Community First Choice, often called CFC, is a Health First Colorado (Colorado Medicaid) benefit that can help pay for hands-on support in your home or community. It is intended for people who need help with daily routines so they can stay independent and avoid unnecessary placement in a facility.
A waiver is not required to receive CFC. What matters is meeting the Level of Care (LOC) criteria through an assessment. If you are enrolled in an HCBS waiver, that typically means you already meet LOC requirements, and you may also be able to access CFC benefits along with your waiver services, depending on your situation and service plan.
In-Home Support Services (IHSS) is now offered under CFC. IHSS is a service model that allows members to receive support in their home with greater flexibility and control. IHSS can include help with daily living activities and certain approved health-related tasks, based on the member’s assessment and care plan. This approach supports a person-centered model of care, meaning services are built around what matters most to the member and how they prefer support to be provided.
If you want help navigating CFC and IHSS or getting started, ANIMO HomeCare can help you understand your options, prepare for next steps, and coordinate supports that fit your household.
In-Home Support Services (IHSS) is an option within Community First Choice (CFC) that gives members more control over how in-home support is delivered. In this model, the member helps guide day-to-day care, including choosing and overseeing attendants, while an IHSS-approved agency supports the service plan and coordination.
IHSS under CFC is used to deliver core in-home supports based on the member’s assessed needs and approved service plan. These commonly include:
Personal care support: hands-on assistance, supervision, or cueing for daily personal needs.
Homemaker support: help with essential household tasks tied to health and safety.
Health Maintenance Activities (HMA): routine health-related tasks that are allowed under Medicaid rules when the member cannot complete them independently.
Independent living core supports: the IHSS model includes required elements intended to support stable, safe services in the home.
What is approved depends on the assessment results and the authorized plan. Not every member receives every type of support.
IHSS is designed to offer more choice in who provides care. In many situations, members can select attendants who are relatives. Some circumstances may also allow a “legally responsible person” to provide certain services when permitted by program rules and specifically authorized in the service plan.
Even though IHSS is member-directed, an IHSS-approved agency plays a supporting role. This can include items such as backup coverage planning, access to nursing oversight when required by the model, and required program supports that help services run safely and consistently.
Confirm you have Health First Colorado with full benefits.
Connect with your local Case Management Agency (CMA). This is the starting point for CFC and IHSS planning.
Complete required assessments to determine:
Whether you meet the CFC level-of-care requirement, and
Whether you have an assessed need for personal care, homemaker, and/or approved health maintenance activities.
Work with your CMA to build an approved service plan that lists the supports you can receive and the amount authorized.
Choose an IHSS-approved agency and set up services (attendants, scheduling, oversight, and backup plans).
Services begin once the plan and provider setup are complete. Ongoing reviews happen at least annually, and sooner if there is a significant change in needs.
A waiver is not required to access CFC; meeting the level-of-care criteria is what matters. However, people enrolled in HCBS waivers generally already meet level-of-care requirements and may be able to use CFC and IHSS alongside their waiver services, depending on their plan and eligibility.
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