Timelines
Case Manager has 30 days from receipt of SDP to review plan- what if we receive plan a few days before the renewal?
Still have 30 days
What makes someone eligible for the CFSS Enhanced Rate?
10 hours or more daily and/or has EN home care rating.
The Budget Model pays out more money than the Agency Model- True or False?
False! It is a big misconception that the Budget Model pays out more money, or the process moves faster than the Agency Model. CFSS hours/budgets are the same across the two models, and the process follows the same essential steps.
In general, what document(s) is the CM responsible to edit in the approval of CFSS?
Just the Lead Agency Addendum (and Support Plan/ USA of course)! We don’t have the flexibility to adjust the dates in the SDP, but can adjust on the Addendum.
Who must sign the SDP?
Person/guardian, consultation service provider MUST sign the SDP. FMS as needed. CM does NOT need to sign. CM must sign the Addendum
We all know about the requirement to have a Waiver service other than Case Management authorized for our clients by 90 Days (DD) or 120 Days (CADI), to keep the Waiver open. Does CFSS Count as a Waiver Service to meet this requirement? Why or Why not?
No, CFSS is a State Plan service, like PCA is. Another service must be authorized (in addition to OR replacing CFSS)
The CFSS budget calculator can be found on Reach Sharepoint, and Hennepin County Sharepoint (this is a great tool to bookmark!). When entering the FMS cost for a person on the Budget Model for CFSS on a 6 month plan, and you enter the FMS cost for a full year, what happens?
The Budget Calculator will pull the FMS cost for a full year and the budget will be incorrect. If date span is incorrect, the budget will be incorrect. The final date span and budget will be on the Lead Agency Addendum. (You may need to prorate FMS budget, by the number of months its being approved.)
You receive a new transfer client from Hennepin County, whose waive opened this October, therefore they have not been assessed/approved for PCA. They need services faster than CFSS can start. What can we offer them?
IHS w/ and without training, Respite, Homemaker, EAA, 24 Hour EA, PERS
Who is responsible for managing the worker’s wages?
They are determined within CFSS SDP, and managed/ paid by The FMS. Lead Agency/CM does not and should not need to make any changes. If there are questions/concerns about wages, CM should refer to Consultation Services/FMS.
When you are approving a CFSS plan, Case Managers complete the Lead Agency Addendum (DHS-6893W), send the Addendum and Supplemental Summary chart to the Person/Guardian/CFSS Agency/FMS Provider, and do what else with the SDP and Addendum?
Upload SDP and Addendum to MnChoices in ‘Attachments’ under ‘plans and reports’, also best practice to inform Consultation PRovider that plan is approved and in MnChoices.
USAs must have both a Consultation service line and CFSS service lines. At what point should a CM add CFSS to a USA that already has Consultation Services?
Once the CM has completed the CFSS SDP Addendum, and sent to providers/ person- confirming the start date.
You sent in a USA for some coverage work and received a vague edit back from SAU. Look at the Addendum and the USA together and identify what is wrong? **VISUAL**
Procedure Code should be T1019 U9 for Agency model, instead of T1019 UB for Budget model
If the person is on the Agency model, and chooses to use CFSS dollars to pay for a “good”, is an FMS needed?
Yes, and FMS is always needed if the person would like to purchase goods. They will also need to review the SDP and get approval from CM again.
The end date on the CFSS Addendum we create, should match the waiver end date; but you as the Case Manager will likely need to change the start date in the CFSS SDP. WHY?
CFSS cannot be backdated like PCA, CFSS can start the day the plan is approved, but not before.
You are reviewing this SDP for your client Harry, whose waiver span is 2/1/2026-1/31/2027. Can we use this plan, or do we have to send it back in order to complete the Lead Agency Addendum? **VISUAL**
We can use it!
May the Lead Agency authorize 6 months of PCA for the person if they conduct a late reassessment?
Yes, the lead agency may authorize six months of PCA for a late reassessment. The person must have had an active PCA service agreement within 60 days of the authorization. The lead agency may not backdate the service authorization.
What is the maximum number of hours that Paid Parent of a Minor can work?
The maximum hours a PPOM can work weekly is 60, and they are bound by the CFSS State Set rate of pay, currently $24.84. Any other person can pay their staff what they would like, under the Budget Model.
Goods and Services must be included in the SDP, be related to an assessed need, be for the direct benefit of the person, and ___
Increase their independence to complete tasks associated with assessed needs OR decrease their need for assistance with a covered CFSS personal care service from another person
When would we send an NOA (related to reviewing a Service Delivery Plan)?
We should send an NOA when a plan or line item is denied, and it must be sent in the mail to Person, Guardian, Consultation Provider, CFSS Agency, FMS (if applicable). Not if the person is willing to make the changes requested informally.
This plan is missing an area of assessed need (under ADLs). What is it AND what would you do about this? **VISUAL**
The 'Eating' category is missing details about hunger cues, utensils, food preparation, etc.
If there is a late assessment and it takes place within 30 days of the current SA end date, the CFSS Temporary Approval (6893L) can be used – what date will it be effective?
It will be effective the date of the assessment and there will likely be a gap in services.
Temporary budgets- If a person using CFSS at the time of their reassessment will not have an approved CFSS service delivery plan before the end of their current service plan year, the Case Manager must complete the Temporary CFSS Individual Service Delivery Plan Approval (6893L) and upload to MnChoices/share with the team, and complete USA . What information should go on the USA as far as hours/CFSS budget?
Authorize a year of the same CFSS services the person is currently using, based on the new assessment results. After receiving a temporary authorization, all parties must follow the standard process to complete and approve a new version of CFSS Individual Service Delivery Plan (DHS-6893P). If they do not submit a new SDP, the Temporary approval is good for one year. Note- an SDP is needed for any changes/revisions to approved services.
Give an example of a circumstance in which you could approve PCA for a client today?
We can approve PCA for a client that has been assessed for it, so there are hours to reference in their assessment, and they have NOT started the transition to CFSS (no Consultation Services or SDP lines have been entered on the SA).
You receive this SDP today, what should the start date be? **VISUAL #1**
It should NOT backdate to 9/1/26, as written on the plan, but should have a date of either today or in the future, depending on when the CM reviews/approves the ADP and writes the Lead Agency Addendum
When a client turns 65, they are automatically-enrolled in a Managed Care. What code should be used on the USA when authorizing CFSS for these folks?
X5609 Code for all CFSS lines (including Consultation Services)