Georgia Medicaid Community First Choice (CFC): Section 1915(k)

Georgia has not adopted Community First Choice (CFC), the Medicaid attendant-care benefit that runs with no waiting list. If you need in-home attendant care in Georgia today, you get it through the state's Section 1915(c) Home and Community-Based Services (HCBS) waivers instead, mainly the Elderly and Disabled Waiver Program (EDWP), which delivers services through the Community Care Services Program (CCSP) and Service Options Using Resources in a Community Environment (SOURCE) models, and the Independent Care Waiver Program (ICWP). This guide explains what CFC is, why Georgia uses waivers instead, and the exact steps to apply for attendant care here.1,2

In This Guide

• Key Takeaways
• Does Georgia Medicaid Offer Community First Choice?
• Georgia Medicaid Attendant Care Without Community First Choice
• What Community First Choice Is, and Why It Matters in Georgia
• Community First Choice vs. Georgia's HCBS Waivers
• Can You Get Paid to Care for a Family Member in Georgia?
• How to Apply for Medicaid Attendant Care in Georgia
• Frequently Asked Questions
• Learn More

Does Georgia Medicaid Offer Community First Choice?

No. Georgia Medicaid does not operate a Community First Choice program. CFC is a state option, and Georgia has not elected it: the state's Medicaid program inventory lists no 1915(k) benefit, and its home care runs under Section 1915(c) waiver authority instead.1,2,6

That matters because of one practical difference. Where a state runs CFC, attendant care is an entitlement: every resident who meets the program's income and needs tests gets it, statewide, with no waiting list. In Georgia, attendant care runs through capped HCBS waivers, so eligible applicants can sit on a waiting list before a slot opens.1,3

If you came here looking to enroll in Georgia CFC, the useful next move is to apply for the waiver that fits your situation. The rest of this guide covers those waivers and how to start.

Georgia Medicaid Attendant Care Without Community First Choice

Georgia operates four Section 1915(c) HCBS waivers. Two of them cover attendant care for older adults and adults with physical disabilities: the Elderly and Disabled Waiver Program (EDWP), which delivers its services through the CCSP and SOURCE models, and the Independent Care Waiver Program (ICWP). You can read each in depth in our dedicated guides.2

A Section 1915(c) waiver, unlike a state plan benefit, lets the state cap the number of people served and operate a waiting list. That is the structural reason Georgia's attendant-care programs can have waits while a CFC state's cannot.3

CCSP and SOURCE share one financial-eligibility track, because both sit inside EDWP: the Elderly and Disabled Waiver Program income limit of $2,982 a month for a single applicant in 2026 (300 percent of the Supplemental Security Income federal benefit rate), with a $2,000 resource limit for an individual. ICWP sets its own financial rules, so ask the ICWP intake staff what applies to you.7

Community Care Services Program (CCSP)

The Community Care Services Program (CCSP) is one of the two service-delivery models found within EDWP rather than a separate 1915(c) waiver. It serves older adults and adults with physical disabilities who need a nursing-facility level of care, and it pays for personal support, adult day health, home-delivered meals, emergency response, and other in-home services. CCSP is not an entitlement: it is capped and operates a waiting list once its slots are full.4,3

Service Options Using Resources in a Community Environment (SOURCE)

The Service Options Using Resources in a Community Environment (SOURCE) program is the other EDWP service-delivery model, also not a separate 1915(c) waiver. It covers the same kinds of attendant services as CCSP but coordinates them through an enrolled primary-care provider network for members who also have chronic conditions that need active medical management.2

Independent Care Waiver Program (ICWP)

The Independent Care Waiver Program (ICWP) serves adults who apply between the ages of 21 and 64 with severe physical disabilities or a traumatic brain injury, who require a hospital or nursing-facility level of care. ICWP provides personal support services and other supports for independent community living.2

Georgia's two other 1915(c) waivers, the New Options Waiver (NOW) and the Comprehensive Supports Waiver Program (COMP), serve people with intellectual and developmental disabilities. The Department of Community Health administers them and delegates their day-to-day operation to the Department of Behavioral Health and Developmental Disabilities (DBHDD). Personal care is itself one of the services these waivers pay for; see our guide to Georgia Medicaid personal care services.2

What Community First Choice Is, and Why It Matters in Georgia

Community First Choice is an optional Medicaid State Plan benefit under Section 1915(k) of the Social Security Act, added by the Affordable Care Act. It lets a state pay for home and community-based attendant services and supports as a standard Medicaid benefit rather than as a capped waiver. Four features define it.1

• Enhanced federal match. A state that elects CFC has its Federal Medical Assistance Percentage (FMAP) increased by 6 percentage points for CFC services.1
• No waiting list, statewide. Because CFC is a state plan benefit, the state must make attendant services available to eligible individuals on a statewide basis, as needed, with no enrollment cap.1
• A broad income door. CFC reaches individuals eligible for Medicaid whose income does not exceed 150 percent of the federal poverty line, or, if higher, the income level a state uses for institutional-level-of-care eligibility.1
• Required self-direction. Under CFC, the attendant is selected, managed, and dismissed by the individual (or their representative), who controls the services to the maximum extent possible.1

A Personal Care Benefit Delivered as an HCBS State Plan Option

CFC is sometimes described as a personal care state plan option or an HCBS state plan option, in contrast with the 1915(c) waiver model Georgia uses. The label points to the same distinction: a state plan benefit is owed to everyone who qualifies, while a waiver is a capped program the state may limit by slot count and geography. Georgia has not taken up the 1915(k) Community First Choice option, and it delivers its HCBS programs, including the Elderly and Disabled Waiver, under Section 1915(c) waiver authority rather than through a state plan HCBS route. Our guides to the Section 1915(i) HCBS state plan option and to self-directed services under Section 1915(j) explain those two authorities and where Georgia stands on each.1,6

For Georgia families, the takeaway is straightforward: the federal CFC framework is useful for understanding the policy alternatives and how attendant care works in other states, but it is not a benefit you can apply for in Georgia today.

Community First Choice vs. Georgia's HCBS Waivers

The table below compares Community First Choice with Georgia's 1915(c) attendant-care waivers on the points that affect access.

Nationally in 2025, 41 states kept HCBS waiver waiting lists, with more than 600,000 people on them. Among the 33 of those states that reported a wait time, people reached services after an average of about 32 months. Those counts come from KFF's annual survey of state Medicaid officials, which cautions that waiting lists are an incomplete measure of unmet need and are not necessarily comparable from state to state. That backlog is the gap a state plan benefit like CFC is designed to close.8

Can You Get Paid to Care for a Family Member in Georgia?

Sometimes, yes. Through Structured Family Caregiving, a service offered under the CCSP and SOURCE models within EDWP, a live-in family member can be paid to care for a waiver member. There is a firm limit on who qualifies. Georgia Medicaid does not pay a spouse under any of its waiver rails. Legal guardians, parents of a minor child, and conservators are also generally excluded from serving as the paid Structured Family Caregiver, though Georgia does not publish that list on its public program pages, so confirm your own situation with the case manager who runs your assessment. An adult child or another adult relative who lives with the member generally can be paid.5,4

Georgia also offers participant-directed options inside its waivers, which let the member hire and manage their own attendant. The same relative restrictions apply. If your goal is to be paid to care for a spouse, Georgia Medicaid does not allow it; the only routes that pay a spouse are U.S. Department of Veterans Affairs programs and private pay.4

How to Apply for Medicaid Attendant Care in Georgia

Getting waiver attendant care in Georgia is a two-part process: qualify for Medicaid, then get screened for a waiver.4

For the official program inventory, see the Georgia Department of Community Health list of community-based services, and for income and asset rules, see our guide to Georgia Medicaid eligibility and income limits.

Learn More

Find personalized help navigating Georgia Medicaid attendant care 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.