CFSS and lead agencies FAQ

The lead agency assessor informs them.

The lead agency authorizes six months of PCA/CSG if they perform a reassessment for a person already using PCA/CSG.

No.

No. After the reassessment, the person must continue using the same service during the transition period.

The lead agency authorizes 48 units.

No.

Yes. For instructions, refer to DSD MMIS Reference Guide – ASA3 screen for personal care services (T1019).

No. Refer to:

• CFSS Manual – PCA communication to person’s physician, comparison of PCA and CFSS section.
• CFSS Manual – Forms, retired forms section.

Person not on waiver/Alternative Care (AC) (i.e., state plan services only)

The county/tribal nation may ask DHS to end the person’s six-month PCA/CSG service agreement early using CFSS Request Form, DHS-6893I, if all the following are true:

• The person has an approved CFSS service delivery plan.
• The person selected enrolled providers.
• The person wants to start CFSS before the end of their PCA/CSG service agreement.
• The start date of their new service agreement will be at least three months after the start date of their six-month PCA/CSG service agreement.

Person on a waiver/Alternative Care

The county/tribal nation may end the person’s six months of PCA/CSG services early by updating their service agreement.

People age 65 and older who receive PCA/CFSS through their MCO

Follow the MCO’s process for authorization.

The lead agency must email DHS if a person is unable to start CFSS within six months because the consultation services provider cannot complete their work in a timely manner due to the volume of new CFSS enrollees. DHS will develop further guidance, if needed.

The lead agency follows its internal policies to approve CSG for an additional six months. For more information, refer to CBSM – CSG.

The county/tribal nation uses Long-Term Services and Supports Service Rate Limits, DHS-3945 (PDF).

No, the 5% administrative fee does not apply to CFSS. During the six months of CSG services authorize after the person’s reassessment, the county/tribal nation will authorize their 5% administrative fee.

The lead agency may authorize a 45-day temporary start under the same circumstances they used to authorize a 45-day temporary start in PCA. For more information, refer to CFSS Manual – 45-day temporary start of CFSS services.

No. For more information, refer to DSD MMIS Guide - Type B 45-day temporary start of CFSS services.

No. For more information, refer to CFSS policy manual - 45-day temporary start of CFSS services (i.e., emergency start).

No. Refer to CFSS policy manual - 45-day temporary start of CFSS services (i.e., emergency start).

Yes, the lead agency must share CFSS Information Sheet – English, DHS-8477A-ENG (PDF) or a translation:

• DHS-8477A-HMN, Hmong (PDF)
• DHS-8774A-KAR, Karen (PDF)
• DHS-8477A-SOM, Somali (PDF)
• DHS-8477A-SPA, Spanish (PDF)

The lead agency must provide:

• All documents required by MnCHOICES policy (refer to MnCHOICES - MnCHOICES training).
• CFSS eligibility in writing (DHS does not require a specific form).
• DHS – List of consultation services providers.
• CFSS Information Sheet – English, DHS-8477A-ENG (PDF) or translated version:
  • Hmong, DHS-877A-HMN (PDF)
  • Karen, DHS-877A-KAR (PDF)
  • Somali, DHS-877A-SOM (PDF)
  • Spanish, DHS-877A-SPA (PDF).

The lead agency must issue eligibility in writing, but DHS does not require a specific form. DHS recommends using Long-Term Services and Supports Notice of Action (Assessments and Reassessments), DHS-2828A.

Yes.

The lead agency must send CFSS eligibility results to the person 10 business days from the date of assessment.

Yes, the lead agency can decline the request if they determine there is not a significant change in the person’s needs. The lead agency must send a notice of action to the person that documents the lead agency’s decision.

Yes. DHS is working to update MnCHOICES. Lead agencies must refer to the current functionality document for current workarounds.

No.

Yes, if all assessment completion requirements are met.

Yes.

Yes.

DHS is working on updating MnCHOICES. For information about a workaround, refer to the current functionality document in the MnCHOICES application.

Yes.

No, the lead agency completes the MnCHOICES support plan and then revises it after approving the CFSS service delivery plan.

Yes.

The consultation services provider attaches the CFSS service delivery plan to the person’s record in MnCHOICES.

The lead agency uses CFSS Assessment, DHS-6893A when they:

• Have a prior arrangement with DHS that allows them to use the form in place of some of their MnCHOICES assessments.
• Conduct a 45-day temporary start.
• Conduct a 45-day temporary increase until DHS publishes a new form for temporary increase assessments.

For more information, refer to CFSS Manual – Instructions for CFSS Assessment, DHS-6893A.

Yes.

Yes. For more information, refer to CFSS Manual – CFSS consultation services overview.

No.

The lead agency must provide the person with DHS – CFSS consultation services providers. The person is responsible to select a consultation services provider. If the person is unable to contact the consultation services providers themselves, the lead agency may help the person access the information. The lead agency cannot select the consultation services provider for the person.

The assessor (person not on waiver/AC) or the case manager (person on waiver/AC) provides the information, as they do with all people using CFSS.

All consultation services providers are enrolled and listed on DHS – CFSS consultation services providers.

No.

The person notifies the lead agency.

No.

No.

The lead agency authorizes six units. For more information, refer to DSD MMIS Reference Guide – ASA3 screen for consultation services (T1023). The lead agency does not prorate this amount for service agreements that are less than 12 months.

No. The lead agency authorizes six sessions. For instructions, refer to DSD MMIS Reference Guide – ASA3 screen for consultation services (T1023), requested total units section and CFSS_MMIS training in TrainLink.

The consultation services provider bills DHS a flat rate for each session that meets the description on CFSS Manual – Consultation services overview.

If the person does not choose a consultation services provider within 60 days, the lead agency:

• Enters a consultation services (T1023) line on the ASA3 screen of the person’s MMIS service agreement with the DHS no pay number (A342517700) in the PROV NUM field and D in the status field.
• Completes the MnCHOICES support plan.

For more information, see DSD MMIS Reference Guide – ASA3 screen for consultation services (T1023).

No. Consultation services providers must have the ability to provide services statewide (either in person or remotely). For more information, refer to CFSS Manual – Consultation services provider requirements.

Consultation services providers must be able to communicate with people using their preferred method (e.g., email, text, phone call, in-person meeting, video meeting). Both the consultation services provider and the person must agree on the meeting location. For more information, refer to CFSS Manual – Consultation services provider requirements.

As soon as possible. The timeline will vary depending on many factors, such as how quickly the person or their participant’s representative is able to work on the CFSS service delivery plan or the complexity of the CFSS service delivery plan. DHS will provide a more precise timeline at a later date.

The consultation services provider is not responsible to know the person’s waiver/AC budget. They help the person with a CFSS service delivery plan based on their CFSS eligibility. The case manager/care coordinator works with the person to manage their overall services and makes changes if needed.

The person must choose an enrolled CFSS provider agency. DHS discovered an internal process issue in revalidating PCA providers as CFSS providers.  DHS is revalidating providers as quickly as possible.

No. The consultation services provider gives the person a list of CFSS provider agencies and/or FMS providers. The person is responsible to select a provider.

No. Consultation services providers can only view assessment results in all status types after the Get Results function has been completed by the lead agency.

Yes.

Yes. For instructions, refer to CFSS Manual – CFSS consultation services overview, requesting additional units section.

Yes.

DHS regional resource specialists asked counties and tribal nations for their specific processes. DHS emailed this information to consultation services providers.

The lead agency follows its policies.

No.

DHS monitors the capacity of consultation services providers and holds office hours for them.

Examples of covered goods and services include:

• Grab bars (may replace transfers or mobility).
• Wheelchair ramps (may replace mobility).
• Communication device not covered by Medical Assistance (may replace instrumental activities of daily living [IADLs]).
• Grabber or shoehorn tool (may replace dressing).
• Laundry service (may replace IADLs).

Covered goods and services must be related to a person’s assessed needs, so the above examples are only covered for a person who has a related assessed need.

DHS cannot publish a list of covered goods and services because each person’s needs are unique. Lead agencies must follow the guidelines on CFSS Manual – Goods and services through CFSS.

The person selects a financial management services (FMS) provider to help them purchase goods and services. For more information, refer to CFSS Manual – Goods and services through CFSS.

FMS fees are determined by each individual FMS provider, including how the FMS provider structures their fees. For more information, refer to DHS –FMS provider information.

No.

The person works with their consultation services provider, if needed.

Yes, the lead agency can approve goods and services that may take the place of some IADLs. Examples include, but are not limited to, laundry services and grocery delivery (but not the cost of food). For more information, refer to CFSS Manual - Goods and services through CFSS .

No. For more information, refer to CFSS Manual - Goods and services through CFSS.

No. For more information, refer to CFSS Manual - Goods and services through CFSS 

No.

No.

No.

No.

No. They are separate categories of services. For more information, refer to:

• CFSS Manual - PERS
• CFSS Manual - Goods and services through CFSS.

The consultation services provider may help the person identify a potential PERS provider. However, the consultation services provider cannot confirm which providers are enrolled MHCP providers, so the lead agency may need to help the person find an enrolled provider.

No, the lead agency can only approve PERS for adults 18 years or older. For more information, refer to CFSS Manual – PERS.

The consultation services provider gets the person’s signature.

The consultation services provider uploads the CFSS service delivery plan.

The consultation services provider must attach the person’s CFSS service delivery plan to their record in MnCHOICES and notify the lead agency through a method determined by the lead agency (e.g., email, phone).

The consultation services provider must use that lead agency’s process to alert them.

A lead agency professional must approve the CFSS service delivery plan, such as an assessor, care coordinator or case manager. For more information, refer to CFSS Manual – CFSS service delivery plan development and approval process. Case aides cannot approve CFSS service delivery plans. For more information about case management aides, refer to CBSM – Case management aide.

For a person using state plan CFSS or AC/EW, the COR must complete the assessment and approve the CFSS service delivery plan.

For a person using CFSS on a disability waiver, follow the guidance on CBSM – Process and procedure: When a COR completes a MnCHOICES assessment for the CFR.

The lead agency cannot approve a partial CFSS service delivery plan. If the CFSS service delivery plan does not meet CFSS requirements, the lead agency may either:

• Work with the person directly to update the CFSS service delivery plan.
• Refer the person back to the consultation services provider to adjust the CFSS service delivery plan.

The lead agency must use Notice of Action – Explanation of Changes to Your Support Plan, DHS-2828B.

The lead agency has the primary responsibility for the appeal. The lead agency may ask the consultation services provider for information about the development of the CFSS service delivery plan, if needed.

Yes, DHS encourages lead agencies to email DHS if they notice many of the CFSS service delivery plans they receive have the same issue or a specific consultation provider submits a high number of CFSS service delivery plans with issues that are not accompanied by the Consultation Services Provider CFSS Service Delivery Plan Cover Sheet (DHS-6893N). DHS will use this information to train consultation services providers and/or provide technical assistance to specific consultation services providers. Note that DHS published the form on Dec 2, 2024 and CFSS service delivery plans published before this date will not have this document.

Yes.

No. A person who is eligible for a waiver/AC may always choose to use waiver services.

No, the case manager/care coordinator can authorize other waiver/AC services while the person writes their CFSS service delivery plan. The lead agency must ensure services are not duplicative.

The county/tribal nation and MCO use MCO, County Agency and Tribal Nation Communication Form - Recommendation for State Plan Home Care Services, DHS-5841.

No, the lead agency creates one support plan for the person.

The criteria for authorizing extended CFSS are the same as they were in PCA. For instructions, refer to CFSS Manual – Extended PCA/CFSS services.

The person may use either their CFSS funds or their waiver/AC funds to purchase goods, services and/or PERS.

Yes.

Yes.

Yes.

If the person chooses the agency model, they must select a provider agency. If the person chooses the budget model, they must use the same FMS for both CFSS and CDCS.

The lead agency may deny the waiver if using only state plan services can meet the person's needs. The assessor determines if the person is eligible for a waiver.

Yes.

Workers under the CFSS budget model are covered by the terms of the SEIU bargaining agreement. Workers in the CFSS agency model are not. For more information, refer to:

• CFSS Manual – PCA service options and CFSS service models, CFSS-specific information, person’s responsibilities section.
• CFSS Manual – PCA/CFSS worker criteria, requirements and responsibilities, collective bargaining agreement section.

The reimbursement rate/budget is the same in both models. The employer determines the wage within CFSS policy and applicable labor laws. The provider agency is the employer in the agency model. The person is the employer in the budget model (subject to the SEIU collective bargaining agreement). For more information, refer to:

• CFSS Manual – PCA service options and CFSS service models, CFSS-specific information, person’s responsibilities section.
• CFSS Manual – PCA/CFSS worker criteria, requirements and responsibilities, collective bargaining agreement section.

A budget model employer must set the worker’s wage based on the skills and experience required to perform the job tasks the person needs. For more information, refer to:

• CFSS Manual – Paying a spouse or parent of a minor for PCA/CFSS services, Pay rate section.
• CFSS Manual – PCA service options and CFSS service models, CFSS-specific information, person’s responsibilities section.

The PCA/CFSS agency provider is response to help. For more information, refer to July 30, 2024, AASD and DSD eList announcement.

Yes. As of Oct. 1, 2024, PCA workers may be the person’s spouse or parent of minor. For more information, refer to CFSS Manual – Paying a spouse or parent of a minor for PCA/CFSS services.

No. For policy information, refer to CFSS Manual – Paying a spouse or parent of a minor for PCA/CFSS services.

The PCA provider agency must use a U2 modifier on a claim for units provided by a spouse or parent of a minor. The provider agency only uses a U2 modifier if the person is still using PCA. For more information, refer to CFSS Manual – Paying a spouse or parent of a minor for PCA/CFSS services.

The participant’s representative cannot serve as the person’s worker. The person or parent/guardian may ask another family member, neighbor, friend, etc., to be the participant’s representative.

The maximum wage cannot exceed the PCA/CFSS unit rate, including taxes and fees. For more information, refer to CFSS Manual – Paying a spouse or parent of a minor for PCA/CFSS services , pay rate section.

Yes.

The budget is on Long-Term Services and Supports Service Rate Limits, Effective Jan. 1, 2025, DHS-3945 (PDF). The lead agency always authorizes the full worker training and development amount for people using personal care. For instructions, refer to DSD MMIS Reference Guide – ASA3 screen for worker supervision/training.

Worker training and development is required for everyone using CFSS personal care. It is included on a separate line in the support plan.

The lead agency authorizes a worker training and develop budget for all people using personal care (T1019) services, regardless of model.

Yes.

The county/tribal nation needs PCA1 access.

A person’s current service agreement is from Jan. 1, 2024, through Dec. 31, 2024, and the lead agency completes their reassessment on time. The following examples are also in the second module of CFSS_MMIS training in Trainlink.

Person using state plan PCA, not on a waiver/AC

1. The county/tribal nation enters a service agreement from Jan. 1, 2025, through June 30, 2025, with the following lines on the ASA3 screen:
   • PCA personal care (T1019) line with the dates Jan. 1, 2025, through June 30, 2025.
   • Worker supervision (T1019 UA) line with the dates Jan. 1, 2025, through June 30, 2025.
   • Six units of consultation services (T1023) with the dates Jan. 1, 2025, through June 30, 2025.
2. The county/tribal nation approves the person’s CFSS service delivery plan.
3. The county/tribal nation enters a new service agreement with the following lines on the ASA3 screen:
   • Line for consultation services (T1023) with six units and the dates July 1, 2025, through Dec. 31, 2025.
   • Lines for the person’s other approved services with the dates July 1, 2025, through Dec. 31, 2025 (refer to DSD MMIS Reference Guide – ASA3 screen overview for links to pages about the various line types).

Person using PCA on a waiver/AC

1. The county/tribal nation enters a service agreement from Jan. 1, 2025, through Dec. 31, 2025, with the following lines on the ASA3 screen:
   • PCA personal care (T1019) line with the dates Jan. 1, 2025, through June 30, 2025.
   • Worker supervision (T1019 UA) line with the dates Jan. 1, 2025, through June 30, 2025.
   • Six units of consultation services (T1023) with the dates Jan. 1, 2025, through June 30, 2025.
2. The county/tribal nation approves the person’s CFSS service delivery plan.
3. The county/tribal nation enters new lines on the person’s existing service agreement on the ASA3 screen:
   • Line for consultation services (T1023) with six units and the dates July 1, 2025, through Dec. 31, 2025.
   • Lines for the person’s other approved services with the dates July 1, 2025, through Dec. 31, 2025 (refer to DSD MMIS Reference Guide – ASA3 screen overview for links to pages about the various line types).

Person using CSG

1. The county/tribal nation enters a service agreement from Jan. 1, 2025, through June 30, 2025, with the following lines on the ASA3 screen:
   • CSG line (T2025) line with the dates Jan. 1, 2025, through June 30, 2025.
   • CSG administration fee (T2025 UA) line with the dates Jan. 1, 2025, through June 30, 2025.
   • Six units of consultation services (T1023) with the dates Jan. 1, 2025, through June 30, 2025.
2. The county/tribal nation approves the person’s CFSS service delivery plan.
3. The county/tribal nation enters a new service agreement with the following lines on the ASA3 screen:
   • Line for consultation services (T1023) with six units and the dates July 1, 2025, through Dec. 31, 2025.
   • Lines for the persons other approved services with the dates July 1, 2025, through Dec. 31, 2025 (refer to DSD MMIS Reference Guide – ASA3 screen overview for links to pages about the various line types).

Person age 65 or older enrolled in an MCO and not on a disability waiver

The MCO follows its own process.

The types and codes are:

• Consultation services: Provider type 38-C, specialty code S4.
• CFSS provider agency: Provider type 38-O, specialty code S2.
• FMS provider: Provider type 38-F, specialty code S3.

The MCO Provider Eligibility CD file identifies both PCA and CFSS provider agencies as 38-O. CFSS agencies must also have the specialty code S2. CFSS providers will appear in the PECD file after they are enrolled.

Yes, the lead agency could choose to authorize 12 units of consultation services (T1023) for people currently receiving PCA on a waiver/AC.

Yes. For more information, see DSD MMIS Reference Guide - Type B service agreement (SA) for PCA/CFSS.

The lead agency can look up NPI numbers in MMIS using the same process as they would for other provider types.

PCA services.

DHS reviews them as soon as possible. DHS is working on programming MMIS to reduce the number of exception codes.

The lead agency should use Service Agreement and Screening Document (SASD) Support Team Portal to send a screenshot to DHS.

DHS corrected this error on Oct. 16, 2024. If the county/tribal nation continues to experience problems, it can use Service Agreement and Screening Document (SASD) Support Team Portal to send a screenshot to DHS.

The difference is who provides the training. In MMIS, the modifier UD indicates a formal training, such as a workshop or a class. For a person on the agency model, UD is a claims-only modifier. For a person on the budget model, the lead agency always uses the modifier UD.

For more information, refer to DSD MMIS Reference Guide - ASA3 screen for worker supervision/training (PCA: T1019 – UA; CFSS: S5116).

The county/tribal nation must submit a CFSS Request Form, DHS-6893K (PDF). DHS is creating a CFSS version of DHS-4292. Until DHS completes the new form, use the “other” field of DHS-4292.

Yes, the “no pay code” is the same: A342517700. Refer to:

• DSD MMIS Reference Guide – ASA3 screen for personal care services, provider number section.
• DSD MMIS Reference Guide – ASA3 screen for worker supervision/training, provider number section.
• DSD MMIS Reference Guide – ASA3 screen for FMS provider fees, provider number section.
• DSD MMIS Reference Guide – ASA3 screen for PERS, provider number section.
• DSD MMIS Reference Guide – ASA3 screen for goods and services, provider number section.
• DSD MMIS Reference Guide – ASA3 screen for consultation services, provider number section.

No, the county/tribal nation only enters a waiver service agreement.

Yes. For more information, refer to DSD MMIS Reference Guide – ASA3 screen for worker supervision/training (PCA: T1019 – UA; CFSS: S5116).

DHS is working on updating DHS – FMS provider information.

The consultation services provider shares this information. For more information, refer to CFSS Manual – Consultation services provider requirements.

The person’s FMS provider must provide monthly spending reports to the person or their participant’s representative, case manager/care coordinator (if applicable) and consultation services provider. The person or their participant’s representative must review the spending reports and monitor their budget. For more information, refer to CFSS Manual – FMS documentation and reporting for CFSS.

Three entities have responsibilities:

• Consultation services provider helps the person write their CFSS service delivery plan.
• Lead agency approves the CFSS service delivery plan.
• FMS provider implements the CFSS service delivery plan.

No. HCN comes out of the HCN budget. For state plan services, CFSS units/budget and HCN units must fall within the HCN cap.

No. The person may continue to use both CFSS and HCN services, but they cannot convert home care nursing dollars to their CFSS budget. 

If the person previously was converting HCN units to CSG, the county/tribal nation must offer them a new MnCHOICES assessment.

Yes.

The consultation services provider does not receive information about the person’s HCN eligibility.

For a person not on a waiver, the medical review agent (Acentra) and/or DHS merge HCN and CFSS service agreements. If a person is on a waiver, the case manager/care coordinator merges the person’s service agreements.

The CFSS rates are listed on DHS – CFSS codes and rates and Long-Term Services and Supports Service Rate Limits, DHS-3945 (PDF).

Yes, DHS reimburses providers at a different rate for shared personal assistance services. The lead agency does not enter shared care rates on the person’s service agreement. Providers use shared care rates when submitting claims.

The personal care (T1019) and enhanced rate personal care (T1019 TG) rates are the same. The worker training and development budget (S5116) is based on the current worker supervision rate (T1019) and standard number of authorized worker supervision units (8 units per month). All other CFSS rates are new.

Yes, time spent reviewing and coordinating CFSS is billable time. Case managers must follow their lead agency’s policies for how to code and bill this time.

DHS legally cannot give lead agencies detailed instructions on reporting or payment related to random moment studies.

No.

In PCA, the person may contact the lead agency or work with their PCA provider agency to request an early reassessment for change in condition. In CFSS, the person may work with the CFSS provider agency or FMS provider to request a reassessment.

The consultation services provider must upload an updated CFSS service delivery plan into MnCHOICES and notify the lead agency using that lead agency’s preferred communication method. The next step depends on the person’s situation:

• Person using waiver/AC: The lead agency must review the CFSS service delivery plan to ensure there is a not a duplication of service providers.
• Person using state plan services: All providers (new and old) must submit a request to DHS using the CFSS Technical Change Request, DHS-6893K (PDF) to DHS. DHS is developing a CFSS version of this form and will share it when available.

The process varies depending on the type of change. DHS is developing resources and will share them when available.

Yes.

For detailed information, refer to CFSS authorization process.

Existing PCA providers must follow the directions on Enroll with MHCP – community First Services and Supports (CFSS) provider agency enrollment criteria and forms.

The consultation services provider must help the person estimate their budget based on their assessment results and help the person use it to write their CFSS service delivery plan. The lead agency confirms the amount before entering it in MMIS. DHS created the CFSS service agreement calculators to help with these calculations.

The lead agency notifies the provider outside of MnCHOICES, using a method determined by the lead agency.

The CFSS Policy Manual has sections that describe responsibilities based on role. In general:

• The assessor completes the assessment and provides information about services available through CFSS.
• The consultation services provider educates the person on CFSS and helps them with their CFSS service delivery plan.
• The case manager compares the CFSS service delivery plan to the person’s other services and approves and coordinates all services.

No. Schools will continue to provide PCA-like services as part of students’ individualized education plans (IEPs).

To ensure equitable access, DHS:

• Added contact information to all CFSS forms for people whose primary language is not English so they can be connected with an interpreter.
• Translated some CFSS forms for person using services. For links to translated forms, refer to CFSS Manual – CFSS forms and documents. DHS will post additional translated forms on this page as we complete them.

The person cannot use CFSS while in an institution.

DHS-6791E is not applicable for a person who does not have a case manager. The provider agency or FMS provider submits Referral for Reassessment for PCA/CFSS Services, DHS-6893B to the lead agency to request a reassessment for a person not on a waiver/AC. This process is the same as it was in PCA.

The following resources are available for lead agencies:

• CFSS Policy Manual
• DSD MMIS Reference Guide – Type B service agreement (SA) for PCA/CFSS
• On-demand TrainLink courses:
  • CFSS_LA for existing staff
  • CFSS_PO for new staff
  • CFSS_MMIS training
• Office hours.

There are no monitoring requirements for lead agencies for state plan PCA/CFSS. Case managers/care coordinators monitor services as they did before.