Cdass Self-direction Colorado Jun 2026

Colorado’s Consumer-Directed Attendant Support Services (CDASS) program represents a paradigm shift in long-term services and supports (LTSS). Established under the state’s Medicaid Home and Community-Based Services (HCBS) waiver, CDASS allows eligible individuals with disabilities and chronic conditions to recruit, train, schedule, supervise, and dismiss their own personal care attendants. This paper examines the legislative origins of CDASS, its operational framework, fiduciary intermediary roles, participant rights and responsibilities, and comparative outcomes relative to traditional agency-directed care. Drawing on program data, state reports, and participant surveys, the analysis highlights increased consumer satisfaction, reduced unmet care needs, and cost neutrality or modest savings. However, challenges persist, including administrative burden on participants, workforce shortages, and access for individuals with cognitive or communication disabilities. The paper concludes with policy recommendations to expand access, strengthen backup systems, and integrate CDASS principles into broader LTSS reform.