot also be their paid IHSS caregiver.
Rules that apply to parents of minor children
Colorado does allow parents and guardians to be paid for some care they provide to a minor child. But that doesn’t mean Medicaid simply pays a parent for all the caregiving they do.
Under Community First Choice, a parent or guardian providing homemaker services to their minor child is considered a legally responsible person. Colorado currently limits this type of paid homemaker care to 7 hours per week.
The rules for other authorized services and caregivers may differ. That’s why your child’s care plan and IHSS agency help determine which tasks and hours can be paid.
The goal isn't to put a price on everything you do as a parent. It's about identifying covered services your child needs because of their disability or health needs and determining which of those services can be provided by a paid caregiver.
What IHSS Covers and What It Does Not
IHSS may cover authorized homemaker, personal care, and health maintenance activities based on your child’s assessed needs.
Your child’s care plan might involve assisting with everyday activities or health-related tasks that your child is unable to complete independently.
IHSS won’t pay for every hour you spend caring for your child. For example, Colorado rules specifically state that companionship isn't an IHSS benefit. The services have to be included in the approved care plan while also meeting program requirements.
How Much Does IHSS Pay in Colorado?
There isn’t a standard hourly wage paid to every Colorado IHSS caregiver.
Colorado publishes Medicaid reimbursement rates for IHSS services, but those are the amounts paid to IHSS agencies—not automatically the attendant's hourly wage. The actual caregiver wage can depend on the IHSS agency, the type of care provided, and other employment factors.
When comparing IHSS agencies, ask directly:
- What is your current hourly wage for IHSS attendants?
- Does the rate differ based on the type of care provided?
- Are there different rates for overtime, if applicable?
- What benefits or paid time off are available?
This allows you to be proactive instead of assuming what will appear on your paycheck.
How to Apply for IHSS in Colorado
Applying for IHSS isn’t simply signing up as your child’s caregiver. Your child must first qualify for Health First Colorado and be assessed for the services they need. From there, you'll work through the IHSS enrollment process.
Getting a Health First Colorado eligibility determination
After enrolling your child in Health First Colorado, the agency will assess whether they meet the eligibility requirements for the program providing their long-term services and supports.
If you're unsure where to begin, contact Health First Colorado or your local case management agency. A case manager can help determine which services your child may qualify for and explain the next steps.
Requesting a needs assessment
An assessment is required to determine what your child needs and which services are authorized.
This is where it’s important to be specific about your child’s daily care needs. Explain what your child can do independently, where they need help, and what happens when support isn’t available.
Choosing an IHSS agency
If approved, you’ll choose an approved IHSS agency serving your area. The agency is responsible for employment-related duties like hiring attendants, payroll, training, and ensuring services meet Medicaid requirements.
Remember that it’s okay to compare agencies. Ask about caregiver pay, enrollment timelines, training requirements, and how much support they provide families.
Enrolling as the paid caregiver
Once you've chosen an agency, you'll complete its employment and enrollment requirements before you begin providing paid services.
Approval for IHSS doesn't mean every hour of care is payable. Your child's authorized care plan determines the services and hours that Medicaid will cover.
Turn these ideas into a plan built for your child.
Activities at home are a great start, and a Board Certified Behavior Analyst can shape them into a program around your child's real goals. Alpaca Health matches you with one, often within days.
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IHSS, CDASS, and Community First Choice Compared
All of the names can get confusing. It’s especially true since they’re related but aren’t interchangeable.
Community First Choice (CFC) is a Health First Colorado benefit that provides certain long-term services and supports. IHSS and Consumer-Directed Attendant Support Services (CDASS) are two ways eligible members can receive and direct some of those services.
With IHSS, an IHSS agency employs attendants and handles many employer responsibilities. CDASS gives the member or authorized representative more control over hiring, training, scheduling, and managing attendants.
Neither option is automatically better. The right fit depends on how much responsibility your family wants to take on and which option your child qualifies to use.
Can a Parent Be Paid to Care for Their Own Child?
Yes, some Colorado parents may be paid to provide approved care for their minor child. But eligibility and payment depend on your child’s program, assessed needs, authorized services, and caregiver rules.
This doesn't mean Medicaid pays you simply because your child has autism or needs more supervision than another child. The care must qualify as a covered service and be authorized through your child's care plan.
What to Do if There Is a Waitlist in Your County
You may experience challenges in accessing IHSS. You can stay in contact with your case manager and ask what other options are available while you wait. Another IHSS agency might serve your area, or other Health First Colorado services could meet your child’s needs.
Keep detailed notes on who you contacted, when you called, and what you were told. Having this information in one place can make follow-up easier.
Where ABA Therapy Fits Alongside Paid Caregiving
IHSS and ABA therapy serve different needs for your family. IHSS helps eligible children with authorized daily living and health-related needs, while ABA focuses on building skills and addressing behaviors that affect everyday life.
Your child may receive ABA therapy while also receiving other Medicaid-covered services, if they qualify. One service doesn’t necessarily replace the other.
If your child is autistic and you’re trying to balance therapy with caregiving responsibilities, Alpaca Health can help you explore ABA services that fit your family’s needs.
How Alpaca Health Helps Colorado Families
It’s okay to admit you need support. Figuring out Medicaid, caregiving programs, and therapy at the same time can feel like another job in itself.
Alpaca Health helps Colorado families navigate ABA therapy, understand coverage, and find services that work for their child and family.
Get started with Alpaca Health to learn more about ABA therapy and available options in your area.
You don't have to figure this out alone.
Alpaca Health matches your family with a vetted, in-network BCBA, often within days and with no waitlist. We handle the insurance paperwork so you can focus on your child.
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Frequently Asked Questions About IHSS Colorado
Does Colorado have an IHSS program?
Yes. Colorado offers In-Home Support Services through Health First Colorado. Eligible members can receive authorized services at home while having more choice over who provides their care.
What is the IHSS hourly pay rate in Colorado?
There isn’t a set hourly wage for every IHSS caregiver in Colorado. Caregiver wages vary by IHSS agency and other employment factors. Ask individual agencies what they currently pay attendants rather than relying on the state’s Medicaid reimbursement rate.
Can I get paid to care for my autistic child in Colorado?
Possibly. Parents of minor children may qualify for certain authorized services as long as program requirements are met. An autism diagnosis alone doesn’t automatically qualify a parent for payment.
How do I become a paid caregiver for a family member in Colorado?
The first step is determining whether your family member qualifies for Health First Colorado services that allow paid family caregiving. If IHSS is approved, you’ll next choose an agency and complete its requirements to become an attendant or caregiver.
Get started with Alpaca Health to learn more about ABA therapy and available options in your area.
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