The "Community First Choice Option" allows States to provide home and community-based attendant services and supports to eligible Medicaid enrollees under their State Plan. This State plan option was established under the Affordable Care Act of 2010.
This option became available on October 1, 2011 and provides a 6 percentage point increase in Federal matching payments to States for service expenditures related to this option. The final regulation (PDF, 511.17 KB) for the Community First Choice State Plan Option was published in the May 7, 2012 Federal Register. The final regulation (PDF, 721.45 KB) defining the home and community setting criteria for the Community First Choice State Plan Option was published in the January 16, 2014 Federal Register. As required by law, CMS published the Community First Choice: Interim Report to Congress (PDF, 141.62 KB). This report summarizes interim findings on the CFC option. Interim findings include the status of states' submissions of State Plan Amendments for CFC as well as preliminary findings on the implementation and provision of services under CFC. CMS has completed and published the Community First Choice: Final Report to Congress (PDF, 2.22 MB). The report describes findings in four states (California, Montana, Maryland, and Oregon) that have implemented the CFC benefit as of December 2014, and summarizes the status of the CFC benefit in those states as of March 15, 2015. Findings include the status of states’ submissions of CFC State Plan Amendments, status of benefit implementation, provision of services, and where possible, outcomes under CFC.