How long does CFC approval take in Maryland?

From Medicaid confirmation to the interRAI-HC assessment and Plan of Service, most participants are approved within 30–60 days. Angels of Mercy can help move the process along and start private-pay care in the meantime if needed.

Does CFC cost anything out of pocket?

No. Approved Community First Choice services are covered by Maryland Medicaid. There are no copays or fees for the personal-assistance hours in your Plan of Service.

Can family members be paid as caregivers under CFC?

Yes. Maryland CFC allows many family members (with limits — for example, a spouse or legal guardian usually cannot be paid) to be hired and paid through a Residential Service Agency. We can walk you through the rules.

What's the difference between CFC and CO / Community Options waiver?

CFC is a Medicaid state-plan benefit available to anyone who meets nursing-facility level of care. Community Options (CO) is a waiver with additional services (like assistive technology or environmental modifications) for older adults and people with physical disabilities. Many participants qualify for both.

Do I have to switch doctors or Medicaid plans?

No. CFC works alongside your existing Medicaid coverage and providers. You keep your primary care doctor and Medicaid managed care organization.

Maryland Medicaid Guide

Community First Choice (CFC) in Maryland: eligibility, how to apply, and what to expect

Community First Choice is Maryland's Medicaid program that pays for personal-care support in your home — so you or your loved one can stay safely in the community instead of a facility. Here's how it works, step by step.

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What is Community First Choice?

Community First Choice (CFC) is a Maryland Medicaid state-plan option administered by the Maryland Department of Health. It provides long-term services and supports in your home or community for people who would otherwise need care in a nursing facility.

CFC combines what used to be several separate programs into one consistent benefit: personal assistance, home-based support, nurse monitoring, back-up planning, and help transitioning out of a facility if needed.

Step 1

Who qualifies for Maryland CFC?

To receive Community First Choice services, a Maryland resident generally must:

Enrolled in (or eligible for) Maryland Medicaid
Live in your own home, a family member's home, or a community setting (not a nursing facility or assisted living)
Meet a nursing-facility level of care as determined by the interRAI-HC assessment
Need help with activities of daily living such as bathing, dressing, mobility, toileting, or meal prep
Any age — CFC serves children, adults, and seniors with disabilities or chronic conditions

Not sure if you qualify? Our intake team can review your situation and help you request a screening — even if you don't have Medicaid yet.

What services are covered

CFC covers a coordinated bundle of in-home supports designed to keep you safe and independent at home.

Personal assistance

Help with bathing, dressing, grooming, toileting, transfers, and mobility.

Home & community support

Meal preparation, light housekeeping, laundry, shopping, and errands related to daily living.

Nurse monitoring

A registered nurse oversees your plan and visits regularly to ensure safe, quality care.

Back-up planning

A back-up plan so that if your regular caregiver is unavailable, your care doesn't stop.

How to apply

The Maryland CFC application, step by step

1
Confirm Medicaid eligibility
If you're not already on Maryland Medicaid, apply through Maryland Health Connection or your local Department of Social Services. CFC requires active Medicaid coverage.
2
Request a CFC screening
Call Maryland Access Point (MAP) at 1-844-627-5465 or ask your doctor, hospital discharge planner, or a Residential Service Agency like Angels of Mercy to help start the request.
3
Complete the interRAI-HC assessment
A state-contracted nurse visits your home to assess your functional needs, medical status, and living situation. This determines your level of care and approved hours.
4
Meet your Supports Planner
Once approved, a Supports Planner is assigned to help build your Plan of Service, coordinate providers, and monitor your care over time.
5
Choose a Residential Service Agency
You choose the agency that will provide your personal assistance services. Angels of Mercy is a licensed Maryland RSA and CFC provider — we handle caregiver matching, training, and scheduling.
6
Start of care
Your caregiver begins on your approved schedule. Your nurse and Supports Planner check in regularly to make sure the plan continues to meet your needs.

After you're approved

CFC is designed to be flexible and person-centered. Once your Plan of Service is in place, you and your family know exactly what to expect.

What to expect

A written Plan of Service listing your approved services and weekly hours
A trained, background-checked caregiver matched to your needs and preferences
Ongoing RN supervision and periodic in-home visits
Freedom to change caregivers or agencies if the match isn't right
No cost to you for approved CFC services — the state pays the agency directly
Annual re-assessment to adjust your plan as your needs change

Frequently asked questions about Maryland CFC

Ready to start Community First Choice care in Maryland?

Angels of Mercy is a licensed Maryland Residential Service Agency and CFC provider. We help you navigate eligibility, coordinate with your Supports Planner, and match you with a trained caregiver you'll love.

Talk to our intake team See our CFC services

Program details reflect the Maryland Department of Health's Community First Choice program. For official rules, visit health.maryland.gov/mmcp/ltss.