Community First Services and Supports (CFSS): Frequently Asked Questions

With the transition to Community First Services and Supports (CFSS), you might have questions about what this means to you. At PICS, we will be with you every step of the way as your services transition from Consumer Support Grant (CSG) to CFSS. You will find a list of frequently asked questions below.

Q.    Why is the Minnesota Department of Human Services (DHS) making the change from the Consumer Support Grant (CSG)/Personal Care Assistance (PCA) to CFSS?
A.    The Affordable Care Act included regulation for the Community First Choice State Plan benefit. It allows states to amend their Medicaid state plan to meet the regulation requirements, expand self-directed options and receive the enhanced Federal benefit. To adapt Community First Choice and expand self-directed options, the DHS redesigned its state plan PCA and CSG services to the CFSS program to offer increased flexibility and choice for home care services.

Q.    How is the funding different between CSG and CFSS?
A.    CSG only uses state funds. CFSS uses both state and matching federal funds, which could increase the annual budget.

Q.    What do I need to do to enroll in CFSS?
A.    If you are currently receiving CSG services, you will transition to CFSS at your annual assessment.

Q.    How can I learn about my options in CFSS?
A.    Consultation services providers will be available to answer any questions about CFSS.

Q.    Is use of a consultation services provider required?
A.    Yes, everyone must select a consultation services provider. A list of eligible consultation services provider agencies will be supplied by the assessor and can be found on the DHS website. The consultation services provider will educate on CFSS and the two model options, and they can assist with writing the service plan. However, people can make decisions about how much they use their consultation services provider.

Q.    Can I switch between the agency and budget models mid-year?
A.    Yes, you can choose to change models once during the year.

Q.    What are the CFSS business models, and the similarities and differences between both?
A.    There are two business models, agency and budget. In both models, care can be self-directed. If the person receiving services cannot self-direct their own care, someone else, such as a family member or friend, can direct the care on that person’s behalf as their Representative.

PICS supports individuals with the budget model. Under the budget model, the person receiving services is the employer. As the employer, the person receiving services or their Representative can determine Workers’ wages, so long as the wage rates comply with minimum wage laws, SEIU collective bargaining agreement and CFSS statute. The person receiving services, or their Representative, will also decide who the Workers are, the tasks the Workers complete, and assist with the creation and the implementation of the service plan.

In the agency model, the person receiving services, or their Representative, will select an agency to provide the needed services, and the agency is the employer and will determine Workers’ wages.  

Q.    What is PICS’ role under the budget model?
A.    For individuals who choose the CFSS budget model, PICS’ role is to provide the payroll and administrative tasks related to employment, similar to how PICS supports individuals currently using CSG services.

Q.    How does PICS support individuals who use the CFSS agency model in purchasing goods and services?
A.    For those that choose the agency model and have approved goods and services in the service plan, a Financial Management Services (FMS) provider will be required.  As an FMS provider, PICS can assist with the purchase of these items.

Q.    How do I transition from CSG to CFSS?
A.    Individuals who qualify for CFSS will choose either the budget or agency model.  Program eligibility will be determined by the assessment.

Q.    Who can approve the CFSS service plan?
A.    The lead agency of the person receiving services must approve the service plan.  This can be the assessor, care coordinator or case manager.

Q.    Can a Representative also be a Worker for the person receiving services?
A.    No, under CFSS the Worker and Representative cannot be the same person. This requirement is a change for those transitioning from CSG. For current CSG Representatives who also act as Workers, either a different Worker or another individual must provide Representative responsibilities if they choose to continue as a Worker.

Q.    Can a parent or spouse be paid to provide services to their minor child or spouse under CFSS?
A.    Yes, parents of minors and spouses can be paid to provide caregiving services under CFSS, as long as they are not the Participant’s Representative.

Q.    Are there different requirements for Workers under CFSS?
A.    Yes, all Workers will be required to complete online training, be issued a certificate and provide a copy of that certificate to PICS. For those who would like to complete the training ahead of submitting hiring paperwork to PICS HR, the training can be found on the DHS PCA and CFSS Training and Tests website.

All Workers will also be required to complete a DHS NetStudy 2.0 background study.

All Workers will be required to track the activity/task they are completing when working with the person receiving services. These activities/tasks will need to be tracked per shift.

Q.    Is there a restriction on how many hours a Worker can provide caregiving services?
A.    A Worker is limited to 310 hours per month between all the individuals they work with. It is the responsibility of the Worker and the Representative to track these hours.

Q.    What is the “worker training and development budget?” 
A.    Under the budget model, the worker training and development budget can be used to send Workers to classes related to the specific assessed needs and care of the person receiving services.

Consultation services can provide further information on how to include worker training in your service plan.

Q.    Will there be additional paperwork to complete with PICS?
A.    Yes. To ensure a smooth transition to CFSS, PICS will be sending the required paperwork to Representatives and Workers.

If you have additional questions, please reach out to your PICS service coordinator.