Consumer-directed care gives Medicaid participants the power to choose, hire, and manage their own caregivers instead of relying on agency-assigned staff. In Colorado, this model operates through state-specific programs that put the person receiving care in the driver's seat.
If you or a loved one needs daily support at home, this approach offers something traditional home care often cannot: real control over who shows up, when they arrive, and how care is delivered. Understanding how Colorado's programs work, who qualifies, and what services are covered makes it easier to take the first step.
Consumer-directed care is a Medicaid-based model where the person receiving services can recruit, hire, train, and supervise their own caregivers. Rather than accepting whoever an agency sends, participants build a care team they know and trust.
Colorado offers this concept through its own programs. While the structure differs from New York's well-known CDPAP, the core idea is the same: people stay at home with more independence and more say over their daily support.
Nationwide, more than 1.5 million people already self-direct their Medicaid home and community-based services through consumer-directed programs, and that number continues to climb as more states expand access.
Colorado provides several pathways for participants who want to direct their own care.
CDASS has long been Colorado's primary consumer-directed option, and elements of it now operate alongside or within the Community First Choice (CFC) structure. Through this program, participants manage their own attendants and service budgets while receiving support across three key areas:
A financial management service (FMS) provider handles payroll processing, tax filings, and compliance documentation, so participants stay focused on care decisions while the paperwork is managed for them.
Beyond CDASS and CFC, Colorado also offers In-Home Support Services (IHSS) and similar self-directed models. These allow participants to receive home-based support while maintaining control over how and by whom care is delivered. Eligibility and scope vary by program.
Not everyone on Medicaid automatically qualifies. Two primary criteria must be met.
Participants must be enrolled in Colorado's Medicaid program and meet an institutional level of care. This means their assessed needs must be significant enough that, without home-based support, they would require placement in a nursing facility or similar institution.
The participant must either be capable of managing their own care responsibilities, including hiring, scheduling, and supervising, or appoint a trusted representative to handle those duties. This representative is often a family member who understands the participant's needs.
Programs cover three main categories of support, all tied to the approved care plan.
This includes hands-on assistance with activities of daily living:
Homemaker support covers routine household tasks that the participant cannot safely perform independently:
These are health-related supports that help participants remain safely at home, including medication reminders and assistance, basic skilled tasks delegated by a nurse, and ongoing health monitoring outlined in the care plan.
Managing all of this on your own can feel like a second job. Panda Care Homecare walks families through every step of consumer-directed enrollment, from eligibility checks to caregiver onboarding, so you spend less time on paperwork and more time on what actually matters.
Once eligibility is confirmed, the process follows a clear path.
A case manager or nurse evaluates the participant's medical and functional needs. This assessment confirms eligibility, determines the required level of support, and helps create a care plan with a corresponding service budget.
The participant selects their caregivers, often family or friends, where allowed. Selected caregivers complete enrollment paperwork, background checks, and any required orientation with support from a coordinating agency or fiscal intermediary.
The participant or representative sets schedules, assigns tasks, and oversees daily care delivery. Hours are tracked and timesheets submitted to the financial management service for payroll. Accurate, timely submissions ensure caregivers are paid without delays.
Clear roles keep the program running smoothly.
Oversees hiring, training, supervision, scheduling, and communicates any changes in needs to the case manager.
Provide day-to-day support according to the approved care plan and document their time and tasks accurately.
Case managers handle assessments and service planning. Fiscal agencies support payroll, compliance, and caregiver training resources.
Consumer-directed care offers advantages that traditional agency models cannot match. Research published in Health Affairs Scholar found that over half of older adults receiving Medicaid personal care already use self-direction, and earlier findings from the Cash and Counseling demonstration showed that self-directed care reduced nursing home admissions by 40% compared to traditional agency-based services.
Key benefits include:
For many families, this model provides a structured framework that allows families to manage care more formally.
Yes, programs like CDASS and CFC allow participants to hire family members or friends as paid caregivers in most cases. Spouses may face restrictions depending on the specific program rules.
CDASS is Colorado's consumer-directed attendant support program that now operates under the Community First Choice umbrella. CFC expanded the framework to include broader personal care and homemaker services.
Consumer-directed care in Colorado puts the person receiving support in control. Through programs like CDASS, CFC, and IHSS, Medicaid participants can hire their own caregivers, manage service budgets, and stay at home with dignity and independence.
Panda Care Homecare simplifies every stage of consumer-directed enrollment. From confirming your Medicaid eligibility to getting your chosen caregiver on payroll, our team handles the details so your family can focus on care, not bureaucracy.
Your loved one deserves care from someone they trust, and you deserve to be compensated for providing it. Call us now and find out how quickly your family can get started!
