Legal authority

Minn. Stat. §256B.85, subd. 11b and 18a

Comparison of PCA and CFSS

DHS is in the process of replacing PCA with CFSS. For more information about this transition, refer to CFSS Manual – Transition from PCA and CSG to CFSS.

Similarities

In PCA and CFSS, the worker’s employer must train, supervise and evaluate the worker.

Differences

In PCA, an individual called the qualified professional (QP) is responsible to:

The lead agency authorizes QP units to pay for the QP’s time.

In CFSS, the entity responsible for these tasks depends on the person’s model:

In both CFSS models, the lead agency authorizes a CFSS worker training and development budget that the worker’s employer (i.e., agency or person) can use flexibly to fulfill these responsibilities.

The rest of this page applies to CFSS only. For PCA-specific information about worker training and development, refer to PCA Manual – QP requirements overview.

Definitions

Responsible party (RP)/participant’s representative: An individual who is age 18 or older and capable of directing care on behalf of a person receiving PCA/CFSS services when the person is assessed as unable to direct their own care. In PCA, this individual is called the RP. In CFSS, this individual is called the participant’s representative.

Note: All references to “representative” on this page refer to the participant’s representative, unless otherwise specified.

CFSS worker training and development budget: A separate budget available to employers of CFSS workers (i.e., CFSS agency or person/representative) to pay for training, observation, monitoring and coaching of CFSS workers. These activities help CFSS workers expand their skills to support the person’s specific needs.

Employer: The entity responsible for recruiting, hiring, supervising, training and firing workers. In the CFSS agency model, the CFSS provider agency is the employer of CFSS workers. In the CFSS budget model, the person or their representative (if applicable) is the employer of CFSS workers.

Supervising professional: An individual with the background necessary to train the worker on a specific task and evaluate the worker’s competence to perform that task. An individual may meet this definition because of their education, training and/or experience. The supervising professional’s role is similar to the QP’s role in PCA. An active QP can serve as a CFSS supervising professional if they complete training on CFSS policy. For more information, refer to CFSS Manual – PCA/CFSS provider agency training requirements.

If the person receives health-related tasks in the agency model, the CFSS agency must ensure an individual with the license, education, training or work experience appropriate to the task(s) trains and supervises the worker. For more information, refer to CFSS Manual – PCA/CFSS health-related procedures and tasks.

Overview

The process for CFSS worker training and development depends on the model the person uses.

Agency model

When a person is eligible for and chooses to receive CFSS services through the agency model:

1. The person includes ideas and information about their worker’s training needs when they write their service delivery plan.

2. The lead agency authorizes worker training and development for the person.

3. The CFSS provider agency and person write and refine the worker training and development plan.

4. The supervising professional trains the person’s worker and ensures they are competent.

5. The worker attends classes, if applicable.

6. The CFSS provider agency bills DHS for time the supervising professional spends training the worker and for classes, if applicable.

Budget model

When a person is eligible for and chooses to receive CFSS services through the budget model:

1. The person includes a worker training plan in their individual service delivery plan, with help from their consultation services provider if desired.

2. The consultation services provider reviews the service delivery plan, including the worker training plan, and submits it to the lead agency.

3. The lead agency approves the service delivery plan and authorizes worker training and development for the person.

4. The person trains their worker and ensures they are competent.

5. The worker attends classes, if applicable.

6. The financial management services (FMS) provider bills DHS for classes, if applicable.

Covered services

Training, supervision and evaluation of workers

In the CFSS agency model, the CFSS provider agency can use the worker training and development budget to pay the supervising professional(s) to:

In the CFSS budget model, the person or their representative cannot use the worker training and development budget to pay themselves to meet their employer responsibilities.

Classes and workshops

In both the CFSS agency and budget models, the worker’s employer can use the CFSS worker training and development budget to pay the fees for a worker attending a class or workshop on topics related to the person’s assessed needs.

A class can take place in a variety of settings and have varying amounts of learners (e.g., one-on-one training, traditional classroom course, online class).

Non-covered services

In both the CFSS agency and budget models, the worker’s employer cannot use the CFSS worker training and development budget to pay for:

Additional information for budget model

In the CFSS budget model, the person or their representative also cannot:

Employer’s responsibilities (provider agency or person)

The worker’s employer is responsible to train, supervise and evaluate the worker’s competency.

In the agency model, the CFSS provider agency is the employer. The person works with the supervising professional to train and supervise the workers.

In the budget model, the person is the employer. The person trains and supervises the workers.

The following sections describe the specific responsibilities of the employer.

Worker training plan

All people using CFSS must have a worker training plan. The employer must create a plan that describes:

Training on the needs of the person

The employer must orient each worker to the person’s needs and train them on the tasks the person needs.

Supervision and evaluation

For each worker, the employer must:

If the worker is a minor, the employer must complete all worker competency evaluations in person and in a setting where the person is receiving CFSS services.

Note: If the person meets the exception requirements described on CFSS Manual – CFSS provider agency evaluation of services, the provider agency can conduct these evaluations remotely.

Documentation

For each worker, the employer must document:

Updates to the worker training plan

The employer must update the worker training plan in all of the following situations:

Billing

Agency model

For people who use the agency model, the CFSS provider agency is responsible to:

Budget model

For people on the budget model, the FMS provider is responsible to bill on the person’s behalf. For additional information, refer to the FMS provider responsibilities section.

Requesting additional funds

All people receive the same initial worker training and development budget.

To request additional funds for the person’s worker training and development budget, the CFSS provider agency (agency model) or FMS provider (budget model) must request an increase from the following entities:

The CFSS provider agency or FMS provider must submit the following documentation to the appropriate entity:

Person’s responsibilities

In the CFSS agency model, the person is responsible to work with the supervising professional to train and supervise their workers.

In the CFSS budget model, the person is responsible to train and supervise their workers. For additional information, refer to the employer responsibilities section above.

Consultation services provider’s responsibilities

The consultation services provider is responsible to provide the person with:

For additional information, refer to CFSS Manual – CFSS consultation services provider requirements.

Provider agency’s responsibilities

For people who use the agency model, the CFSS provider agency is responsible for the activities listed in the employer responsibilities section above. CFSS provider agencies must pay for the worker’s time out of their operational costs to comply with labor law. They cannot bill DHS or the MCO for this time.

FMS provider’s responsibilities

For people on the budget model with a worker who attends a class as a part of the approved service delivery plan, the FMS provider is responsible to:

Example: A worker provided four hours (16 units) of personal care services and attended a two-hour class. The FMS provider: