By streamlining common services under CFC, Colorado aims to:
- Increase access to care
- Standardize services across populations
- Improve flexibility in how individuals receive support
- Expand consumer direction opportunities
As Colorado transitions to new Medicaid service models, it’s more important than ever for individuals and families to understand the differences between Community First Choice (CFC) and Home and Community-Based Services (HCBS) Waivers.
At PASCO, we are committed to helping families navigate these changes with clarity and confidence. Below, we break down the essentials of both programs to help you understand what each offers, who qualifies, and how they impact your home health care options.
What Is Community First Choice (CFC)?
Community First Choice (CFC) is a Medicaid program that expands service and support delivery options for Home and Community-Based Services (HCBS) to Health First Colorado (Medicaid) individuals who need long-term care, including individuals who are currently on an HCBS waiver.
Key Features of CFC:
- Available statewide to all qualifying Medicaid members that meet institutional level of care (LOC), and have an assessed need for a CFC services (s)
- Allows individuals to self direct their attendant services or work with an agency to handle these services for you
- Expands access to services and new tasks including Acquisition, Maintenance, and Enhancement Skills (AME), under Personal Care and Homemaker services
- Promotes independence and community integration, empowering participants to choose caregivers and manager their own care
- Improves quality of life by offering personalized care that enhances well-being and community participation
CFC implementation timeline
July 1, 2025
CFC services go live for eligible members
2025–2026
Transition period from HCBS waivers to CFC
Fall 2026
CFC fully integrated; overlapping HCBS services removed
What Are HCBS Waivers?
Home and Community-Based Services (HCBS) Waivers are specialized Medicaid programs under Section 1915(c). They are tailored to specific populations with unique medical, cognitive, or physical needs and provide a wide array of services, often beyond basic daily support.
Adult HCBS Waivers in Colorado:
- Brain Injury Waiver (BI)
- Community Mental Health Supports Waiver (CMHS)
- Complementary and Integrative Health Waiver (CIH)
- Developmental Disabilities Waiver (DD)
- Elderly, Blind and Disabled Waiver (EBD)
- Supported Living Services Waiver (SLS)
Children’s HCBS Waivers in Colorado:
- Children with Life Limiting Illness Waiver (CLLI)
- Children’s Home and Community-Based Services Waiver (CHCBS)
- Future State (beginning July 1, 2025) merging CLLI and CHCBS waivers into a single program called Children with Complex Health Needs (CwCHN)
- Children’s Extensive Support Waiver (CES)
- Children’s Habilitation Residential Program Waiver (CHRP)
Each waiver targets a specific demographic and medical need, offering a customized package of services that may include behavioral therapy, supported employment, or residential habilitation.
Which Services Are Moving to CFC?
With the rollout of CFC, several services currently offered through waivers will transition into the CFC program. These include:
- Consumer Directed Attendant Support Services (CDASS)
- In-Home Support Services (IHSS)
- Personal Care (AME task)
- Homemaker Services (AME task)
- Health Maintenance Activities
- Medication Reminders
- Home Delivered Meals
- Personal Emergency Response System (PERS)
- Remote Supports
Transition Setup Services
These services will no longer be available through HCBS Waivers and must be accessed through CFC once it is implemented.
Note: To access these services under CFC, members must have an assessed need and meet the institutional level of care requirement.
Why This Change Matters
By streamlining common services under CFC, Colorado aims to:
- Simplify access to care
- Standardize services across populations
- Improve flexibility in how individuals receive support
- Expand consumer direction opportunities
However, it’s important to note that CFC does not replace all waiver services. Many specialized therapies, residential supports, and habilitation services will remain in the waiver programs.
What Stays in the HCBS Waivers?
Services not moving to CFC and remaining under specific waivers include:
- Behavioral counseling and mental health therapy
- Day habilitation and prevocational training
- Residential habilitation and group homes
- Supported employment services
- Complementary and integrative therapies (e.g., acupuncture, massage)
- Specialized medical equipment and vehicle modifications
- Music & Massage Therapy
- Individual and Family Therapy
How PASCO Can Help
At PASCO, we are experts in both HCBS Waivers and the upcoming Community First Choice program. We are here to:
- Help you understand eligibility
- Guide you through service transitions
- Assist with self-direction models like HSS and CDASS
- Advocate for your needs during this evolving landscape
Need Help Navigating These Programs?
Contact our experienced team. We’re here to make sure you and your loved ones receive the care you need, in the setting you prefer.
