CFC (Community First Choice) Personal Assistant Services + Habilitation

Texas implemented the Community First Choice program June 1, 2015.

What’s Community First Choice?

• The “Community First Choice Option”  allows States to provide home and community-based attendant services and supports to eligible Medicaid recipients under their State Plan.
  • CFC is a Medicaid State Plan entitlement service and must be provided to those individuals that meet the eligibility criteria.
  • This State plan option was established under the Affordable Care Act of 2010. (Source: Medicaid.gov)
  • This option provides states with a 6% increase in federal matching funds for Medicaid for these services. (Source: TxHHSC)

Eligibility
To be eligible for CFC services, an individual must:

1. Be a child or an adult who is receiving Medicaid
2. Require an institutional level of care (like required for CLASS, MDCP, or HCS) documenting that they would qualify for one of these:
   • A nursing facility – based on physical needs
   • An institution of mental disease – based on mental health needs
   • An intermediate care facility for individuals with an intellectual disability or related condition – based on intellectual and developmental needs

Why is this good news!?!

Individuals receiving Medicaid will be eligible to request habilitation (attendant care) through Community First Choice.

• If the Medicaid recipient has traditional Medicaid, they will call the PCS Intake Line (1-888-276-0702) to request an assessment.
• If the Medicaid recipient has STAR or STAR+Plus Medicaid, they will call their Managed Care Organization (MCO) to request Community First Choice.
  • If their needs are due to a physical or medical impairment, the MCO will complete the level of care assessment.
  • If their needs are based on IDD (Intellectual & Developmental Disabilities) or mental illness, the LIDDA will complete the LON.
    • Many times the MCO ignores the request for CFC if the LIDDA has not uploaded a level of need to the Medicaid computer. I highly recommend also contacting the LIDDA for your county and also making the CFC request. Follow this link and enter your county to find the LIDDA for your area.