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Update - Community First Choice Option (CFCO)

On Dec. 30, 2013, DOH submitted for CMS approval a Medicaid state plan amendment (SPA) #13-35 consumer-directed, person-centered home and community based attendant services and supports through the Community First Choice Option (CFCO).  The amendment, if approved, will be effective as of Oct. 1, 2013.

As you may recall, LeadingAge NY had participated in the CFCO advisory group and DOH provided an update at our 2013 Annual Conference on this initiative.

The CFCO is a federal option under the Affordable Care Act that allows states to provide consumer-controlled personal attendant services and supports in their state plan. To be eligible for services under this option, individuals must be assessed as requiring an institutional level of care and be capable of directing their own services directly or through a representative.  Services must be related to an individual’s need for assistance with activities of daily living, instrumental activities of daily living, and/or health related tasks. Services may also include assistance with transitioning from institutional to community- based settings.

New York's CFCO SPA covers personal care, consumer-directed personal care, home health care, home and community support services, community habilitation, home maintenance (chore service), community transportation, and congregate/home delivered meals. Services also include functional skills training, coaching and prompting the individual to accomplish the ADL, IADL and health-related skills. In addition, the State has opted to offer the optional services of assistive/adaptive devices, home modifications, and transitional services including moving expenses and those to establish a home.  Personal Emergency Response Services (PERS) and other technologies that permit the beneficiary to summon assistance in an emergency will also be covered.

Individuals will be assessed using core standardized assessments including the Uniform Assessment System (UAS-NY) and the Comprehensive Assessment System (CAS).

Like the current Consumer Directed Personal Assistance Program (CDPAP), services will be authorized by the local social services district or managed care plan, as applicable.  Managed care plans will be expected to enter into contractual relationships with home care agencies or other entities that serve as fiscal intermediaries for the benefciary and personal attendants.  Notably, unlike the conventional Medicaid personal care program, criminal history checks will not be required of CFCO personal attendants.

For additional information please review Appendix III, Subpart K and Appendix IV, the notice published in the NYS register. 

Contact:Cheryl Udell, cudell@leadingageny.org, 518-867-8871