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Community First Choice (CFC) is a new Federal Medicaid State Plan Option that creates a mechanism for states to meaningfully support the civil rights of people with disabilities and provides states with additional federal funding leveraged from the savings associated with transitioning from an institutionally-biased system for providing long term services and supports to a “Community First” model.

The Federal Government provides an incentive for states to provide long-term services and supports in home and community-based settings. The Government will pay an additional six percent of spending on long-term services and supports in home and community-based settings, to states which choose the Community First Choice Option. New York has announced that it will implement CFC, but has not yet done so. Every day that New York delays implementing CFC, it leaves aside money it could be receiving, added up to nearly $440,000,000 per year. This includes $299 million per year from broad implmentation of CFC, $57 million per year from reducing the long term Medicaid Nursing Facility population by 10% as outlined in Governor Cuomo's Olmstead Plan, and $83 million in federal funds per year by bringing services provided by The Office for Persons with Developmental Disabilities into alignment with new federal rules governing home and community based settings.

The Center for Disability Rights, in collaboration with NYAIL, developed a detailed fiscal analysis outlining the financial impact that full implementation of CFC would have on New York and the State's Medicaid budget. Click the link below for the full report.



Investing in Community Living: Proposed Olmstead Budget Initiatives for New York State

Broad implementation of the Community First Choice (CFC) Option provides the Cuomo Administration with the opportunity to fund initiatives that realize the goals established in the State's historic Olmstead Plan. CDR's paper (linked below) outlines critical first-year investments New York can make to assure that seniors and people with disabilities can live in the most integrated setting and proposes initial recommendations of action for the following years.


Support for this work was provided by the New York State Health Foundation (NYSHealth)