Alaska Community First Choice and Personal Care Services (CFC-PCS)

Community First Choice Personal Care Services (CFC-PCS) is Alaska’s Medicaid program for hands-on help at home with daily activities. It replaced much of Alaska’s older personal care program and is available to Medicaid members who meet an institutional level of care and live in their own home. For the wider picture, see our Alaska Long-Term Care Medicaid guide.

Figures change periodically. Double-check current amounts before relying on them.

At a glance

Item	Details
Type of program	Community First Choice (state plan home care benefit)
Who runs it	Alaska Department of Health, Division of Senior and Disabilities Services (SDS)
Age	Adults and children (personal care is not available to children under 6)
Care need	Nursing facility level of care (or, in some cases, an institutional level of care for people with intellectual or developmental disabilities)
Alaska 2026 income rule (long-term care)	$2,982 a month (300% of the SSI rate)
Alaska 2026 asset limit (single applicant)	$2,000
Waiting list	No. It is a state plan benefit

CFC personal care in brief

To sum up, Alaska Department of Health, Division of Senior and Disabilities Services (SDS) oversees CFC personal care. Who it is for: adults and children (personal care is not available to children under 6). Care need required: Nursing facility level of care (or, in some cases, an institutional level of care for people with intellectual or developmental disabilities). On waiting lists, the current picture is: No. It is a state plan benefit. Each of these points is covered in more depth below, alongside the general Alaska rules from our state guide. Other Alaska programs, and general guides on care at home, are linked at the end of this page for comparison with CFC personal care.

What the program is

Alaska’s Division of Senior and Disabilities Services (SDS) runs CFC. A person starts by contacting an Aging and Disability Resource Center (ADRC), then works with a care coordinator who helps complete the CFC application (form CFC-06). SDS assesses the person’s needs with its Consumer Assessment Tool, which sets how much personal care time is authorized. Services can be given through an agency or through a consumer-directed agency, which lets the person choose their own worker.

CFC personal care rests on a federal option called Community First Choice, which brings extra federal money for attendant care offered through the regular Medicaid program. Because it is a state plan benefit, there is no cap on the number of people served. Core services are attendant help with daily activities, plus skill-building and backup supports.

Who qualifies in 2026

In Alaska, the basic requirements for CFC personal care are that the person:

Is enrolled in Alaska Medicaid and meets its income and resource rules
Meets a nursing facility level of care (or an ICF/IID level of care for some people)
Lives in a private home, not an assisted living home
Is not a child under 6 (for personal care services)
Lives in Alaska and is a U.S. citizen or qualified non-citizen

The money test. CFC personal care requires full Medicaid eligibility under Alaska’s long-term care financial rules. The income and asset figures in the table above are Alaska’s 2026 Long-Term Care Medicaid figures from our state guide. The home (up to the equity limit, when the person or a spouse lives there or plans to return), one vehicle, belongings and a small burial fund are generally not counted by Alaska Senior and Disabilities Services. Married couples get extra protection in Alaska: the spouse at home keeps a share of assets and may get some of the applicant’s income. See Spousal impoverishment rules.

What the care test means in practice. The care test looks at how much help a person needs with everyday activities such as bathing, dressing, eating, using the toilet, moving around and taking medicines, and at memory problems and supervision needs. A nurse or social worker working with Alaska Senior and Disabilities Services usually does it in person, wherever the person is living. Have a relative present to describe the hard days, and keep a medication and diagnosis list handy. See Nursing home level of care and Activities of daily living.

What services it can pay for

Services depend on the person’s assessed needs and written care plan. Depending on the plan, they can include:

Help with bathing, dressing, eating, toileting, moving and transfers
Help with medications as allowed
Light housework, laundry and meal preparation linked to the person’s care
Shopping for essential items
Help with learning skills to do more independently, where offered
Emergency response systems for some people

The menu is broad, but the plan is built from need, and unpaid family help is factored in. A change in health is a reason to request a reassessment.

Directing your own care and paying family

Alaska offers both agency-based and consumer-directed personal care. In the consumer-directed model, the person (or a representative) chooses and supervises the worker, and a consumer-directed agency handles employment paperwork.

How to apply

Applying usually involves two decisions: one about money (financial eligibility for Medicaid) and one about care needs. In plain terms, the steps are:

Contact an Aging and Disability Resource Center (ADRC) to talk about options.
Choose a certified care coordinator, who helps complete the Community First Choice application (CFC-06).
If not already on Medicaid, apply through the Alaska Division of Public Assistance.
SDS schedules an assessment using its Consumer Assessment Tool.
SDS issues a decision and service plan; services start with the agency or consumer-directed agency you choose.

Before contacting Alaska Senior and Disabilities Services, see Applying for a waiver and the documents checklist for what to gather.

Waiting lists

Because CFC-PCS is a state plan benefit, there is no waiting list for slots. Delays usually come from paperwork and scheduling the assessment, so getting a care coordinator early helps.

General advice is in Waiver waiting lists.

How it relates to nursing home Medicaid

CFC-PCS uses the same level of care as nursing home Medicaid, so a person who qualifies could also qualify for a nursing home. It lets them stay home instead. People who need more than personal care, such as adult day services or residential supported living, may also qualify for the Alaskans Living Independently (ALI) Waiver, which can be combined with CFC.

Rules shared with nursing home Medicaid. Most money rules carry over from nursing home Medicaid. The five-year look-back for gifts generally applies, so a gift or transfer for less than fair value can cause a period when Medicaid will not pay for long-term care services. Alaska Senior and Disabilities Services can also use estate recovery to seek repayment for long-term care services received after 55. Some participants pay a monthly share of income toward services.

Income in a nursing home. In 2026, Alaska lets a nursing home resident keep $200 a month for personal needs; the rest of their income mostly pays toward care. Details are in our state guide.

Tips for families

Do not wait for a crisis. Lists and assessments for CFC personal care take time, and the start date is usually when you first request help.
Keep a paper trail: copies of forms and notices, plus the names and dates of every call to Alaska Senior and Disabilities Services.
Read every notice. If services are denied, cut or ended, the notice explains how to request a fair hearing and the deadline. Requesting one before the deadline often keeps services in place during the appeal.
Report changes in income, assets, address or living situation to Alaska Senior and Disabilities Services when they happen.
Mark renewal dates. Eligibility and the care plan are usually reviewed annually; see Renewals.
Get help with complex CFC personal care cases, such as a spouse at home or past gifts. A certified Medicaid planner or a legal aid office can review how Alaska’s rules fit a family’s situation.

Common questions

Can a family member be my paid worker? Often, yes. Alaska’s Community First Choice rules allow a spouse or other legally responsible person to be paid as a personal care assistant if they are qualified and employed by a certified provider agency. That is different from Alaska’s older state plan personal care, which does not pay spouses or other legally responsible individuals.

Does CFC-PCS work in assisted living? No. CFC personal care is for people in a private home, not an assisted living home.

What is the difference between CFC and the old personal care program? Alaska moved most personal care into Community First Choice, which requires an institutional level of care.

Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.