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FreedomCare helps Denver County families get paid through Colorado Medicaid for the care they're already giving a parent, sibling, or other loved one at home.
If you are caring for a parent in Park Hill, a spouse in Capitol Hill, or an adult child with a disability in Montbello, FreedomCare can help you find out whether Colorado Medicaid will pay you for that care. Denver families have real options under Health First Colorado and the new Community First Choice (CFC) program, and most do not require moving someone you love into a facility. This page walks through how Medicaid home care works in Denver, who qualifies, and how a family member can become the paid caregiver.
Denver County and the City of Denver are the same jurisdiction, covering about 155 square miles from the foothills to Stapleton and from Globeville to Hampden. About 712,000 people live in Denver. It is the largest Medicaid population in Colorado by a wide margin, and the city's Case Management Agencies and Department of Human Services handle high volume every day. That scale is useful for families: the systems are well established, the enrollment paths are clear, and there are more resources within a short drive than anywhere else in the state.
Denver has the largest Medicaid enrollment of any county in Colorado. As of December 2025, about 197,700 Denver residents are enrolled in Health First Colorado, or roughly 28 percent of the city's population. That scale shapes the local home care market: there are multiple Case Management Agencies that handle CFC enrollment, multiple home care providers, and significant familiarity with consumer-directed pathways like CDASS and IHSS.
For families in Denver, the local healthcare picture is unusually rich. UCHealth, Denver Health, Saint Joseph, Rose Medical Center, National Jewish, and Children's Hospital Colorado all have a presence in or near the county. Many Denver families come into the CFC conversation after a hospital discharge, when a parent or spouse needs ongoing care at home and the family suddenly has to figure out who is going to provide it. That moment is hard, and Denver Human Services and the Aging and Disability Resource Center are both equipped to help families work through next steps.
Home care in Denver tends to follow one of three patterns: an agency-delivered model where a licensed home care provider assigns a caregiver, consumer-directed care through CDASS where the member fully manages their own caregiver, or self-directed care with IHSS agency support. FreedomCare operates as an IHSS agency in Colorado. We work with Denver families who want a relative or trusted person to be the paid caregiver while keeping a licensed agency in the loop for payroll, training, and compliance.
Colorado runs Medicaid through Health First Colorado, the state's name for its Medicaid program. If you qualify, you can receive long-term care at home instead of in a nursing facility. The main pathway for that is Community First Choice, a Health First Colorado state plan benefit that went live on July 1, 2025.
CFC covers personal care (help with bathing, dressing, mobility, toileting), homemaker services (light cleaning, laundry, meal prep), and health maintenance activities like medication reminders. To qualify, you need to be enrolled in Health First Colorado and meet what the state calls a nursing facility level of care, which means your care needs are significant enough that you would otherwise qualify for placement in a facility. A local Case Management Agency or Single Entry Point agency makes that determination.
CFC replaced and expanded what used to live inside several Home and Community-Based Services (HCBS) waivers. If you are already on an HCBS waiver, you do not lose anything. At your next Continued Stay Review, your case manager moves you over to CFC for the services that have transitioned. Waiver-based access to those specific services ends June 30, 2026, and after that, CFC becomes the only pathway. You can still keep waiver-only services like respite or specialized therapies that have not moved.
CFC gives families three ways to receive care:
Both CDASS and IHSS let you hire a family member, friend, or trusted person you already know. The rules around who can be paid vary slightly, and there are specific limits for what Colorado calls Legally Responsible Persons (spouses, and parents of minor children). Those caregivers can be paid in some cases, but only for services beyond their existing legal obligation and within hour caps set by HCPF. We walk through the specifics with each family during enrollment.
| Pathway | How It Works | Who It Tends to Fit |
|---|---|---|
| Community First Choice (CFC) | A Health First Colorado state plan benefit launched July 1, 2025. Covers personal care, homemaker, and health maintenance services for members who meet a nursing facility level of care. | Anyone enrolled in Health First Colorado who needs care equivalent to a nursing home but wants to stay home. |
| Standard Medicaid home care (agency-based) | Care delivered by a licensed home care agency. The agency hires, trains, schedules, and pays the caregivers assigned to you. | Members who prefer an agency to handle everything and assign a caregiver. |
| Family caregiver pathways (CDASS and IHSS) | Two self-direction options inside CFC. You choose your own caregiver, including a family member or friend, and manage their schedule and tasks. CDASS is fully member-directed with a Financial Management Services vendor. IHSS gives you support from a licensed IHSS agency that helps with payroll, training, and oversight. | Families who want a relative or trusted person to provide care, with the program handling pay and compliance. |
This is the part that surprises most families: in Colorado, the person you care for usually gets to choose you. Medicaid does not require an outside aide. Under CDASS and IHSS, the member is in charge of their own care, which means they can hire a son, daughter, sibling, niece, friend, or neighbor instead of being assigned a stranger.
You are not applying for a job. You are stepping into a caregiving role you may already be filling. The program brings structure, pay, training, and support to work you are likely doing for free right now. That distinction matters because the rules and the paperwork are built around the member, not the caregiver.
For the member or patient, the steps are: enroll in Health First Colorado if you are not already, contact a Case Management Agency, complete a level of care assessment, then choose CFC and a delivery option (agency, CDASS, or IHSS). If you choose CDASS or IHSS, you pick your caregiver.
For the caregiver, the steps follow the member's. Once the member is approved and selects you, you complete the onboarding required by the program: background check, basic training, paperwork, and enrollment with the FMS or IHSS agency that processes pay. FreedomCare handles the IHSS side of that for families across Colorado.
A few numbers that shape the local picture:
A lot of Denver families are caring for parents who lived through major changes in the city. People who bought homes in Park Hill or Berkeley decades ago are now in their seventies or eighties, often still living in those houses, and now needing help. Home care lets them stay. The financial logic is straightforward: a nursing facility absorbs most of a member's income and may force a sale of long-held assets; CFC and IHSS keep the person home and let a family caregiver be paid for the work they would otherwise do unpaid.
There are reasons people pick home care that go beyond cost. The biggest one is familiarity. The person you are caring for stays in the place they know, with the people they know, and with their routines intact. That alone slows cognitive decline for many older adults and reduces the kind of disorientation that often comes with a move into assisted living or a nursing facility.
Care from a family member tends to be more consistent. Staff turnover in facilities is high. A daughter, spouse, or sibling already knows the small things, like which side your father prefers to be helped from, what medications cause which side effects, and the words that calm your mother down when she gets agitated. That continuity is hard to replicate.
There is also a financial side. The annual cost of a semi-private room in a Colorado nursing facility runs into the six figures for most families. Medicare does not pay for long-term care beyond short rehab stays. Medicaid does, but only when you qualify, and a facility absorbs most of the member's income. CFC and self-direction keep the person at home and let a family caregiver receive pay for the work they would otherwise do unpaid.
For families in Denver County, the choice often comes down to two things: keeping the person home and keeping the household financially stable while caregiving demands grow.
FreedomCare operates as an IHSS agency in Colorado. We work with families across the state, including Denver County, who want to keep a family member at home and get paid for the care they provide. Our role is to make the IHSS side of CFC work for you: enrollment, caregiver onboarding, payroll, and ongoing support.
What that looks like in practice:
We do not assign outside aides. The whole point of self-direction is that the member picks someone they already trust. Our job is to make the system around that choice work cleanly. You can read about how families across Colorado are using these programs or what we stand for in our vision and values.
Community First Choice (CFC) is a Health First Colorado state plan benefit that started on July 1, 2025. It covers personal care, homemaker services, and health maintenance activities for Colorado Medicaid members who need care at a nursing facility level. CFC replaced parts of several HCBS waivers and brought CDASS and IHSS into one statewide program.
Yes. Health First Colorado covers home care primarily through CFC. If you qualify for Medicaid and a Case Management Agency confirms you need a nursing facility level of care, you can receive personal care, homemaker help, and health maintenance services at home instead of in a facility.
Yes. The whole point of CFC is to keep you home if that is what you want and your care can be safely managed there. The level of care assessment establishes that you need significant help, and the service plan determines what kind of care, and how much, you receive. Most members in CFC stay in their own home or with family.
Yes, under CDASS or IHSS. You can hire an adult child, sibling, niece, nephew, in-law, or friend as your paid caregiver. Spouses and parents of minor children fall under what Colorado calls Legally Responsible Persons, with additional rules and hour limits. We go over what applies to your relationship during enrollment.
You need to be enrolled in Health First Colorado and meet the financial and medical eligibility rules. Medically, that means a Case Management Agency assesses you and confirms you need a nursing facility level of care. Financially, Medicaid has income and asset limits that vary by program and household size. Your local Case Management Agency or county human services office can confirm where you stand.
Most Denver families see the level of care assessment scheduled within a few weeks of contacting a Case Management Agency. CFC service approval typically follows within 30 to 60 days, assuming Health First Colorado enrollment is already in place. Because Denver's case management network is one of the largest in the state, scheduling tends to be predictable, and hospital discharge planners at Denver Health, UCHealth, and Saint Joseph can sometimes accelerate intake when a member is leaving the hospital with a new care need.
Denver Human Services handles Medicaid applications and renewals for Denver residents. You can apply in person, online through Colorado PEAK, or by phone at 720-944-3666. After enrollment, you contact a Case Management Agency to begin the CFC assessment.
Yes. Denver has more hospital discharge volume than any other Colorado county, and our enrollment process is built for tight timelines. If you or a family member is being discharged from Denver Health, UCHealth, Saint Joseph, Rose, or another Denver hospital with a new home care need, the first step is to get the discharge planner connected to a Case Management Agency. From there, we can move quickly on the IHSS side once the member's CFC assessment is in motion.
Yes. We work with families throughout Denver County, including Park Hill, Capitol Hill, Montbello, Stapleton, Globeville, Hampden, Berkeley, Washington Park, and West Denver. Most enrollment and caregiver onboarding happens by phone, video, and email, so location within the city is rarely a barrier.
If you are caring for a family member in Denver County and want to find out whether Colorado Medicaid can pay you for that care, we can help you take the next step. Contact FreedomCare to talk with someone about CFC eligibility and how IHSS works for your family. Most calls take about 15 minutes and there is no obligation.
Important Disclaimer: This page is for general information and is not legal, medical, or financial advice. Medicaid eligibility, Community First Choice rules, and caregiver pay policies are set by the Colorado Department of Health Care Policy and Financing (HCPF) and may change. Eligibility is not guaranteed and is determined by your Case Management Agency and Health First Colorado based on your individual circumstances. Verify program requirements directly with HCPF, your Case Management Agency, or your county human services office before making care or financial decisions.
These are the starting points if you are not sure where to begin.
Denver Regional Council of Governments (DRCOG) Area Agency on Aging. Serves Denver along with Adams, Arapahoe, Broomfield, Clear Creek, Douglas, Gilpin, and Jefferson. DRCOG provides free options counseling, caregiver respite vouchers (up to 32 hours of in-home care), help applying for benefits, and Long-Term Care Ombudsman services. Call 303-480-6700. The DRCOG office is at 1001 17th Street, Suite 700, in downtown Denver.
drcog.org/programs/area-agency-aging-aaaHandles Medicaid applications, renewals, food assistance, and other benefits for Denver residents. Main number: 720-944-3666. The main office is at 2929 W. 10th Avenue, Denver. You can also apply online through Colorado PEAK.
denvergov.org/.../Denver-Human-ServicesThe state Medicaid program. Member Contact Center: 1-800-221-3943.
healthfirstcolorado.comOfficial CFC hub from the Colorado Department of Health Care Policy and Financing, with the program memo, billing manual, and Case Management Agency directory.
hcpf.colorado.gov/cfcFree civil legal aid for low-income Denver residents. Located in the Civic Center Plaza at 1905 Sherman Street, Suite 400. Call 303-837-1313.
coloradolegalservices.org/public-benefits/medicaid-appeals/Paratransit service for Denver residents who cannot use regular bus or rail because of a disability. Covers the entire city.
rtd-denver.com/services/access-a-rideOnline portal to apply for Health First Colorado and related benefits.
coloradopeak.secure.force.comCounty population, age, income, poverty, and related statistics.
census.gov/quickfacts/denvercountycoloradoWe’ll help you find the right program for your family.
Why Families Choose FreedomCare
We help families across Colorado every day.
We’ll help you find the right program for your family.
Why Families Choose FreedomCare
We help families across Colorado every day.
You’ve been caring for your loved one because it’s the right thing to do. FreedomCare can help you navigate Colorado’s CFC program, understand your options, and take the first step toward care from someone you trust while they get paid for it.
