Greater Houston Senior Living Guide
Community First Choice (CFC) Attendant Services in Houston
Community First Choice (CFC) is a federal Medicaid option within the STAR+PLUS program that provides personal attendant services. CFC helps people who meet an institutional level of care remain in their homes and communities instead of moving to a nursing facility.
How CFC Fits Within STAR+PLUS
CFC is not a separate Medicaid program. It is a service category within STAR+PLUS. If you are enrolled in STAR+PLUS and meet the functional eligibility criteria, your MCO must offer you CFC services. The key difference from standard PAS is that CFC is a federal entitlement — if you qualify, your MCO cannot deny services due to budget constraints.
CFC also gives you more control. You can hire, train, and manage your own attendants (including family members in some cases), or you can receive services from a home health agency. This is called the Consumer Directed Services (CDS) option.
Who Qualifies for Community First Choice?
- Must be enrolled in STAR+PLUS
- Must meet an institutional level of care (nursing facility level)
- Determined by a functional needs assessment from your MCO
- No separate application — your MCO evaluates you for CFC eligibility
What Home Health Services Are Covered?
- Personal attendant services — help with bathing, dressing, eating, mobility
- Habilitation services — skill-building for daily living activities
- Emergency backup attendant services
- Support management — help coordinating and managing your care
- Voluntary training for attendants you select (CDS option)
What Is NOT Covered?
- Skilled nursing (covered under standard STAR+PLUS home health, not CFC)
- Physical, occupational, or speech therapy (separate benefit)
- Home modifications beyond what STAR+PLUS HCBS waiver covers
- Room and board
How to Enroll
- You must be enrolled in STAR+PLUS first.
- Contact your MCO and request a functional needs assessment.
- If the assessment shows you meet institutional level of care, CFC is offered.
- Choose between agency-directed or Consumer Directed Services (CDS).
- If agency-directed, select a home health agency contracted with your MCO.
For eligibility questions, call the HHSC Benefits Helpline at 2-1-1 or visit hhs.texas.gov.
Find an Agency That Accepts Community First Choice
Browse HHSC-licensed home health agencies in the Houston area that accept Community First Choice.
Find Community First Choice Agencies →FAQ
Community First Choice — Frequently Asked Questions
Can a family member be my CFC attendant?
Yes, under the Consumer Directed Services (CDS) option, you can hire family members (except a spouse) as your paid attendant. The CDS employer of record (Financial Management Services Agency) handles payroll and taxes.
How many hours of CFC can I get per week?
Hours are based on your individual functional assessment. There is no fixed cap — your MCO must provide enough hours to meet your assessed needs. Some members receive 20-40+ hours per week.
Is CFC different from PAS?
CFC is a type of personal attendant service, but it is a federal entitlement with stronger protections than state-funded PAS. If you qualify for CFC, your MCO must provide it. Standard PAS may be subject to state budget limitations.
What is the CDS option?
Consumer Directed Services lets you be the employer of your own attendants. You hire, train, schedule, and supervise them. A Financial Management Services Agency handles payroll. This gives you maximum flexibility and control.
Can I use both CFC and other STAR+PLUS home health services?
Yes. CFC covers attendant services, but you can also receive skilled nursing, therapy, and other medically necessary home health services through STAR+PLUS at the same time.
Related Medicaid Programs
This guide is for informational purposes only. Houston Senior Living Guide is not affiliated with HHSC, CMS, or any MCO.