Community First Services and Supports (CFSS)
Community First Services and Supports (CFSS) means the assistance and support program under Medical Assistance State Plan for accomplishing activities of daily living, instrumental activities of daily living, and health-related tasks through hands-on assistance to accomplish the task or constant supervision and cueing to accomplish the task, or the purchase of goods that replace the need for human assistance.
Why Community First & Support
- Redesign and improve services.
- PCA, CSG CFSS
- Better and different support to those living in community.
- Expand self-directed services under HCBS
- Improved individual outcomes.
- Opportunities Under the 2010 Patient Protection & Affordable Care Act for Medicaid State Plan Option “K” and “I” and 1115
Broader service scope - skills development, goods & technology to replace human assistance, transition etc.
- 6% enhanced Federal Financial Participation (FFP).
- 2013 Legislation established authority MN Statutes 256B.85
- 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.
- Activities of daily living, such as eating, bathing, grooming and transferring.
- Health-related tasks
- Instrumental activities of daily living, shopping, cooking, laundry and medications.
- Observation and redirection of behaviour.
What Is New?
On CFSS, the state includes a budget for worker training and development. This budget provides your employer with money to use to train you on the specific needs of the person you are working with. For example, if you work with a person who has autism, your employer could use this budget to send you to a training on how to best support individuals with autism.
First, CFSS participants will now be permitted to work as CFSS workers for other participants. Also, additional family members can now serve as workers. They now include the participant’s spouse, and the parents, step-parents, or legal guardians of a minor
In CFSS, participants get the assistance of a new support role, consultation services, when they write their plan. Consultation services will also help people decide between the two models offered by CFSS.
The agency model works very similarly to how PCA works now, while the budget model gives the person more control over things like worker wages and benefits.
Unlike PCA, a CFSS plan can also include the purchase of goods to aid in the person’s independence.
In CFSS people have greater flexibility in how to spread their dollars throughout a service plan year.
CFSS Programs
The services take place in both person’s home and in the community. As a worker, you might go with the person to support their ability to participate in community activities.
CFSS require many roles to be successful. In both programs, the person is always at the centre of the process. The person or someone they know asks for an assessment from a lead agency. The lead agency’s assessor then talks to the person about options to meet the person’s needs. The assessor determines if the person is eligible for the program. The assessor might also determine that the person needs a representative to help make important decisions.
One of the main tasks that PCA and CFSS workers support is carrying out activities of daily living, or ADLs. As a worker, you support the person in doing these activities so that they can remain in the community.
Eight ADL’s -Activities of Daily Living:
Dressing
- Grooming
- Bathing
- Eating
- Toileting
- Transfers
- Positioning
- Mobility
Some workers perform instrumental activities of daily living, or IADLs
- Assistance with meal preparation
- Shopping
- Communication
One of the main tasks that PCA and CFSS workers support is carrying out activities of daily living, or ADLs. As a worker, you support the person in doing these activities so that they can remain in the community.
Eight ADL’s -Activities of Daily Living:
Dressing
- Grooming
- Bathing
- Eating
- Toileting
- Transfers
- Positioning
- Mobility
Some workers perform instrumental activities of daily living, or IADLs
- Assistance with meal preparation
- Shopping
- Communication
Professional Boundaries and Data Privacy
As a worker, you will get to know the person you work with very well. As part of your work, you might help them with very personal things, such as going to the bathroom. Do not share with others the things you learn about this person through your work. People participating in the PCA program or the CFSS program have the same right to dignity and privacy as any other person. You also have the legal obligation to protect the privacy of the person you work with. The Health Insurance Accountability Act (HIPPA) is a federal law that protects the person’s private data.
Examples of private data:
- The fact that the person is participating in PCA of CFSS programs
- The contents of the person’s plan
- The person’s diagnoses
- Services performed