Connecticut’s healthcare system offers a variety of programs aimed at providing comprehensive care for its residents. Among these, the Community First Choice (CFC) program stands out as a managed care medical program for customers seeking greater control over their personal care services. Approved in 2015 as part of Connecticut’s 1915(k) State Plan Amendment, CFC empowers Medicaid enrollees to manage their care in a self-directed manner, emphasizing individual choice and autonomy.
At the heart of Connecticut’s CFC program is the principle of self-direction. This managed care medical program for customers allows participants to take on the role of an employer, giving them the authority to hire, supervise, and train their own personal care attendants (PCAs). This model shifts the traditional paradigm of care, placing the individual receiving services at the center of the care process. Enrollees can manage their budgets independently or with assistance from a designated support person, excluding spouses or legally responsible individuals, further enhancing their control over their care plan.
For those participating in this managed care medical program for customers, creating job descriptions for PCAs is a key responsibility. This ensures that the hired attendants possess the necessary skills and understanding of their roles. Participants can also propose a desired pay rate for their attendants, subject to state approval. This flexibility allows individuals to attract qualified caregivers, especially when specialized skills or language proficiency are required. Connecticut’s guidelines recommend that attendants be at least 16 years old, experienced in personal care, capable of following instructions, and physically able to perform the required services. Recognizing the importance of well-trained caregivers, Connecticut facilitates access to additional training opportunities, including collaborations with community colleges for personal attendant certification and Certified Nursing Assistant (CNA) training for PCAs, reinforcing the quality of this managed care medical program for customers.
Within this managed care medical program for customers, the Medicaid enrollee is formally recognized as the employer. The state’s Division of Health Services (DHS) plays a crucial role in overseeing the financial aspects of the program. DHS establishes individual budgets and monitors monthly spending to ensure fiscal responsibility. Participants who consistently overspend their allocated budget may risk losing access to the CFC option, while underutilization is also tracked by DHS to optimize resource allocation. While the state does not specifically track the employment of family members as paid caregivers, it is estimated that approximately 30 percent of the roughly 4,000 individuals utilizing this managed care medical program for customers choose to engage family members as their PCAs.
Connecticut’s CFC program is designed to be inclusive, serving a broad spectrum of individuals. Older adults and people with physical disabilities who require institutional levels of care are eligible to participate. This ensures that this managed care medical program for customers reaches those with significant care needs, offering them an alternative to traditional institutional settings. By emphasizing self-direction and personalized care, Connecticut’s CFC program provides a valuable option within its broader managed care medical program for customers, enhancing the quality of life and independence for its enrollees.
