Connecticut · state plan
Community First Choice (CFC) in Connecticut
Community First Choice is a Connecticut Medicaid state plan benefit that lets a member hire, train and manage their own personal care attendant (PCA) using a budget. A fiscal intermediary runs payroll, and self-directed PCAs are paid under a union contract that set a $23/hour minimum on January 1, 2026. Relatives other than a spouse or legal guardian can be hired.
Also called: CFC · Community First Choice Connecticut · CT CFC · self-directed PCA Connecticut · 1915(k)
Who do you care for?
Quick facts
- Pay
- $23/hour minimum
- Adult children & other relatives
- Yes
- Spouse
- Not right now
- Parent of a minor child
- Not right now
- Waitlist
- none
Who qualifies for CFC
- Enrolled in Connecticut Medicaid (HUSKY) and living in the community.
- Needs an institutional level of care — help with activities such as bathing, dressing, eating, toileting or transferring — as found in a state assessment.
- Able to act as the employer, or has a representative who will; stand-alone CFC members must be employers to get services.
- No age limit is published for CFC; children and adults both use it.
Who can be paid as the caregiver
- Adult children & other relatives Yes
- the state's CFC site says most family members and friends can be hired, with some exclusions the care manager will explain.
- Spouse Not right now
- spouses are excluded as paid attendants under CFC.
- Parent of a minor child Not right now
- parents of minor children and legal guardians are excluded from being paid CFC attendants.
- Living together
- the attendant may or may not live with the member.
Who employs the caregiver: Self-directed. The member (or representative) is the employer; a state-contracted fiscal intermediary handles payroll, taxes and timesheets through electronic visit verification.
Spouse rules differ by program — see spouse pay in Connecticut.
How much CFC pays
$23/hour minimum. Self-directed PCAs in DSS and DDS programs are covered by a collective bargaining agreement between the PCA Workforce Council and 1199 SEIU. The minimum rose to $23.00/hour on January 1, 2026, with no wage cap. The agreement was extended through June 30, 2027, and DSS filed SPA 26-AA for further raises effective on or after July 1, 2026. Live-in per diem and overnight rates also exist; sleep time is paid at state minimum wage.
Hours and budget: CFC uses a budget method: a level-of-need assessment sets a dollar budget, and the member decides how many hours and at what wage within it. Participants have both budget authority and employer authority.
Compare with other Connecticut programs on the Connecticut caregiver pay page, or across states in pay rates by state.
Is there a waitlist?
CFC is a state plan entitlement with no enrollment cap. A 2026 proposal to move CFC members into capped waivers was dropped in April 2026, so eligible people can still enroll.
How to apply for CFC
- Apply online through the Community First Choice page on the DSS website, or call 2-1-1 and choose Option 3 (Monday–Friday, 8:30 a.m.–5:00 p.m.).
- If not already on Medicaid, apply for HUSKY Health at the same time.
- Complete the in-home assessment that sets the level of need and budget.
- Choose and hire your attendant, complete fiscal intermediary paperwork and background checks, then start services.
- Community First Choice (CT DSS) — apply via 2-1-1, Option 3 · 2-1-1 · official site
- PCA Workforce Council · 860-418-6370 · official site
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CFC questions
Can I hire my daughter or son as my CFC attendant?
Yes. Adult children and most other relatives and friends can be hired. The exclusions are spouses, legal guardians, and parents of minor children.
How much do CFC caregivers get paid in Connecticut?
The union contract set a $23.00/hour minimum for self-directed PCAs starting January 1, 2026, with no cap. The member can pay more if the budget allows. Further raises were proposed for July 2026.
Is there a waiting list for Community First Choice?
No. CFC is a Medicaid entitlement. In 2026 the governor proposed moving members into capped waivers, but the administration dropped that plan in April 2026.
Can a spouse be paid under CFC?
No. Spouses are excluded. A spouse may want to look at VA caregiver programs if the person is a veteran.
Who does payroll?
A state-contracted fiscal intermediary pays the attendant, withholds taxes and tracks hours through electronic visit verification. The member stays the employer.
Sources: portal.ct.gov · portal.ct.gov · portal.ct.gov · portal.ct.gov · ctmirror.org · medicaidplanningassistance.org · Updated 2026-10-08. Program rules change — always confirm with the program.
Where most Connecticut caregivers are
Counties with the most residents aged 65 and older. The rules are the same everywhere in Connecticut — pick yours for the local picture.
Across the line
States that border Connecticut
Each state writes its own rules, and they differ more than people expect — a spouse who can be paid on one side of the line often cannot be on the other.