Texas Community First Choice (CFC) / Consumer Directed Services (CDS)¶
Texas Community First Choice (CFC) is a 1915(k) Medicaid state plan option (since 2015) providing personal assistance services to individuals with functional limitations. Consumer Directed Services (CDS) is an option within multiple HCBS waivers (STAR+PLUS, CLASS, DBMD, HCS) allowing participants to hire, manage, and supervise their own attendants, including family members and spouses, as an alternative to agency-directed care.
CFC and CDS provide personal assistance services including help with activities of daily living (bathing, dressing, grooming, eating), health maintenance tasks, and habilitation services. CFC was established by SB 7 (2013 Legislature) and began June 1, 2015. Under CDS, the participant (or their legally authorized representative) serves as the employer of record, hiring and managing their own attendants. Family members, including spouses, can be hired as paid caregivers. Hourly pay rates range from $10-$18/hr depending on the managed care organization and geographic region. CFC is available as an entitlement to Medicaid-eligible individuals who need help with ADLs and meet institutional (nursing facility) level of care criteria. States receive 6% increase in federal matching funds for CFC services. HCBS waiver-based CDS options (STAR+PLUS, CLASS, DBMD, HCS) often have long waitlists, particularly for IDD waivers which can have multi-year waits. Individuals on 1915(c) waiver interest lists who meet eligibility requirements may be eligible for CFC services.
Some details for this program are still being verified. Check the official source for the most current information.
Eligibility¶
- Household income at or below 138% of the Federal Poverty Level
- Care recipient must have a qualifying disability or need for assistance
- Must be a resident of TX
- Must be Medicaid-eligible
- Must require a nursing facility level of care
Services¶
CFC and CDS provide personal assistance services including help with activities of daily living (bathing, dressing, grooming, eating), health maintenance tasks, and habilitation services. CFC was established by SB 7 (2013 Legislature) and began June 1, 2015. Under CDS, the participant (or their legally authorized representative) serves as the employer of record, hiring and managing their own attendants. Family members, including spouses, can be hired as paid caregivers. Hourly pay rates range from $10-$18/hr depending on the managed care organization and geographic region. CFC is available as an entitlement to Medicaid-eligible individuals who need help with ADLs and meet institutional (nursing facility) level of care criteria. States receive 6% increase in federal matching funds for CFC services. HCBS waiver-based CDS options (STAR+PLUS, CLASS, DBMD, HCS) often have long waitlists, particularly for IDD waivers which can have multi-year waits. Individuals on 1915(c) waiver interest lists who meet eligibility requirements may be eligible for CFC services.
How to apply¶
Apply online or find more information at the official program page.