The Centers for Medicare and Medicaid Services gave its first approval for a Community First Choice Option under Medicaid to California. This option under the Affordable Care Act allows states to receive a 6% increase in their federal Medicaid share for new community-based attendant services and supports for people with disabilities who are eligible for an institutional level of care. Texas is also considering applying for the Community First Choice Option pending legislative approval.
The Texas Department of Aging and Disability Services’ Legislative Appropriations Request includes the Community First Choice Option as an exceptional item that would provide 11,902 persons with a combination habilitation and attendant care service via a managed care organization for $3.8 million in state general revenue. Some people question whether the current funding proposal is too low and strongly recommend that the agency recalculate the request in a manner that would ensure a strong direct support workforce.
California will receive an estimated $258 million the first year of its the Community First Choice Option and $315 million the second year. Increased funding is available as long as the Community First Choice Option is included in the state’s Medicaid program.