8,000+
FreedomCare helps Boulder 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 Boulder, a spouse in Longmont, or a family member with a disability in Lafayette or Louisville, FreedomCare can help you figure out whether Colorado Medicaid will pay you for the care you are already providing. Community First Choice (CFC) went live across the state on July 1, 2025, and it changed what is possible for Boulder County families who want their loved one to stay home instead of moving into a facility.
Boulder County is home to about 330,000 people across Boulder, Longmont, Lafayette, Louisville, Erie, Superior, Niwot, Nederland, and the mountain communities west of the Front Range. The 65-and-older population here is growing faster than almost any other group, and Boulder County's own Area Agency on Aging projects the 80-plus population will increase by roughly 220 percent through 2050. Demand for home-based care is climbing fast, and many families are looking for options that keep the household intact.
Boulder County's overall poverty rate is lower than the state average, but Medicaid still plays a major role in long-term care here. As of December 2025, about 46,000 Boulder County residents are enrolled in Health First Colorado, and a meaningful share of those members are older adults or people with disabilities who need help with daily living.
There is a hard reality behind the county's aging trend. A semi-private room in a Boulder County nursing facility ran about $144,000 a year in 2023, which is unattainable as private pay for most households. Medicare does not cover long-term custodial care. Medicaid does, but only if you qualify, and the number of long-term care beds accepting Medicaid in Boulder County is limited. That math is part of why CFC matters so much locally: it lets families provide care at home, with a paid family caregiver, instead of trying to find a facility bed.
Care under CFC in Boulder County tends to follow one of three patterns: agency-delivered services, consumer-directed care through CDASS where the member fully manages their own caregiver, or self-direction with IHSS agency support. FreedomCare operates as an IHSS agency in Colorado, and that model fits families who want a relative or trusted person to provide care while a licensed agency handles 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:
Boulder County's population is unusual in another way. A high share of residents have advanced degrees and have worked in research, technology, education, or healthcare. That demographic is aging now, and many of those families are caring for parents who lived independently for decades and are only now needing help. The shift can feel sudden, and CFC can help bridge it before a facility becomes the only option.
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 Boulder 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 Boulder 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.
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 Boulder 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. Hospital discharge planners at Boulder Community Health, UCHealth Longs Peak, AdventHealth Avista, and Good Samaritan can sometimes help speed up assessments when a member is leaving the hospital.
Boulder County Housing and Human Services handles Medicaid applications and renewals for residents. You can apply in person at the Boulder or Longmont office, online through Colorado PEAK, by phone at 303-441-1000, or by mail. After enrollment, you contact a Case Management Agency to begin the CFC assessment.
Yes. We work with families throughout Boulder County, including Boulder, Longmont, Lafayette, Louisville, Erie, Superior, Niwot, and the mountain communities. Most enrollment and caregiver onboarding happens by phone, video, and email, so distance from a city center is rarely a barrier.
If you are caring for a family member in Boulder 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.
Boulder County has its own AAA, separate from the metro Denver region. Information and referral, options counseling, Medicare counseling, caregiver support, Long-Term Care Ombudsman, and veteran services. Resource Navigator: 303-441-1617. No income requirement; most services are free.
bouldercounty.gov/departments/community-services/area-agency-aging/Handles Medicaid applications, renewals, and benefits for residents. Main intake: 303-441-1000. Offices in Boulder and Longmont. You can also apply through Colorado PEAK.
bouldercolorado.gov/government/departments/housing-human-servicesThe state Medicaid program. Member Contact Center: 1-800-221-3943.
healthfirstcolorado.comThe state's official CFC information hub, including the implementation memo, billing manual, and Case Management Agency directory.
hcpf.colorado.govFree civil legal aid for low-income Boulder County residents. Located in Louisville. Call 303-449-7575.
coloradolegalservices.orgParatransit service for residents who cannot use regular bus or rail because of a disability. Covers most of Boulder County's urbanized areas. For mountain communities, contact BCAAA for local transportation options.
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/bouldercountycoloradoWe’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 Pennsylvania 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.
