Colorado Community First Choice (CFC)
Community First Choice (CFC) is a Health First Colorado state plan benefit that began on July 1, 2025. It provides personal care and homemaker services, and related supports, to Medicaid members who live in the community and meet an institutional level of care. This page is part of our Colorado 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 | Health First Colorado (HCPF) |
| Age | Health First Colorado members of any age who meet the criteria |
| Care need | An institutional level of care (for older adults, a nursing facility level of care) |
| Colorado 2026 income rule (long-term care) | $2,982 a month. Higher income needs an income trust |
| Colorado 2026 asset limit (single applicant) | $2,000 |
| Waiting list | No. It is a state plan benefit |
Colorado CFC in brief
In short, Colorado CFC is run by Health First Colorado (HCPF). Its target group is health First Colorado members of any age who meet the criteria; on care need, the rule is: An institutional level of care (for older adults, a nursing facility level of care). On waiting lists, the current picture is: No. It is a state plan benefit. The sections below repeat these points with more detail, and our state guide covers the Colorado rules that apply to every long-term care program. Families weighing Colorado CFC against other Colorado options can use the related pages at the end to compare programs side by side.
What the program is
Before CFC, Colorado delivered most personal care and homemaker help through its waivers. CFC went live on July 1, 2025. From July 2025 through 2026, waiver members moved over to CFC, while people not on a waiver and new members began using it. In July 2026, CFC services were taken out of the HCBS waivers, and the formal waiver changes with CMS run from fall 2026 through January 2027. As a state plan benefit with extra federal matching funds, CFC is not limited by waiver slots. Members can self-direct personal care, homemaker and health maintenance activities through Consumer-Directed Attendant Support Services (CDASS) or In-Home Support Services (IHSS), or get personal care and homemaker services through an agency. Members can use CFC alongside an HCBS waiver such as the EBD Waiver, as long as the same service is not paid twice.
Community First Choice is an option in federal Medicaid law that lets a state offer attendant care as part of its regular Medicaid program, with extra federal funding. As a state plan benefit, it has no enrollment cap. Core services are attendant help with daily activities, plus skill-building and backup supports.
Who qualifies in 2026
A person generally must meet all of these conditions:
- Has full Health First Colorado (Medicaid) coverage
- Meets an institutional level of care through the state’s level of care assessment, or is enrolled in an HCBS waiver and receives at least one waiver service a month
- Is willing to receive services at home or in a community setting rather than an institution
Financial eligibility. The person must qualify for full Medicaid under Colorado’s rules for long-term care. The income and asset figures in the table above are Colorado’s 2026 Long-Term Care Medicaid figures from our state guide. Health First Colorado’s countable assets do not usually include the home (within the equity limit, if the applicant or a spouse lives there or intends to return), one car, personal belongings and a small burial fund. Married couples get extra protection in Colorado: the spouse at home keeps a share of assets and may get some of the applicant’s income. See Spousal impoverishment rules.
How the care assessment works. For Colorado CFC, an assessor checks how much help the person needs with bathing, dressing, eating, toileting, mobility and medications, and whether memory loss calls for supervision. A nurse or social worker working with Health First Colorado usually does it in person, wherever the person is living. Before a Colorado CFC assessment, it helps to line up a family member who can describe a typical bad day, and to have a list of diagnoses and medications ready. 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:
- Personal care: hands-on help with bathing, dressing, eating and other daily activities, including skills training
- Homemaker services, including skills training
- Health maintenance activities
- Home-delivered meals
- Medication reminders
- Personal emergency response systems
- Remote supports
- Transition setup for people moving out of an institution
Not every participant gets every service; the plan reflects assessed need and the help family already gives. When needs grow, request an updated assessment.
Directing your own care and paying family
CFC can be self-directed through CDASS or In-Home Support Services. In both, the member chooses attendants, and family members can often be hired.
How to apply
Getting Colorado CFC means passing a money test and a care test. Step by step:
- Contact your local case management agency to request a Community First Choice assessment.
- Apply for Health First Colorado if not already enrolled.
- Complete the functional assessment with the case manager.
- Choose agency or self-directed services.
Before contacting Health First Colorado, see Applying for a waiver and the documents checklist for what to gather.
Waiting lists
Because CFC is a state plan benefit, there is no waitlist for slots.
General advice is in Waiver waiting lists.
How it relates to nursing home Medicaid
CFC uses an institutional level of care, so many members could qualify for a nursing home. It is designed to help them stay home. Financial eligibility follows Health First Colorado’s long-term care rules, with the 2026 income rule ($2,982 a month) and asset limit in our state guide.
What is the same as nursing home Medicaid. Colorado’s financial rules for Colorado CFC track the nursing home rules closely. The five-year look-back still matters: a transfer for less than fair value can delay payment for long-term care services. Health First Colorado can also use estate recovery to seek repayment for long-term care services received after 55. Under Colorado CFC, income above an allowance may go toward the cost of care each month.
If a nursing home becomes necessary. A Colorado nursing home resident keeps a 2026 personal needs allowance of $110.36 a month, and most other income goes to the facility. Our state guide covers the nursing home rules in detail.
Tips for families
- Do not wait for a crisis. Lists and assessments for Colorado CFC 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 Health First Colorado.
- Use your appeal rights. Notices that deny or reduce services explain how to request a fair hearing; acting quickly can protect current services.
- Report changes in income, assets, address or living situation to Health First Colorado when they happen.
- Expect yearly reviews of both Medicaid eligibility and the care assessment. See Renewals.
- Protect a spouse at home. Spousal protections must be claimed; a certified Medicaid planner or legal aid office can explain them for your family.
Common questions
Does CFC replace the EBD Waiver? No. In July 2026, CFC services such as personal care, homemaker help, meals and emergency response were taken out of the waivers and are now provided through CFC. The EBD Waiver still covers other services, such as adult day services and alternative care facilities.
Can I hire my own attendant? Yes, through CDASS or IHSS.
When did CFC start? CFC went live on July 1, 2025. Waiver members moved over through 2026, and CFC services were removed from the waivers in July 2026.
Related pages
- Colorado Long-Term Care Medicaid guide
- Colorado EBD Waiver
- Consumer-directed care
- Three kinds of Long-Term Care Medicaid
- PACE programs
Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.