Minn. Stat. §256B.0659, Minn. Stat. §256B.0652

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 both PCA and CFSS:

Differences

In PCA:

In CFSS:

There are small technical differences in the PCA and CFSS processes, as described in the following sections.

The instructions on this page only apply to:

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.

A provider, county or tribal nation can send a request to DHS to make changes or corrections to an SA that contains incorrect information. This information may include, but is not limited to:

This page includes instructions to:

Provider instructions

If a PCA/CFSS provider agency, FMS provider or consultation services provider believes there is an error on a person’s SA, that provider must contact the county/tribal nation immediately.

County/tribal nation instructions

Within 30 days of receiving an SA with an error the county/tribal nation cannot resolve, the county/tribal nation must submit a request using PCA Request Form, DHS-4292 or CFSS Request Form, DHS-6893I. The request must include:

DHS responsibilities

If the county/tribal nation accurately completed all required fields and DHS considers the request appropriate, DHS will make the correction to the SA and issue a new SA to the person and the provider agency/FMS provider.

Shared care

Stopping shared care

If a person chooses to stop using shared care, they do not need an updated SA. All people using shared care can choose to switch to one-on-one services at any time.

Starting shared care

If a person using PCA chooses to start using shared care, either the person or the PCA provider agency must contact the county/tribal nation. The county/tribal nation must submit a request to DHS to update the person’s SA using PCA Request Form, DHS-4292. After DHS updates the SA, the PCA provider agency will be able to bill for shared care.

DHS does not need to update CFSS SAs for shared care because all CFSS services agreements allow for shared care.

PCA Choice and traditional PCA

At the time of the assessment, the assessor indicates if PCA Choice is an option for a person. The assessor enters Y for a person who can use PCA Choice and N for a person who cannot.

If the assessor indicated PCA Choice as an option, the person does not need an updated SA to change options.

If the assessor indicated PCA Choice was not an option and the person wants to start using PCA Choice, the person must contact the county/tribal nation. DHS will only update an SA from N to Y if the request comes from the county/tribal nation using PCA Request Form, DHS-4292.

CFSS agency model and CFSS budget model

If a person wants to switch CFSS service models, they must follow the directions on CFSS Manual – PCA/CFSS process to change service options/models.

Using multiple PCA/CFSS agencies

A person who wants to use multiple agencies must use traditional PCA or the CFSS agency model. Provider agencies can submit a request to DHS to update the SA to traditional PCA using PCA Technical Change Request, DHS-4074A or CFSS Technical Change Request, DHS-6893K.

For more information, refer to CFSS Manual – Flexibility to combine PCA/CFSS agencies and/or home care services.

Note: A person cannot use multiple consultation services providers or FMS providers.

To prevent a gap in a person’s services, DHS will update the start date or end date of an SA if both of the following are true:

Either the provider agency/FMS provider or the county/tribal nation may submit the request.

Provider agency/FMS provider instructions

The provider agency/FMS provider must submit PCA Technical Change Request, DHS-4074A or CFSS Technical Change Request, DHS-6893K to DHS and include:

DHS will update the SA, unless the county/tribal nation has documented failed attempts to contact the person or RP/representative.

County/tribal nation instructions

The county/tribal nation must submit PCA Request Form, DHS-4292 or CFSS Request Form, DHS-6893I to DHS and include:

DHS responsibilities

If DHS considers the request appropriate, DHS will make the correction to the SA and issue a new SA to the person and the provider.

The provider agency/FMS provider listed on the person’s current SA must report a change in the person’s RP/representative. The provider agency/FMS provider must:

Within 183 days of the start of a CFSS SA

If the person is not currently using PCA and the request is within 183 days of the start of the SA:

183 days or more after the start of a CFSS SA

If the request is 183 days or more after the start of the SA, the county/tribal nation must direct the CFSS provider agency or FMS provider to submit CFSS Technical Change Request, DHS-6893K.

If the FMS provider (CFSS budget model only) submits a background study for a potential worker and the worker fails the background study, the FMS provider must bill for the background study using a specific procedure code.

To bill for a failed background study: