Resource: CDCS budget impacts when purchasing PCA/CFSS, home care and extended waiver services

Page posted: 6/11/25

This page is a quick reference guide for lead agencies to understand personal care assistance (PCA), Community First Services and Supports (CFSS), home care and extended waiver service costs that come out of the person’s consumer directed community supports (CDCS) budget.

This page only applies to the services listed below. For information about other allowable CDCS services, refer to CDCS Manual – Allowable and unallowable goods and services under CDCS.

Extended PCA/CFSS and extended home care

A person who chooses to purchase the following traditional waiver services must include the cost in their CDCS budget:

· Extended PCA.

· Extended CFSS.

· Extended home care services.

For policy information, refer to:

· CDCS Manual – Purchasing traditional waiver/AC goods and services under CDCS.

· CFSS Manual – Extended PCA/CFSS services.

· CBSM – Extended home care services.

Services through Alternative Care (AC)

A person who chooses to purchase the following traditional AC services must include the cost in their CDCS budget:

· PCA.

· CFSS.

· Home care.

For policy information, refer to CDCS Manual – Purchasing traditional waiver/AC goods and services under CDCS.

State plan PCA

A person using PCA and CDCS must include the total costs of the following items in their CDCS budget:

· PCA units.

· PCA supervision.

For policy information, refer to PCA Program Manual.

For authorization information, refer to:

· DSD MMIS Reference Guide – ASA3 screen for personal care services (T1019).

· DSD MMIS Reference Guide – ASA3 screen for worker supervision/training (PCA: T1019 – UA; CFSS: S5116).

State plan CFSS

Agency model

A person using the CFSS agency model and CDCS must include the total costs of all approved CFSS services they will use in their CDCS budget. This includes:

· Personal care (required).

· Consultation services (required).

· Worker training and development (required).

· CFSS goods and services (if person chooses to purchase).

· CFSS personal emergency response system (PERS) (if person chooses to purchase).

Note: The lead agency must authorize the standard amounts for consultation services and worker training and development listed in Long-Term Services and Supports Service Rate Limits, DHS-3945 (PDF) for all people using the CFSS agency model.

People using the agency model and lead agencies can use the CFSS agency model on CDCS calculator to help with their calculations.

The lead agency must complete the CDCS support plan section on Lead agency addendum to CFSS Individual Service Delivery Plan, DHS-6893W with the CFSS dollar amount the person enters on their CDCS community support plan.

For policy information, refer to CFSS Policy Manual.

For authorization information, refer to:

· DSD MMIS Reference Guide – ASA3 screen for consultation services (T1023).

· DSD MMIS Reference Guide – ASA3 screen for personal care services (T1019).

· DSD MMIS Reference Guide – ASA3 screen for worker supervision/training (PCA: T1019 – UA; CFSS: S5116).

· DSD MMIS reference guide – ASA3 screen for goods and services (T5999).

· DSD MMIS reference guide – ASA3 screen for PERS (S5160, S5161, S5162).

Budget model

A person using the CFSS budget model and CDCS must include the total costs of all approved CFSS services they will use in their CDCS budget. This includes:

· Consultation services (required).

· Financial management services (FMS) fees (required).

· Personal care (if person chooses to purchase).

· Worker training and development (if person chooses to purchase personal care).

· CFSS goods and services (if person chooses to purchase).

· CFSS PERS (if person chooses to purchase).

· Failed background studies (if person’s CFSS personal care worker fails a background study; does not apply to any CDCS workers).

Note: The lead agency must authorize the standard amounts for consultation services and worker training and development (if applicable) listed in Long-Term Services and Supports Service Rate Limits, DHS-3945 for all people using the CFSS budget model.

The lead agency must complete the CDCS support plan section on Lead agency addendum to CFSS Individual Service Delivery Plan, DHS-6893W with the CFSS dollar amount the person enters on their CDCS community support plan.

For policy information, refer to CFSS Policy Manual.

For authorization information, refer to:

· DSD MMIS Reference Guide – ASA3 screen for consultation services (T1023).

· DSD MMIS Reference Guide – ASA3 screen for FMS provider fees (T2040 – UB and UA).

· DSD MMIS Reference Guide – ASA3 screen for personal care services (T1019).

· DSD MMIS Reference Guide – ASA3 screen for worker supervision/training (PCA: T1019 – UA; CFSS: S5116).

· DSD MMIS reference guide – ASA3 screen for goods and services (T5999).

· DSD MMIS reference guide – ASA3 screen for PERS (S5160, S5161, S5162).

Home care nursing (HCN)

A person using HCN and CDCS must include the total cost of HCN units in their CDCS budget.

For policy and authorization information, refer to CBSM – HCN.

State plan skilled nursing visit (SNV)

A person using SNV and CDCS must include the total cost of SNV units in their CDCS budget.

For policy and authorization information, refer to CBSM – SNV.

State plan home health aide (HHA)

A person using HHA and CDCS must include the total cost of HHA units in their CDCS budget.

For policy and authorization information, refer to CBSM – HHA.

State plan and extended home health therapies

If a person is using home health therapies, the lead agency does not include the cost in a person’s CDCS budget.

For policy and authorization information, refer to CBSM – Home health therapies.