CFSS and lead agencies FAQ

Review: CFSS authorization process.

No.

It must send results 10 business days from the date of assessment.

It must provide:

• All documents required by MnCHOICES policy.
• Forms for long-term services and supports (LTSS) assessment, eligibility and support planning.
• CFSS eligibility in writing (DHS does not require a specific form).
• DHS – List of consultation services providers.
• CFSS Rights and Responsibilities, DHS-6893R (PDF).
• 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).

Eligibility must be in writing. DHS does not require a specific form. DHS recommends form 2828A.

Yes.

Submit the CFSS/PCA Request form – DHS-4292. DHS is updating the DHS-4292 to include CFSS. If you need it before the update, use the PCA version, “other” field.

The person must inform the lead agency once they choose a provider.

Yes.

No. See: CFSS policy manual - Paying a spouse or parent of a minor for PCA/CFSS services.

No. See: CFSS policy manual - PCA communication to person’s physician, comparison of PCA and CFSS section, and CFSS policy manual – Forms, retired forms section.

Yes, this will be updated to include CFSS.

Yes, MnCHOICES was designed for CFSS and DHS updated it.

No. Lead agencies authorize six sessions. See: Type B MMIS guide - ASA3 screen for consultation services (T1023), requested total units section and CFSS_MMIS training in Trainlink.

Consultation service providers may request additional units, if needed. See CFSS manual – CFSS consultation services overview, requesting additional units section.

Yes.

Yes, the “no pay code” will remain the same: A342517700. See Type B MMIS guide:

• ASA3 screen for personal care services, provider number section.
• ASA3 screen for worker supervision/training, provider number section.
• ASA3 screen for FMS provider fees, provider number section.
• ASA3 screen for PERS, provider number section.
• ASA3 screen for goods and services, provider number section.
• ASA screen for consultation services, provider number section.

Look up NPI numbers in MMIS. The provider number search functionality is unchanged.

No, consultation services may not request for services to begin before the service agreement start date.

The budget is $1,272.96/year. Worker training and development is always authorized for people using personal care. See MMIS type B guide - ASA3 screen for worker supervision/training.

The maximum wage may not exceed the PCA/CFSS unit rate, including taxes/fees. See CFSS manual - Paying a spouse or parent of a minor for PCA/CFSS services, Pay rate section.

A budget model employer must set a wage aligned with the skills and experience required to perform the job tasks the person needs. See:

• 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 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.) See:

• CFSS manual – PCA service options and CFSS service models, CFSS-specific information, person’s responsibilities section.
• CFSS manual – provider agency worker wage and benefit requirements.

FMS providers must help people using the budget model comply with the SEIU collective bargaining agreement. See:

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

Yes.

No, a person on a waiver will have one service agreement. This is not a change.

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

No.

They do not. The consultation services provider helps them with a plan based on their eligibility. Case manager/care coordinator works with the person on their overall service and makes changes if needed.

No.

The consultation services provider. See: Financial management service provider information.

The regional resource specialists asked lead agencies for their specific process. DHS will share with consultation services providers once complete.

No. HCN comes out of home care nursing budget. For State Plan, CFSS units/budget and HCN units must fall within the HCN cap.

Existing PCA providers will need to go through the revalidation process to become a CFSS provider agency.

The consultation services provider will attach the service delivery plan to the person's record in MnCHOICES for the care coordinator to review. The provider will notify the care coordinator that the plan has been attached through a method developed by the MCO (i.e. email, phone).

The assessor will complete the DHS-5841.

Beginning Oct. 1, the PCA providers will use a U2 modifier for parent of minor/spouse units in claims.

The person may use either their CFSS funds or the waiver funds to purchase PERS. A person is not required to use their full CFSS benefit before accessing waiver/AC services.

People who use the agency model will also use an FMS provider to obtain goods/services. Review the Goods and services through CFSS page of the CFSS Policy Manual for more information.

DHS has not yet developed an addendum or form to request mid-year changes. We are in the process of developing workflows for the wide variety of revisions that might occur. For most revisions, the lead agency will approve the change; plan approval may not be done by the consultation services provider. DHS will share more information about the revision process once available.

CFSS eligibility needs to be given to the person within 10 days of the assessment.

The lead agency may authorize a 45-day temporary start of CFSS services if the person needs emergency support services.

Lead agencies use form 6893A if they:

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

If the service delivery plan does not meet CFSS requirements, the lead agency may either: 

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

The lead agency may not approve a partial plan. The lead agency must approve or deny the plan within 30 days. An NOA is only issued if the plan is denied.

At reassessment, the lead agency must enter a three-month PCA/CSG service agreement. The lead agency must add a line for consultation services for three months. This will allow the person time to meet with the consultation services provider, select the agency or budget model, select a provider and develop the service delivery plan. Initial assess for CFSS does not include a PCA/CSG authorization.

Six units.

If a person is currently receiving PCA/CSG and reassessed for CFSS, the lead agency authorizes three months of PCA/CSG at the reassessment amount. If a person is not currently receiving PCA/CSG, the lead agency authorizes CFSS. The lead agency does not authorize PCA/CSG for three months.

No. CFSS is being implemented and an NOA is not issued.

No. A person’s assessment would not show dual eligibility for PCA and CFSS.

Lead agencies will be uploading the legacy assessments into MnCHOICES and complete a MnCHOICES support plan with transition plan reason.

The FMS provider is responsible for purchasing goods in both the agency and budget models.

A lead agency professional must approve the service delivery plan (assessor, care coordinator, case manager). Public health nurses that are part of the lead agency (interdisciplinary team), may approve the CFSS service delivery plan. A contracted agency public health nurse may not approve the CFSS service delivery plan.

No, this does not replace human assistance.

A person may use both CFSS and CDCS, if desired. If a person chooses to use CDCS and CFSS, the funding for CFSS comes from within the CDCS budget. The person will need to choose the agency or budget model. If the person chooses the budget model, they must use the same CFSS and CDCS FMS provider. If the person chooses the agency model, the person must select a CFSS provider agency.

Workers under the CFSS budget model are under the provisions of the SEIU bargaining agreement.

Yes. Extended CFSS services may be authorized if the person is eligible and on a waiver. Visit the Extended CFSS Services page of the CFSS Policy Manual for more information.

CFSS provider agencies will be identified as 38-O, with a specialty code S2. A PCPO is also a 38-O, so the specialty code is important.

After the reassessment, a person will continue with the same services they had been using. If they were using CSG before reassessment, they will remain on CSG for the three-month period until CFSS begins.

No.

The lead agency may deny the waiver if state plan can meet the person's needs. It is the role of the assessor to determine if a person is waiver eligible.

Yes, the consultation services provider must upload an updated service delivery plan into MnCHOICES: 

• Waiver/AC: The lead agency must review the service delivery plan to ensure there is a not a duplication of service providers. 
• Type B: The providers (new and old) must submit the technical change request to DHS.

The lead agency assessor must send the assessment results to the person within 10 days and provide them with: 

• A list of consultation services providers. 
• A Community First Services and Supports (CFSS) fact sheet, DHS-8477A (PDF). This form is also available in Hmong, Karen, Somali and Spanish.
• The CFSS Individual Service Delivery Plan, DHS‑6893P (PDF).

In CFSS, a person authorized for a 45-day temporary start does not need to work with a consultation services provider before they start services. After the 45-day temporary start, the person must follow the normal process.

Yes.

No.

The lead agency will make the PERS referrals. Consultation services providers may assist the person in identifying a potential PERS provider, but are unable to confirm which PERS providers are enrolled with the correct indicator.

Yes, time spent reviewing and coordinating CFSS is billable time. Case managers should follow their lead agency policies.

No, the person is responsible to select a CFSS provider agency. The consultation services provider will provide the person with a list of CFSS agency providers and FMS providers.

The consultation services provider will review the MnCHOICES assessment and educate the person on the agency vs. budget model. The consultation services provider and lead agency will be able to calculate the CFSS budget based on the assessment. The lead agency confirms the amount before entering in MMIS.

Worker training and development replaces RN supervision. This is authorized in dollars instead of units.

Yes, only adults are eligible to receive PERS.

The consultation services provider must have the ability to provide services statewide (either in person or remotely). The person may choose to meet in person, by phone or by video.

Yes, a consultation services provider is required for all people, regardless of the model.

The lead agency must provide the person with their eligibility information within 10 days, but does not have to enter the service agreement within 10 days. The county/tribal nation may edit the Type B service agreements for up to 60 days. If the person does not select a consultation services provider within 60 days, the county/tribal nation enters a service agreement with the "no pay code" and the provider must submit a request to DHS to update the service agreement. Note: MCOs use their own systems and processes.

The CFSS service authorization will be for nine months. Example: 

Authorize Type B service agreement: 

• Three months of PCA/CSG 1/1/25 – 3/30/25. 
• Six sessions of consultation services. 

Receive and approve service delivery plan:

• Nine months of CFSS services 4/1/25 – 12/31/25 (units/dollars calculated to nine months). 
• Six sessions of consultation services and full worker training and development budget.

The consultation services provider will notify the lead agency outside of MnCHOICES. They will follow the process developed by each lead agency.

After the consultation services provider attaches the service delivery plan to the person’s record in MnCHOICES and the lead agency reviews and approves the service delivery plan.

This process will not change with the implementation of CFSS. The process will remain the same as today.

The lead agency will notify the provider outside of MnCHOICES.

Yes, the lead agency will enter the authorization for consultation services for both Type B and waiver service agreements.

No, the MnCHOICES support plan should be closed and then revised when the consultation services provider is chosen and service delivery plan is submitted for approval.

In both PCA and CFSS, the lead agency:

• May authorize a 45-day temporary start for state plan PCA/CFSS services until the lead agency can schedule an in-person assessment.
• May not extend a 45-day temporary start; the person must have a new service agreement with a provider identified to continue services.
• In PCA, a person may use traditional PCA or PCA Choice during the 45-day temporary start.
• In CFSS, a person may only use the CFSS agency model during the 45-day temporary start.
• Unused units from the 45-day temporary start do not carry over to the CFSS service agreement because a new assessment will need to be completed.

No, other waiver services can be authorized on the service agreement while the CFSS service delivery plan is being developed. The lead agency will need to ensure services are not duplicative once all are approved.

The person will have one support plan. CFSS will be available under the service menu of a waiver support plan.

The roles vary based on the task being provided. Each page of the CFSS policy manual distinguishes the role of the person, lead agency, consultation services provider, agency provider and FMS provider depending on the task. The assessor provides information on what is available under CFSS, while the consultation services provider educates the person on what is allowed based on their individual assessment. The lead agency gives final approval.

While schools will continue to provide PCA-like services as part of IEP plans, they will not be classified as CFSS services.

A person may use both CFSS and CDCS, if desired. CFSS is foundationally a personal care service. People may decide to use some of their CFSS funds to purchase things that are allowable. If they choose to use only personal care in CFSS, people on a waiver may use waiver funds to receive other items/services that are coverable on a waiver. If a person chooses to use CDCS and CFSS, the funding for CFSS comes from within the CDCS budget.

The lead agency may only authorize extended PCA/CFSS services when all of the following conditions are met: 

• The person meets basic PCA/CFSS service access criteria on CFSS Policy Manual – Eligibility for PCA/CFSS services. 
• The person has a need for PCA/CFSS services identified during the assessment. 
• The person is using an HCBS waiver. 
• The person is authorized to receive MA state plan, non-waiver PCA/CFSS services. 
• The person’s need for PCA/CFSS services is of greater frequency or duration than state plan PCA/CFSS allows. 
• PCA/CFSS services do not duplicate other waiver services the person is using.

PCA1 access is needed.

DHS is in the process of determining which forms will be translated. It is also publishing the language block, which lists a phone number to call and the languages available for free translation services, on each form. Consultation services providers are required to have access to interpreting services and use these services if requested by the person. Some consultation services providers have employees on staff who speak other languages. Language-specific information can be found on the Consultation services providers webpage. Two grant opportunities were available for BIPOC-owned consultation services provider groups to prepare for CFSS.

People may continue to receive CFSS and home care nursing services. Under CFSS, people may not convert home care nursing dollars to the CFSS budget. County/tribal nations must offer people who are currently doing this a new MnCHOICES assessment.

Lead agencies may be able to capture some reimbursement through the Social Service Time Study (SSTS).

If the parent/guardian is a CFSS worker, they may not also be the responsible party. The person may ask another family member, neighbor, friend, etc., to be the responsible party.

The lead agency must let DHS know if people are unable to begin CFSS within three months because of a concern with the consultation services providers. If there are concerns with consultation services providers' ability to complete their work in a timely manner because of the volume of new CFSS enrollees, communicate this information to DHS. DHS will develop further guidance at that time, if needed.

Lead agencies will authorize three months based on the MnCHOICES reassessment.

Example:

• In the old service authorization, the person was eligible for five hours per day.
• Person is now eligible for six hours per day.
• Authorize three months of PCA/CSG at six hours per day.

Yes, starting Oct. 1, PCAs may be the spouse or parent of minor. The lead agency does not need to do anything to allow the parent or spouse to become the PCA worker.

Referrals may begin Oct. 1, 2024. Do not refer anyone assessed before Oct. 1 to a consultation services provider.

No, we must be statewide in our transition to CFSS. The State Plan benefit is available to all who qualify for it, and we must include waiver people.

No.

CFSS will be implemented on a rolling basis. Lead agencies are responsible for prioritizing their assessment assignments and waitlists. DHS would not be able to give guidance as to whether a person has a change in their condition which would necessitate a new assessment. If the lead agency determines there is not a significant change in need, they must send a notice of action documenting that decision.

No, the MnCHOICES assessor will close the assessment when finalized. The consultation services must be captured in a support plan once the person chooses a provider.

Yes, the lead agency will complete a support plan for both waiver and State Plan Type B service agreements.

If the person does not choose a consultation services provider within three months, services remain denied until the person chooses a consultation services provider.

The lead agency will send in a request form to the Service Agreement and Screening Document (SASD) Support Team team, formerly the resource center, using the SASD Support Team Portal. DHS will add a consultation services line to the person’s PCA service agreement until CFSS begins.

Unlike PCA, the CFSS budget line is for the length of the service agreement and the person may spend funds flexibly throughout the year. The lead agency, consultation services provider and FMS provider are responsible for monitoring spending.

DHS is completing user acceptance testing this week and hopes to post the MMIS manual and training soon.

Type B and waiver agreements containing CFSS services are entered as they are now for PCA. The MMIS security groups have not changed.

Worker training and development is required for both models and will be a separate line on the service agreement. The worker training and development will cover the supervising professional(s)' training, supervision and evaluation of workers in the agency model, as well as pay for classes and workshops in both the agency and budget model.

We have not yet set a date. The CFSS rates will be based on the PCA rates.

Yes, CFSS agency rates vary based on shared care, the same as PCA. Like PCA, the lead agency does not enter shared care rates or modifiers. This is claims only.

No, the formal rates will be posted and not include the $50/15 minutes. For the CFSS budget model, the rates are determined by the employer (the person).

The person should work with their consultation services provider to add any changes to their service delivery plan. The consultation services provider will connect with the lead agency to approve any changes to the plan. The lead agency updates the person's support plan, as needed, and sends it to the person.

If the person has a case manager, the case manager is responsible to provide information about the consultation services providers. If the person is State Plan only, the assessor is responsible to provide the person with information about the consultation services providers. There will be a handout.

The consultation services provider will upload the service delivery plan into the MnCHOICES system as an attachment.

The consultation services provider will communicate with the lead agency outside of MnCHOICES. The consultation services provider must follow the lead agency's protocol for notification. Each lead agency is responsible to develop their own process for who gets notified and how.

No. The completion of the service delivery plan will occur as soon as possible and will vary depending on many factors (how quickly the person or person’s representative is able to work on the plan, complexity of the service delivery plan, etc.). DHS will provide a more precise timeline at a later date.

CFSS is foundationally a personal care service. People may decide to use some of their personal care funds to purchase things that are allowable, but if they choose to use only personal care in CFSS, people on a waiver may use waiver funds to receive other items/services that are coverable on a waiver.

No, people are not required to purchase goods and services. Approved goods must be the most cost-effective option, but the most cost-effective does not always mean the least expensive.

In an agency model, a good or service purchased through the FMS does not have a monthly fee line. There would be a goods/services line that includes the cost of the good/service and the fee for the FMS to process that good/service. FMS providers will post.

Covered goods and services must be:

• Related to an assessed need.
• For the direct benefit of the person.
• Increase the person’s independence or decrease their need for assistance from another person.
• Included in the person’s service delivery plan.

Covered goods may include, but are not limited to:

• 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 [IADL]).
• Grabber tool, shoehorn tool (may replace dressing).

Covered services may include, but are not limited to:

• Meal delivery (eating or IADL).
• Laundry service (IADL).

If someone is determined to be waiver eligible, then they have a choice about using all or some of their State Plan CFSS benefit. If the person qualifies for CFSS and their needs can be met by CFSS including personal care/goods/services/PERS, they would not be waiver eligible. CFSS could be used for only goods/services if the person has supports for any other assessed needs and the plan addresses health and safety.

The lead agency may email DHS if they have concerns about a specific consultation provider.

Consultation services providers are going through the enrollment process.

DHS monitors the capacity of consultation services providers. We are holding office hours for consultation services providers.

Yes, they will be reviewing the assessment in MnCHOICES and will upload the CFSS service delivery plan for lead agency approval in MnCHOICES.

It will remain where it is.

There is a handout in development that will available soon.

CFSS on a Type B agreement does not change when a person is in a hospital or facility. We rely on edits in claims to be sure services are not paid during a hospital or nursing facility stay (for example). Waivers will work the way they do now.

Using the “no pay code” in MMIS will not affect MnCHOICES. If the person does not select a provider within 60 days, lead agencies will enter a service agreement in MMIS with the "no pay code" and the provider will need to submit a request to DHS to update the service agreement.

All consultation services providers have access to the MnCHOICES system and have received training on how to view the MnCHOICES support plan and upload the CFSS service delivery plan.

The MnCHOICES support plan is a product of MnCHOICES and located within the MnCHOICES application. The CFSS service delivery plan is not a product of MnCHOICES. The consultation services provider will attach the CFSS service delivery plan to the person’s record in the MnCHOICES system after it has been completed.

Yes, the Community First Services and Supports (CFSS) Policy Manual has been published.

Yes, the lead agency will enter a three-month PCA/CSG service agreement, including a line for consultation services. Previously, DHS had announced that an additional three months may be added, if needed, when there was a delay in receiving consultation services. However, after reviewing feedback from recipients, providers and lead agencies, DHS has determined three additional months will be added for all recipients to allow for a smooth transition to CFSS. The MMIS Manual will include additional information on how to enter a service agreement.

Lead agencies should follow their internal policies about approving CSG for an additional three months. Documentation should include:

· Person information (name, PMI number, FMS provider)

• Dates of service (three months)
• Total budget amount
• Direct support worker hours (wages, hours and associated taxes/fees)
• Goods and services (cost and associated fees).

A lead agency professional must approve the service delivery plan (assessor, care coordinator, case manager).

No, case management aides may not assume responsibilities that require professional judgment or development of support plans. A qualified case manager/assessor must supervise and direct the case management aide. Case management aides perform administrative activities as assigned by a case manager. For more information on case management aides, see CBSM - Case management aide.

DHS will not publish a list of allowable and unallowable goods and services; however, the CFSS policy manual will be revised to include additional guidance. Lead agencies need to follow CFSS statute when approving goods and services for a person. Goods and services need to replace the need for human assistance and be related to the person’s assessed need.

No, the 5% administrative fee does not apply to CFSS. An exception will be made during the three months a person is transitioning to CFSS and still receiving CSG, during which the county will receive the 5% administrative fee.

No. An assessment or reassessment done before Oct. 1, 2024, will be for PCA or CSG services. Assessments and reassessments done on or after Oct. 1, 2024, will be for CFSS services. CFSS will begin after the assessment/reassessment. Review Community First Services and Supports (CFSS): Timelines to learn more and review specific scenarios.

The lead agency will provide a list of CFSS consultation services providers to the person. The person is responsible for selecting a consultation services provider. If the person is unable to contact the consultation services providers themselves, the lead agency may work with the person to access the information and assist the person in selecting a provider. The lead agency may not select the consultation services provider for the person.

Yes, 2024 legislation allows for parents of minors and spouses to be paid for providing PCA services, beginning on Oct. 1, 2024, until the person receiving services moves to CFSS.

Yes, if the person is eligible for both services.

Yes, they may ask for a MnCHOICES assessment to learn about all the service options available.

Lead agencies must upload the information into MnCHOICES for the consultation services provider to review.

The legacy MnCHOICES system will retire on Oct. 1, 2024. DHS is updating the legacy PCA paper documents, PCA Assessment and Service Plan DHS-3244 (PDF), for CFSS.

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

We expect this process to remain the same with the start of CFSS.

The lead agency assessor notifies the person about CFSS during their assessment/reassessment.

Three entities will be responsible:

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

Lead agencies should:

• Complete on-demand Trainlink courses:
  • CFSS_LA for existing staff.
  • CFSS_PO for new staff.
  • MMIS training (not yet published.)
• Review all published resources.
• Attend office hours.
• Develop their own internal policies and procedures.

The lead agency requirements remain the same.

DHS will publish more information about plan revisions.

The monitoring requirements will stay the same. There are no additional requirements for CFSS.

The person will work with their consultation services provider, if needed.

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

The lead agency is responsible for PERS referrals.

The FMS provider is responsible for sharing spending report information with the person and the case manager/care coordinator (if applicable).

CFSS providers will appear in the PECD file after they are enrolled.

MCOs were provided instructions and authorization codes a few years ago. Updated rates will be provided soon.

CFSS is a rolling launch. People will be exiting PCA throughout the next 18 months. MCOs are expected to pay the established rates for the service type (CFSS/PCA) the member receives.