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CFSS Policy Manual

CFSS Policy Manual


Overview of the PCA and CFSS processes

Page updated: 11/26/24

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.

Overview

This page provides an overview of the process to access PCA and CFSS. Use this page as a resource to understand the entire process. Refer to the specific policy pages listed in the resources section for instructions about each step.

Generally, these steps happen in the order listed on this page. However, some steps can happen at the same time or in a different order.

Process for CFSS agency model

To access CFSS agency model services:

1. The person requests an assessment.

2. The lead agency conducts the assessment and determines the person’s need for services.

3. The person selects CFSS services, if eligible.
Note: A person eligible for a waiver or AC may choose to use the waiver or AC instead of or in addition to CFSS services.

4. The lead agency provides the person with a list of consultation services providers.

5. The person chooses a consultation services provider and notifies the lead agency of their choice.

6. The lead agency issues a service authorization for consultation services.
Note: During the transition year, the lead agency also authorizes six months of PCA personal care services and six months of QP units to avoid a gap in the person’s services.

7. The person selects the agency model, a CFSS provider agency and a financial management services (FMS) provider, if applicable.
Note: An FMS provider is only required if the person will purchase goods and services.

8. The person writes the service delivery plan with help from the consultation services provider, if desired.

9. The consultation services provider reviews the service delivery plan.

10. The lead agency approves the service delivery plan.

11. The lead agency issues a service authorization to the CFSS provider agency, personal emergency response (PERS) provider and FMS provider, if applicable.
Note: During the transition year, the lead agency takes the appropriate action based on the person’s situation:

  • · Person not on waiver/AC: End the current SA and enter a new SA that starts on the day after the end of the six-month SA and ends on the last day of the person’s service plan year. For most people, this new SA lasts for six months.
  • · Person on a waiver/AC and not enrolled in a managed care organization (MCO): Enter new lines on the existing SA for the person’s approved CFSS services. The new lines start on the day after the end of the six-month lines and end on the last day of the person’s service plan year. For most people, these new lines last for six months.
  • · People age 65 and older who receive PCA/CFSS through their MCO: Follow the MCO’s process for authorization.
  • 12. The person and CFSS provider agency fill in any details missing in the service delivery plan.

    13. The person and CFSS provider agency train the workers.

    14. All of the following happens:

  • · The workers deliver care according to the service delivery plan.
  • · The FMS provider facilitates the purchase of goods and services, if applicable.
  • · The PERS provider delivers PERS equipment and ongoing services, if applicable.
  • 15. The person and CFSS provider agency oversee and evaluate services.

    16. The CFSS provider agency requests a reassessment 60 days before the end of the current authorization.

    Process for CFSS budget model

    To access CFSS budget model services:

    1. The person requests an assessment.

    2. The lead agency conducts the assessment and determines the person’s need for services.

    3. The lead agency provides the person with a list of consultation services providers.

    4. The person chooses a consultation services provider and notifies the lead agency of their choice.

    5. The lead agency issues a service authorization for consultation services.
    Note: During the transition year, the lead agency also authorizes six months of PCA personal care services and six months of QP units to avoid a gap in the person’s services.

    6. The person selects the budget model and an FMS provider.

    7. The person writes the service delivery plan with help from the consultation services provider, if desired.

    8. The consultation services provider reviews the service delivery plan.

    9. The lead agency approves the service delivery plan.

    10. The lead agency issues a service authorization to the FMS provider and the PERS provider, if applicable.
    Note: During the transition year, the lead agency takes the appropriate action based on the person’s situation:

  • · Person not on waiver/AC: End the current SA and enter a new SA that starts on the day after the end of the six-month SA and ends on the last day of the person’s service plan year. For most people, this new SA lasts for six months.
  • · Person on a waiver/AC and not enrolled in an MCO: Enter new lines on the existing SA for the person’s approved CFSS services. The new lines start on the day after the end of the six-month lines and end on the last day of the person’s service plan year. For most people, these new lines last for six months.
  • · People age 65 and older who receive PCA/CFSS through their MCO: Follow the MCO’s process for authorization.
  • 11. The person trains the workers, if applicable.

    12. All of the following happens:

  • · The workers deliver care according to the service delivery plan, if applicable.
  • · The FMS provider facilitates the purchase of goods, if applicable.
  • · The PERS provider delivers PERS equipment and ongoing services, if applicable.
  • 13. The person oversees and evaluates services.

    14. The FMS provider requests a reassessment 60 days before the end of the current authorization.

    Process for PCA (traditional PCA and PCA Choice) for historical reference

    Note: All assessments happening on or after Oct. 1, 2024, will follow the CFSS agency model or CFSS budget model process. DHS will keep the PCA process on this page until the end of the transition for reference.

    To access PCA services:

    1. The person requests an assessment.

    2. The lead agency conducts the assessment and determines the person’s need for services.

    3. The person selects PCA services, if eligible.
    Note: A person eligible for a waiver or Alternative Care (AC) may choose to use the waiver or AC instead of or in addition to PCA services.

    4. The person selects a PCA provider agency and one of the following options:

  • · Traditional PCA services.
  • · PCA Choice.
  • 5. The lead agency issues a service authorization.

    6. The person and the qualified professional (QP) write the care plan.

    7. The person and the QP train the workers.

    8. The workers deliver services according to the care plan.

    9. The person and the QP oversee and evaluate services.

    10. The PCA provider agency requests a reassessment 60 days before the end of the current authorization.

    Resources

    MMIS updates

    DSD MMIS Reference Guide – MMIS transition from PCA and CSG to CFSS

    Assessment and reassessment

    CFSS Manual – Assessment for PCA/CFSS services
    CFSS Manual – Eligibility for PCA/CFSS services
    CFSS Manual – Reassessment for PCA/CFSS services

    Service options and models

    CFSS Manual – Overview of PCA/CFSS service options

    Providers

    CFSS Manual – CFSS consultation services provider requirements
    CFSS Manual – CFSS financial management services (FMS) provider requirements
    CFSS Manual – CFSS PERS
    CFSS Manual – Comparison of PCA QP services and CFSS services
    CFSS Manual – PCA/CFSS provider agency requirements overview

    Service delivery plan

    CFSS Manual – PCA/CFSS service delivery plan
    CFSS Manual – PCA/CFSS service delivery plan development and approval process

    Worker training

    CFSS Manual – CFSS worker training and supervision
    PCA Manual – QP overview

    Supervision and evaluation of services

    CFSS Manual – CFSS provider agency evaluation of services
    PCA Manual – QP overview

    Waivers and AC

    CBSM – Waiver and AC programs overview

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