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What is IHSS vs. a CNA program?

Which care option is right for your family member experiencing a disability or long-term illness?

If you have a family member that is in need of in-home care outside of the regular medical care provided by a doctor or physician, you may be eligible for CNA or IHSS services provided (and paid for) by the state of Colorado. Depending on your case, your family member’s needs, and your qualification for Health First Colorado Medicaid options, you can find the right options for providing the best care your family member may need. PASCO is here to help navigate.

What is IHSS?

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

IHSS is an available option under the following Home and Community-Based Sevices (HCBS) waivers:

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 have the ability to 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.

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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 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.

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.

hair brush

Personal Care


Homemaking Services*

Health Maintenance

Any type of care to help the family member experiencing a disability to maintain a normal day-to-day life.  Depending on the severity of need, homemaker services range from basic cooking and cleaning to regular in-home tasks (like laundry).  Personal care services include things like help with bathing, changing and getting around the house.  Health maintenance services include medication or medical device administration and usage or help using the bathroom.

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)
  • Complementary and Integrative Health Waiver (CIH) (Formerly known as 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), 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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Next Steps

If you’ve found yourself in the situation where you need assistance outside of regular medical care, contact PASCO today. We can help you navigate the complicated system to find the right type of program that you qualify for and then help you find the services you need to take care of your family in the best way possible.

Family CNA Program

If you are already providing a bulk of the medical and in-home care for your disabled or sick family member, becoming a CNA (Certified Nurse’s Assistant) might be the most beneficial solution for you and your individual situation. A CNA certification differs from the IHSS program because you will attend school, learn a fixed set of skilled tasks, and gain a transferable skill set and possible career path while caring for your loved one.

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Who Receives Care?

As in IHSS, any person (family member or child) who needs extra assistance outside of regular medical care provided by doctor or physician and is on a Health First Colorado Medicaid could be eligible for CNA care. This can be someone who was born with or has an injury-related disability or someone with a long-term illness.

Who Provides Care?

You – after you become trained and certified in the state of Colorado as a CNA.  When you become a CNA, you provide skilled care for your family member.  You are most likely already providing these services as a basic part of living with and loving a person experiencing a disability or long-term illness. CNAs are employed by an agency (like PASCO) , even though they work within their own home and with their own family members.

What Care Services Are Provided?

CNAs focus on skilled services where a level of maximum assistance is required. like ambulation for individuals who may not be able to bear weight, modified texture diets or G-tube feeds, skin care needs with open wounds, toileting, use of durable medical equipment, or if the individual is unable to direct their own care.

Who Pays for the Care?

The employing agency (like PASCO) bills Health First Colorado (Medicaid)  for the services rendered and pays the CNA an hourly rate as an employee of that agency.  This is one way you can earn an income for provided care to your loved one with compassionate agency support and oversight.

Next Steps

If you are interested in becoming a CNA so you can be paid to take care of your family member, contact PASCO today.  You will need to enroll in CNA school (which is reimbursed to you here at PASCO) and then pass a written and clinical exam. PASCO can help you find the right training program and help with exam materials.  Upon certification, you can become an employee of PASCO so that you can be paid to take care of your family members.



Who Needs Care?Child
Someone w/ a Disability
Someone w/ a Long-Term Illness
Who Provides the Care?Me or another Family Member
Someone else or a team provided by PASCO
What Care Services are Provided? Personal Care (Prompting or minimal assistance with activities of daily living)
Homemaker Services
Health Maintenance (Activities of daily living requiring skilled CNA or nursing level of care)
Who Pays for the Care Services?Medicaid

If you have a family member or child with a long-term illness or disability, contact PASCO today. We can help you identify what programs you qualify for so you can provide the best care for your loved ones.

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