Minn. Stat. §256B.0652, subd. 9 and 14, Minn. Stat. §256B.85, subd. 5

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, the lead agency:

Differences

Service options

In PCA, a person can use traditional PCA or PCA Choice during the 45-day temporary start.

In CFSS, a person can only use the CFSS agency model during the 45-day temporary start.

Consultation services

PCA does not include consultation services, so these requirements are not applicable.

In CFSS, a person authorized for a 45-day temporary start does not need to work with a consultation services provider before they start services. To continue using CFSS services beyond the 45-day temporary start, the person must have an assessment, select a consultation services provider, complete an orientation with that provider, select a model and write an approved plan before their temporary authorization ends. The person must complete all of these steps to continue receiving services after the 45-day temporary start.

45-day temporary start of service: A process to allow a person not currently receiving services to begin PCA/CFSS services temporarily until the lead agency assessor can schedule and complete an in-person assessment.

Responsible party (RP)/participant’s representative: An individual who is age 18 or older and capable of directing care on behalf of a person receiving PCA/CFSS services when the person is assessed as unable to direct their own care. In PCA, this individual is called the RP. In CFSS, this individual is called the participant’s representative.

Note: All references to “representative” on this page refer to the participant’s representative, unless otherwise specified.

The lead agency can authorize a temporary start of PCA/CFSS services if the person needs emergency support services. The temporary start cannot be longer than 45 days. The lead agency must complete an in-person assessment for services to continue beyond 45 days.

The amount of time authorized for the temporary start of service does not affect the amount of time for future authorizations.

If a PCA/CFSS provider agency starts providing services to a person before they receive authorization, the provider agency has five business days to request a temporary start from the lead agency.

The lead agency’s responsibilities depend on the person’s situation.

Person not on a waiver and not enrolled in a managed care organization (MCO)

After receiving a request for a 45-day temporary start, the county/tribal nation must:

1. Conduct a telephone assessment to determine the person’s service needs and consult with the following people, as applicable:

2. Determine the person’s eligibility using the standard PCA/CFSS eligibility criteria on CFSS Manual – Eligibility for PCA/CFSS services.

3. Enter the results of the assessment into the Medicaid Management Information System (MMIS), including:

4. Authorize 45 days of personal care services.

5. Authorize the standard amount of consultation services (CFSS only; refer to CFSS Manual – CFSS consultation services overview).

6. Resolve any technical edits.

7. Confirm the service agreement automatically routed to DHS by checking for it in the county/tribal nation’s queue the next day. If the service agreement did not route, the country/tribal nation must route it manually to the 590 queue.

If the person wants services to continue, the county/tribal nation is responsible to complete an in-person MnCHOICES assessment before the end of the 45-day period.

Person on a waiver and not enrolled in an MCO

The lead agency does not need to do anything in this situation because a 45-day temporary start of service is only for people not already receiving services.

Person age 65 and older enrolled in an MCO

If the person is enrolled in an MCO, the MCO should follows its own policies and procedures for a 45-day temporary start.

The PCA/CFSS provider agency is responsible to document the person’s need for the temporary start of services in their file. This documentation may include:

The provider agency must comply with all Minnesota Health Care Programs (MHCP) provider requirements, including enrollment of individual workers. The provider agency also must fulfill all responsibilities it typically fulfills for people who receive non-temporary services.

If the person selects a provider agency before the 45-day temporary start, the provider agency can start providing services. The provider agency has five business days to request a temporary start of PCA/CFSS services from the lead agency.

Additional CFSS-specific responsibility

In addition to the responsibilities listed above, the CFSS provider agency must develop a temporary service plan. DHS is in the process of developing a template for this plan.

If the person’s CFSS services continue beyond 45 days, the consultation services provider is responsible to help the person write the service delivery plan, to the extent the person desires, and review the service delivery plan through the usual process.

DHS is responsible to: