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FreedomCare helps Douglas 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 Highlands Ranch, a spouse in Castle Rock, or a family member with a disability in Parker or Lone Tree, FreedomCare can help you find out whether Colorado Medicaid will pay you for that care. Even in higher-income counties like Douglas, Medicaid plays a real role in long-term care, and Community First Choice (CFC) opened up new pathways when it launched on July 1, 2025. This page walks through how it all works locally and what your next step looks like.
Douglas County sits between Denver and Colorado Springs along the I-25 corridor, covering 843 square miles from the foothills to the eastern plains. About 377,000 people live here, mostly in Highlands Ranch, Castle Rock, Parker, Lone Tree, Castle Pines, and Roxborough Park. Douglas has the highest median household income of any county in Colorado and ranks among the highest in the country. That income picture creates a particular kind of confusion when families start looking at Medicaid, because eligibility for an older parent or adult child is set by their own income, not the household's.
Douglas has a relatively small Medicaid population as a share of its residents. As of December 2025, about 30,186 Douglas County residents are enrolled in Health First Colorado, roughly 8 percent of the county. That percentage is well below the metro Denver average, but the absolute number is meaningful, and the older-adult population here is growing fast. By 2030, projections from local aging organizations suggest one in four Douglas County residents will be 60 or older.
For families in Castle Rock, Highlands Ranch, and Parker, the local situation is usually this: a parent has Medicare and possibly supplemental insurance, but Medicare does not cover long-term custodial care. As needs grow, families start looking at private pay for home care (which runs into the thousands per month), or assisted living (which runs higher still), or Medicaid. CFC is the path that lets a family member become the paid caregiver while the parent stays at home.
Home care in Douglas County tends to follow one of three patterns: an agency-delivered model where a home care provider sends out a caregiver, consumer-directed care through CDASS where the member acts as their own employer, or self-directed care with IHSS agency support. FreedomCare operates as an IHSS agency in Colorado. We work with Douglas County families who want a relative or trusted person to be the paid caregiver while keeping a licensed agency in the loop for payroll 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 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:
The Medicaid conversation in Douglas County often starts with a misconception. Adult children look at their own income or their parents' lifetime earnings and assume Medicaid is out of reach. That is often not the case. An older parent's Medicaid eligibility is based on their income and assets, not the household around them. Spend-down rules, spousal impoverishment protections, and disability-based pathways can all change the math. We can help you think through what applies to your situation before you make assumptions.
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 Douglas 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 Douglas 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 Douglas 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. Sky Ridge Medical Center and Castle Rock Adventist Hospital discharge planners can sometimes accelerate assessment timing when a member is leaving the hospital with a new care need.
Douglas County Human Services handles Medicaid applications and renewals for county residents. You can apply in person at offices in Castle Rock, Highlands Ranch, or Parker, online through Colorado PEAK, or by phone. After enrollment, you contact a Case Management Agency to begin the CFC assessment.
Possibly, yes. Medicaid eligibility for an older parent applying on their own is based on their income and assets, not yours. Many Douglas County families assume their parents will not qualify because of where they live or the family's broader financial picture. That is not how it works. If a parent has a fixed retirement income below the Medicaid limit and assets within the allowable range, they may qualify regardless of your household. We can talk through specifics with you.
If you are caring for a family member in Douglas 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 Douglas County along with Adams, Arapahoe, Broomfield, Clear Creek, Denver, 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.
drcog.org/programs/area-agency-aging-aaaThe county funds local nonprofits that provide transportation, chore, homemaker, and personal care services for older adults. Douglas County Resource Navigation connects seniors and people with disabilities to free information and referrals. Call 303-660-7460.
douglasco.gov/.../senior-services/A nonprofit volunteer network that helps Douglas County older adults stay independent. Services include companionship visits, help around the house, and transportation to medical appointments. Located at 104 Fourth Street, Castle Rock. Call 303-814-4300.
agingresourcesdougco.orgThe 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.gov/cfcFree civil legal aid for low-income Douglas County residents. Call 303-837-1313.
coloradolegalservices.org/public-benefits/medicaid-appeals/Paratransit service for residents who cannot use regular bus or rail because of a disability. Covers most of urbanized Douglas County. Some rural areas rely on local nonprofit transportation, which Douglas County Resource Navigation can help connect.
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/fact/table/douglascountycoloradoWe’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.
