Colorado IHSS: How to Get Paid as a Family Caregiver — A Step-by-Step Guide
Colorado IHSS: How to Get Paid as a Family Caregiver — A Step-by-Step Guide
Colorado is a state of wide-open spaces and a deep streak of independence. If you’re caring for a family member here, you already know what that means — families handle things. But what many Colorado families don’t realize is that the state has several programs that can pay you for the work you’re already doing.
Colorado isn’t as famous as California or New York for paying family caregivers, but its system has something those states don’t: a newer, flexible paid family leave program that can provide partial income when you need to step into caregiving, alongside Medicaid waiver paths that can create longer-term paid arrangements.
This guide walks you through everything that’s available, who qualifies, and how to apply — without the jargon.
(Remember: I’m not a Medicaid caseworker or an attorney. Rules can change. Use this as your map, and always confirm details with your local Area Agency on Aging or a benefits counselor.)
The Colorado Landscape: An Overview
Colorado has more than one way for family caregivers to get paid. The main paths are:
- In-Home Support Services (IHSS) under HCBS Waivers — for people on Medicaid who need help with daily living. This is the primary path to becoming a paid family caregiver.
- Colorado Paid Family Leave (FAMLI) — a newer statewide program that provides partial wage replacement for up to 12 weeks when you need time off to care for a family member with a serious health condition.
- Veteran-Directed Care — for veterans and their families, with strong local VA support.
- Private Options — long-term care insurance and personal care agreements, which we’ll cover too.
Each has different rules, different timelines, and fits different situations. We’ll go through them one by one.
Who Can Get Paid Through IHSS, and Who Can’t
Colorado’s IHSS program allows many family members to be hired as personal care attendants, with a few important boundaries.
Can be paid:
- Adult children caring for a parent
- Siblings
- Grandchildren
- Other relatives (nieces, nephews, cousins)
- A trusted friend or neighbor
Cannot be paid (with some exceptions):
- A spouse. In Colorado, spouses are generally not eligible to be paid as IHSS attendants under most waiver programs. This is similar to Texas and Florida. However, there are some narrow exceptions through certain waivers — it’s always worth asking.
- A legal guardian, in many cases, though some Colorado waivers do allow guardians to serve as paid attendants under specific conditions. This is one area where Colorado is more flexible than some other states.
A Colorado-specific thing to know: Colorado’s waiver system varies by waiver type and by the agency that administers it. The rules can differ. Don’t assume you’re ineligible until you’ve spoken to a case manager who knows your specific waiver program.
Program 1: In-Home Support Services (IHSS) Under HCBS Waivers
Colorado’s IHSS is not a single program like California’s. It’s a service available under multiple Home and Community-Based Services (HCBS) waivers. These waivers are designed to keep people at home rather than in nursing homes.
The main waivers that can include IHSS are:
- Elderly, Blind, and Disabled (EBD) Waiver — for seniors and adults with physical disabilities.
- Community Mental Health Supports (CMHS) Waiver — for adults with serious mental illness.
- Brain Injury (BI) Waiver — for people with traumatic brain injuries.
- Spinal Cord Injury (SCI) Waiver — specific to spinal cord injuries.
- Children’s Home and Community-Based Services (CHCBS) Waiver — for children with significant disabilities.
- Supported Living Services (SLS) Waiver — for adults with intellectual and developmental disabilities.
Each waiver has its own eligibility criteria and waitlist situation. The one most relevant to family caregivers of elderly parents is the EBD Waiver.
How It Works
- The care recipient is assessed and approved for the waiver.
- A service plan is created that includes IHSS hours — help with bathing, dressing, meal preparation, light housekeeping, and other personal care tasks.
- The care recipient can choose to hire a family member as their personal care attendant, often through an agency that acts as the fiscal intermediary.
- The fiscal intermediary handles payroll, tax withholding, and issues a W-2.
Who Qualifies
- Financial: The care recipient must be eligible for Medicaid in Colorado (called Health First Colorado). Income and asset limits apply, with the primary home and one vehicle exempt.
- Functional: The care recipient must need help with activities of daily living at a level that qualifies them for nursing-home-level care. An assessor from the single entry point (SEP) agency in your area conducts this evaluation.
- The care recipient must live at home or in a family member’s home — not in a nursing facility.
The Waitlist Reality
Some Colorado HCBS waivers have waitlists. The EBD waiver has had a waitlist for years. But other waivers — like the BI and SCI waivers — may have shorter or no waitlists depending on the moment. The key is to get screened and find out.
Program 2: Colorado Paid Family Leave (FAMLI)
This is the program that makes Colorado different from many other states.
FAMLI (Family and Medical Leave Insurance) is a state-run paid leave program that began paying benefits in 2024. It provides partial wage replacement to eligible workers who need time off to:
- Care for a family member with a serious health condition.
- Bond with a new child.
- Address their own serious health condition.
- Handle needs related to domestic violence or sexual assault.
How It Works for Family Caregivers
If you are employed in Colorado and need to take time off to care for a parent, spouse, or other close family member with a serious health condition, FAMLI can pay you a portion of your wages during that time.
- You can take up to 12 weeks of paid leave per year.
- The wage replacement rate is on a sliding scale — up to 90% for lower-wage workers, with a cap at a certain weekly maximum.
- You apply through the Colorado Department of Labor and Employment’s FAMLI division.
- Your job is protected while you’re on leave.
What This Means Practically
FAMLI is not a permanent “salary for family caregivers.” It’s time-limited. But it can be a lifeline. If your mom has a stroke and you need to be with her for the first few months, FAMLI can replace part of your income while you do that. It can also cover you while you’re applying for longer-term programs like the EBD waiver.
Combine this with federal FMLA protections, and you have a base layer of income and job security while you navigate the bigger system.
How to Apply: A Step-by-Step Path
Step 1: Get screened for an HCBS waiver.
Contact your local Single Entry Point (SEP) agency. These are county-level offices that handle intake for all long-term care programs in Colorado. You can find yours by calling the statewide number at 1-844-264-6368 or visiting the Health First Colorado website.
Step 2: Ask specifically about IHSS within the waiver.
When you speak with the SEP case manager, say: “I am a family caregiver for [name]. I want to know if they qualify for a waiver that includes In-Home Support Services, and whether I can be hired as their paid personal care attendant.”
Step 3: If there’s a waitlist, get on it — and explore FAMLI in the meantime.
The EBD waiver waitlist is long. But the SEP will tell you about other waiver options. While you wait, apply for FAMLI if you’re employed and need income replacement right now. Visit famli.colorado.gov to apply.
Step 4: Apply for Health First Colorado (Medicaid) if not already enrolled.
Visit colorado.gov/peak or call the Member Contact Center at 1-800-221-3943.
Step 5: If approved for a waiver with IHSS, complete the attendant enrollment process.
This includes background checks, identity verification, and orientation through the fiscal intermediary agency. Once you’re enrolled, you can start logging hours.
How Much Does It Pay?
IHSS wages through HCBS waivers: Rates vary by waiver, region, and the fiscal intermediary. They typically range from $12 to $17 per hour. You receive a W-2 and are eligible for workers’ compensation.
FAMLI benefits: Up to 90% of your average weekly wage, capped at a weekly maximum (which adjusts annually — check the FAMLI website for current figures). This is paid through the state, similar to unemployment insurance, and is designed to partially replace your income while you provide care.
What If the Care Recipient Has Dementia?
If your loved one has Alzheimer’s or another dementia and cannot direct their own care, they will need a designated representative to handle the employer responsibilities in a self-directed care arrangement.
In Colorado, the SEP agency and your case manager can help set this up. The designated representative cannot be the same person who is being paid as the attendant. So if you want to be the paid caregiver, another trusted family member or friend will need to serve as the representative. This is a conversation to have early.
Private Alternatives If Public Programs Don’t Fit
- Long-term care insurance: Check your loved one’s policy. Many cover in-home care by family members.
- Personal Care Agreement: A formal contract drafted with an elder law attorney. This can pay you from your loved one’s private funds and can also help with Medicaid asset protection later.
- VA benefits: Colorado has a significant veteran population. The VA’s Veteran-Directed Care program and Aid & Attendance pension can pay family caregivers. Call the VA Caregiver Support Line at 1-855-260-3274.
Common Mistakes Colorado Families Make
- Assuming there’s only one waiver. Colorado has multiple HCBS waivers with different rules and waitlist lengths. Ask your SEP about all of them, not just the EBD waiver.
- Not knowing FAMLI exists. FAMLI is new, and many families still don’t realize it’s available. If you’re employed in Colorado, this is money you’ve contributed to through payroll deductions. Use it.
- Assuming a spouse can be paid. Spouses are generally excluded from paid attendant roles in Colorado’s waiver programs, though there are some narrow exceptions. Know this upfront and explore alternatives.
- Getting lost in the SEP system. Colorado’s single entry point system is designed to streamline intake, but it can feel like a maze. If you’re not getting answers, call the statewide number and ask for your case to be escalated.
Your Colorado Action Plan
- Today: Find your local Single Entry Point agency. Call 1-844-264-6368.
- This week: Start the screening process for HCBS waivers.
- If employed: Visit famli.colorado.gov and explore FAMLI eligibility. Apply if you need income replacement now.
- Apply for Health First Colorado (Medicaid): colorado.gov/peak or 1-800-221-3943.
- If caring for a veteran: Call the VA Caregiver Support Line at 1-855-260-3274.
Resources for Colorado Families
- Colorado Single Entry Point (SEP) system: 1-844-264-6368 — your first call.
- Health First Colorado (Medicaid): colorado.gov/peak or 1-800-221-3943
- Colorado FAMLI: famli.colorado.gov
- Colorado Area Agencies on Aging: Find yours through the Eldercare Locator at eldercare.acl.gov or call 1-800-677-1116.
- VA Caregiver Support Line: 1-855-260-3274
The Bottom Line
Colorado isn’t the easiest place to get paid as a family caregiver through Medicaid. The waitlists are real, and the waiver system can feel fragmented. But Colorado has something most other states don’t — FAMLI — and that’s a meaningful, immediate resource for employed caregivers who need to step into care without losing their entire income.
The path starts with a phone call to the Single Entry Point. Make it. Get screened. Find out where you stand. And while you’re waiting, explore FAMLI, VA benefits, and private options. You don’t have to wait for everything to line up before you take the first small step.
Ready to explore other states? Our state-by-state paid caregiver guide covers every option across the country.
Last updated: 2026
Disclaimer: WiseCareNest provides educational content. This is not legal or benefits advice. Consult with a qualified professional for your specific situation.