Overview of the PCA and CFSS processes for people receiving services through a managed care organization (MCO)
Page updated: 2/5/26
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.
Introduction
This page provides an overview of the process for people to access PCA and CFSS through their MCO. MCOs and providers use this page as a resource to understand the entire process. Generally, the steps happen in the order listed on this page. However, some steps can happen at the same time or in a different order. Refer to the links in the resources section for detailed instructions about each step.
For interactive videos about the content of this page, refer to CFSS detailed authorization process for MCOs and consultation services providers.
For information about the process for counties and tribal nations, refer to CFSS Manual – Overview of the PCA and CFSS process for people not receiving services through an MCO.
This page includes processes for:
Process for people age 65 or older enrolled in MSHO or MSC+ who are not using BI, CAC, CADI or DD waivers
To access CFSS for people age 65 or older enrolled in MSHO or MSC+ who are not using BI, CAC, CADI or DD:
1. The MCO care coordinator conducts the MCO MnCHOICES assessment and determines the person’s eligibility for programs and services.
2. The person selects CFSS services, if eligible.
Note: A person on the Elderly Waiver (EW) may choose to use all, some or none of the CFSS services for which they are eligible, in addition to their EW services.
3. The MCO care coordinator sends the person:
DHS-8477A-HMN, Hmong (PDF).
DHS-8774A-KAR, Karen (PDF).
DHS-8477A-SOM, Somali (PDF).
DHS-8477A-SPA, Spanish (PDF).
4. The person chooses a consultation services provider and notifies the MCO care coordinator of their choice.
5. The MCO care coordinator adds the consultation services provider to the person’s MnCHOICES support plan and assigns the consultation services provider to the person’s record.
6. The MCO care coordinator authorizes consultation services using the MCO’s process.
Note: At reassessment, if the person has not yet completed the transition to CFSS, the MCO care coordinator also authorizes PCA personal care services and qualified professional (QP) units according to PCA/CFSS transition policy.
7. The consultation services provider reviews the person’s assessment results from MnCHOICES.
8. The person chooses a model and takes the applicable action:
Note: An FMS provider is only required if the person will purchase goods and services. A PERS provider is only required if the person will use PERS.
Note: A PERS provider is only required if the person will use PERS.
9. The person writes the CFSS service delivery plan with help from the consultation services provider, if desired.
10. The consultation services provider reviews the CFSS service delivery plan and does all the following:
11. The MCO care coordinator reviews the CFSS service delivery plan and does one of the following:
12. The MCO care coordinator updates the person’s MnCHOICES support plan.
13. The MCO care coordinator sends all the following to the person and their providers (if applicable):
14. The MCO care coordinator authorizes the person’s approved CFSS services using the MCO’s process.
Note: During the transition for people using PCA, the MCO care coordinator begins a CFSS authorization that starts the day after the end of the transition period or when the person has CFSS supports in place, whichever is sooner.
15. If the person chose the agency model, the person and CFSS provider agency finalize the CFSS service delivery plan by taking the following steps:
16. The person trains the workers (with the CFSS provider agency, if using the agency model).
17. All the following happens:
18. The person oversees and evaluates services (with the CFSS provider agency, if using the agency model).
19. The CFSS provider agency (agency model) or FMS provider (budget model) requests a reassessment 60 days before the end of the current authorization using Referral for Reassessment for PCA/CFSS Services, DHS-6893B.
Process for people age 65 or older enrolled in MSHO or MSC+ using BI, CAC, CADI or DD
To access CFSS for people 65 or older enrolled in MSHO or MSC+ using BI, CAC, CADI or DD:
1. The county/tribal nation assessor conducts the MnCHOICES assessment and determines the person’s eligibility for programs and services.
2. The MCO care coordinator conducts the MCO MnCHOICES health risk assessment (HRA) and determines the person’s need for additional MCO services.
3. The person selects CFSS services, if eligible.
4. The county/tribal nation sends the person:
DHS-8477A-HMN, Hmong (PDF).
DHS-8774A-KAR, Karen (PDF).
DHS-8477A-SOM, Somali (PDF).
DHS-8477A-SPA, Spanish (PDF).
5. The county/tribal nation waiver case manager begins developing the MnCHOICES support plan with the person.
6. The person chooses a consultation services provider and notifies the county/tribal nation waiver case manager of their choice.
7. The county/tribal nation waiver case manager adds the consultation services provider to the person’s MnCHOICES support plan and assigns the consultation services provider to the person’s record. They update the service agreement to include the consultation service provider using procedure code X5609 and the DHS no-pay code provider number (A342517700). Then, they send the MnCHOICES support plan to the person and provider for signatures.
8. The county/tribal nation waiver case manager sends Lead Agency Communication Form: Recommendation for State Plan Home Care Services, DHS-5841 to the MCO care coordinator requesting consultation services.
Note: During the transition for people using PCA, the county/tribal nation waiver case manager also requests six months of PCA personal care services and six months of qualified professional (QP) units on DHS-5841.
9. The MCO care coordinator reviews DHS-5841 and follows the MCO’s process to authorize the service(s), including ensuring providers are within the MCO’s provider network, and adds the consultation services provider to the person’s record (if not completed in step 5).
10. The consultation services provider reviews the person’s assessment results from MnCHOICES.
11. The person chooses a model and takes the applicable action:
Note: An FMS provider is only required if the person will purchase goods and services. A PERS provider is only required if the person will use PERS.
Note: A PERS provider is only required if the person will use PERS.
12. The person writes the CFSS service delivery plan with help from the consultation services provider, if desired.
13. The consultation services provider reviews the CFSS service delivery plan and does all the following:
14. The county/tribal nation waiver case manager reviews the CFSS service delivery plan and does one of the following:
15. The MCO care coordinator reviews DHS-5841 and the CFSS service delivery plan and does one of the following:
16. The MCO care coordinator includes the approved CFSS services on the person’s MnCHOICES MCO support plan.
17. The county/tribal nation waiver case manager updates the person’s MnCHOICES support plan using procedure code X5609 and the DHS no-pay code provider number (A342517700) and sends it to the person and any waiver service providers, as agreed upon by the person.
18. The MCO care coordinator sends all the following to the person and their providers (if applicable):
19. The MCO authorizes the person’s approved CFSS services using the MCO’s process.
Note: During the transition for people using PCA, the MCO care coordinator begins a CFSS authorization that starts the day after the end of the transition period or when the person has CFSS supports in place, whichever is sooner.
20. If the person chose the agency model, the person and CFSS provider agency finalize the CFSS service delivery plan by taking the following steps:
21. The person trains the workers (with the CFSS provider agency, if using the agency model).
22. All the following happens:
23. The person oversees and evaluates services (with the CFSS provider agency, if using the agency model).
24. The CFSS provider agency (agency model) or FMS provider (budget model) requests a reassessment from the county/tribal nation 60 days before the end of the current authorization using Referral for Reassessment for PCA/CFSS Services, DHS-6893B.
Resources
Assessment and reassessment
CFSS Manual – Assessment for PCA/CFSS services
CFSS Manual – Eligibility for PCA/CFSS services
CFSS Manual – Reassessment for PCA/CFSS services
Service options and models
CFSS Manual – Overview of PCA/CFSS service options
Providers
CFSS Manual – CFSS consultation services provider requirements
CFSS Manual – CFSS financial management services (FMS) provider requirements
CFSS Manual – CFSS PERS
CFSS Manual – Comparison of PCA QP services and CFSS services
CFSS Manual – PCA/CFSS provider agency requirements overview
Service delivery plan
CFSS Manual – PCA/CFSS service delivery plan
CFSS Manual – PCA/CFSS service delivery plan development and approval process
Worker training
CFSS Manual – CFSS worker training and supervision
PCA Manual – QP overview
Supervision and evaluation of services
CFSS Manual – CFSS provider agency evaluation of services
PCA Manual – QP overview
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