Community First Choice (CFC)
Guaranteed Access to Home Care. No Waiver Required.
Community First Choice (CFC) is Colorado’s new Medicaid benefit that allows you to access paid family caregiving immediately—without the waitlists or strict enrollment caps of traditional waivers.
What is Community First Choice?
A New Era for Colorado Families
Starting July 1, 2025, Colorado changed the rules for home care. Community First Choice (CFC) is a new Medicaid State Plan benefit designed to help older adults and people with disabilities remain in their homes.
Unlike the “Waiver” system (like EBD or DD), CFC is an Entitlement Benefit. This means if you meet the criteria, you must be served. There are no waiting lists for these specific services.
How it Works
From “Helping Out” to “Hired”
We have simplified the Community First Choice process into three easy steps:
The Match
The Medicaid member selects you (their trusted family member or friend) as their preferred caregiver.
The Onboarding
We hire you as an official Caregivers First Choice employee. We handle your background check, training, and setup.
The Care
You continue caring for your loved one in their home, but now you receive a paycheck for the personal care, homemaking, and health tasks you perform.
Core Services Covered
Under the Community First Choice (CFC) program, you are compensated for the essential tasks that keep your loved one safe, healthy, and comfortable at home. We categorize these services into three main levels of care:
Homemaker Services
Creating a safe, clean, and organized living environment. As a caregiver, you manage the household to ensure your loved one can live with dignity. You can be paid for:
- Home Hygiene: Floor care (mopping/vacuuming), dusting, trash removal, and cleaning essential areas like the bathroom and kitchen.
- Daily Living Support: Bed making, changing linens, and handling laundry.
- Nutritional Support: Menu planning, grocery shopping, meal preparation, and dishwashing.
- Life Management: Appointment management and money management assistance.
Personal Care
Hands-on assistance with Activities of Daily Living (ADLs). These are the essential physical tasks required to help your loved one get through their day safely.
- Hygiene & Grooming: Bathing, dressing, hair care, skin care (preventative), and shaving (electric).
- Mobility: Transfers, walking assistance, and positioning.
- Bladder & Bowel Assistance: Changing incontinence pads, emptying catheter/ostomy bags, and assistance with toileting.
- Respiratory Assistance: Cleaning/changing oxygen tubing and filling water reservoirs.
- Eating: Assistance with eating by mouth using common utensils.
Health Maintenance Activities (HMA)
Skilled care tasks delegated to you. HMA includes higher-level health tasks that typically require a nurse, but which you can be trained to perform for your loved one. This allows family members to handle complex medical needs at home.
- Skilled Bladder & Bowel: Catheter insertion/irrigation, bowel programs (digital stimulation), and enemas.
- Skilled Respiratory: Suctioning, nebulizer treatments, and ventilator care.
- Skilled Skin Care: Wound care for open wounds and dressing changes.
- Medical Management: Medication administration (not just reminders) and management of medical/exercise regimens.
Yes, Children Are Eligible Too
Many families assume home care benefits are only for seniors. This is false. Community First Choice is a vital resource for Colorado children with disabilities and complex medical needs.
If your child is eligible for Medicaid and meets an Institutional Level of Care (such as Hospital or Intermediate Care Facility levels), they are entitled to CFC services.
The “Extraordinary Care” Standard
For children, eligibility hinges on one key concept: Extraordinary Care. According to state rules, Medicaid does not pay for typical parental responsibilities (like bathing an infant). However, it does pay for care that “exceeds the range of care a family member would ordinarily perform” for a child of the same age.
- Example: Bathing a 2-year-old is typical parental care. Bathing a 12-year-old is considered Extraordinary Care and is eligible for paid support.
Can Parents Be Paid?
Yes. Under CFC, parents (as Legally Responsible Persons) can be hired as attendants to provide this “Extraordinary Care,” provided they meet employment criteria.
Everything You Need to Know About CFC
Navigating Medicaid rules is complicated. We made it simple. Select a topic below to learn the specific rules for 2026.
2026 Family Caregiver Pay Rates
We don’t hide our rates. See our transparent “Tiered Wage Ladder” for 2026 and learn how experienced family caregivers can earn up to $24.20/hour.
Maximizing Your Authorized Hours
New “Soft Caps” and the “16-hour rule” can limit your care. Learn how to build a compliant Care Team to ensure you have coverage around the clock.
Can I Hire My Spouse?
Yes. The old rules regarding spousal pay have changed. Learn about the new “Soft Caps” and how your spouse can be paid for the critical care they provide.
CDASS vs. Agency
Think CDASS is the only way to hire family? Think again. Our Agency Model allows you to hire loved ones without becoming an employer or handling tax audits.
Why Switch to Community First Choice?
| Feature | Community First Choice (CFC) | Traditional HCBS Waivers |
|---|---|---|
| Access | Guaranteed. No waitlists for eligible members. | Conditional. Enrollment caps may apply. |
| Eligibility | Broader. Needs Medicaid + Institutional Level of Care. No specific diagnosis required. | Targeted. Restricted to specific populations (e.g., Brain Injury, Elderly). |
| Family Care | Allowed. Spouses & family members can be hired. | Allowed. Rules vary by waiver. |
| Cost | $0. No cost to the member. | $0. No cost to the member. |
Does My Loved One Qualify?
To hire a family caregiver through this program, the Medicaid member typically needs:
- Full Medicaid Eligibility (Health First Colorado). – The individual receiving care must have active Health First Colorado (Medicaid) coverage.
- Institutional Level of Care: The individual receiving care must meet the “Institutional Level of Care” (meaning you need the type of support typically provided in a nursing facility or hospital) requirement.
- Assessed Need The individual receiving care must need hands-on help with daily activities like bathing, dressing, or transferring.
Note: If your loved one is already on a waiver (like EBD or CIH), they will transition to CFC benefits during their annual review between July 2025 and June 2026.
Local. Transparent. Caregiver-Centric
We are an Arvada-based agency built on a simple promise: The funding belongs in the caregiver’s pocket. We use technology to keep overhead low so we can pay you what you’re worth.
Common Questions from Families
Is Community First Choice the same as IHSS?
Not exactly. In-Home Support Services (IHSS) is the model of care where you can direct your own attendants. Community First Choice (CFC) is the benefit (the funding source). Previously, you could only get IHSS through a waiver. Now, under CFC, you can access IHSS without needing a waiver, meaning there are no waitlists for these specific services.
Can I hire my spouse under CFC?
Yes. Spouses are considered “Legally Responsible Persons” (LRPs) and can be hired as attendants. While the old “40-hour cap” is gone, new 2026 “Soft Caps” apply to everyone. Generally, a spouse can provide up to ~45 hours/week of Personal Care without needing an exception.
Does my child qualify for Community First Choice?
Yes, if they meet an Institutional Level of Care. For children, Medicaid pays for “Extraordinary Care”—tasks that exceed what a parent would typically do for a child of the same age (e.g., suctioning a tracheostomy or bathing a teenager).
What is the difference between CFC and a Waiver?
The biggest difference is access. CFC is a State Plan Entitlement, meaning there are no enrollment caps or waitlists. Waivers (like EBD or DD) offers additional services (like Respite or Home Modifications) but may have enrollment limits.