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What is IHSS in Colorado?

In Colorado, In-Home Support Services (IHSS) represents self-directed care. The person receiving services or their authorized representative is the right person to make choices about how their care is delivered.


IHSS is a participant-directed service delivery option, that empowers the recipient of services to direct their own care with support from an agency.

David BolinPASCO Advocacy Leader

Colorado’s In-Home Support Services (IHSS)

In Colorado, IHSS represents self-directed care. At PASCO, we believe the individual receiving services is the best person to make decisions regarding their own care. That is why advocates such as David Bolin, PASCO Advocacy Leader, have worked hard and fought to allow for In-Home Support Services, or IHSS, to be expanded as a service provided by agencies such as PASCO. David advocated for this service in Colorado, because “IHSS is a participant-directed service delivery option, that empowers the recipient of services to direct their own care with support from an agency.”

As an agency that administers IHSS services, we provide resources, support, and individual advocacy efforts for individuals and families. Agency support allows for a person with a disability to become more independent by taking advantage of the core services of independent living, which include Personal Care, Health Maintenance, and Homemaker Services. These specific services allow individuals receiving care to live more independently in their homes and community. 

With IHSS, the Nurse Practice Act is waived. This means that skilled tasks that are normally only allowed to be performed by a licensed caregiver (Nurse or CNA) can be provided by the caregiver without the licensure or credentials typically required. Instead, the caregivers’ skills are deemed competent and verified by a Registered Nurse (RN) of the IHSS Agency and these skilled tasks can be completed in the home or in the community. This provides a lower barrier of entry as a caregiver.

Personal Care Services

bathing, dressing, eating, and hygiene

Homemaking Services

housekeeping, meal prep, and laundry

Health Maintenance Services

medication administration, transferring and positioning, and specialized feeding

How do I receive IHSS Services?

Each service provided depends entirely on the needs of the individual requiring support. In order to access these services, you can start with your local Single Entry Point or Private Case Management agency, which will get you in touch with a case manager to assess those specific needs. What’s essential about these services is the idea that the participant is directing their care and the caregiver is trained by the participant to provide those individual needs.

Our team of advocates are largely credited for the design and expansion of IHSS services. They participated in sit-ins, protests, meetings, and more in order to get the funding passed through Medicaid. Their advocacy efforts are now focused on expanding these services to other waivers so that even more individuals can benefit. Currently, IHSS services are provided under the Elderly, Blind, and Disabled (EBD), Complementary and Integrative Health (CIH) (formerly Spinal Cord Injury (SCI)), and Children’s Home and Community-Based Services (CHCBS) waivers; we hope to see this one day as a benefit to anyone who qualifies for long-term services with Medicaid.


Participant direction was the key to expansion David Bolin helped design for IHSS in Colorado. What was his inspiration for designing it? The recipients. “Whether it be from children’s services to adult services, or from a nursing home into the community, the goal for me has always been: let the person who knows what they need, direct their services. They know their disability better than anybody – It’s all about the recipient of services.”