Minnesota Minnesota

DSD MMIS Reference Guide

DSD MMIS Reference Guide


Type B service agreement (SA) for PCA/CFSS

Page posted: 5/20/11

Page reviewed:

Page updated: 7/22/25

Transition from PCA to CFSS

DHS is in the process of replacing personal care assistance (PCA) and the Consumer Support Grant (CSG) with Community First Services and Supports (CFSS). For more information about this transition, refer to CFSS Manual – Transition from PCA and CSG to CFSS.

For a Medicaid Management Information System (MMIS) transition summary, refer to DSD MMIS Reference Guide – MMIS transition from PCA and CSG to CFSS.

Similarities

The county/tribal nation completes the same screens for PCA and CFSS. The fields on most screens are the same for PCA and CFSS.

Differences

The county/tribal nation might enter different line types on the ASA3 screen.

The procedure codes and modifiers on the ASA3 screen are different for PCA and CFSS.

In CFSS, the county/tribal nation may update the SA for up to 183 days.

Some screens have minor differences.

Overview

This reference guide is specific to PCA/CFSS services.

A person who does not receive waiver services or the Alternative Care (AC) program

For a person who does not receive waiver services or the AC program, the county/tribal nation uses the DSD MMIS Reference Guide for instructions to enter a type B home care SA into MMIS for PCA or CFSS services.

A person who receives waiver services

For a person who receives waiver or AC and PCA or CFSS services, the county/tribal nation refers to:

  • · The instructions below.
  • · The instructions on DSD MMIS Reference Guide – ASA3 screen overview.
  • · Instructions for Completing and Entering the LTCC Screening Document and Service Agreement into MMIS, DHS-4625 (PDF) for information on all other screens.
  • PCA/CFSS SA instructions

    The county/tribal nation enters the person’s SA into MMIS to:

  • · Document the results of the person’s MnCHOICES assessment or CFSS Assessment, DHS-6893A.
  • · Authorize or deny services.
  • The instructions to enter services vary if the person receives:

  • · PCA or CFSS services.
  • · Waiver or state plan services.
  • Person eligible for PCA

    To enter the person’s PCA SA in MMIS, the county/tribal nation uses the results of the person’s MnCHOICES assessment or PCA Assessment and Service Plan, DHS-3244 (PDF).

    Note: As of Oct. 1, 2024, the county/tribal nation no longer enters PCA SAs. For more information, refer to DSD MMIS Reference Guide – MMIS transition from PCA and CSG to CFSS.

    Person eligible for CFSS

    To enter the person’s CFSS SA in MMIS:

    1. The county tribal nation conducts the assessment.

    2. The county/tribal nation gives the person DHS’ list of consultation services providers.

    3. The person selects a consultation services provider and informs the county/tribal nation of their choice.

    4. The county/tribal nation uses the person’s MnCHOICES assessment or CFSS Assessment, DHS-6893A to enter an initial SA in MMIS that authorizes the following services on the ASA3 screen:

  • · Consultation services.
  • · Six months of PCA or CSG services for reassessments during the transition year to avoid a gap in services.
    Note: The county/tribal nation follows instructions to enter a PCA personal care (T1019) line and a PCA worker supervision/training (T1019UA) line.
  • 5. The person works with their consultation services provider to complete their CFSS Individual Service Delivery Plan, DHS-6893P.

    6. The consultation services provider uploads the person’s service delivery plan to the MnCHOICES application.

    7. The county/tribal nation reviews and approves the service delivery plan.

    8. The county/tribal nation uses the service delivery plan to update the person’s SA to authorize the person’s remaining services on the ASA3 screen.

    For more information, refer to DSD MMIS Reference Guide – ASA3 screen overview.

    Person not eligible for PCA/CFSS

    The county/tribal nation follows instructions based on the person’s circumstances:

  • · For a person who does not currently receive any services or a person who currently receives state plan services only, the county/tribal nation follows the instructions on DSD MMIS Reference Guide – Notice of termination, denial or reduction of PCA/CFSS services for a type B home care SA.
  • · For a person who receives waiver or AC services, the county/tribal nation refers to Instructions for Completing and Entering the LTCC Screening Document and Service Agreement into MMIS, DHS-4625 (PDF).
  • Type B SA for PCA/CFSS

    The county/tribal nation begins at the AKEY SA screen to review authorization history or start a new SA.

    COPY FROM feature

    The county/tribal nation can use the COPY FROM feature to save time when they enter a new type B PCA, CSG or CFSS SA for a person with a previous type B PCA, CSG or CFSS SA. The COPY FROM feature prompts MMIS to copy information from the person’s previous SA into the person’s new SA.

    COPY FROM feature instructions

    To use the COPY FROM feature, the county/tribal nation:

    1. Enters the following values on the AKEY screen:

  • · ACTION CODE: a
  • · AUTHORIZATION TYPE: t
  • · AGMT TYPE: b
  • · COPY FROM: the 11-digit SA number of the person’s previous SA.
  • 2. Presses the enter key to create the new SA.

    3. Confirms the copied information is correct and completes the remaining fields.

    Fields that do not copy

    MMIS does not complete the following fields when the county/tribal nation uses the COPY FROM feature:

  • · ASA1 screen: AGMT START/END DT field.
  • · ASA2 screen: OVR LOC and RESP PARTY NAME fields.
  • · ASA3 screen: All service lines.
  • · AHC1 screen: ASSESSMENT DATE, BEGIN DATE and END DATE fields and X in CD column for the service requested.
  • · AHC2 screen: REF COMP, EN, PROV OWN/CTRL and LEVEL 1 BEH fields.
  • · AHC3 screen: ADDITIONAL INFORMATION field.
  • · ADHS screen: DHS COMMENTS field.
  • · APRV screen: PROVIDER COMMENTS field.
  • · ARCP screen: RECIPIENT COMMENTS field.
  • To complete the remaining fields, the county/tribal nation must manually enter the person’s information in their new SA.

    SA letters

    MMIS automatically generates SA letters overnight. DHS sends the person’s SA letter to the person and the provider(s) listed on SA lines.

    SA letters communicate:

  • · Assessment results.
  • · Service dates.
  • · Authorized services (if applicable).
  • · Service reduction, termination or denial (if applicable).
  • To inform the person about legal action, refer to CBSM – Notice of action.

    Reference guides

    MMIS displays screens in a queue order. The reference guides follow the MMIS queue order:

  • · ASA1 screen for PCA/CFSS
  • · ASA2 screen for PCA/CFSS
  • · ASA3 screen overview
  • · AHC1 screen for PCA/CFSS
  • · AHC2 screen for PCA/CFSS
  • · AHC3 screen for PCA/CFSS
  • · ADHS screen for PCA/CFSS
  • · APRV screen for PCA/CFSS
  • · ARCP screen for PCA/CFSS
  • · Finalize a type B SA for PCA/CFSS
  • Additional resources

    The following quick guides summarize how to enter a type B SA for specific scenarios:

  • · 45-day temporary increase of PCA/CFSS services.
  • · 45-day temporary start of PCA/CFSS services.
  • · EN home care rating for PCA/CFSS.
  • · Notice of termination, denial or reduction of PCA/CFSS services.
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