Transition from PCA and CSG to CFSS
Page updated: 3/5/24
Starting in 2024, DHS is transitioning from personal care assistance (PCA) and the Consumer Support Grant (CSG) to Community First Services and Supports (CFSS).
This page provides information about the following topics:
Why is DHS making this change?
The Affordable Care Act allowed DHS to implement changes that will give people more choice and control of how they use services.
What will not change for people using PCA?
Many things will stay the same for people using PCA, including, but not limited to:
Note: In PCA, this representative is called the “responsible party (RP).” In CFSS, this representative is called the “participant’s representative.”
For more information, review the CFSS roles and responsibilities training.
What will change for people using PCA?
The following sections provide brief descriptions of what will change for people using PCA. For additional information, review the CFSS overview training.
Consultation services providers
CFSS consultation services providers will help a person succeed by ensuring they:
For more information, review the consultation services provider training and CFSS roles and responsibilities training.
PCA does not include consultation services providers.
Budget model
The CFSS budget model gives a person more control over employment-related activities. Financial management services (FMS) providers will support people using the budget model. For more information, review the agency and budget models training, CFSS math training and CFSS roles and responsibilities training.
PCA does not have a budget model.
Family members serving as workers
In CFSS, a person’s spouse or parent of a minor will be able to provide CFSS services to that person. DHS recognizes the value of allowing people to receive supports from family members. For more information, review the new potential workers training.
In PCA, a person’s family member can deliver PCA services, with limitations. The family member cannot deliver services if they are the person’s spouse or the person’s parent if the person is a minor.
People using CFSS serving as workers
A person using CFSS will be able to provide CFSS services to other people. There are many benefits when people who receive services are also able to provide services. People who receive services have a right to competitive employment opportunities. Expanding the pool of potential workers benefits everyone who uses these services.
People often ask DHS how it is possible for people who receive services to also provide services. People who use CFSS have a wide variety of skills and needs. For example, a person might need support eating because of a swallowing disorder, and they are able to provide services to another person who needs support with transfers. For more information, review the new potential workers training.
In PCA, a person using PCA cannot serve as a PCA worker for another person.
Purchase of goods and services
In CFSS, a person will be able to purchase allowable goods and services to replace the need for human assistance and/or give the person more independence and control. Examples of goods and services include:
For a person on the CFSS agency model, a CFSS provider agency will employ their workers, and an FMS provider will support them with purchasing goods and services.
For a person on the CFSS budget model, an FMS provider will support them with purchasing goods and services.
For more information, review the goods, services and personal emergency response systems (PERS) training and CFSS math training.
In PCA, a person is not able to purchase goods and services.
Purchase of PERS
In CFSS, a person will be able to purchase PERS to help them remain safe while alone in their own home. For more information, review the goods, services and PERS training.
In PCA, a person is not able to purchase PERS.
Worker training and development
In CFSS, agencies and people who employ CFSS workers will have a separate, dedicated budget for training about the specific needs of the person the worker supports. This will give agencies and people who employ workers more flexibility in training workers, and it will allow workers to best serve people’s specific needs. For more information, review the worker training and development training.
In PCA, the qualified professional (QP) is responsible to train and supervise PCA workers. The worker training and development budget replaces QP units.
Note: The CFSS agency’s supervising professional will still be responsible to train the worker, ensure they are competent and supervise them. However, the qualifications are more flexible, and multiple supervising professionals can work with a person’s workers, if appropriate.
For more information, review the CFSS roles and responsibilities training.
Eligibility for rating LT
In CFSS, a person who continues to meet the eligibility for the current rating LT will now have the rating P, Q or R and be eligible for at least five units per day. The rating LT in PCA will no longer exist in CFSS.
In PCA, a person with the rating LT receives two units per day.
For more information, review the CFSS eligibility training.
Flexibility of dollars/units
In CFSS, a person will have increased flexibility for distributing units/dollars throughout the year. They can choose to distribute units/dollars through their service plan year, unless they are on the Minnesota Restricted Recipient Program (MRRP).
In PCA, a person has some flexibility for distributing units/dollars, but not as much flexibility as they will have in CFSS. In PCA, a person not on the MRRP can only use up to 75% of their units in each half of the service plan year.
What will not change for people using CSG?
Many things will stay the same for people using CSG, including, but not limited to:
Note: If the person is using CSG as an alternative to home care nursing, the lead agency must offer the person a MnCHOICES assessment and work with the person on how to meet their needs based on the assessment results.
Note: There are more restrictions in CFSS for covered goods and services.
What will change for people using CSG?
The following sections provide brief descriptions of what will change for people using CSG. For additional information, review the CFSS transition from CSG training and CFSS overview training.
Service models
In CFSS, there will be two service models: the budget model and the agency model. A person using CSG may wish to select the budget model to continue being the employer of their workers.
Both CFSS models will include more options than were available in PCA, including paying spouses and parents of minors to provide services and purchasing goods and services.
Consultation services providers
CFSS consultation services providers will help a person succeed by ensuring they:
CSG does not include consultation services providers. In CSG, the lead agency performs the functions of the consultation services provider, if needed.
Budget
If a person using CSG selects the budget model, their budget will be approximately twice as large as it was before, unless:
If a person using CSG selects the agency model, they will get service units and work with a provider agency instead of having a budget.
Purchase of goods and services
A person using CSG is already able to purchase goods and services.
The federal government is helping fund CFSS services, so DHS must align its laws and policies with both state and federal guidelines. Because of federal guidelines, a person may see some changes to the goods and services that are covered. Their consultation services provider will help them identify any differences that might affect them.
Purchase of PERS
In CFSS, a person will be able to purchase PERS to help them remain safe while alone in their own home.
Worker training and development
In CFSS, agencies and people who employ CFSS workers will have a separate, dedicated budget for training about the specific needs of the person the worker supports. This will give agencies and people who employ workers more flexibility in training workers, and it will allow workers to best serve people’s specific needs.
In the CFSS agency model, the provider agency will be responsible to train the workers. In the CFSS budget model, the person will be responsible to train the workers.
In CSG, the person is responsible to train the workers.
Transition plan: Phase I (current phase)
What has DHS already done?
DHS has completed the following tasks:
What does DHS need to do?
DHS is working to complete the following tasks:
Note: DHS will update existing PCA forms that require minor changes on a rolling basis throughout the next year.
What do people receiving services (PCA or CSG) or their representative need to do?
People receiving services do not need to do anything at this time. After DHS rolls out CFSS, lead agencies will give people information at their reassessment, and consultation services providers will educate people about CFSS.
People receiving services can review the general training on CFSS now, if they desire.
What do lead agencies need to do?
Lead agency assessors, case managers and care coordinators must complete “Community First Services and Supports (CFSS) for lead agencies," an online training in TrainLink (course code CFSS_LA).
Lead agencies also must review the CFSS Policy Manual and MMIS Manual when DHS posts the content.
If DHS posts other trainings for lead agencies, lead agencies must complete those trainings as well.
What do current PCA provider agencies need to do?
Current PCA provider agency owners must:
DHS may require provider agencies to complete other tasks before CFSS rollout. DHS will send providers more information when available.
What do current QPs and designated billing people need to do?
Current QPs who will continue to provide training and supervision in CFSS can complete the CFSS transition training for PCA agency owners/managers/QPs to continue providing services in CFSS.
When DHS makes training available, the agency’s designated billing person needs to complete the PCA/CFSS agency resource and MN–ITS training. DHS will notify agencies when the training is available.
What do current FMS providers need to do?
When DHS makes training available, current FMS providers must:
DHS will notify FMS providers when training is available.
What do current PCA workers need to do?
Current PCA workers do not need to do anything at this time, but DHS encourages them to complete the Personal Care Assistance (PCA) and Community First Services and Supports (CFSS) Training and Test now.
Workers who took the test after April 15, 2020, and have a certificate titled “PCA and CFSS Support Worker Training” have already met this training requirement.
Workers who took the test before April 15, 2020, and have a certificate titled “Personal Care Assistant Training” will need to complete the new training at a date yet to be determined.
What do current CSG workers need to do?
Current CSG workers need to complete the Personal Care Assistance (PCA) and Community First Services and Supports (CFSS) Training and Test and enroll as CFSS workers. The person’s provider agency or FMS provider will assist the worker with enrollment.
What do consultation services providers need to do?
DHS contracted with 22 consultation services providers, as announced in the March 31, 2022, eList announcement. Those providers must:
Transition plan: Phase II (15 months, estimated start: 2024)
DHS anticipates starting phase II in 2024. During the transition year, people will transition to CFSS at the time of their assessment. For more information, review the CFSS transition process training.
What will DHS do?
In phase II, DHS will:
What do people receiving services (PCA or CSG) or their representative need to do?
In phase II, people receiving services will:
What will lead agencies need to do?
In phase II, lead agencies will:
Note: Consultation services providers will review the service delivery plans for compliance with CFSS program rules.
DHS and lead agencies will work together to avoid gaps in services.
What do current PCA provider agencies need to do?
In phase II, current PCA provider agencies will continue providing PCA services as long as people are receiving PCA through the agency. As people transition to CFSS, the provider agency will start offering CFSS services.
What do FMS providers need to do?
In phase II, FMS providers will start offering CFSS FMS services.
What do consultation services providers need to do?
In phase II, consultation services providers will start offering consultation services.
What do current workers need to do?
In phase II, PCA workers will:
Note: Workers who completed the training and test after April 15, 2020, have already completed this requirement.
Transition plan: Phase III
In phase III, DHS will discontinue PCA and CSG services after all people have transitioned to CFSS. To do this, DHS will:
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