Community First Choice (CFC)

What is Community First Choice?

Community First Choice (CFC) provides certain services and supports to individuals living in the community who are enrolled in the Medicaid program and meet CFC eligibility requirements. Services and supports may include:

  • activities of daily living (eating, toileting, and grooming), activities related to living independently in the community, and health-related tasks (personal assistance services);
  • acquisition, maintenance, and enhancement of skills necessary for the individuals to care for themselves and to live independently in the community (habilitation);
  • providing a backup system or ways to ensure continuity of services and supports (emergency response services); and
  • training people how to select, manage and dismiss their own attendants (support management).

In Texas, CFC may be available to people enrolled in Medicaid, including those served by:

  • 1915 (c) waiver programs;
  • Medicaid managed care; and
  • personal care services for children.

Individuals may use the Consumer Directed Services (CDS) option for certain CFC services.

CFC as a state plan Medicaid service is available to individuals with a need for habilitation, personal assistance or emergency response services who receive services in the following HHS waiver programs:

  • Community Living Assistance and Support Services (CLASS);
  • Deaf Blind with Multiple Disabilities (DBMD);
  • Home and Community-based Services (HCS); and
  • Texas Home Living (TxHmL).

CFC is also available through managed care organizations for individuals who meet eligibility criteria. Read more about eligibility for CFC and CFC for children in Traditional Medicaid.

For questions about CFC services provided under the HHS waiver programs, email HHSC CFD.


CFC via Waiver Programs

Statutes and Rules


Code of Federal Regulations (CFR), Title 42, Chapter 441, Subchapter K

Other Rules and Statutes

Support Management

Support management is voluntary training on how to select, manage, and dismiss attendants. Support management will be available to all individuals who use CFC personal assistance services and habilitation service. Individuals may request Support Management during the person-centered planning process.

Providers and FMSAs will provide the CFC Support Management Handout (PDF in English) or CFC Support Management Handout (PDF in Spanish), along with a verbal explanation, to individuals whose service plan includes Support Management.