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

In both PCA and CFSS, a person who is ventilator dependent receives the home care rating EN. For a person with the home care rating EN, the process to complete a PCA or CFSS service agreement (SA) is the same.

Differences

For a person with the home care rating EN, there are now no differences between a PCA and CFSS SA.

This page describes how to complete select fields on select screens for a PCA or CFSS SA for a person who receives the home care rating EN (i.e., a person who is ventilator-dependent).

For all other screens, the county/tribal nation follows the same instructions for all home care ratings.

The county/tribal nation follows the instructions below to complete select fields on the AHC1 screen.

HOME CARE RATING field

In both PCA and CFSS, MMIS auto-populates the EN rating in the HOME CARE RATING field based on the entry in the EN field on the AHC2 screen. The county/tribal nation cannot edit this field.

TOTAL TIME field

In both PCA and CFSS, the county/tribal nation cannot edit the TOTAL TIME field. MMIS leaves this field blank for a person with the home care rating EN.

Remaining fields

To complete the remaining fields, refer to DSD MMIS Reference Guide – AHC1 screen for PCA/CFSS.

The county/tribal nation follows the instructions below to complete the EN field on the AHC2 screen.

EN field

In both PCA and CFSS, the county/tribal nation enters Y in the EN field to indicate the person meets the criteria for ventilator dependence.

Note: The county/tribal nation enters X in all other fields for items that have a corresponding “yes” (Y) in the person’s applicable assessment.

Remaining fields

To complete the other fields on the AHC2 screen, refer to DSD MMIS Reference Guide – AHC2 screen for PCA/CFSS.

The county/tribal nation follows the instructions below to complete the ADDITIONAL COMMENTS field on the AHC3 screen.

ADDITIONAL COMMENTS field

In both PCA and CFSS, the county/tribal nation uses the ADDITIONAL COMMENTS field to document:

The county/tribal nation must date and initial all comments.

Remaining fields

To complete the other fields on the AHC3 screen, refer to DSD MMIS Reference Guide – AHC3 screen for PCA/CFSS.

A person with the home care rating EN is eligible for 96 units (i.e., 24 hours) per day and up to 16 additional units (i.e., 4 hours) if they require some two-person cares.

The county/tribal nation follows the instructions below to confirm a person who receives the home care rating EN does not exceed their eligible units. To calculate the total eligible units, the county/tribal nation:

Note: If the person does not have a personal care (T1019) line, the county/tribal nation uses the goods and services (T5999) line.

MMIS posts an exception code the county/tribal nation must resolve if the county/tribal nation enters lines on the ASA3 screen that have a total unit/dollar amount that exceeds 112 times the number of days in the person’s personal care (T1019) line.

MMIS does not post an exception code if the person is eligible for less than 112 units per day and the county/tribal nation enters units/dollars that exceed the person’s eligible units/dollars.