CFSS is a new self-directed home and community-based service developed by the Minnesota Department of Human Services.
CFSS program will replace PCA personal care assistance services and the CSG Consumer Support Grant. After all people have moved to CFSS, PCA and CSG will no longer be service options.
People who use CFSS will have more options and supports: CFSS will offer participants more control, flexibility, responsibility, and choice in how they use the service. CFSS is a program under the Medical Assistance waiver and Alternative Care programs.
Unlike PCA, in CFSS a person’s spouse or the parent of a minor may serve as that person’s support worker. People may choose to purchase goods to aid in their independence. The CFSS budget model allows people to choose to be the employer of their support workers. The state provides a budget that the provider agency or the person may use to train workers on the individual needs of the person. The consultation services provider will provide education and support in writing the person’s plan
The eligibility requirements for CFSS will be the same as PCA. The person must: Live in his or her own home. Be able to direct care or have a representative who can direct care on his/her behalf. Be on one of Minnesota’s health care programs. Have an assessment that determines he/she is eligible.
CFSS will cover the same main services as PCA:
Activities of daily living, such as eating, bathing, grooming, and transferring. Health-related tasks. Instrumental activities of daily living, such as shopping, cooking, laundry and assistance with medications. Observation and redirection of behavior. CFSS is meant to expand people’s choices and control over their care, including the purchasing of goods to aid a person’s independence
CSG allows individuals with disabilities to purchase items, services and supports needed due to the individual’s disability. These services and items can help the individual with some of their everyday living needs (such as personal cares, taking care of the home, socialization, etc.)
However, CSG will be transitioning to CFSS Budget model. In the budget model of CFSS, people who currently use CSG will have a budget to spend on goods and services that are covered by CFSS. Previous CSG users will also be able to use the agency model if they choose. Because Minnesota does not get federal funding for CSG, a participant’s CSG budget is equivalent to half of the PCA units for which the participant is assessed to be eligible. In CFSS, a previous recipient of CSG will have access to dollars or units roughly equivalent to twice his or her CSG budget. In addition, the CFSS budgets will be higher than CSG budgets. Because CSG is a state-funded program and only uses state funds or 50% of what PCA is funded at. CFSS is a federally funded program. When CFSS is operational, people who transition to CFSS will get the full benefit of the federal and state financial participation (i.e., 50% federal dollars and 50% state dollars).
Communication options are many go to Robland CS website at communityfistconsultantservices.com for online intake admission. More communication options are calling in directly to reach the switch board and getting email address.
Community First CS is located at 3249 19th St NW, Suite 3, Rochester, MN 55901
Community First Consultation Services staff are fluent in English, Somali, Arabic and Deka languages. We use interpreters to match the client to remove communication problems.
You can reach staff through the switch board for any of the programs or contact staff directly
Community First CS parent company Robland Home Health Care, Corp has been in business for over 13 years to date.
For the many years in existence Community First CS never has any negative reviews or complaints.
Community First CS provides consultant services to diverse populations in the state of Minnesota both in rural and metropolitan areas.
CFSS is available to a person who meets one of the following criteria: is an MA enrollee, except for MA enrollees who are eligible for home care services coverage under Medicare; is a participant in the alternative care program; is an MA waiver recipient (elderly waiver, developmental disabilities waiver, brain injury waiver, community alternative care waiver, or community alternatives for disabled individuals waiver); or has medical services identified in a participant’s individualized education program and is eligible for MA special education services. In addition to meeting the eligibility criteria above, a person must also: require assistance and be determined dependent in one activity of daily living (ADL) or Level I behavior based on an assessment; and not be a family support grant recipient.
CFSS services include: assistance with ADLs, including eating, toileting, grooming, dressing, bathing, mobility, positioning, and transferring; assistance with instrumental activities of daily living (IADLs), such as meal planning, preparation, and cooking; shopping for food, clothing, or other essential items; laundry; housecleaning; assistance with medications; managing finances; communicating needs and preferences during activities; arranging supports; and assistance with traveling around and participating in the community; assistance with health-related procedures and tasks that can be taught or assigned by a state licensed health care or mental health professional and performed by a support worker; assistance to acquire, maintain, or enhance the skills necessary for the participant to accomplish ADLs, IADLs, or health-related procedures and tasks; expenditures for items, services, supports, environmental modifications, or goods, including assistive technology; observation and redirection for behavior or symptoms when there is a need for assistance; back-up systems or mechanisms, such as the use of pagers or other electronic devices, to ensure continuity of the participant’s services and supports; services provided by a consultation services provider under contract with DHS and enrolled as a Minnesota health care program provider; services provided by a financial management services provider; services of up to 40 hours per seven-day period provided by a support worker who is a parent, step-parent, or legal guardian of a participant who is under age 18, or who is the participant’s spouse, regardless of the number of parents providing services, combination of parents and spouses providing services, or number of children who receive MA services; and worker training and development services
CFSS will be provided by support workers who will be employed by agency providers or the participant. Support workers must enroll with the Department of Human Services, complete a background study, and meet all other requirements. Agency providers must be MA-enrolled health care program providers and meet all applicable provider standards and requirements, including compliance with background study requirements, reporting maltreatment of minors and vulnerable adults, providing the participant with service-related rights, and verifying and maintaining records of all services and expenditures by the participant.
Community First CS Agency provides consultation services. Consultation services is a component of CFSS. Consultation services providers will support people receiving CFSS by providing education to help them make informed choices about meeting their needs with CFSS. Consultation Services educates the person about CFSS; helps the person write their plan and approves the plan.
The Agency model is selected by the client to provide services. CFSS agency provider is the employer of the worker(s). The agency can hire qualified workers that the participant recommends. Establishes the schedule for the worker, with the participant. Assists the participant to customize the service delivery plan with the appropriate tasks. Assist the participant to implement the plan and backup plan. Provides training, supervision and evaluation for the worker(s). Assist the participant in addressing health and safety needs specified in the CFSS service delivery plan.
In the Agency model the lead agency will authorize a worker training and development budget. The Agency can use this budget to pay staff members to train a worker on the specific needs of a person. Many agencies will have their current Qualified Professional continue to serve in this role, but this budget gives the agency more flexibility- the best training plan for some workers might involve multiple staff members who have different areas of expertise. Agencies can use the worker training and development budget to pay for classes or individual trainers to perform these tasks. This budget is for training on the needs of the person (It cannot be use for general training and orientation that agencies give to all workers) Also cannot be use for workers time while they are receiving the training. If clients using the Agency Model chooses to purchase goods after the person makes an approved plan that involves goods. The lead agency will authorize unit(s) for direct care to the agency provider and dollars for purchasing goods to the (FMS) Financial Management Services.
In the Budget Model the client will select a Financial Management Services provider. Clients using the budget model will also have a separate worker training and development budget. People on the budget model can use their worker training and development budget to pay for classes or individual trainers for their workers. Goods are news CFSS clients can purchase goods to aid in their independence in either model. Clients using the budget model chooses to purchase goods they use part of their budget to pay for those goods.
The main difference between Agency & Budget Models is who is responsible for employer related tasks such as recruiting, hiring and training. In CFSS agencies will support people using the agency model. FMS provider will support clients using the budget model.
Services that provide help with financial tasks, billing and employer-related responsibilities for people who self-direct their services through consumer directed community supports (CDCS) or the Consumer Support Grant (CSG). These services are provided by financial management services (FMS) providers
Financial management services (FMS) provider: A Minnesota Health Care Programs (MHCP)-enrolled organization that people use to help them with employer-related responsibilities and financial management service tasks.
FMS providers perform vendor fiscal/employer agent (VF/EA) tasks. This means the FMS provider’s role is to support the person to fulfill his/her responsibilities in being the employer of his/her workers. The FMS provider performs tasks that include, but are not limited to:
- • Billing DHS and paying vendors or the person’s individual workers for authorized goods and services
- • Ensuring what the person spends his/her funds on follows the rules of the program and the lead-agency-approved plan
- • Helping the person obtain workers’ compensation
- • Educating the person on how to employ workers
- • Documenting and reporting all spending of program funds
- • Initiating background studies for workers
- • Filing federal and state payroll taxes for workers on the person’s behalf.
Consultation services provide upfront information and ongoing support to people who are eligible for and choose to use CFSS. The responsibilities of consultation services providers are only within the scope of CFSS. They are not responsible to coordinate services within the larger social service system.
Can current PCA agencies offer both CFSS consultation services and CFSS agency services? As long as an entity meets enrollment criteria, they can enroll as both a CFSS consultation services provider and CFSS agency provider.
Can the consultation services provider be employed by the agency? While one entity can enroll and provide both of these services, CFSS policy does not allow them to provide both services to the same person.
Is there going to be monitoring in place to address conflict of interest?
The consultation services provider must be a neutral party in the person’s choice between the agency and budget models, as well as the person’s choice of providers.
Who is responsible to approve CFSS plans, the lead agency or the consultation services provider?
It depends on the person’s situation: If the person receives only state plan CFSS services, the consultation services provider is responsible to approve the person’s CFSS individual service delivery plan If the person is on a waiver, AC or has a care coordinator through an MCO for seniors, the consultation services provider is responsible to get the person’s CFSS individual service delivery plan in order for the case manager or care coordinator to review. The case manager or care coordinator is responsible to review the plan to ensure: There is no duplication of services, The person’s health and safety needs are addressed Any required coordination with the person’s other services are addressed.
People Responded with the following suggestions to question 9:
Background and experience
A rating or grading system published to ensure that they are supportive, efficient and competent
A formal grievance process for participants and providers to raise issues with Consultation Service providers.
DHS also should have a process to hold them accountable.
People Responded with the following suggestions to question 10, other:
- •Reviews from current clients
- • Detailed information on process and length of time.
Financial Management Services or FMS Required for people using the budget model
Supports the Participant who is responsible for staffing and employment-related activities
Pays for approved items in the plan
Bills DHS for approves items in the plan
Monitors the budget Required for purchasing goods in the agency model When goods are approved for a person in the agency model, the person will have to use an FMS to:
Pay for the approved good in the plan
Bill DHS for the approved good in the plan FMS Provider
Monitor spending for approved good
- communication options
- Languages spoken
- contact information
- how long the agency has been in business
- online reviews for the agency
- specific populations the agency serves
People Responded with the following suggestions to question:
A rating system and their track record. Customer service and accuracy
General reputation, customer service satisfaction information
How fast can staff/workers be hired and working?
How much time will it take for them to get paid?
A. communication options
D. Languages spoken
E. contact information
F. how long the agency has been in business
G. online reviews for the agency
H. specific populations the agency serves
Budget model in CFSS
When a person is not fulfilling their employer duties, will there be criteria for switching them from the budget model to the agency model?
We are in the process of developing guidelines and policy that provide direction to the lead agency (if applicable), FMS provider and consultation services provider when a person on the budget model is not fulfilling their employer duties.
How will the CFSS assessment reflect service level for both agency and budget model? Does the assessment determine hours per day, like in PCA? If someone chooses the budget model, are they limited to that number of hours per day?
The eligibility process will not change. The assessment will determine the person’s home care/CFSS rating and the units or hours per day for which they are eligible. In the CFSS agency model, the service authorization will be issued in units according to the person’s assessment. The service will be authorized in one annual line. There will be exceptions to authorizing services in one line such as, but not limited to, changing providers. In the CFSS budget model, the service authorization will be issued in dollars, which is the unit rate multiplied by the number of units for which the person is eligible. In both models, as in PCA now, the person can use units or the budget flexibly for services, and they are not limited to a specific number of hours per day.
budget is calculated by multiplying the unit rate by the number of units for which the person is eligible. DHS intends to have a document that shows the budget amount associated with the home care ratings.
Do workers need background checks if they provide services to a person using the budget model? Will there be a separate line item for those costs?
Yes, all CFSS workers will need a background study. This includes workers for both the budget model and the agency model. DHS will provide more specific information about service agreement entry closer to the CFSS implementation date.
FMS providers and the agency model Do people on the agency model only choose an FMS provider when a good is in their approved plan? If a person chooses the agency model and they have a good listed in their plan, they will use both a CFSS agency provider and an FMS provider. The agency will provide the direct care components, and the FMS provider will only support the purchase of the good. Extended CFSS What if a person on a waiver needs extended CFSS?How is this need communicated to the consultation services provider? After a person on a waiver meets with their consultation services provider to develop their CFSS individual service delivery plan, the consultation services provider sends the plan to the case manager. At that time, the case manager and the person discuss what other support options the person needs. The case manager enters the service authorization with all CFSS information and all other waiver services, including extended CFSS. Page 9 of 10 Distributed January 2021 DHS does not expect the waiver case manager to communicate information about waiver services, including extended CFSS, to the consultation services provider. Like PCA, extended CFSS is not available in alternative care. Worker training and development Will nurse supervision (i.e., qualified professionalsupervision) still happen in CFSS, or does consultation servicestake its place? In PCA, a qualified professional (QP) supervises PCA workers. The qualifications for a QP are set in PCA statutes. It is only necessary for the QP to be a registered nurse (RN)when a person needs a worker to do health-related tasks that require RN supervision. In CFSS, the employer completes worker training and development tasks. The agency is the employer in the agency model, and the person is the employer in the budget model. In the agency model, the agency is required to have an appropriate, qualified employee to complete the required training and development tasks. This employee could be an RN. In the budget model, the person is responsible for the supervision and training of their workersrelated to all tasks including health-related tasks. The consultation services provider will ask the person to report what tasks they completed, and they will provide technical assistance when needed. MCOs for seniors and CFSS When a person is enrolled in an MCO for seniors and using the agency model, will they have to work with a CFSS agency provider enrolled in that MCO? Yes, a person enrolled in an MCO for seniors will have to choose a CFSS agency that is contracted with their MCO. Training How will DHS notify families aboutthese changes?When will the notification happen? Currently, there are two videos on the DHS CFSS page for people we serve that explain CFSS. We encourage lead agencies to share this information with people who currently receive PCA. We will create a communication plan with specific information about when families will get more information from DHS. Will staff preparation and training change,or will it remain similar to the current one? We are not sure what staff training this question references. Page 10 of 10 Distributed January 2021 For direct care workers, the PCA/CFSS training that we released in April 2020 fulfills training requirements for both PCA and CFSS. If this question is referring to lead agency training, CFSS policy staff will provide additional information about what lead agencies need to know for CFSS closer to the CFSS implementation date.
Assessor and case manager duties for assessment and service agreement entry in CFSS-
Will the MnCHOICES assessor be responsible to write the person’s support plan for CFSS? The current duties of an assessor will not change as we transition to CFSS, however, depending on the person’s situation: · If the person receives only state plan CFSS services, the assessor will write both the community support plan (CSP) and coordinated services and supports plan (CSSP) · If the person is on a waiver or AC, the assessor will write the CSP and the case manager will write the CSSP.
No, there will not be changes to the legacy assessment process. However, there will be changes to the data entry process for CFSS services. The lead agency will do the initial MMIS authorization/data entry for consultation services. When the completed CFSS individual service delivery plan comes back to the lead agency from the consultation services provider, the lead agency will need to do additional MMIS authorization/data entry to reflect the finalized plan. Additional MMIS authorization/data entry may include entering goods, CFSS agency provider or FMS provider.
We recognize the addition of consultation services could potentially extend the time it takes for the person to get started with CFSS services. As we transition to CFSS, a person’s PCA services will continue while they wait to start CFSS services to ensure continuity of care. We will continue to have internal discussions about this topic as lead agencies provide us with feedback. Will the MnCHOICES assessor have approval responsibilities for the CFSS individual service delivery plan (e.g., reviewing to ensure the services/goods in the plan meet the person’s assessed needs)?
No, the assessor is not responsible to review or approve a person’s CFSS individual service delivery plan. The role of the assessor will not change as we transition to CFSS. If the person receives only state plan CFSS services, the consultation services provider is responsible to review and approve the plan within the scope and rules of CFSS. Then, the lead agency will enter the CFSS service authorization into MMIS following the approval of the plan
It depends on the person’s situation: If the person receives only state plan CFSS services, the consultation services provider is responsible to approve or deny parts of the plan or the entire plan, issue the notice of action and participate in the appeal. If the person is on a waiver, AC or in an MCO for seniors, the case manager or care coordinator is responsible to approve or deny parts of the plan or the entire plan, issue the notice of action and participate in the appeal.
It depends on the person’s situation: If the person receives only state plan CFSS services, the lead agency has no responsibility to answer questions after the assessment is complete and the service authorization is entered, just like in PCA.
If the person is on a waiver or AC: The case manager is still responsible for case management type issues and questions. The case manager should refer the person to the consultation services provider for questions specifically about CFSS (e.g., model difference, process to hire a worker, etc.) The consultation services provider should refer waiver/AC questions to the person’s waiver/AC case manager.
Does the lead agency enter the lines for CFSS and training/supervision, FMS and budget for goods? How is the information reported back to lead agency (e.g., whether the person chooses agency or budget, the goods rate, the FMS provider)? Who is responsible to authorize CFSS?
The lead agency is responsible to authorize CFSS in MMIS. The lead agency will enter the authorization/lines based on the information in the CFSS individual service delivery plan. The lines include: Consultation services CFSS services (CFSS agency or FMS provider) Worker training and development Goods, if applicable. The consultation services provider will send the CFSS individual service delivery plan to the lead agency to enter the details of the plan into MMIS.
The duties of an assessor will not change as we transition to CFSS. Assessors will still be required to fulfill their duties in either MnCHOICES or the legacy assessment, as they do in PCA (e.g., CSP and CSSP responsibilities). CFSS will follow the same requirements as PCA. Our goal is to follow a similar process to what happens now in PCA (i.e., faxing a request to the Resource Center to update the service agreement) if a person makes a change. We will provide more finalized and detailed information in future trainings.
We assume this question is about the lead agency’s ability to make changes to a type B service agreement after the service agreement has been entered and approved. Page 6 of 10 Distributed January 2021 If a person receives only state plan CFSS services, the person’s service agreement will still be a type B service agreement. The lead agency will enter the service agreement, just like in PCA. However, DHS is making a change to the process for CFSS to allow the lead agency to edit the service agreement for a longer period of time after consultation services have been approved. DHS plans for type B service agreement changes to work very similarly to what happens now in PCA.
A fax is sent to the Resource Center and the Resource Center will update the service agreement.
For type B service agreements, DHS plans changes in CFSS throughout the year to work very similar to what happens now in PCA (i.e., faxes come to the Resource Center to update the service agreement)
We are still working on the details of who submits the change request form to the resource center either the consultation service provider, FMS or CFSS agency.
Are consultation services providers added to the service agreement? If not, how are they paid? Yes, the lead agency will add consultation services to the person’s service agreement.
At this time, like PCA, assessors are not expected to complete the LTSS improvement tool for state-plan-only CFSS.
Home care nursing and CFSS How does CFSS work for people who also receive home care nursing (HCN)? CFSS will work the same as it does now when a person receives a combination of PCA services and HCN services. The HCN monthly budget limit and unit limit will still apply.