Medicaid Members Can Remain at Home with CFC
Community First Choice (CFC), administered by the Department of Social Services (DSS), is offered to active Medicaid members. This benefit allows individuals at an institutional level of care to receive services and supports in their home.
To be eligible for Community First Choice (CFC), individuals must:
- Be an active Medicaid member
- Be able to self-direct services. This means that the participant or a representative has decision-making authority over how financial assistance is spent and the authority to recruit, hire, train and supervise the individuals who furnish their services.
- Meet the DSS Level of Care requirement which means that without the services the individual would otherwise receive services in an institutional setting, such as a nursing home
Individuals receiving benefits from a Medicaid Waiver using Personal Care Assistance services will automatically be enrolled in CFC.
Applicants are assessed to determine a level of need and given a budget. The budget is based on the person’s need for assistance with Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), and health-related tasks. The budget provides individuals with the necessary funding for services to help them achieve their goals.
Individuals who cannot afford the cost of care, but are over Medicaid’s limits may still qualify. The state has a program that evaluates an individual’s care costs and their income. If it is calculated that the person cannot meet their care costs, they can qualify for Medicaid by spending-down their income over the limit on their medically-necessary care costs.
Types of services and supports that can be used for Community First Choice (CFC)
CFC offers a variety of services and supports to help individuals meet their goals and to provide hands-on care and supervision in their home and community.
Educational services will be available to help increase the individual’s independence and manage their in-home staff. Participants can use Medicaid funds (with some limitations)–with ADLs, IADLs or health-related tasks–in the way that they deem best meets their needs.
Available services are listed below:
- Workers’ Compensation
- Home Delivered Meals
- Support and Planning Coach
- Assistive Technology
- Environmental Modifications
- Transitional Services
Individuals may choose to allocate funds to create a hospice approach and team if needed.
For additional information on the CFC program please download this brochure.