If you’re applying for Maryland Medicaid home care, you may hear two terms repeatedly:

• Community First Choice (CFC)
• Community Personal Assistance Services (CPAS)

They are two of Maryland’s Home and Community-Based Services (HCBS) programs, funded by Medicaid. Both allow individuals to receive personal care services at home. Both may allow approved family or friend caregivers to be paid.

The key difference is level of care.

CFC vs CPAS in Maryland: What’s the Difference?

If you’re applying for Maryland Medicaid home care, you may hear two terms repeatedly:

• Community First Choice (CFC)
• Community Personal Assistance Services (CPAS)

Both programs allow individuals to receive personal care services at home. Both may allow approved family or friend caregivers to be paid.

The key difference is the level of care.

What Is Community First Choice (CFC)?

Community First Choice (CFC) is a Medicaid entitlement program for individuals who:

• Have full Maryland Medicaid
• Meet Nursing Facility Level of Care (NFLOC)
• Require significant assistance with daily activities

NFLOC means the person’s needs are high enough that they could qualify for nursing home care [1].

Because CFC serves individuals with higher care needs, services and authorized hours may be more extensive.

There is no waitlist if eligibility is met.

What Is Community Personal Assistance Services (CPAS)?

Community Personal Assistance Services (CPAS) is also a Medicaid entitlement program.

CPAS is for individuals who:

• Have full Maryland Medicaid
• Need assistance with at least one Activity of Daily Living (ADL)
• Do not meet Nursing Facility Level of Care

Think of CPAS as support for moderate care needs, while CFC is for higher levels of need [2].

Like CFC, CPAS does not have enrollment caps.

Can I Choose Between CFC and CPAS?

No.

The state determines placement based on:

• Functional assessment results
• Level of care determination
• Medicaid eligibility
• Service needs

Families do not select the program directly.

Which Program Pays Family Caregivers?

Both CFC and CPAS may allow eligible family or friend caregivers to be paid, with restrictions (such as spouses and parents of minor children typically being excluded).

Approval depends on:

• The person receiving care’s eligibility
• Background checks
• Required caregiver qualifications

Not Sure Which One Applies to You?

Most families are unsure whether their loved one meets Nursing Facility Level of Care.

The state assessment determines placement — but preparation matters.

If you’re unsure whether CFC or CPAS is the likely pathway, call Concierge Home Care of Maryland or request a callback. Our team can help you understand the criteria and prepare for the evaluation process.

References and Resources

[1] Maryland Community First Choice (CFC): Program details and NFLOC eligibility standards.

[2] Maryland Community Personal Assistance Services (CPAS): Overview of eligibility and covered services.