What you’ll learn in this guide to self-directed care in Colorado:
- What is self-directed care?
- Who qualifies for self-directed care?
- How self-directed care works in Colorado
- The difference between IHSS and CDASS care models
- Benefits of self-directed care
- The step-by-step enrollment process
- Key roles and responsibilities in consumer-directed care program
- How Entrust Health supports families with self-directed care
- Frequently asked questions about self-managed caregiving in Colorado
Community First Choice (CFC) and IHSS: The Future of Consumer-Directed Care in Colorado
Self-directed care in Colorado is being revolutionized through Community First Choice (CFC) and In-Home Support Services (IHSS), two Medicaid-funded initiatives that empower individuals and their families to take control of their own caregiving. As of July 1, 2025, IHSS will be exclusively accessed through CFC, streamlining access and expanding eligibility while reinforcing the values of choice, dignity, and independence.
These programs enable clients to direct their own care, choosing who provides it, how it’s delivered, and when. Under CFC, individuals gain access to IHSS, which offers a consumer-directed care program where trusted caregivers, often family members, can be hired and compensated to provide personal care, homemaker support, and health maintenance activities at home.
While Colorado also offers Consumer Directed Attendant Support Services (CDASS), it is the IHSS model, especially through the emerging Community First Choice (CFC) framework, that is gaining momentum for its comprehensive support, nursing oversight, and alignment with Medicaid’s self-directed care goals.
What is self-directed care?
Self-directed care, also known as consumer-directed or participant-directed care, refers to a model where individuals manage their own care services, including the selection and supervision of caregivers. It puts clients in charge, ensuring care reflects their personal needs, culture, and routine.
Through IHSS under CFC, clients develop tailored care plans in collaboration with a registered nurse and case manager and then oversee care delivery from start to finish. Consumer-directed home care packages are tailored to individual schedules, providing highly personalized and reliable in-home support.
Families interested in self-directed care will find that it allows for more consistency, especially when a loved one is cared for by someone they know and trust. It’s an empowering option for those with chronic conditions, developmental disabilities, or who simply prefer to age or recover in place.
Who is self-directed care for?
Colorado Medicaid recipients who require assistance with Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), or health maintenance tasks are eligible for CFC and IHSS. This includes:
- Children with disabilities
- Adults with chronic medical conditions
- Older adults requiring ongoing support
Self-direction for individuals with cognitive and developmental differences is a vital application of this model, providing family-directed home care that is both flexible and affirming. Those pursuing a participant-directed option benefit from a Medicaid self-directed care structure that recognizes the unique needs and strengths of each household.
How self-directed care works in Colorado
Colorado offers two key consumer-directed care programs:
Consumer-Directed Attendant Support Services (CDASS)
- Participants manage all aspects of their care independently, including hiring, supervising, and paying caregivers.
- It is best suited for those who want complete autonomy and are comfortable handling an array of administrative responsibilities.
In-Home Support Services (IHSS)
- Combines participant choice with agency support.
- Entrust Health, as your steward and strategic communicator of choice, handles payroll, background checks, nurse oversight, and compliance.
- With the transition to Community First Choice (CFC), all IHSS services, previously part of multiple waiver programs like CHCBS, CIH, and EBD, will be integrated into one streamlined system.
Families engaging with IHSS under CFC:
- Receive a nurse assessment to determine care needs
- Work with a provider agency like Entrust Health to enroll and develop a care plan
- Hire and train their chosen caregiver (often a family member)
- Manage care schedules, compliance, and reporting with agency support
While CDASS remains a viable option for certain individuals who prefer greater fiscal and administrative control, IHSS offers a guided path with built-in clinical oversight and agency-supported care management.
Benefits of self-directed care
Self-directed care through IHSS and CFC offers transformative benefits:
- Autonomy: Families choose caregivers and control how care is delivered
- Continuity: Trusted relationships improve consistency and emotional well-being
- Support: Agencies provide nursing oversight, caregiver training, and 24/7 guidance
- Accessibility: Streamlined Medicaid access and fewer bureaucratic hurdles
Consumer-directed home care is proven to enhance satisfaction, lower stress, and promote better outcomes by making care decisions more responsive to the individual.
How to enroll in a self-directed care program
Starting with self-managed home care in Colorado is easier with the right support. Here’s how to begin:
- Verify Medicaid Enrollment: Ensure you’re active with Health First Colorado.
- Initiate a CFC Functional Assessment: A nurse evaluates your needs and recommends services.
- Select IHSS: Choose it as your model for in-home, consumer-directed attendant care.
- Develop a Care Plan: Work with Entrust Health to create a personalized service outline.
- Hire a Caregiver: Often a family member or trusted friend who completes the required training.
- Start Services: Care delivery begins with full agency support and oversight.
Roles & responsibilities within consumer-directed home care
Key roles in consumer-directed care under IHSS include:
- Consumer/Participant: Leads the care plan, supervises caregivers, and tracks services.
- Caregiver: Provides daily support, logs activities, and ensures consistent care.
- Case Manager: Coordinates services and maintains compliance with Medicaid guidelines.
- Provider Agency (e.g., Entrust Health): Offers training, nursing support, payroll management, and backup care solutions.
This collaboration ensures care is responsive, accountable, and effective for families across Colorado.
Entrust Health & self-directed care services
Entrust Health is a proud partner in advancing IHSS services under Community First Choice. We offer comprehensive support for families pursuing Medicaid self-directed care, including enrollment help, nursing assessments, and caregiver resources.
Our services include:
- Medicaid application and CFC navigation
- Registered nurse evaluations and care plan development
- Family caregiver training and administrative onboarding
- Support for questions and emergencies
- Complete payroll and EVV compliance management
Entrust Health currently serves families across the 15 counties that make up Colorado’s Front Range, also known as the I-25 corridor. We are deeply committed to these communities and provide responsive, regionally focused care support.
Have questions, or ready to start? Contact us at info@entrust.health or call (719) 501-1286.
FAQs About Our Self-Directed Service Model
Is Entrust Health an approved IHSS provider through Health First Colorado (Medicaid)?
Yes, we are fully certified and specialize in IHSS under the CFC model.
Do you support consumer-directed care?
Yes. We help families implement self-directed solutions with step-by-step support.
Can Entrust Health assist with enrollment into IHSS or a transition from traditional home care?
Absolutely. We guide families through assessments, paperwork, and care coordination.
Is a nurse provided to complete the required IHSS assessment and care plan?
Yes. Our registered nurses handle all clinical evaluations and ensure personalized plans.
What training and support does Entrust Health provide for family caregivers?
From onboarding to ongoing coaching, we ensure caregivers feel prepared and supported.
Does Entrust Health offer backup or replacement care if my caregiver is unavailable?
Yes. Our team is available to help arrange interim support.
Is there a dedicated point of contact for questions?
Yes. Each client is paired with a care coordinator for consistent communication.
What services are covered through IHSS under Entrust Health’s care model?
Services include personal care, homemaker support, and health maintenance tasks.
Does Entrust Health manage caregiver payroll, timesheets, and Electronic Visit Verification (EVV)?
Yes. We handle all the administrative aspects so families can focus on caregiving.
Does Entrust Health serve clients on CHCBS, CIH, and EBD waivers?
Yes. These services are now integrated under CFC, ensuring broader and simpler access.
How soon can services begin after approval?
Typically, within days of completing the enrollment and assessment steps.
Does Entrust Health serve specific counties or regions in Colorado?
Yes. Entrust Health serves families in the 15 counties of the Front Range, covering the I-25 corridor.
Let Entrust Help You Take the Lead on Care that Fits Your Loved One’s Needs
Contact us today at info@entrust.health or give us a call at (719) 501-1286 to speak with someone who understands your journey. We’re here to listen, help.