Minnesota Minnesota

CFSS Policy Manual

CFSS Policy Manual


Flexible use of PCA/CFSS services

Page posted: 8/26/24

Page reviewed:

Page update:

Legal authority

Minn. Stat. §256B.85 subd. 11, Minn. Stat. §256B.0659, subd. 15, Minn. Stat. §256B.0646, Minn. R. 9505.2166, Minn. R. 9505.2238

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

PCA and CFSS both allow people to use the units/dollars authorized by the lead agency flexibly.

Differences

In PCA, people's units are divided into two 6-month spans, with some limitations.

In CFSS, people able to use the units/dollars flexibly throughout the entire service plan year.

Definition

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.

Requirements

A person using PCA/CFSS can use their units/dollars flexibly, unless any of the following is true:

  • · Person is on the Minnesota Restricted Recipient Program (MRRP) (refer to CFSS Manual – MRRP).
  • · Lead agency denies flexible use.
  • · DHS revokes or denies flexible use.

    • When using PCA/CFSS units/dollars in a flexible manner, a person cannot:

  • · Transfer units/dollars from one service plan year to another.
  • · Add additional units/dollars, unless they experience a change in condition.

    • Person's responsibilities

    A person using PCA/CFSS must:

  • · Communicate to applicable providers (e.g., consultation services provider, PCA/CFSS provider agency, financial management services [FMS] provider) if they have a change in condition that requires additional services.
  • · Determine how to use the total authorized amount of PCA/CFSS services to meet their needs and ensure their health and safety.
  • · Develop a month-to-month plan to use PCA/CFSS units/dollars as part of their service delivery plan.
  • · Monitor their use of PCA/CFSS services to ensure the authorized amount meets their needs throughout the service plan year.

    • Additional policy

    Refer to the following sections for PCA- and CFSS-specific policies:

  • · PCA-specific information.
  • · CFSS-specific information.

    • DHS responsibilities

    When a person is at risk of exceeding their authorized PCA/CFSS units/dollars, MMIS generates a written notice to the person and/or RP/representative and provider(s).

    Additional resources

    CFSS Manual – MRRP
    CFSS Manual – Transition from PCA and CSG to CFSS

    PCA-specific information

    Overview

    In PCA, a person's total authorized units must be divided between two 6-month date spans. A person cannot use more than 75% of their total authorized units in a 6-month date span.

    Lead agency’s responsibilities

    The lead agency must:

  • · Check to see if the person is on the MRRP and, if so, authorize one line for each month.
  • · Discuss with the person how they would like to split their units into the two 6-month spans.
  • · Authorize each 6-month span with the correct number of units in MMIS.

    • PCA provider agency’s responsibilities

    The PCA provider agency must:

  • · Work with the person to complete a month-to-month plan for the use of units and add it to their service delivery plan.
  • · Monitor the person's use of units.
  • · Notify the person/RP if the person will likely use or has used more units than authorized in a service plan year.

    • Misuse, denial and revocation

    DHS can deny or revoke a person's flexible use of PCA services based on information gathered.

    CFSS-specific information

    Overview

    In CFSS, a person can use their units or dollars flexibly throughout the service plan year, unless they are disallowed (as described in the requirements section above).

    Lead agency’s responsibilities

    The lead agency must:

  • · Check to see if the person is on the MRRP and, if so, authorize one line for each month.
  • · Authorize the total units/dollars in MMIS after the person selects a model and a CFSS provider agency/FMS provider.

    • Consultation services provider’s responsibilities

    The person's consultation services provider must:

  • · Help the person determine how to use the total authorized amount of CFSS services to meet their needs and ensure their health and safety, if requested.
  • · Help the person develop a month-to-month plan to use CFSS units/dollars as part of the service delivery plan, if requested.
  • · Review the plan and ensure the planned monthly use of units/dollars can meet the person's needs.

    • CFSS provider agency’s responsibilities

    For a person using the CFSS agency model, the CFSS provider agency must:

  • · Ensure the person completes a month-to-month plan for the use of CFSS units and adds it to their CFSS service delivery plan.
  • · Monitor the person's use of CFSS units.
  • · Notify the person/representative if the person uses more CFSS hours than planned.

    • FMS provider responsibilities

    For a person using the CFSS budget model, the FMS provider must:

  • · Provide monthly reports to the person and/or representative detailing how many dollars they used and how many remain in their service plan year.
  • · Provide monthly reports to the person's case manager/care coordinator, if applicable.

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