Minn. Stat. §256B.0659, subd. 13 and subd. 15

DHS is in the process of replacing PCA with Community First Services and Supports (CFSS). The entity responsible for performing QP functions in CFSS varies. For more information, refer to CFSS Manual – Comparison of QP services and CFSS services.

For information about the transition, refer to CFSS Manual – Transition from PCA and CSG to CFSS.

Qualified professional (QP): Person who provides training, supervision and evaluation of an agency's PCA workers and the services they deliver. A QP performs the following duties:

For more information about services provided by a QP, see PCA Manual – QP services.

The annual service authorization for each person who receives PCA services includes a 96-unit limit for QP services. The PCA provider agency should use the 96 units flexibly over the 12 months of the person’s service authorization.

For information about entering the annual 96 units on the MMIS service agreement, counties and tribal nations can use DSD MMIS Reference Guide – Type B service agreement for PCA services.

The PCA provider agency may request additional units if a person’s circumstances require more than 96 units. These circumstances could include, but are not limited to, when:

QP services are not covered if they exceed the amount indicated on the person’s current service agreement. DHS must update the person’s service agreement with additional units if the agency needs to exceed the initial 96 units.

State plan

To request increased QP units for a person who receives fee-for-service state plan PCA, the PCA provider agency must submit PCA Technical Change Request, DHS-4074A (PDF) to DHS with all of the following information:

Waivers and Alternative Care (AC)

To request increased QP units for a person on a waiver/AC, the PCA provider agency must contact the person’s waiver/AC case manager.

Managed care organizations (MCOs)

When a person’s PCA services are through an MCO, the PCA provider agency must follow the MCO’s process to request increased QP units. The PCA provider agency should contact the MCO for more information (see DHS – MCO contacts for MHCP providers)

Waiver/AC case managers may authorize more or fewer QP units, as needed, to meet minimum requirements listed on PCA Manual – QP services.

If a person is fee for service, the case manager must contact the Service Agreement and Screening Document (SASD) Support Team for help forcing edits to authorize more than 96 units of QP supervision per year.

For state plan services, DHS reviews the request and, if approved, notifies the PCA provider agency via MN-ITS and issues a new service agreement with additional QP units.

For fee-for-service waiver services, the SASD Support Team forces edits to authorize more than 96 units of QP services at the request of the waiver case manager.

For PCA services through an MCO, DHS is not involved in the process.