Alaska · state plan
Community First Choice (CFC) in Alaska
Community First Choice is an Alaska Medicaid option for people who need institutional-level care. It covers personal care, chore, supervision and cueing, skill building and emergency response systems. Since August 1, 2025, a spouse, the parent of a minor child (age 6+) or a court-appointed guardian can be paid for CFC personal care if hired by a CFC personal care agency.
Also called: CFC · CFC-PCS · Community First Choice Personal Care Services · Alaska CFC · 1915(k)
Who do you care for?
Quick facts
- Pay
- $24–$26/hr
- Adult children & other relatives
- Yes
- Spouse
- Yes
- Parent of a minor child
- Yes
- Waitlist
- none
Who qualifies for CFC
- Enrolled in Alaska Medicaid.
- Meets an institutional level of care: nursing facility, ICF/IID, or Institution for Mental Disease (under 22 or over 65).
- Children under 6 cannot get CFC personal care.
- Not living in a licensed assisted living home while receiving waiver residential services.
Who can be paid as the caregiver
- Adult children & other relatives Yes
- relatives can be hired through a CFC personal care agency.
- Spouse Yes
- spouses are legally responsible individuals who may provide CFC personal care if employed by a CFC-PCS agency (effective August 1, 2025).
- Parent of a minor child Yes
- a parent can be paid for CFC personal care for a child over age 6 if hired by the agency.
- Living together
- not required; a legally responsible worker may need a designee to verify timesheets.
Who employs the caregiver: Agency. The caregiver, including a spouse or parent, must be hired by a CFC personal care agency; the member directs day-to-day care.
Spouse rules differ by program — see spouse pay in Alaska.
How much CFC pays
$24–$26/hr. No family-caregiver wage is published. The CFC personal care agency that employs the caregiver sets the wage from the Medicaid rate; aggregators report about $24–$26/hour.
Hours and budget: An SDS assessment creates a service plan that sets personal care time. SDS has said it will not enforce the 40-hour weekly limit in 7 AAC 127.015(a)(3) for legally responsible workers.
Compare with other Alaska programs on the Alaska caregiver pay page, or across states in pay rates by state.
Is there a waitlist?
CFC is a state plan option, not a capped waiver.
How to apply for CFC
- Contact your local Aging and Disability Resource Center (ADRC) or Developmental Disabilities Resource Connection (DDRC) for the person-centered intake.
- Choose a care coordinator, who helps you file the CFC-06 application.
- Get an SDS assessment for level of care and personal care time.
- Pick a CFC personal care agency; if a spouse or parent will be the worker, the agency hires them.
- Aging and Disability Resource Center (ADRC) · 1-877-625-2372 · official site
- Alaska Division of Senior and Disabilities Services · 1-800-478-9996 · official site
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CFC questions
Can a spouse get paid through Alaska CFC?
Yes. Since August 1, 2025, a spouse can be paid for CFC personal care when hired by a CFC personal care agency.
Can parents be paid to care for their child under CFC?
Yes, for children over age 6 who get CFC personal care. The parent must be hired by a CFC-PCS agency and follow the service plan.
Is there a 40-hour limit for family caregivers?
The regulation has a 40-hour weekly limit for legally responsible workers, but SDS's June 27, 2025 memo says it will not enforce that limit for CFC personal care.
What is the difference between CFC and PCS?
CFC requires an institutional level of care and allows legally responsible individuals to be paid. State Plan PCS does not require that level of care but bars spouses and parents of minors.
How do I start?
Call the ADRC at 1-877-625-2372 for an intake, then work with a care coordinator on the CFC-06 application.
Sources: health.alaska.gov · jedc.org · health.alaska.gov · health.alaska.gov · Updated 2026-10-08. Program rules change — always confirm with the program.
Where most Alaska caregivers are
Counties with the most residents aged 65 and older. The rules are the same everywhere in Alaska — pick yours for the local picture.