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Community First Choice (CFC)

On October 1, 2018, Alaska added a new program called Community First Choice (CFC, also known as 1915(k)) to the array of programs available to Alaskans needing long term services and supports. To be eligible for CFC, participants must meet the same institutional level of care that makes them eligible to receive home and community-based waiver services. CFC offers participants autonomy in managing their care, and allows the State to receive a higher percentage of federal financing for that care.

The first services added to Alaska’s CFC program were CFC Personal Care Services (PCS) and Personal Emergency Response Systems (or PERS, a subtype that had been covered within the Specialized Medical Equipment waiver service), and case management (for people who receiving only CFC services and no waiver services). At CFC startup, waiver recipients who also received personal care services and/or PERS were enrolled in CFC to continue receiving those services. If a Medicaid waiver recipient receiving PCS does not want to be enrolled in CFC, “regular” PCS continues to be available as a state plan Medicaid service.

CFC PCS is different from regular State Plan PCS because, in addition to being only for people who meet an institutional level of care, it can include payment for these:

  • Supervision and reminders – Additional CFC-PCS time may be available to recipients shown to have cognitive impairment or behavior issues.
  • Skills training>Recipients may be eligible to receive skills training from a personal care assistant (PCA), so that the recipient can learn to do activities more independently.
  • Worker supervision - Recipients can receive training to help manage their PCAs.

Regular State Plan PCS continues to be available for people who need assistance with activities of daily living but who do not meet an institutional level of care, as well as those who do meet an institutional level of care but opt not to enroll in CFC.

As of January 1, 2021, Alaska will be adding Chore services to its CFC program. Unless they decline to receive Chore services after that date, waiver recipients who have Chore on their support plans will be enrolled in CFC in order to keep receiving Chore services. Chore services will only be available as a CFC service starting January 1, 2021. Chore services will not be available for Medicaid waiver recipients who opt not to enroll in CFC.

Notification letters explaining the transfer process were sent to all recipients of waiver Chore services in November.

Who is Eligible for CFC?

  • Applicants for the CFC Program must meet federal rules on financial and medical needs, including being determined to need an institutional level of care.
  • The first step to determine eligibility is to call or visit your local ADRC or DDRC. Applicants often find it helpful to ask a family member or friend to help with the call or to go with them to the ADRC or DDRC office.

Frequently Asked Questions

CFC Program Staff Contact
1835 Bragaw Street, Suite 350
Anchorage, AK 99508
Phone: 907-269-3666 or 800-478-9996
Fax: 907-269-8164