Minn. Stat. §256B.85, subd. 7

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

Effective Oct. 1, 2024, a person’s spouse or the parent of a minor can provide PCA/CFSS services under the conditions outlined on this page for PCA, the CFSS agency model and the CFSS budget model.

Differences

In PCA, provider agencies must bill DHS for services provided by the person’s spouse or parent of a minor using the claims modifier U2.

In CFSS:

In the CFSS budget model, there is a limit on the amount a person can pay their spouse or parent of a minor.

Parent: All references to “parent” on this page include the following:

Minor: A person who is younger than age 18.

Spouse: Anyone to whom a person is legally married.

Seven-day period: A consistent payroll week. The financial management services (FMS) provider or provider agency determines the day of the week their seven-day payroll week consistently starts.

To pay a spouse or parent of a minor for PCA/CFSS services, all of the following requirements must be met.

Qualifications

The spouse or parent of a minor must:

Covered services

A spouse or parent of a minor can be paid to help their spouse or child with tasks beyond what is considered ordinary responsibility (e.g., doing additional laundry for a 12-year-old child who is incontinent).

The service provided must not be an activity the spouse or parent of a minor would typically perform or be responsible to perform, such as:

Role

While providing PCA/CFSS services as identified in the service delivery plan, the spouse or parent of a minor must function as a paid worker, not as a spouse or parent. The spouse or parent of a minor must follow all policies that apply to all workers, including recording hours worked that correspond to the job description and general work schedule. The schedule can include variability for school schedules, extracurricular activities, illness, absent workers, etc. For more information, refer to the hours per week section on this page.

In the CFSS budget model, the compensation for the spouse or parent of a minor (including wages, benefits and payroll-related taxes) cannot exceed the established unit rate for CFSS services. The FMS provider should reference the CFSS rate for the fiscal year in which the spouse or parent of a minor provides services in Long-Term Services and Supports Service Rate Limits, DHS-3945 (PDF).

This requirement is in addition to the requirements that apply to all CFSS workers in the budget model, including applicable local, state or federal minimum wage requirements and the terms of the Service Employees International Union (SEIU) Healthcare Minnesota and Iowa collective bargaining agreement.

Consumer directed community supports (CDCS) also allows a worker who is the person’s spouse or the parent of a minor to receive payment. If there is a person using CDCS in the same household(s) as a person using CFSS, the limits apply to the total hours from both CFSS and CDCS.

The amount of CFSS/CDCS personal care hours for which provider agencies and FMS providers can bill for spouses and parents of minors depends on their circumstances. The limits in this section apply regardless of:

Spouse or one parent of a minor providing services

The provider agency/FMS provider cannot bill for more than 60 hours in a seven-day period for:

More than one parent of minor providing services

If more than one parent of minor provides services to their minor child(ren):

PCA/CFSS wages as income

As with other PCA/CFSS workers, PCA/CFSS wages of a spouse or parent of a minor are considered income. Once the spouse or parent receives wages, they can use that income at their discretion.

Consequences

PCA/CFSS income may affect the worker’s eligibility for programs with income-based eligibility criteria.

For CFSS, the case manager/care coordinator must conduct a semiannual review of services provided by a spouse or parent of a minor.

If the person does not have a case manager or care coordinator, the consultation services provider must conduct the semiannual review.

The semiannual review can happen in person or remotely.