Medicaid self-directed care
Consumer-Directed Attendant Support Services (CDASS)
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- Who qualifies
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Health First Colorado (Medicaid) members who meet eligibility for Community First Choice, including an assessed need for Personal Care, Homemaker or Health Maintenance Activities and an institutional level of care, who take part in service planning with their Case Management Agency and want to self-direct all aspects of their in-home care. If you are already enrolled in an HCBS waiver, you automatically meet the institutional level of care.
With CDASS you hire, train and supervise your own attendants, set their schedules and tasks, and manage a service budget with help from a Financial Management Services provider. CDASS is a service delivery option under Community First Choice.
Source: Consumer-Directed Attendant Support Services (CDASS) (Colorado Department of Health Care Policy and Financing)Checked
- Can a family member be paid
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Yes. Yes. Under Community First Choice, family members may be hired as an attendant to provide Homemaker, Personal Care and Health Maintenance Activities just as any other attendant, whichever service delivery method the member chooses.
Every caregiver, family or not, is limited to 16 hours a day and, since July 1, 2026, to a weekly number of hours for one member: see the hours limit below. A spouse, or a parent or guardian of a minor child, also has a separate Homemaker limit.
- Can a spouse be paid
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Depends. Yes for Homemaker, with a limit. For an adult member, HCPF counts the spouse as a Legally Responsible Person. Since June 13, 2026, Legally Responsible Persons can be paid for no more than 7 hours a week of Homemaker per member, and CDASS attendants who are Legally Responsible Persons cannot be paid for more than that. Hours above 7 must come from another qualified caregiver.
This memo replaces the earlier 10-hour and 5-hour Homemaker limits. HCPF's Community First Choice memo (OM 25-057) says family members may be hired for Personal Care and Health Maintenance Activities just as any other attendant, but neither memo says in so many words that a spouse may be paid for Personal Care: confirm with your Case Management Agency.
- Hours limit
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A caregiver can work no more than 16 hours a day. One caregiver can provide no more than 84 hours a week to one member from July 1 through December 31, 2026, 70 hours a week from January 1, 2027, and 56 hours a week from July 1, 2027, unless an exception is approved or there is a documented emergency. The weekly limit covers Personal Care, Homemaker and Health Maintenance Activities, including through CDASS.
A spouse, or a parent or guardian of a minor child, can also be paid for no more than 7 hours a week of Homemaker per member (HCPF OM 26-042). CDASS employers can ask for an exception to the weekly limit.