8,000+
FreedomCare helps Arapahoe 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 Aurora, a spouse in Centennial, or an adult child with a disability in Littleton or Englewood, FreedomCare can help you figure out whether Colorado Medicaid will pay you for that care. The new Community First Choice (CFC) program, launched July 1, 2025, makes it easier for Arapahoe County families to receive long-term care at home, often from a relative or trusted person, instead of moving someone into a facility.
Arapahoe County is the third most populous county in Colorado, home to about 667,000 people spread across Aurora, Centennial, Littleton, Englewood, Greenwood Village, Sheridan, Cherry Hills Village, Foxfield, Glendale, and the unincorporated areas east toward the plains. Roughly 13 percent of residents are 65 or older, and the county's older population is growing faster than its working-age population. Demand for home-based care is real, and FreedomCare works with families across the county.
Arapahoe County has one of the largest Medicaid populations in Colorado. As of December 2025, about 147,000 Arapahoe County residents are enrolled in Health First Colorado, the second-highest county enrollment in the state. Roughly 22 percent of all Arapahoe County residents are on Medicaid at any given point, which means CFC enrollment volume here is steady and the Case Management Agencies are experienced.
For families in Aurora, where a large share of the county's Medicaid population lives, the local hospital system is anchored by the University of Colorado Anschutz Medical Campus and Children's Hospital Colorado. Many Arapahoe County families come into the CFC conversation right after a hospitalization or a new diagnosis at Anschutz, when discharge planning forces a decision about who is going to provide ongoing care at home. That timing is hard, and most families have not had a chance to research their options. We can talk through it.
Home care in Arapahoe County tends to follow one of three patterns: an agency-delivered model, consumer-directed care through CDASS, or self-directed care with IHSS agency support. FreedomCare operates as an IHSS agency in Colorado, which is the option that fits families who want a relative or close friend to be the caregiver while keeping the licensed-agency safety net 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.
Here are the numbers that drive demand for home care across the county.
The healthcare infrastructure in Arapahoe County is unusually concentrated. Anschutz Medical Campus, Children's Hospital Colorado, and the Rocky Mountain Regional VA Medical Center all sit in the Aurora corridor, which means many families travel into Aurora for specialty care even if they live elsewhere in the metro region. After discharge, those same families often look for home-based support, and that is where CFC and IHSS come in.
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 Arapahoe 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 Arapahoe 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 Arapahoe 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 after the assessment, assuming Medicaid enrollment is already in place. Hospital discharge planners can sometimes accelerate the assessment if the member is being released home with a new care need.
Arapahoe County Department of Human Services handles applications. You can apply in person at offices in Aurora, Centennial, Littleton, or Englewood, online through Colorado PEAK, by phone at 303-636-1170, or by mail. After enrollment, you contact a Case Management Agency to begin the CFC eligibility and assessment process.
Yes. We work with families across the county, including Aurora, Centennial, Littleton, Englewood, Greenwood Village, Sheridan, and the unincorporated areas. Most enrollment and caregiver onboarding can be done by phone, video, and email, so location within the county is rarely a barrier.
If you are caring for a family member in Arapahoe 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.
If you are not sure where to begin, start with one of the following.
Serves Arapahoe County along with Adams, Broomfield, Clear Creek, Denver, Douglas, Gilpin, and Jefferson. 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.
drcog.org/area-agency-agingHandles Medicaid applications, renewals, and other benefits. Main number: 303-636-1170. Offices in Aurora, Centennial, Littleton, and Englewood. You can also apply through Colorado PEAK.
arapahoeco.gov/your_county/county_departments/human_services/index.phpThe state Medicaid program. Check enrollment, apply, or update information. 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/programs-parents-and-caretakersFree civil legal aid for low-income residents of Arapahoe County. Call 303-837-1313.
coloradolegalservices.org/public-benefits/medicaid-appeals/Paratransit service for residents who cannot use regular bus or rail due to disability. Covers most of Arapahoe County.
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/arapahoecountycoloradoWe’ll help you find the right program for your family.
Why Families Choose FreedomCare
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Why Families Choose FreedomCare
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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.
