Community First Choice Self-Advocacy Tips

Community First Choice is an important option under CT’s Medicaid program that provides extensive personal care attendant (PCA) services in the community as needed for activities of daily living or instrumental activities of daily living to avoid institutionalization at Medicaid expense.  

Under the CFC option, there is no individual cost cap based on the alternative cost of nursing home care and there is no limit on the number of slots as there is under several of the home and community-based services waivers (like the PCA and Katie Beckett waivers).  Rather, there is a flexible budget for hiring PCAs based on the assessed level of need, assuming the individual meets a nursing home level of care.  Even 24-hour care is covered under CFC where medically necessary.

CFC is substantially under-utilized in CT.  In addition, DSS does not readily inform consumers that they can get substantially more hours, through an exception process, than the initial assessment by its contracted access agency might produce.  Also, the access agencies may also be reluctant to request additional hours which DSS is likely to deny. The required notice of due process is also often lacking when requested exceptions for more hours are denied or not acted upon in a timely way.

A well-attended webinar about CFC, including advocacy tips, was presented by Sheldon Toubman, DRCT’s Litigation Attorney, on December 5th. A PowerPoint from that webinar is available upon request.

In addition, Attorney Toubman urged participants to refer to DSS’s current CFC Operating Manual, dated 2016, which is attached, for additional information about the rules governing the program (although the manual is expected to be revised soon by DSS).  Also attached is a flyer about basic due process rights under this program.

If you have further questions about the CFC program or believe your needs are not being met under it, please feel free to contact Attorney Toubman at:

Sheldon V. Toubman, Litigation Attorney

Sheldon.toubman@disrightsct.org

(475)345-3169