IHSS is a statewide program administered by the Department of Health Care Policy and Financing (Colorado’s Medicaid Program.) It provides support for families to direct and manage the long-term care services they need to live in the home and community.

What Services Does IHSS Provide?

Services include homemaking services, such as meal preparation, laundry, taking out the garbage, and cleaning. They also include personal care services and non-medical care: bathing, dressing, grooming, and feeding. Health Maintenance (Skilled Care Tasks) are included to assist with health-related activities normally performed by a CNA, LPN, or RN. The Nurse Practice Act has been waived so family members can perform these tasks with agency oversight.

IHSS is a service delivery option to help you get the additional care your family members may need. It is an option provided in addition to regular Medicaid care by doctors and physicians. If your family member’s health conditions prove the need for additional care like personal care, homemaker services, and health maintenance, a series of Medicaid waivers can help pay you for these services.

What Care Services Are Provided?

IHSS is a client-directed care program. The client chooses their IHSS approved agency (like PASCO), and the agency will hire and train your loved one to provide the services your family needs. The agency will also provide all administrative functions, like authorizations, HR support, billing, and payroll, offer around-the-clock supports to clients, and agency nurses are regularly available for assistance and to conduct routine visits to confirm that the plan of care and environment remain appropriate.

Who Receives Care?

Those who are part of Colorado’s Health First Medicaid’s specific Home and Community-Based Services (HCBS) waivers. This is a family member who may have functional limitations or is experiencing a disability, long-term illness, or spinal cord (or similar) injury who needs assistance with activities of daily living outside of what is provided by a doctor or physician.

Who Pays for the Care?

Any care that is outside of your regular Health First Colorado program is provided under the IHSS program.

The following types of waivers allow In-Home Support Services (IHSS):

  • Elderly, Blind & Disabled (EBD)
  • Spinal Cord Injury (SCI) – Adults
  • Home and Community-Based Services (HCBS) – Children

IHSS is funded through specific HCBS waivers and those funds are sent to the agency to coordinate the delivery of care. The agency then pays an hourly rate to the IHSS employee based on discipline (Health Maintenance Attendant (HMA), Relative Personal Care (R/PC), and Homemaker (HMK) Services.

What this means is that the approved agency helps to coordinate the care, and Health First Colorado (Medicaid) pays that agency for the services provided. This is similar to the way the Family CNA program works where the family caregiver is paid to provide services.


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