SAVE COMMUNITY FIRST CHOICE (CFC)-
CONNECTICUT’S FIRST CHOICE!
CFC provides vital services for Medicaid recipients who need a high level of care and would otherwise have to live in institutions. We urge legislators to reject the Governor’s proposal to end this program. CFC helps people stay in their own homes, often at a lower cost to the state than nursing home or 1:1 group home care. We also urge them to require DSS to keep this program running by passing a state law specifically requiring this.
The Governor plans to end the CFC program, which is currently available to everyone who meets its strict requirements. People already using CFC would be moved to limited home and community-based services (HCBS) waivers, which can cap the number of participants and hours of care. New applicants would face a long waiting list. See the DSS commissioner’s testimony at the 2/18/26 public hearing on the Governor’s proposal, starting at 29:57 (the intention is to end the “entitlement” under CFC and put all new applicants on a waiting list).
The Governor says that self-directed care under CFC is hard for many people to manage. However, many prefer this way to get needed services. And for those who would prefer agency-based services, there is an easy solution that DSS has agreed to in the past: add agency-based services as an option under CFC, just as New York, Colorado, and Texas have done. See, for example, Community First Choice Option | Department of Health Care Policy and Financing (CO).
The intention to swap out CFC services for services under waivers that have no entitlement removes protections for those relying on these home-based services.
Many will simply not qualify for any of the alternative waivers, e.g., young adults with intellectual disabilities who do not meet the IQ cut-off for DDS waivers.
For the minority of CFC enrollees who have extensive care plans, including 24-hour care, waivers will also likely require reductions in hours of service, because the waivers will have cost caps based on the average alternative cost of nursing home care.
Individuals newly acquiring disabilities, e.g., due to spinal cord/brain injury, will be put on a waiting list and have their health care rationed.
CFC has finally allowed CT to make meaningful progress on the promise in its 2025-2028 Long-Term Care Plan to “rebalance” care away from institutions, while saving state Medicaid dollars
For HCBS programs, success is seen in higher enrollment: More people enrolling—and the resulting higher costs—means the program is working, with new enrollees saving more money.
This is especially true for CFC, since each new enrollee saves Connecticut an average of $29,000 per year ($64,000 instead of $93,000). If the Governor’s proposal passes, Connecticut will also lose the 6% higher federal match for expenditures under CFC compared to waivers and nursing homes.
PLEASE DON’T SEND CT BACKWARD BY AGAIN INSTITUTIONALIZING US!!
For more info, contact SAVE CFC COALITION through Sandra Roberts at 203-668-9218 or Sandra_roberts14@aol.com , or Mary Caruso at 203-889-6484 or meirbode@aol.com
