Maryland Community First Choice CFC: Get Paid to Provide Care
The Community First Choice (CFC) program allows eligible caregivers to be paid for providing in-home care through Maryland Medicaid. CFC is an entitlement program with no waiting list.
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Program Overview
What is the Community First Choice CFC Program?
In Maryland, many family caregivers devote themselves to supporting a loved one at home. While this care is given with love and dedication, it can also place financial pressure on families. The Community First Choice (CFC) program, offered through Maryland Medicaid, allows eligible caregivers to be paid for providing in-home care—recognizing their commitment and helping provide the financial support they deserve.
The Maryland Department of Health recognizes that older adults and individuals with disabilities often achieve better health outcomes when they can remain in their own homes. Through the Community First Choice program, Maryland helps reduce reliance on nursing homes by expanding access to home and community-based services.
The Community First Choice (CFC) program is an entitlement-based Maryland Medicaid initiative. Unlike some other Medicaid waiver programs, CFC does not have a waiting list. If an individual qualifies, they are entitled to receive services right away.
One of the most valuable features of the Maryland Community First Choice (CFC) program is the consumer-directed care option, which allows participants to choose their own caregiver—such as a trusted family member or friend—while maintaining control over how their care is delivered. In many cases, family members, friends, or neighbors can become paid caregivers, providing trusted support from someone the individual already knows and feels comfortable with.
Eligibility Requirements
To qualify for CFC, the individual needing care must meet eligibility requirements established by the Maryland Department of Health, based on both clinical need and financial eligibility.
Clinical Requirement
Clinical Eligibility
The individual receiving care must meet a "nursing facility level of care," meaning they require assistance with activities of daily living, such as bathing, dressing, or meal preparation. A nurse from the local health department or a state-contracted agency will conduct a medical assessment to determine the level of care required.
Financial Requirement
Financial Eligibility: Income and Assets
Because this is a Medicaid program, there are strict income and asset limits.
Income
For a single person, the income limit is generally tied to Supplemental Security Income (SSI) standards or a percentage of the federal poverty level.
Assets
For an individual, asset limits are typically capped at $2,500 (does not include primary home, household furnishings and appliances, personal effects, and a vehicle).
Married Couples
If a married couple is involved, the rules become more complex. Maryland uses "Spousal Impoverishment" rules to protect the non-applicant spouse.
The Role of the Spouse in Maryland Home Care
In Maryland Medicaid programs like Community First Choice (CFC), it’s important to distinguish between spousal financial eligibility rules and who can be a paid caregiver.
For Medicaid eligibility, when only one spouse applies, the state allows certain income and assets to be protected for the non-applicant spouse. These "spousal impoverishment protections" help ensure the healthy spouse can maintain financial stability.
Separately, under Maryland’s consumer-directed care model, a spouse is allowed to be a paid caregiver if all program requirements are met. This gives families greater flexibility to keep care at home while receiving compensation through Medicaid.
Accessing Community-Based Services through MAP
To begin the Maryland Medicaid and CFC/CPAS application process, we recommend starting with Family Love Care. Our team will pre-screen for eligibility, help you understand your options, and guide you through the next steps.
If you are a good fit, we will refer you to the appropriate state entry point—such as Maryland Access Point (MAP)—and help ensure your application is submitted correctly and moves forward without unnecessary delays.
As Maryland’s primary resource for long-term care services, MAP serves as the “front door” to home and community-based programs, connecting applicants to the necessary state departments and Support Planning Agencies (SPAs) for assessment and care planning.
Once eligibility is confirmed, a support planner will help develop a care plan that includes personal assistance, supports for independent living, and expanded community-based services. This plan reflects the Community First philosophy, helping individuals remain at home rather than entering a nursing facility.
Benefits of the Community First Choice Program
The CFC program offers a broad range of benefits designed to support both the caregivers and the program participants.
Financial Support
Family caregivers can receive a competitive hourly wage, providing much-needed financial assistance.
Health & Safety
CFC includes support for home modifications and assistive technology.
Ongoing Support
Participants receive ongoing support from a support planner to adjust the care needed as time goes on.
Nurse Monitoring
Regular visits from a nurse ensure the health and medical stability of the client.
Licensed RSA Provider
Why Trust Family Love Care for Your CFC Journey?
While the Community First Choice (CFC) program is a Maryland Medicaid State Plan benefit, all personal assistance services must be provided through a licensed agency. In Maryland, caregivers cannot work directly with the state—they must be employed by an approved provider like Family Love Care.
Our team manages the administrative side of care, including caregiver onboarding, payroll, tax withholding, and ongoing support, while also providing the required caregiver training, nursing supervision, and clinical oversight to ensure full compliance with Maryland Medicaid standards.
We understand that Maryland families want trusted, compassionate care at home. Through programs like CFC, we help eligible caregivers get paid while supporting their loved ones in a familiar environment—keeping the individual at the center of every care decision.
Community First: A Future of Independent Living
Maryland is committed to expanding community-based services so families can care for loved ones in a familiar environment. The Community First Choice (CFC) program is a key initiative that makes this possible. By providing financial assistance and support services, the state helps older adults and individuals with disabilities live safely and with dignity at home.
If you are currently providing unpaid care for a loved one, help may be available through Maryland Medicaid. Whether you are a spouse or an adult child, the Community First Choice (CFC) program is designed to support family caregivers.
The Path to Enrollment: A Step-by-Step Guide
Initial Contact
Start by reaching out to Family Love Care for a quick Maryland CFC eligibility pre-screening. Our team will guide you through the process and, if appropriate, connect you with Maryland Access Point (MAP) to begin the official application.
Nurse Assessment
A nurse will visit to verify the nursing facility’s level of care.
Support Planning
Work with a planner to define the services you need, including personal assistance and meal preparation.
Agency Selection
Start by reaching out to Family Love Care, a licensed Residential Services Agency (RSA) in Maryland, for a quick CFC eligibility pre-screening. Our team will guide you through the process and, if appropriate, connect you with Maryland Access Point (MAP) to begin the official application.
Contact Us Today for Ongoing Support
Navigating Maryland Medical Assistance and the Department of Health can feel overwhelming, but you don’t have to do it alone. Contact Family Love Care to learn how you may be able to get paid to care for a loved one through the Community First Choice (CFC) program. Our team is here to help you qualify and get started.
Frequently Asked Questions
Common questions about the Maryland CFC program
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