Connecticut Community First Choice: Can Family Be Paid? (2026)

If you care for a parent or other relative on Connecticut Medicaid, Community First Choice lets them hire their own personal care attendant, and certain relatives and friends can fill that paid job.1,2 The Connecticut General Assembly's Office of Legislative Research (OLR) says spouses and legal guardians can't be paid under Community First Choice (CFC).2 To apply for CFC in Connecticut, dial 2-1-1 on a weekday.3

In This Guide

• Who Qualifies for Community First Choice in Connecticut
• Which Family Members Can Be the Paid Attendant
• How Community First Choice Fits With Connecticut's Home Care Waivers
• Who Runs Payroll
• Is There a Waiting List for Community First Choice?
• What the Attendant Is Paid, and Taxes
• How to Apply for Community First Choice in Connecticut

Who Qualifies for Community First Choice in Connecticut

DSS describes Community First Choice (CFC) as an optional State Plan service created by the Affordable Care Act that "will allow eligible individuals to access Personal Attendant Care (PCA) and other services and supports through self-direction."1 DSS started CFC in 2015 as a Medicaid state plan service under section 1915(k) of the Social Security Act.2

DSS's page doesn't spell out who qualifies. OLR does: in 2025 it wrote that Connecticut's CFC program "is open to Medicaid beneficiaries who can self-direct PCA services and would otherwise require an institutional level of care (e.g., nursing home care)."2 According to OLR, CFC can cover:

• help with daily activities such as bathing and dressing
• household chores
• meal preparation and delivery
• home safety modifications2

Your relative doesn't have to manage it alone. OLR says participants, "or someone they appoint," choose their services, manage them and decide who provides them. OLR's 2018 report says Connecticut's CFC program has no age requirement.2

Your relative must qualify for Connecticut Medicaid, whose 2026 long-term care countable-asset limit is $1,600 for one person; in Connecticut, income over the limit leads to a spend-down period rather than an outright denial.5 Our guide to Connecticut Medicaid income and asset limits explains the rest.

Which Family Members Can Be the Paid Attendant

If you're the adult child, sibling or friend already doing this care, you may be able to be the one who gets paid. OLR's 2025 report says Connecticut CFC participants "may hire certain relatives and friends to provide services," and that spouses and legal guardians "are excluded from receiving compensation" under CFC.2 OLR's older 2016 report on family care providers gave a longer CFC list, saying family members "other than spouses, legally liable relatives, conservators, and guardians may receive reimbursement for attendant services."2 Neither report names adult children or defines "legally liable relatives."2

These are the legislature's summaries, not DSS rules: DSS's own CFC page doesn't say who may be hired.2 Before you count on CFC pay, ask DSS: "Can I be hired as my relative's CFC attendant?" and get the answer in writing. If you care for your husband or wife, our guide to getting paid to care for a spouse in Connecticut covers the options.

How Community First Choice Fits With Connecticut's Home Care Waivers

CFC is also how two other DSS programs handle self-directed personal care, and their family-pay wording differs.

Age 65 and older. The Connecticut Home Care Program for Elders (CHCPE) serves residents 65 and older who are at risk of nursing home placement.6 DSS's CHCPE page says, "Personal Care Attendant Services - family members are NOT eligible to be paid for taking care of relatives with very rare exceptions." Yet the CHCPE renewal application DSS posted in 2025 says personal care assistance is available "either as a self-directed model through the state's 1915(k) option or through an agency."7 If your parent is on CHCPE, ask DSS which rule governs a relative hired through CFC.

Ages 18 to 64. DSS says adults must be 18 to 64 to apply for Connecticut's Personal Care Assistance (PCA) Waiver.8 Connecticut's PCA Waiver 2024 renewal application says, "Self-directed PCA is available in the state under the state plan 1915(k) option."8

A live-in relative. The draft renewal applications DSS posted for the PCA Waiver in 2024 and CHCPE in 2025 say a relative who lives in the home may instead be paid through Adult Family Living, as long as they are not a legally liable relative.8,7 An older CHCPE regulation still says the AFL caregiver must not be the person's relative, so ask DSS which rule applies.7

Who Runs Payroll

OLR's 2017 report says CFC participants self-direct their services "using individual budgets, with the support of a fiscal intermediary."2 In Connecticut's self-directed programs, payroll runs through a fiscal agent assigned program by program rather than statewide. DSS's CFC page names none, and DSS re-bids the contract from time to time.1 Ask DSS which fiscal intermediary will pay you before your first shift.

Is There a Waiting List for Community First Choice?

Some websites promise CFC never has a waiting list. Don't plan around CFC staying a permanent, waitlist-free entitlement.1 DSS's CFC page links a March 2026 FAQ describing a proposal, not a final decision: "The Governor is proposing to transition CFC participants" from the State Plan to a 1915(c) waiver or another authority, and the Governor's proposed budget reflects an effective date of April 1, 2027. The OLR descriptions in this guide predate that proposal.2 When you call, ask DSS whether the proposal was adopted, how it would affect your relative and whether a wait applies today.

What the Attendant Is Paid, and Taxes

Typical pay is about $18.75 an hour (estimate based on home care aide wages in Connecticut, BLS, May 2025), the median for the occupation, not a CFC rate.4 Your CFC hours depend on your relative's individual budget, so ask DSS what they will be.2 If you're thinking of cutting back at work, set that hourly figure and those hours against the paycheck you'd give up before you decide.

The tax treatment of CFC pay is less settled, so it's worth sorting out with a tax professional before your first paycheck, not at filing time. DSS describes CFC as a State Plan service, not a section 1915(c) waiver, so IRS Notice 2014-7 doesn't automatically apply. For a non-waiver program, the IRS says it depends on "the nature of the payments and the purpose and design of the program."9 Our guide to whether Medicaid waiver payments are taxable explains more.

How to Apply for Community First Choice in Connecticut

Learn More

Find personalized help getting paid as your relative's Community First Choice attendant at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.