Understanding Community First Choice: A Vital Medicaid Option

Definition

Community First Choice (CFC) is a Medicaid option that empowers states to deliver home and community-based attendant services and support mechanisms to populations with disabilities, including those prone to homelessness.

Description

Enacted as part of the Affordable Care Act in 2010, Community First Choice (CFC) is a critical optional Medicaid benefit. Its central thrust is to promote inclusive community living for all, thus moving away from institutionalization. By targeting disabled individuals, it helps to maintain their independence, safeguard their well-being, and bolster their quality of life. While leveraged primarily for those suffering disabilities, it’s also a crucial vehicle to prevent homelessness among these vulnerable groups.

Objectives

• Increase the funding available to states for the purpose of community-based support services.
• Reduce the number of people with disabilities living in institutions.
• Improve the quality of life for individuals with disabilities.
• Prevent homelessness for disabled and at-risk individuals.

Mechanisms

• Federal match for State-administered programs.
• Provision of home and community-based attendant services.
• A framework for individual function and support assessment.
• Development and implementation of person-centered planning strategies.

Benefits

• People with disabilities can avoid institutionalization.
• Increased funding for states to improve and expand local programs and services.
• Development of more inclusive and accommodating communities.
• Reduction in rates of homelessness among disabled populations.

Challenges

• Ensuring widespread state participation.
• Sustaining adequate funding to ensure the durability of the program.
• Maintaining high-quality, personal care attendant services across all participating states.
• Overcoming the stigma and social bias related to disability and homelessness.

Examples

• Oregon, one of the early adopters of CFC, has seen a significant reduction in the number of disabled individuals in institutions since the launch of the program.
• Maryland has effectively used CFC to provide an all-inclusive array of disability services, ranging from helping individuals perform activities of daily living to executing health-related tasks.

Further Reading

1. Community First Choice: Option for Medicaid Community-Based Attendant Services and Supports - A Guide to Assist States in Implementation
2. Community First Choice: An Innovative Option for Medicaid Home and Community-Based Services