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FreedomCare helps Elbert 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 an aging parent in Elizabeth, a spouse in Kiowa, or a family member with a disability in Simla or Agate, FreedomCare can help you find out whether Colorado Medicaid will pay you for that care. Rural counties in Colorado have access to the same Health First Colorado and Community First Choice (CFC) programs as the Front Range, even though the local infrastructure looks different. This page walks through how it works for Elbert County families.
Elbert County stretches across 1,851 square miles of rolling plains and ranchland east of Denver and Douglas County. About 30,000 residents live here, most in Elizabeth, Kiowa (the county seat), Simla, Ponderosa Park, Elbert, and the unincorporated agricultural communities. The county is one of the most rural in the Front Range corridor and one of the fastest-growing as families move out from the metro area for land and quiet. The older-adult share here is meaningfully higher than the state average, and rural distances make home-based care more important, not less.
Elbert has one of the smaller Medicaid populations in Colorado. As of December 2025, about 3,062 Elbert County residents are enrolled in Health First Colorado, or roughly 10 percent of the population. The total is small, but the need is real: a county with a median age above the state average, scattered settlements, and limited local healthcare infrastructure has to rely on home-based care more than its urban counterparts do.
Elbert County does not have a hospital within its borders. Most residents who need acute or specialty care travel west to facilities in Castle Rock or Parker, north to the metro Denver hospitals, or south to UCHealth Memorial or Penrose-St. Francis in Colorado Springs. That distance shapes a lot about how home care works here. A parent in Kiowa or Simla who needs help with bathing, meal preparation, and medication reminders usually does not want to relocate to the Front Range for a facility, especially in winter. A family caregiver who can show up reliably is often the difference between staying home and moving away from everything familiar.
CFC offers three ways for Elbert County families to receive care: an agency-delivered model where a home care provider sends out a caregiver, consumer-directed care through CDASS where the member fully manages their own caregiver, and self-directed care with IHSS agency support. FreedomCare operates as an IHSS agency in Colorado. We work with rural families, and almost all enrollment and caregiver onboarding can be completed by phone, video, and email, so distance from a metro center is not a barrier.
Colorado runs Medicaid through Health First Colorado, the state's name for its Medicaid program. If you qualify, you can receive long-term services and supports (LTSS) 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 activities of daily living, or ADLs, like bathing, dressing, mobility, and toileting), homemaker services (light cleaning, laundry, meal preparation), 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:
Many Elbert County families are caring for a parent or spouse who has lived on the same land for decades. The pull to stay home is stronger here than almost anywhere else in the state, and the financial picture often makes a facility impossible. CFC and IHSS give families a way to get paid for the work they are already doing while the older adult stays in the home they know.
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 Elbert 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 Elbert 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.
Medicaid home care eligibility in Colorado has two parts. You need to be enrolled in Health First Colorado, and you need a Case Management Agency to confirm you require a nursing facility level of care. Financially, Medicaid has income and asset limits that vary by program and household size. Medically, the assessment looks at how much help you need with activities of daily living (ADLs) and instrumental activities of daily living. Your local Case Management Agency or county human services office can confirm where you stand.
Most Elbert County 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. Rural distance can add some scheduling complexity, and most case managers will arrange parts of the process by phone and video to reduce travel.
Elbert County Human Services handles Medicaid applications and renewals for county residents. The office is in Kiowa. You can also apply online through Colorado PEAK or by phone through the Health First Colorado Member Contact Center. After enrollment, you contact a Case Management Agency to begin the CFC assessment.
Yes. We work with families throughout Elbert County, including Elizabeth, Kiowa, Simla, Ponderosa Park, Elbert, Matheson, Agate, and the unincorporated agricultural areas. Most enrollment and caregiver onboarding is done by phone, video, and email, so the drive to a city is not part of the process. We are used to working with rural families.
If you are caring for a family member in Elbert 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.
East Central Council of Governments (ECCOG) Area Agency on Aging. Serves Elbert County along with Cheyenne, Lincoln, and Kit Carson counties as Colorado's Region V. ECCOG funds and coordinates home and community-based services, nutrition programs, transportation, and caregiver support for older adults across the eastern plains. Rural transportation in Elbert County is limited; ECCOG funds local transportation programs for older adults across the four-county region, and county Human Services can connect residents to non-emergency medical transportation for Medicaid-covered appointments.
eccog.comHandles Medicaid applications, renewals, food assistance, and other benefits for Elbert County residents. The main office is in Kiowa. You can also apply online through Colorado PEAK.
elbertcounty-co.govThe 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 Elbert County residents. The Denver office serves Elbert along with several other counties. Call 303-837-1313.
coloradolegalservices.org/public-benefits/medicaid-appeals/Online portal to apply for Health First Colorado and related benefits.
coloradopeak.secure.force.comCounty population, age, income, poverty, and related statistics.
census.gov/quickfacts/.../elbertcountycoloradoWe’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.
