Resource: CFSS mid-year changes for people age 65 or older who are enrolled in a managed care organization (MCO)
Page updated: 2/11/26
This page is a resource for MCOs and CFSS providers when people using CFSS experience changes in the middle of their service year. It applies to CFSS services only and assumes the person selects in-network providers.
This page includes information about:
For information about the processes for counties/tribal nations, refer to CFSS Manual – CFSS mid-year changes for counties and tribal nations.
Note: If a person is using CFSS on a waiver/AC, the case manager must confirm any changes to their services are within their consumer directed consumer supports (CDCS) and/or AC/EW budget, if applicable. For more information, refer to CFSS Manual – PCA/CFSS services on a waiver/AC.
Changes for people on MSHO or MSC+, with or without EW
Type of change | Does consultation services provider revise CFSS service delivery plan? | Does MCO care coordinator approve? | Does MCO care coordinator complete DHS-6893W or equivalent MCO form? | Additional MCO required actions | Provider actions | Resources |
Moving units/dollars between personal care, goods/services, personal emergency response systems (PERS) and financial management services (FMS) fee | Yes, consultation services provider must revise the service delivery plan | Yes, MCO care coordinator must approve | Yes, MCO care coordinator must complete a new Lead Agency Addendum to CFSS Individual Service Delivery Plan, DHS-6893W or equivalent form | MCO care coordinator must: 1. Update the MnCHOICES support plan 2. Send approval or denial, termination or reduction (DTR) to the person and their providers 3. Adjust the authorization, if applicable | CFSS provider agency discusses with the person how they will use their updated number of units (agency model only) | |
Changing the cost of a specific good/service, PERS or FMS fee | Yes, consultation services provider must revise the service delivery plan | Yes, MCO care coordinator must approve | Yes, MCO care coordinator must complete a new Lead Agency Addendum to CFSS Individual Service Delivery Plan, DHS-6893W or equivalent form | MCO care coordinator must: 1. Update the MnCHOICES support plan 2. Send approval or DTR to the person and their providers 3. Adjust the authorization, if applicable | N/A | |
Changing a specific good/service | Yes, consultation services provider must revise the service delivery plan | Yes, MCO care coordinator must approve | MCO care coordinator only completes a new Lead Agency Addendum to CFSS Individual Service Delivery Plan, DHS-6893W or equivalent form if the total authorized amount changes | MCO care coordinator must: 1. Update the MnCHOICES support plan 2. Send approval or DTR to the person and their providers 3. Adjust the authorization, if applicable | N/A | |
Changing a specific worker training and development class | Yes, consultation services provider must revise the service delivery plan | Yes, MCO care coordinator must approve | MCO care coordinator only completes a new Lead Agency Addendum to CFSS Individual Service Delivery Plan, DHS-6893W or equivalent form if the total authorized amount changes | MCO care coordinator must: 1. Update the MnCHOICES support plan 2. Send approval or DTR to the person and their provider 3. Adjust the authorization, if applicable | N/A | |
Adding more consultation services sessions | No | No | No | MCO follows its authorization process | Consultation services provider contacts the MCO care coordinator for authorization | |
Adding more worker training and development | No | No | No | MCO follows its authorization process | CFSS provider agency or FMS provider contacts the MCO care coordinator to request an increase | |
Adding failed background study (budget model only) | No | No | No | MCO follows its authorization process | FMS provider communicates the number of failed background studies to the MCO care coordinator | N/A |
Changing models | Yes, consultation services provider must revise the service delivery plan | Yes, MCO care coordinator must approve | Yes, MCO care coordinator must complete a new Lead Agency Addendum to CFSS Individual Service Delivery Plan, DHS-6893W or equivalent form | MCO care coordinator must: 1. Update the MnCHOICES support plan 2. Send approval or DTR to the person and their providers 3. Adjust the authorization, as applicable | CFSS provider agency and FMS provider must contact the MCO care coordinator and participate in a coordinated transfer of care | CFSS Manual – PCA/CFSS process to change service options/models |
Changing an FMS provider | Yes, consultation services provider must revise the service delivery plan | Yes, MCO care coordinator must review the service delivery plan for conflicts of interest | Yes, MCO care coordinator must complete a new Lead Agency Addendum to CFSS Individual Service Delivery Plan, DHS-6893W or equivalent form if the care coordinator knows how the authorization will be split | MCO care coordinator must: 1. Update the MnCHOICES support plan 2. Adjust the authorization as applicable 3. Direct the consultation services provider to update the service delivery plan | Both FMS providers must contact the MCO care coordinator and participate in a coordinated transfer of care | Care coordinators should refer to resources specific to the MCO |
Changing or adding a CFSS provider agency | Consultation services provider updates the provider information only | Yes, MCO care coordinator must review the service delivery plan for conflicts of interest and approve it | No | MCO care coordinator must: 1. Update the MnCHOICES support plan 2. Adjust the authorization, as applicable 3. Direct the consultation services provider to update the service delivery plan | CFSS provider agencies must contact the MCO care coordinator and participate in a coordinated shared or transfer of care | Care coordinators should refer to resources specific to the MCO |
Changing a consultation services provider | Consultation services provider updates the provider information only | Yes, MCO care coordinator must review the service delivery plan for conflicts of interest and approve it | No | MCO care coordinator must: 1. Update the MnCHOICES support plan 2. Adjust the authorization, as applicable 3. Direct the consultation services provider to update the service delivery plan | New consultation services provider must: 1. Contact the MCO care coordinator to request authorization 2. Attest that the person or their participant’s representative agreed to the change | Care coordinators should refer to resources specific to the MCO |
Changing a PERS provider | Consultation services provider updates the provider information only | No | No | MCO care coordinator must: 1. Update the MnCHOICES support plan 2. Adjust the authorization, as applicable 3. Direct the consultation services provider to update the service delivery plan | New PERS provider must: 1. Contact the MCO care coordinator to request authorization 2. Attest that the person or their participant’s representative agreed to the change | Care coordinators should refer to resources specific to the MCO |
Changing the participant’s representative | Consultation services provider updates the participant’s representative information only | No | No | MCO care coordinator must update the MnCHOICES support plan and MCO systems | CFSS provider agency or FMS provider must complete a new PCA Program Responsible Party Form/CFSS Participant Representative Agreement, DHS-6893F and follow any additional MCO instructions | Care coordinators should refer to resources specific to the MCO |
Changes for people on MSHO or MSC+ with BI, CAC, CADI or DD waivers
The MCO care coordinator and county/tribal nation waiver case manager use Recommendation for State Plan Services, DHS-5841 to coordinate changes to the person’s services.
Type of change | Does consultation services provider revise CFSS service delivery plan? | Does county/tribal nation review and MCO care coordinator need to approve the CFSS service delivery plan? | Lead agency required actions | Does MCO care coordinator complete DHS-6893W or equivalent MCO form? | Provider actions | Lead agency resources |
Moving units/dollars between personal care, goods/services, personal emergency response systems (PERS) and financial management services (FMS) fee | Yes, consultation services provider must revise the service delivery plan | Yes, MCO care coordinator must approve | County/tribal nation: 1. Sends DHS-5841 to the MCO 2. Updates the support plan MCO: 1. Updates the support plan 2. Sends approval or DTR to the person and their providers 3. Returns DHS-5841 to the county/tribal nation with updates 4. Adjusts the authorization, if applicable | Yes, MCO care coordinator must complete a new Lead Agency Addendum to CFSS Individual Service Delivery Plan, DHS-6893W or equivalent form | CFSS provider agency discusses with the person how they will use their updated number of units (agency model only) | |
Changing the cost of a specific good/service, PERS or FMS fee | Yes, consultation services provider must revise the service delivery plan | Yes, MCO care coordinator must approve | County/tribal nation: 1. Sends DHS-5841 to the MCO 2. Updates the support plan MCO: 1. Updates the support plan 2. Sends approval or DTR to the person and their providers 3. Returns DHS-5841 to the county/tribal nation with updates 4. Directs the consultation services provider to update the service delivery plan 5. Adjusts the authorization, if applicable | Yes, MCO care coordinator must complete a new Lead Agency Addendum to CFSS Individual Service Delivery Plan, DHS-6893W or equivalent form | N/A | |
Changing a specific good/service | Yes, consultation services provider must revise the service delivery plan | Yes, MCO care coordinator must approve | County/tribal nation: 1. Sends DHS-5841 to the MCO 2. Updates the support plan MCO: 1. Updates the support plan 2. Sends approval or DTR to the person and their providers 3. Returns DHS-5841 to the county/tribal nation with updates 4. Directs the consultation services provider to update the service delivery plan 5. Adjusts the authorization, if applicable | MCO care coordinator only completes a new Lead Agency Addendum to CFSS Individual Service Delivery Plan, DHS-6893W or equivalent form if the total authorized amount changes | N/A | |
Changing a specific worker training and development class | Yes, consultation services provider must revise the service delivery plan | Yes, MCO care coordinator must approve | County/tribal nation: 1. Sends DHS-5841 to the MCO 2. Updates the support plan. MCO: 1. Updates the support plan 2. Sends approval or DTR to the person and their providers 3. Returns DHS-5841 to the county/tribal nation with updates 4. Directs the consultation services provider to update the service delivery plan 5. Adjusts the authorization, if applicable | MCO care coordinator only completes a new Lead Agency Addendum to CFSS Individual Service Delivery Plan, DHS-6893W or equivalent form if the total authorized amount changes | N/A | |
Adding more consultation services sessions | No | No | MCO adjusts the authorization, if applicable | No | Consultation services provider contacts the MCO care coordinator for authorization | |
Adding more worker training and development | No | No | MCO adjusts the authorization, if applicable | No | CFSS provider agency or FMS provider contacts the MCO care coordinator for authorization | |
Adding failed background study (budget model only) | No | No | MCO adjusts the authorization, if applicable | No | FMS provider communicates the number of failed background studies to the MCO care coordinator | Care coordinators should refer to resources specific to the MCO |
Changing models | Yes, consultation services provider must revise the service delivery plan | Yes, MCO care coordinator must approve | County/tribal nation: 1. Sends DHS-5841 to the MCO 2. Updates the support plan MCO: 1. Updates the support plan 2. Sends approval or DTR to the person and their providers 3. Returns DHS-5841 to the county/tribal nation with updates 4. Adjusts the authorization, if applicable | Yes, MCO care coordinator must complete a new Lead Agency Addendum to CFSS Individual Service Delivery Plan, DHS-6893W or equivalent form | CFSS provider agency and FMS provider must contact the MCO care coordinator and participate in a coordinated transfer of care | CFSS Manual – PCA/CFSS process to change service options/models |
Changing an FMS provider | Yes, consultation services provider must revise the service delivery plan | MCO care coordinator reviews the service delivery plan for conflicts of interest | County/tribal nation: 1. Sends DHS-5841 to the MCO 2. Updates the support plan MCO: 1. Updates the support plan 2. Sends approval or DTR to the person and their providers 3. Returns DHS-5841 to the county/tribal nation with updates 4. Directs the consultation services provider to update the service delivery plan 5. Adjusts the authorization, if applicable | Yes, MCO care coordinator must complete a new Lead Agency Addendum to CFSS Individual Service Delivery Plan, DHS-6893W or equivalent form | Both FMS providers must contact the MCO care coordinator and participate in a coordinated transfer of care | |
Changing or adding a CFSS provider agency | Consultation services provider updates the provider information only | MCO care coordinator reviews the service delivery plan for conflicts of interest | County/tribal nation: 1. Sends DHS-5841 to the MCO 2. Updates the support plan MCO: 1. Updates the support plan 2. Sends approval or DTR to the person and their providers 3. Returns DHS-5841 to the county/tribal nation with updates 4. Directs the consultation services provider to update the service delivery plan 5. Adjusts the authorization, if applicable | No | Both CFSS provider agencies must contact the MCO care coordinator and participate in a coordinated transfer of care New provider must attest that the person or their participant’s representative agreed to the change | |
Changing consultation services providers | Consultation services provider updates the provider information only | MCO care coordinator reviews the service delivery plan for conflicts of interest | County/tribal nation: 1. Sends DHS-5841 to the MCO 2. Updates the support plan MCO: 1. Updates the support plan 2. Sends approval or DTR to the person and their providers 3. Returns DHS-5841 to the county/tribal nation with updates 4. Directs the new consultation services provider to update the service delivery plan 5. Adjusts the authorization, if applicable | No | Both consultation services providers must contact the MCO care coordinator and participate in a coordinated transfer of care New provider must attest that the person or their participant’s representative agreed to the change | |
Changing a PERS provider | Consultation services provider updates the provider information only | MCO care coordinator reviews the service delivery plan for conflicts of interest | County/tribal nation: 1. Sends DHS-5841 to the MCO 2. Updates the support plan MCO: 1. Updates the support plan 2. Sends approval or DTR to the person and their providers 3. Returns DHS-5841 to the county/tribal nation with updates 4. Directs the consultation services provider to update the service delivery plan 5. Adjusts the authorization, if applicable | No | New PERS provider must: 1. Contact the MCO care coordinator to request authorization 2. Attest that the person or their participant’s representative agreed to the change | |
Changing the participant’s representative | Consultation services provider updates the participant’s representative information only | No | County/tribal nation and MCO update their respective plans and systems | No | Consultation services provider contacts the county/tribal nation and MCO care coordinator about the change CFSS provider agency or FMS provider must complete a new PCA Program Responsible Party Form/CFSS Participant Representative Agreement, DHS-6893F and follow any additional MCO instructions | Care coordinators should refer to resources specific to the MCO |
Resources
CFSS Manual – CFSS mid-year changes for counties and tribal nations
CFSS Manual – Changing PCA/CFSS providers
CFSS Manual – Consultation services overview
CFSS Manual – Overview of the PCA and CFSS processes
CFSS Manual – PCA/CFSS process to change service options/models
CFSS Manual – PCA/CFSS service delivery plan changes
CFSS Manual – PCA/CFSS services on a waiver/AC
CFSS Manual – Worker training and supervision
PCA Program Responsible Party Form/CFSS Participant Representative Agreement, DHS-6893F
Recommendation for State Plan Services, DHS-5841
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