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.

Similarities

In both PCA and CFSS:

Differences

There are additional service options available in CFSS that are not available in PCA. For example, PCA does not cover the purchase of goods and services.

A person might be eligible for PCA/CFSS, waiver/AC or both. An assessment determines their eligibility based on their needs.

A person’s eligibility is not based on how they intend to use a program. For example, a person might plan to use a good or service that can be covered by CFSS or a waiver/AC. However, the assessor does not include the person’s intent when determining their PCA/CFSS eligibility.

If a person is using PCA/CFSS on a waiver/AC, the case manager/care coordinator must review all of the person’s services to confirm there is no duplication.

Services that are always duplicative

A person cannot receive PCA/CFSS if they use the following waiver/AC services:

Note: A person can use PCA/CFSS if they use family residential services not paid for by waiver/AC.

Services that might be duplicative

Some waiver services include tasks also covered by PCA/CFSS. A person can use both services if the tasks performed by the workers are not duplicative.

Personal care

The following waiver/AC services might cover similar support as PCA/CFSS personal care:

If a person will use a waiver/AC service that covers similar support as PCA/CFSS personal care, they cannot receive the same service from a PCA/CFSS worker and a waiver/AC service provider at the same time.

A person can receive similar support from both providers at different times. For example, a person can receive help with bathing from their ICLS provider one day and their PCA/CFSS worker another day.

Goods and services

A person who needs a good or service covered by both their waiver and CFSS can choose to pay for it through their waiver or CFSS. The criteria for covered goods/services through waivers and CFSS are different.

For more information, refer to CFSS Manual – Goods and services through CFSS.

A person cannot purchase the same good or service through both waiver and CFSS to meet the same assessed need. They must use their waiver and CFSS cooperatively to purchase needed goods and services without creating a duplication and ensuring their needs are met.

Note: A person on AC cannot use CFSS funds to purchase goods and services.

Personal emergency response system (PERS)

A person eligible to receive PERS through their waiver or CFSS can choose to pay for it through their waiver or CFSS. For more information, refer to CBSM – PERS and CFSS Manual – CFSS PERS.

Note: A person on AC cannot use CFSS funds to purchase PERS.

Disability waivers

If a person is on a disability waiver, all of their CFSS services come out of the county/tribal nation’s waiver aggregate.

AC/EW

If a person on AC/EW is not using CDCS, their case mix budget cap includes the following CFSS services:

The AC/EW case mix budget cap does not include consultation services.

A person eligible for both PCA/CFSS and a waiver/AC can choose to use:

If a person uses both PCA/CFSS and CDCS:

The case manager must: