Minnesota Minnesota

CFSS Policy Manual

CFSS Policy Manual


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:

  • · Changes for people on Minnesota Senior Health Options (MSHO) or Minnesota Senior Care Plus (MSC+), with or without Elderly Waiver (EW).
  • · Changes for people on MSHO or MSC+ with Brain Injury (BI), Community Alternative Care (CAC), Community Access for Disability Inclusion (CADI) or Developmental Disabilities (DD) waivers.
  • 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)

    CFSS Manual – PCA/CFSS service delivery plan changes

    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

    CFSS Manual – PCA/CFSS service delivery plan changes

    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

    CFSS Manual – PCA/CFSS service delivery plan changes

    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

    CFSS Manual – PCA/CFSS service delivery plan changes

    Adding more consultation services sessions

    No

    No

    No

    MCO follows its authorization process

    Consultation services provider contacts the MCO care coordinator for authorization

    CFSS Manual – Consultation services overview

    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

    CFSS Manual – Worker training and supervision

    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)

    CFSS Manual – PCA/CFSS service delivery plan changes

    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

    CFSS Manual – PCA/CFSS service delivery plan changes

    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

    CFSS Manual – PCA/CFSS service delivery plan changes

    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

    CFSS Manual – PCA/CFSS service delivery plan changes

    Adding more consultation services sessions

    No

    No

    MCO adjusts the authorization, if applicable

    No

    Consultation services provider contacts the MCO care coordinator for authorization

    CFSS Manual – Consultation services overview

    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

    CFSS Manual – Worker training and supervision

    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

    CFSS Manual – Changing PCA/CFSS providers

    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

    CFSS Manual – Changing PCA/CFSS providers

    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

    CFSS Manual – Changing PCA/CFSS providers

    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

    CFSS Manual – Changing PCA/CFSS providers

    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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