AWA Position on CFCO

Statement of Support, Community First Choice Option:


The Arkansas Waiver Association fully supports implementation of the Community First Choice Option (CFC) in Arkansas. We cite these salient points as justification for our unqualified support:

  • CFC is simply a funding option. While CFC does have programmatic requirements, they are similar to existing Waiver requirements, and no major programmatic changes to our state’s supports will be required.
  • Changes to our systems of supports and services will come. Many of the changes will result from our state's Payment Improvement Initiative, which our Legislature previously approved. These changes were initiated BEFORE CFC was envisioned, and are going to happen with or without CFC. Some in our state are confused about these two concepts and have connected CFC with changes that have nothing to do with CFC. Do not be swayed by these arguments.
  • CFC does not dictate the closure of Human Development Centers (HDC's) or nursing homes. It simply encourages states to invest in community placements and settings. The HDC's and nursing homes will continue to be available in our state after the implementation of the CFC. If the increased availability of community options reduces the need for HDC or nursing home placements over time, then that will be the result of market forces and individual choice, not a state mandate.
  • CFC encourages states to invest in community placements and settings by increasing the federal government's Medicaid matching fund rate by six percentage points.
  • Supports currently provided by the state under a Medicaid Waiver will become part of our state plan services, and will be available to all who qualify, not just to those who are fortunate enough to have lived through the long waiting period (currently estimated at 8 years).
  • Some fear that even with the six percentage point increase in the federal matching rate the long-term costs of CFC will strain the state’s budget to the breaking point. Officials from Developmental Disabilities Services and the Division of Medical Services (Medicaid) have used very conservative assumptions to project the costs twelve years into the future, and these projections show a net gain for our state’s budget.
  • Because of the increased level of federal Medicaid matching funds, we will be able to support the almost 3000 people who are eligible for services and are currently on the Medicaid Waiver waiting list with the current level of state funding. There will no longer be a waiting list.