✴️ Community First Choice Option
✴️ This is a Priority Project for the Office of Community Living
Community First Choice (CFC), also known as 1915(k), is an optional Medicaid program that allows states to offer select home and community based attendant services and supports to eligible members on the State Plan, expanding these long-term care services to more Health First Colorado (Colorado's Medicaid Program) members.
Promoting self-direction, relocation out of institutions, and person-centered practices are significant goals of CFC. Members will have the option to self-direct their attendant care services or to receive services through an agency. CFC gives members access to service delivery models that allow them to control their own budget, select and dismiss their attendants, and provide training for the people who provide their care. By expanding these options, members will experience greater choice and control over how they receive services.
Furthermore, the CFC option provides a 6 percentage point increase in Federal matching payments to states for CFC service expenditures. With the authority from Senate Bill 23-289, Colorado is currently working to implement CFC by July 1, 2025.
The Centers for Medicare and Medicaid Services (CMS) approved the CFC State Plan Amendment in December 2024.
Who Qualifies?
CFC is not a unique Health First Colorado eligibility group. You must meet financial and program requirements to receive Community First Choice services. You must be willing to receive services in your home or community setting rather than an institutional facility.
Level of Care Requirement
- You must meet an institutional level of care:
- An institutional level of care refers to an individual who has needs that require services in their home and community to keep them from long-term care placement in a nursing home, hospital, intermediate care facility for individuals with intellectual disabilities, or an inpatient mental health facility. Institutional level of care is determined by the state prescribed level of care eligibility assessment.
Eligibility Group
- You may qualify for CFC if you are:
Eligible for Health First Colorado (Colorado’s Medicaid program) under the State Plan and meet an institutional level of care requirement,
OR
- Are enrolled in a Home and Community-Based Services (HCBS) waiver and receive at least one waiver service per month.
Financial Requirements
- You must meet the financial eligibility requirements for full Medicaid benefits through Health First Colorado.
Service delivery options and services under CFC
- Service Delivery Options: Members can choose to self-direct Personal Care, Homemaker, and/or Health Maintenance Activities through In-Home Support Services (IHSS) or Consumer Directed Attendant Support Services (CDASS). Alternatively, members can access Personal Care and Homemaker services through an agency.
- Services:
- Health Maintenance Activities
- Home Delivered Meals
- Homemaker - Includes AME
- Medication Reminder
- Personal Care (Providers must have a Class A or Class B License, view Policy Memo PM 23-008) - Includes the task Acquisition, Maintenance, and Enhancement of Skills (AME)
- Personal Emergency Response Systems
- Remote Supports
- Transition Setup
On July 1, 2025, these services moved from the Home and Community Based Services (HCBS) Waivers into CFC. Current waiver members are able to access the above CFC services and any other needed services through their waiver until their next Continued Stay Review (CSR) during the transition year from July 1, 2025 through June 30, 2026. At their next CSR, members will begin receiving the above services through CFC and any remaining needed services through their waiver, as long as they remain eligible and continue to utilize at least one waiver service per month.
CFC does not preclude members from utilizing services across other HCBS and State Plan authorities, including 1915(c) waivers, as long as there is no duplication of those services.
Waiver-based access to the transitioned CFC services will end on June 30, 2026. After that date, these services will only be available through CFC.
- View the HCBS Waivers and CFC Comparison charts for a side-by-side comparison of services between each HCBS waiver and CFC.
- View the CFC Duplication of Service Chart to understand what services can and cannot be used with CFC.
What is the timeline for the CFC transition year?
- July 1, 2025: CFC is active and available to eligible members
- July 2025 through 2026: Current waiver members transition to CFC at the time of their Continued Stay Review
- Non-waiver members and new members can begin accessing CFC during this transition year by undergoing an assessment with their local Case Management Agency
- Fall 2026 through January 2027:
- Complete HCBS Waiver actions with the Centers for Medicare and Medicaid Services to remove CFC services from the waivers
- Submit Rule and Regulations to remove CFC services from the HCBS Waivers
Contact Us
If you have more extensive feedback or questions, email hcpf_cfc@state.co.us. If you have limited access to the internet, call Maddie Quartaro at 303-866-2354 for assistance.