DHS is in the process of replacing personal care assistance (PCA) and the Consumer Support Grant (CSG) with Community First Services and Supports (CFSS). For more information about this transition, refer to CFSS Manual – Transition from PCA and CSG to CFSS.

For a Medicaid Management Information System (MMIS) transition summary, refer to DSD MMIS Reference Guide – MMIS transition from PCA and CSG to CFSS.

Similarities

The process to enter a 45-day temporary increase to a service agreement (SA) is the same for PCA and CFSS.

Differences

In CFSS, the county/tribal nation:

This page describes how to enter an SA to request a 45-day temporary increase of PCA or CFSS services. For more information, refer to CFSS Manual – 45-day temporary increase of PCA/CFSS services.

For a person who is not on a waiver that needs a 45-day temporary increase, the county/tribal nation:

DHS merges the SA with the person’s current SA.

The county/tribal nation follows the instructions below to complete select fields on the ASA1 screen. The county/tribal nation must:

Agreement start date field (AGMT START DT)

In the AGMT START DT field, the county/tribal nation enters the date increased services will start in MMDDYY format.

Agreement end date field (AGMT END DT)

In the AGMT END DT field, the county/tribal nation enters the date increased services will end in MMDDYY format. The entry can be up to 45 days after the date in the AGMT START DT field. If the county/tribal nation enters an end date more than 45 days after the date in the ADMT START DT field, MMIS posts an exception code the county/tribal nation must resolve.

Remaining fields

To complete the remaining fields, refer to DSD MMIS Reference Guide – ASA1 screen for PCA/CFSS.

On the ASA3 screen, the county/tribal nation only enters one line.

Procedure code field (PROC)

In the PROC field, the county/tribal nation enters the personal care services procedure code (T1019).

Modifiers field (MOD1-4)

In the MOD1-4 field, the county/tribal nation enters the temporary increase (U6) modifier. The county/tribal nation also enters the enhanced rate (TG) modifier, if applicable.

CFSS only

The county/tribal nation enters the modifier for the model the person selected:

If the county/tribal nation enters a personal care (T1019) line without a model modifier, MMIS posts an exception code the county/tribal nation must resolve.

If the county/tribal nation enters a model modifier that does not match the model modifier on the person’s current SA or any other type of CFSS line with a temporary increase (U6) modifier, DHS returns the 45-day temporary increase request to the county/tribal nation for correction.

Requested total units field (REQ TOT UNITS)

PCA and CFSS agency model

In the REQ TOT UNITS field, the county/tribal nation enters the number of units for which the person is eligible for increased PCA/CFSS personal care services. The county/tribal nation:

1. Divides the number of minutes in the TOTAL TIME field on the ASA1 screen of the person’s current SA by 15.

2. Locates the number of units for which the person is eligible in section 6 (i.e., authorization summary) of their CFSS Assessment for 45-Day Temporary Increase, DHS-6893M.

3. Subtracts the result of step 1 from the result of step 2.

4. Multiplies the result of step 3 by the number of days in the SA (up to 45 days).

5. Enters the result of step 4 in the REQ TOT UNITS field of the temporary increase personal care (T1019 – U6) line.

CFSS budget model

The county/tribal nation leaves the REQ TOT UNITS blank.

Requested total amount field (REQ TOT AMT)

PCA and CFSS agency model

MMIS auto-populates the REQ TOT AMT field. The county/tribal nation cannot edit this field.

CFSS budget model

In the REQ TOT AMT field, the county/tribal nation enters the number of dollars for which the person is eligible for increased PCA/CFSS personal care services. The county/tribal nation:

1. Divides the number of minutes in the TOTAL TIME field on the ASA1 screen of the person’s current SA by 15.

2. Locates the number of units for which the person is eligible in section 6 (i.e., authorization summary) of their CFSS Assessment for 45-Day Temporary Increase, DHS-6893M.

3. Subtracts the result of step 1 from the result of step 2.

4. Multiplies the result of step 3 by the number of days in the SA (up to 45 days).

5. Multiplies the result of step 4 by the current CFSS personal care rate listed on DHS – CFSS codes and rates:

6. Enters the result of step 5 in the REQ TOT AMT field of the temporary increase personal care (T1019 – U6) line.

The county/tribal nation follows the instructions below to complete select fields on the AHC2 screen.

PCA and CFSS assessment fields

The county/tribal nation enters X in each assessment field that has a corresponding “yes” (Y) in the person’s CFSS Assessment for 45-Day Temporary Increase, DHS-6893M.

Remaining fields

To complete the other fields on the AHC2 screen, refer to DSD MMIS Reference Guide – AHC2 screen for PCA/CFSS.

The county/tribal nation follows the instructions below to complete the ADDITIONAL COMMENTS fields on the AHC3 screen.

ADDITIONAL COMMENTS field

In the ADDITIONAL COMMENTS field, the county/tribal nation enters:

The county/tribal nation must date and initial all comments.

Remaining fields

To complete the other fields on the AHC3 screen, refer to DSD MMIS Reference Guide – AHC3 screen for PCA/CFSS.

To finalize a 45-day temporary increase, the county/tribal nation:

1. Presses function key F9 to prompt the MMIS exception control function.

2. Resolves all exception codes other than:

3. Presses function key F9 again to clear the exception codes.

4. Presses function key F3 to save entries.

5. Manually routes the SA to DHS. To do this, the county/tribal nation:

6. Presses function key F3 to save the SA and exit.

DHS merges the 45-day temporary increase SA with the person’s current SA.