Iowa · self-direction option
Consumer Choices Option (CCO) in Iowa
The Consumer Choices Option lets Iowa Medicaid waiver members control a set monthly budget and hire their own workers, including adult children and other relatives. Veridian Fiscal Solutions acts as the financial management service and pays the workers. Since individual CDAC ended on December 31, 2025, CCO is the main way to hire a family member directly.
Also called: CCO · Consumer Choice Option · Iowa self-directed waiver · Iowa CCO Veridian
Who do you care for?
Quick facts
- Pay
- $2,691/month (reported)
- Adult children & other relatives
- Yes
- Spouse
- Not right now
- Parent of a minor child
- Not right now
- Waitlist
- possible
Who qualifies for CCO
- Enrolled in Iowa Medicaid and in an Iowa Home and Community-Based Services (HCBS) waiver (for example the Elderly, Health and Disability, Physical Disability, Brain Injury or Intellectual Disability waiver).
- Meets the waiver's level-of-care requirement.
- Willing to act as employer, or to name someone to help manage the budget.
Who can be paid as the caregiver
- Adult children & other relatives Yes
- adult children, siblings, grandchildren and friends can be hired as CCO employees.
- Spouse Not right now
- a spouse cannot be the paid worker.
- Parent of a minor child Not right now
- parents, stepparents and guardians of a child 17 or under cannot be paid.
- Living together
- the worker may live with the member or not.
Who employs the caregiver: Self-directed. The member is the employer; Veridian Fiscal Solutions handles payroll and taxes; an optional Independent Support Broker helps with budgeting and hiring.
Spouse rules differ by program — see spouse pay in Iowa.
How much CCO pays
$2,691/month (reported). The member sets the worker's wage within a monthly individual budget built from the waiver services in the plan. Iowa does not publish a single CCO wage; third-party guides report up to about $2,691 a month (2026).
Hours and budget: The case manager or MCO turns the approved waiver services into a monthly dollar budget; the member decides how many hours and what wage to pay within it.
Compare with other Iowa programs on the Iowa caregiver pay page, or across states in pay rates by state.
Is there a waitlist?
CCO has no list of its own, but the waiver must have a slot. The Elderly Waiver had no waitlist in January 2026; most other Iowa waivers had waitlists (about 26,665 Iowans waiting in December 2025).
How to apply for CCO
- Apply for Iowa Medicaid and the right HCBS waiver through Iowa HHS (hhs.iowa.gov or 800-338-8366).
- Complete the waiver level-of-care assessment.
- Ask your case manager or managed-care organization to enroll you in CCO.
- Pick an Independent Support Broker if you want one, sign the Veridian FMS agreement, and have your worker sign the employment agreement.
- Iowa Medicaid Member Services · 1-800-338-8366 · official site
- Veridian Fiscal Solutions — CCO · not published on the HHS page · official site
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CCO questions
Can I get paid to care for my parent in Iowa?
Yes. If your parent is on an Iowa HCBS waiver and uses CCO, they can hire you, and Veridian pays you.
Can a spouse be paid under CCO?
No. Iowa does not let a spouse be the paid worker.
What happened to individual CDAC?
Iowa stopped individual Consumer Directed Attendant Care on December 31, 2025. Members had to move to CCO or an agency provider.
Who decides my worker's wage?
You do, within your monthly CCO budget. The budget must also cover employer taxes.
What is an Independent Support Broker?
A person you can choose to help you build your budget and hire workers. It is optional.
Sources: hhs.iowa.gov · hhs.iowa.gov · iowatotalcare.com · Updated 2026-10-08. Program rules change — always confirm with the program.
Where most Iowa caregivers are
Counties with the most residents aged 65 and older. The rules are the same everywhere in Iowa — pick yours for the local picture.
Across the line
States that border Iowa
Each state writes its own rules, and they differ more than people expect — a spouse who can be paid on one side of the line often cannot be on the other.