Oregon is the first state to implement a Community First Choice (CFC) Option program. Initially, there was confusion about guardians serving as paid caregivers under the K Plan. State officials are working with the Centers for Medicare and Medicaid Services (CMS) to develop a process to allow guardians, frequently family members, to continue as paid caregivers. The regulations governing CFC include strong conflict of interest provisions. Without a process to allow guardians to be paid caregivers, individuals with intellectual and developmental disabilities and their advocates in Oregon feared that some individuals would be forced into institutional placements.