If you have a child or adult family member with a disability in Colorado, you’ve probably seen the phrase Community First Choice โ or just CFC โ come up somewhere. A case manager mentioned it. Someone in a Facebook group asked about it. A Health First Colorado letter used the acronym without explaining it. And yet it’s the most important change to how Colorado funds in-home care in more than a decade.
This post walks through what CFC actually is, why Colorado built it, who qualifies, how it overlaps with IHSS and CDASS, and what families still on the old Parent CNA pathway need to do before the transition year runs out.
What is Community First Choice?
CFC is a Medicaid state plan benefit. The technical name for the category, if you ever need it, is “option 1915(k) of the Social Security Act.” Colorado turned it on July 1, 2025.
What matters for families is the structure. Because it’s a state plan benefit โ not a waiver โ there’s no waitlist and no limited number of slots. If your loved one is on Medicaid and meets the functional eligibility bar for long-term services and supports (LTSS), CFC is available to them. Full stop.
The practical effect: CFC is how Colorado now pays for the day-to-day personal care a person with a disability needs to keep living at home rather than in a facility.
Why Colorado created CFC
Colorado’s home-care system used to be a maze. Different waivers for different ages and diagnoses (CHCBS for kids, EBD and SLS for adults, and others). Different delivery models stacked on top (IHSS, CDASS). A separate Parent CNA pathway off to the side. Two problems kept showing up over and over:
– The CNA license barrier. On Parent CNA / Family CNA, a family member could get paid โ but only after completing CNA school and getting hired as a certified nurse aide through an agency. For a lot of parents, especially single parents or working parents, that 75+ hour training window wasn’t realistic.
– Uneven access. What you could get depended on which waiver you’d landed in, not on what your loved one actually needed. Move between waivers, and your benefit mix could change.
CFC was built to fix both. Family caregivers no longer need a CNA license. Eligibility is broader. And the benefit is consistent statewide โ same rules in Pueblo as in Fort Collins.
Who can provide the care
This is the piece most families zero in on. Under CFC, the paid caregiver can be:
- A family member โ parents, spouses, adult children, siblings (state rules around legally responsible individuals still apply in certain situations)
- A friend or neighbor the family trusts
- A professional caregiver employed by a home-care agency
No CNA license is required. Training still happens, as it should โ this is hands-on work with a vulnerable person โ but the credential wall that used to keep so many families on the sidelines is gone.
How CFC is delivered
Colorado offers CFC through three delivery models. You pick the one that fits how your family actually wants to live:
- Agency model. A home-care agency (Voyager, for example) employs the caregiver. The agency handles scheduling, payroll, taxes, workers’ comp, HR, and compliance paperwork. This is the lowest-hassle option and where most new families start.
- In-Home Support Services (IHSS). The family directs day-to-day care โ who does what, when โ while the agency remains the employer of record and carries the admin load.
- Consumer Directed Attendant Support Services (CDASS). Fully self-directed. You (or an authorized representative) are the employer, with a financial management services vendor handling the payroll mechanics.
You’re not locked in. If you start on the agency model and decide later you want more control, you can switch to IHSS or CDASS. The benefit travels with your loved one even when the delivery model changes.
Who qualifies
Two tests have to be met. The person receiving care has to:
- Be enrolled in Health First Colorado (Colorado’s Medicaid program), and
- Meet the functional eligibility bar for “institutional level of care” โ meaning, without in-home support, they’d qualify for a nursing facility, hospital, or ICF-IID placement
The functional piece is assessed by a case manager using Colorado’s uniform LTSS assessment. You don’t have to diagnose yourself; they walk through a structured set of questions about daily activities, medical needs, and safety. If you’re brand new to Medicaid long-term services, the right starting point is usually your county’s Department of Human Services or the Health First Colorado enrollment line.
What Voyager does
Voyager has been helping Colorado families through these home-care transitions for years. First on Parent CNA, now on CFC. A few things we do a little differently from the big national chains:
We coordinate directly with your case manager so you’re not the one chasing paperwork between offices
Our intake team is based in Colorado and knows Colorado Medicaid โ you’re not calling a 1-800 number that routes to three states over
We run our own CNA school, which is still a useful asset under CFC because safety training doesn’t go away just because the license requirement did
Bilingual (English / Spanish) support from the first phone call through onboarding
We coordinate directly with your case manager so you’re not the one chasing paperwork between offices
Where to go from here
If you’re not yet enrolled in CFC โ or if you’re on Parent CNA and you’re not sure what happens after June 30, 2026 โ the right first step is a short call with a Voyager intake specialist. We’ll walk through your loved one’s current care, your Medicaid status, and whether CFC (via agency, IHSS, or CDASS) is the cleanest path forward
Call 719-400-2222 or request a callback online to talk with a Voyager intake specialist about CFC.
