Colorado Comparison Guide
IHSS vs. CDASS in Colorado: Which Program Fits Your Family?
Both In-Home Support Services (IHSS) and Consumer Directed Attendant Support Services (CDASS) let Colorado families get paid in-home care through Health First Colorado — but they work very differently. Here's a clear, side-by-side breakdown.
Quick answer
Choose IHSS if you want a home care agency to handle hiring, training, supervision, and payroll while still allowing a family member to be paid. Choose CDASS if you want to act as the employer, set the pay rate, and have maximum flexibility over who provides care and when.
What is IHSS?
In-Home Support Services (IHSS) is an agency-directed Medicaid service. A Health First Colorado approved home care agency — like Aventra Care — employs the caregiver, including a family member if that's what the client prefers. The agency handles recruiting, training, scheduling, supervision, payroll, taxes, and workers' compensation. The client retains the ability to direct their own care plan within the agency framework.
What is CDASS?
Consumer Directed Attendant Support Services (CDASS) is a client-directed Medicaid option. The client (or an Authorized Representative) becomes the employer: they recruit, hire, train, schedule, and supervise their own attendants. A Financial Management Services (FMS) vendor processes payroll, taxes, and workers' comp. CDASS provides the most control but also the most responsibility.
Side-by-side comparison
| Factor | IHSS | CDASS |
|---|---|---|
| Who employs the caregiver | The home care agency (e.g., Aventra Care). | The client (or their Authorized Representative). |
| Agency involvement | High — recruiting, training, scheduling, supervision, and quality oversight. | Low — the client directs care; an FMS vendor handles payroll only. |
| Payroll, taxes, workers' comp | Handled entirely by the agency. | Handled by a Financial Management Services (FMS) vendor on the client's behalf. |
| Training & certification | Agency provides PCP/HMK training and ongoing competency checks. | Client decides what training the attendant needs. |
| Hiring family members | Allowed — family member is hired as an agency employee. | Allowed — family member is hired directly by the client. |
| Scheduling flexibility | Agency coordinates schedules and backup coverage. | Client builds the schedule and arranges backup themselves. |
| Pay rate control | Set by the agency within Medicaid limits. | Client sets the rate within a monthly allocation. |
| Best for families who want | Hands-off support with professional oversight. | Maximum control over who provides care and how. |
When IHSS is the better fit
You want someone else to handle hiring, training, supervision, and payroll.
A family member wants to be paid but isn't comfortable being the legal employer.
You need reliable backup coverage if the regular caregiver is sick or unavailable.
You value built-in clinical oversight from an agency RN.
When CDASS is the better fit
You (or your Authorized Representative) are ready to be the employer and manage caregivers.
You want to set the pay rate within your monthly allocation.
You already have specific people in mind to hire and don't need agency recruiting.
You want maximum scheduling flexibility and full control of who enters your home.
How Aventra Care supports both paths
Aventra Care is a Health First Colorado approved home care agency. We deliver IHSS directly, employ family caregivers, and help families weigh whether IHSS or CDASS better fits their situation. If CDASS turns out to be the right choice, we'll point you toward the next steps with your case manager and an FMS vendor.
If you'd like a free, no-pressure conversation to figure out which program is right for your family, we're here.
Not sure which program is right for you?
Talk with a care advisor at Aventra Care. We'll review your family's situation and explain whether IHSS, CDASS, or a different waiver service makes the most sense.
Frequently asked questions
Can I hire a family member under both IHSS and CDASS?
Yes. Both programs allow family caregivers (with some restrictions on spouses and parents of minor children). IHSS hires them as agency employees; CDASS hires them as the client's own employees.
Which program pays more in Colorado?
CDASS often produces a higher hourly take-home because the client controls the rate within a monthly budget. IHSS rates are set by the agency but include training, supervision, and payroll handled for you.
Do I have to manage payroll and taxes with CDASS?
CDASS uses a Financial Management Services (FMS) vendor that handles payroll, taxes, and workers' compensation. The client still acts as the employer of record.
What if I don't want to manage caregivers myself?
Choose IHSS. The agency recruits, trains, schedules, supervises, and pays the caregiver — your family just receives care.
Can I switch from CDASS to IHSS (or back) later?
Yes. You can change service delivery options through your case manager if your needs change. Aventra Care can support you whichever model you choose.
Related reading: How to become a paid family caregiver in Colorado.