Commentary: CFSS represents positive evolution of services for people with disabilities

It’s not surprising that questions have been raised about changes coming to a service that Minnesota has provided for nearly […]

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It’s not surprising that questions have been raised about changes coming to a service that Minnesota has provided for nearly 40 years to help people with disabilities live more independently. As it replaces Minnesota’s nation-leading Personal Care Assistance program, Community First Services and Supports (CFSS) may mean little change in the daily lives of some people with disabilities. For others, it offers opportunities for greater choice, flexibility and independence.

CFSS comes in response to what we have heard from Minnesotans with disabilities about how they would like long-term services and supports in our state to evolve. People told us that they want to continue receiving help with activities of daily living but also want more opportunity to do as much as they can for themselves, be as independent as possible and have flexibility to make choices. We want to take this opportunity to address some concerns as well as provide a status update on the implementation of CFSS.

First and foremost, we expect all people receiving PCA services today to be eligible for CFSS. Like PCA services, CFSS can get help with activities of daily living, instrumental activities of daily living and health-related tasks. CFSS also brings significant enhancements to PCA services being offered today. In addition to traditional PCA services, CFSS workers can assist in enhancing or maintaining skills that can increase independence. Improvements of CFSS include greater flexibility and funding for technology and home and vehicle modifications that help to increase independence. Also, the increased match of federal funding for CFSS will pay for PCA recipients whose needs are at the lowest level to receive at least 75 minutes per day instead of the current 30-minute per day cap.

With CFSS, people will be able to choose between using a more traditional agency model to provide their services or to directly manage their staff by using a budget model. Service amounts will be based on each person’s needs for assistance with activities of daily living and/or behavioral interventions using the current home care rating scale. People receiving services will develop their own service delivery plan with help of a new Consultation Service. The Consultation Service will assist individuals to make informed choices about their options and responsibilities within CFSS.

People will have new options in choosing their support workers. They can buy services from an agency or hire their own staff, including having their spouse work as their paid support worker. Parents, step-parents and legal guardians will be able to work as paid support workers for their minor children.

As DHS continues negotiations with the federal Centers for Medicare and Medicaid Services for approval of CFSS, it is apparent that the initial target implementation date of April 1, 2014, will not be met and another target date has not been set. In addition to CMS approval, DHS needs to complete other work to be ready for implementation. This includes contracting with vendors of Consultation Services to inform and assist program participants in making decisions and finishing plans for administering fiscal support for individuals who use the budget model.

A benefit of this delay is the opportunity for more communication between stakeholders and careful consideration of issues that may arise. This will, ultimately, lead to a better service for Minnesotans. During this time, we encourage you to be involved in addressing and resolving issues and questions. CFSS Implementation Council meetings are open to the public. The next meeting will be held at DHS at 444 Lafayette Road on Monday, June 16, from 2 to 4:30 p.m. Questions, comments and suggestions regarding CFSS can be sent to [email protected]


Loren Colman is assistant commissioner for Continuing Care at the Minnesota Department of Human Services. Alex Bartolic is director of Disability Services at the department.

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