Community First Choice in Maryland: who qualifies and what it covers

Community First Choice (CFC) is a Maryland Medicaid benefit that pays for personal assistance and other supports so you can stay at home. The Department of Health lists no age limit, but you need institutional level of care, a community setting and full Medicaid.

What CFC is

The Maryland Department of Health calls CFC a state plan home and community-based services benefit that helps you get services and support in your home and community instead of in an institution. The Medicaid Administration runs it. The governing regulation is COMAR 10.09.84. For the wider Maryland picture, see the Maryland program overview.

Eligibility

The Department says you must meet all three tests.

1. Medical. You need institutional level of care.
2. Technical. There is no age limit, and you must live in a community setting.
3. Financial. You must already have full Medicaid, which the Department says you have if you have a red and white card.

COMAR 10.09.84.04 adds that participants must live at home, have an active plan of service, and be re-evaluated every 12 months or sooner after a significant change. Eligibility ends if the participant is without services for 30 consecutive calendar days, among other reasons. The page we read gives no income or asset limits.

What CFC covers

You get all Medicaid covered services and benefits, plus these CFC services, according to the Department:

• accessibility adaptations;
• assistive technology;
• consumer training;
• environmental assessments;
• home-delivered meals;
• nurse monitoring;
• personal assistance;
• personal emergency response systems;
• supports planning; and
• transition services.

Personal assistance, under the regulation, covers help with activities of daily living, delegated nursing functions in the plan of service, judgment-based protection from harm, related instrumental tasks and medication assistance when a physician orders it. Food costs and general housekeeping are excluded.

Who provides personal assistance

COMAR says agencies must be licensed as a Residential Service Agency under COMAR 10.07.05. A registered nurse assesses new participants and delegates tasks to a certified nursing assistant or certified medication technician. Workers must have verified qualifications and a criminal history records check. The agency must let participants exercise as much control as they wish to select, train and schedule workers, and the supports planner must help the participant self-direct services.

The agency may not assign the participant's representative to provide services to that participant. The regulation defines the representative to include a legal guardian and a parent or foster parent of a dependent minor.

Hours and budget

The Department sets a personal assistance budget based on assessed need. Up to 12 hours a day is paid in 15-minute units, and participants who need more than 12 hours a day are paid a daily rate. Supports planners and nurse monitors may not be paid for more than 7 hours a day unless the Department preauthorizes it in writing. Personal assistance outside Maryland is covered for no more than 30 days per calendar year.

How to apply

Call Maryland Access Point at 844-627-5465 or the CFC Program at 410-767-1739. The Department says the best way to know if you are eligible is to apply. For coverage help in general, Medicaid.gov lists Maryland Health Connection at 855-642-8572.

See also paid family caregiver in Maryland, home care in Maryland, home health in Maryland, nursing homes in Maryland and developmental disability services in Maryland.

Carevo is a connection platform and directory. We do not run CFC, decide eligibility or set hours.

More about care in Maryland

• All Maryland Medicaid programs for care at home
• Paid family caregiver in Maryland
• Home care providers in Maryland