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Legal authority

Minn. Stat. §256B.85, subd. 5, Minn. Stat. §256B.0659

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:

Differences

There are no differences in the assessment process for PCA and CFSS.

Definitions

MnCHOICES Assessment: A tool to determine eligibility for both PCA and CFSS. For more information, refer to CBSM – MnCHOICES.

Legacy assessment: A paper-based assessment. Some lead agencies have not fully transitioned to MnCHOICES and use the PCA Assessment and Service Plan, DHS 3244 (PDF) or the CFSS Assessment, DHS-6893A (form not yet available). A certified assessor or a public health nurse completes the legacy assessment. Lead agencies must have DHS’ approval to use the paper-based legacy assessment.

The MnCHOICES assessment and legacy assessment use the same criteria and formula to determine eligibility for PCA/CFSS.

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.

Process

A person interested in accessing PCA/CFSS services must receive an assessment to determine their need for services through the following process:

1. The person requests an assessment from the responsible lead agency.

2. The lead agency schedules and conducts the assessment (refer to the certified assessor responsibilities section on CBSM – Support planning for LTSS).

3. The lead agency authorizes services based on the results of the assessment (refer to the case manager responsibilities section on CBSM – Support planning for LTSS).

4. The PCA/CFSS provider agency (PCA and CFSS agency model) or the financial management services (FMS) provider (CFSS budget model) requests a reassessment at least 60 days before the end of the person’s service agreement (refer to CFSS Manual – Reassessment for PCA/CFSS services).

For a more detailed overview of the process, refer to CFSS Manual – Overview of the PCA and CFSS process.

People age 65 and older enrolled in a managed care organization (MCO)

If a person is age 65 or older and enrolled in an MCO, the MCO follows its own process for assessment and service authorization.

Person’s responsibilities

The person is responsible to provide accurate and complete information during the assessment.

Lead agency’s responsibilities

The lead agency is responsible to:

1. Make arrangements to complete an in-person assessment in one of the following locations:

2. Conduct an assessment within 20 business days of receiving the request that:

3. Enter the service agreement into MMIS or the MCO’s authorization system within 10 business days.

4. Send assessment results within 10 business days to the:

5. Review the service delivery plan from the consultation services provider within established timeframes and approve or deny it (CFSS only). For timeline information, refer to CBSM – Support planning for LTSS.

If the lead agency approves the CFSS service delivery plan, they must:

If the lead agency denies the CFSS service delivery plan, the lead agency must follow the requirements described on CBSM – Notice of action.

Temporary start of service for up to 45 days

If a person has an immediate need to begin services, the lead agency can conduct a telephone assessment for a temporary start of services. For more information about that process, refer to CFSS Manual – 45-day temporary start of PCA/CFSS services.

Temporary increase to an existing service agreement for up to 45 days

If a person has a temporary change in condition that requires more support, the lead agency can conduct a telephone assessment for a temporary increase. For more information about that process, refer to CFSS Manual – 45-day temporary increase of PCA/CFSS services.

PCA/CFSS provider agency’s responsibilities

For a person using PCA or the CFSS agency model (including a person using the CFSS agency model and purchasing goods/services), the PCA/CFSS provider agency is responsible to request a reassessment 60 days before the end of the person’s current service authorization.

FMS provider’s responsibilities

For a person on the CFSS budget model, the FMS provider is responsible to request a reassessment 60 days before the end of the person’s current service authorization.

If the FMS provider works with a person who uses the CFSS agency model and purchases goods/services, the FMS provider is not responsible to request a reassessment for that person.

Additional resources

CBSM – Assessment and support planning overview
CBSM – Assessment applicability and timelines
CBSM – MnCHOICES
CBSM – Support planning for LTSS
CFSS Manual – 45-day temporary increase of PCA/CFSS services
CFSS Manual – 45-day temporary start of PCA/CFSS services
CFSS Manual – Overview of the PCA and CFSS process
CFSS Manual – Reassessment for PCA/CFSS services
CFSS Manual – Transition from PCA and CSG to CFSS
DHS – County and tribal nation offices
DSD MMIS Reference Guide