Employment and Community First CHOICES Benefit Groups
The services a person in Employment and Community First CHOICES will receive depend on which benefit group they are in. There are 5 benefit groups:
Essential Family Supports (This is sometimes called “Group 4.”)
Family Support services are for families caring for a child under the age of 21 who has an intellectual or developmental disability (I/DD). The child must live at home with their family (not a foster family).
Adults age 21 with I/DD living at home with their family can also choose to enroll in this group if they qualify.
Essential Supports for Employment and Independent Living (This is sometimes called “Group 5.”)
Essential Support services are for adults age 21 and older who have an I/DD but don’t qualify for the level of care in a nursing home.
- A person age 18-21 with I/DD may be enrolled in this group if they can’t live with their family anymore.
- A person who would qualify to receive care in a nursing home can choose to enroll in this group if CHOICES Group 6 is full and their needs can be met with these services.
Comprehensive Supports for Employment and Community Living (This is sometimes called “Group 6.”)
These services are only for adults age 21 and older who would qualify to get care in a nursing home. (This doesn’t mean the person has to receive care in a nursing home. This program provides services at home and in the community. They just need to qualify for nursing home care.)
- A person age 18-21 with I/DD may be enrolled in this group if they can’t live with their family anymore.
Comprehensive Support services are for people who need more services to help them live in the community and achieve their employment and community living goals.
Intensive Behavioral Family Supports (This is sometimes called “Group 7.”)
This group is for a small number of children under age 21 who live with their family and have I/DD and severe behavior support needs that place the child or others at risk of serious harm. The behaviors are so challenging that the child is at risk of being placed outside the home. This group provides mental health treatment and other services in the home with the family. (The family must be willing to be part of the child’s treatment.) The services will train and support the family to support the child so they can keep living safely together. People are usually in this group short-term. Once the person is stable in the community, they will move to a different benefit group that can safely meet their needs.
Comprehensive Behavioral Supports for Employment and Community Living (This is sometimes called “Group 8.”)
This group is for a small number of adults who have I/DD and severe behavior support needs and are moving into the community from a place with lots of structure and supervision. This could be coming from a mental health hospital, the foster care system, jail, or a nursing home. These services are mostly for adults age 21 or older. But sometimes, a person age 18-20 can get them too. They combine 24/7 residential services with mental health treatment and support. People are usually in this group short-term. Once the person is stable in the community, they will move to a different benefit group that can safely meet their needs.
Please view the Member Benefit Table for a complete list of services covered in each benefit group, how they can help, and any limits.