Minnesota Minnesota

CFSS Policy Manual

CFSS Policy Manual


PCA/CFSS provider agency policies and procedures

Page posted: 8/26/24

Page reviewed:

Page updated:

Legal authority

Minn. Stat. §256B.0659, subd. 21 and 28, Minn. Stat. 256B.85, subd. 12 and 12a

Comparison of PCA and CFSS

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, provider agencies must have a manual that describes their policies and procedures. All required components of the manual are the same for PCA and CFSS.

Differences

CFSS provider agencies must have policies on how they respond to incidents.

Definition

Incident: An occurrence that involves a person using PCA/CFSS and requires a response that is not a part of the ordinary delivery of the services. Incidents include, but are not limited to:

  • · Serious injury to the person.
  • · The person’s death.
  • · Any medical emergency, unexpected serious illness or significant change that requires a call to 911, medical treatment or hospitalization.
  • · Any mental health crisis that requires a call to 911 or a mental health crisis intervention team.
  • · Any situation involving the person that requires a call to 911, the person’s primary health care provider, law enforcement or the fire department.
  • · The person’s unexplained absence.
  • · Behaviors that create an imminent risk of harm to the person or someone else.
  • · A report of alleged or suspected maltreatment.

    • Applicability

    This page applies to:

  • · PCA provider agencies.
  • · CFSS provider agencies.

    • This page does not apply to:

  • · Consultation services providers.
  • · Financial management services (FMS) providers.

    • Overview

    PCA/CFSS provider agencies must have a manual that includes the agency’s policies and procedures. Provider agencies must provide a copy of the manual at initial enrollment with DHS, reenrollment, revalidation and upon DHS’ request.

    The manual must include, at a minimum, policies and procedures about:

  • · Employee misconduct.
  • · Employee training requirements.
  • · Enhanced rate.
  • · Grievances from people who receive services, including the process for notification and resolution of grievances.
  • · Identification and prevention of communicable diseases.
  • · Prohibition of non-compete clauses.
  • · Safety practices for employees and people who receive services.
  • · Service delivery.
  • · Staff hiring and termination.
  • · Assurance that 72.5% of revenue from the Medical Assistance (MA) rate from PCA/CFSS services are used for PCA/CFSS worker wages and benefits (refer to CFSS Manual – PCA/CFSS provider agency worker wage and benefit requirements).

    • Required components

    The following sections explain the required components for the PCA/CFSS provider agency’s manual.

    Employee misconduct

    The PCA/CFSS provider agency must establish procedures for disciplinary actions due to employee misconduct. Misconduct may include, but is not limited to:

  • · Violations of federal and state laws.
  • · Violations of the agency’s own rules for its employees.

    • Disciplinary actions may include, but are not limited to:

  • · Remedial training.
  • · Oral and written reprimands.
  • · Paid or unpaid suspensions.
  • · Demotion.
  • · Discharge.

    • Employee training requirements

    The PCA/CFSS provider agency must establish employee training procedures for:

  • · Initial review of the provider agency’s manual with the employee at the time of hire and frequency of ongoing reviews.
  • · Fraud prevention.
  • · Use of the provider agency’s system for electronic visit verification (EVV).
  • · Training the agency requires beyond the required PCA/CFSS worker standardized training (e.g., additional mandated reporter, data privacy or other training the provider agency requires).
  • · Training documentation.
  • · Training timelines.

    • Enhanced rate

    The PCA/CFSS provider agency must establish procedures for how:

  • · The person and qualified worker can request information about the enhanced rate.
  • · The agency will pass on the revenue from the enhanced rate to an eligible person’s qualified worker(s).

    • Required information for people receiving services and the written agreement

    The PCA/CFSS provider agency must establish procedures for how to:

  • · Provide the person with all required information.
  • · Enter into a written agreement with the person.
  • · Document the completion of the above requirements.

    • Grievances from people who receive services

    The PCA/CFSS provider agency must establish policies and procedures for:

  • · Documentation of grievances and resolutions (refer to the grievance reporting section on this page).
  • · Notices and communications, including how to inform staff, people who receive services and outside resources about grievance policies and procedures.
  • · Instructions for the person to file an internal appeal with the provider agency if they are dissatisfied with the proposed resolution.
  • · Timelines for resolving grievances.

    • Identification and prevention of communicable diseases

    The PCA/CFSS provider agency must:

  • · Establish and implement policies and procedures for prevention, control and investigation of infectious and communicable diseases.
  • · Follow Centers for Disease Control and Prevention guidelines, nationally recognized guidelines and applicable federal and state regulations.

    • Prohibition of non-compete clauses

    The PCA/CFSS provider agency manual must state that the provider agency cannot require workers to sign an agreement stating they will not work for another provider agency or FMS provider.

    Safety practices for employees and people who receive services

    The PCA/CFSS provider agency must establish procedures to:

  • · Report suspected maltreatment of children and vulnerable adults.
  • · Support workers and people receiving services whose safety may be at risk.

    • Service delivery

    The PCA/CFSS provider agency must establish:

  • · Internal controls and processes for PCA/CFSS service delivery, quality assurance and remediation.
  • · Policies and procedures to complete service verification (i.e., confirmation that worker delivered services to the person), including through EVV.
  • · Policies and procedures on service limitations specific to the provider agency.

    • Staff hiring and termination

    The PCA/CFSS provider agency must establish policies and procedures that comply with federal and state regulations to:

  • · Employ, evaluate and supervise staff, including documentation of staff training.
  • · Terminate staff.

    • Response to incidents (CFSS only)

    In CFSS, the provider agency must have policies for how they respond to incidents involving the person. For information about incidents, refer to the definition section on this page.

    Grievance reporting

    At the time of enrollment, reenrollment and revalidation, the PCA/CFSS provider agency must submit a record of grievances and resolutions from the previous year to DHS. Documentation of grievances must include all of the following information:

  • · Date the grievance was received.
  • · Name of the person who made the grievance.
  • · Name of the staff member who received grievance.
  • · Brief description of the issue.
  • · Date(s) the grievance was investigated.
  • · Name of the staff member who investigated the grievance.
  • · Results of the investigation.
  • · Date the grievance was resolved.
  • · Resolution of the grievance, including any quality improvement changes.
  • · Date the resolution was shared with the person who made the grievance.
  • · Name of the staff member who shared the resolution with the person.

    • Additional resources

    CFSS Manual – PCA, CFSS and CSG enhanced rate/budget
    CFSS Manual – PCA/CFSS provider agency worker wage and benefit requirements
    CFSS Manual – PCA/CFSS worker criteria, requirements and responsibilities
    CFSS Manual – Transition from PCA and CSG to CFSS
    DHS – EVV

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