Changes to what is now the Personal Care Assistance (PCA) Program will affect many Minnesotans with disabilities. The Department of Human Services (DHS) Policy bill, HF 1535 (Chapter 78), includes technical and important substantive changes to the Community First Services and Supports program (CFSS). CFSS is the new program which will replace PCA 90 days after federal approval is obtained. DHS has been working on a state plan amendment for CFSS service since 2013, with a mandated Implementation Council. Federal approval for CFSS is delayed until Minnesota’s Home and Community-Based Services (HCBS) waiver settings transition plan is approved by the federal agency, Centers for Medicare and Medicaid Services (CMS). DHS expects CMS’ approval of both the HCBS waiver settings transition plan and CFSS within the next six months.
Changes to the CFSS statute, Minn. Stat. 256B.85, span nearly 40 pages and includes changes of new responsibilities and protections for participants. There are also new DHS obligations when a CFSS agency is sanctioned or closes. CFSS-related services changed by the legislature this year include consultation services, fiscal management services and worker training and development services.
Consultation services will be provided by Medical Assistance (MA) enrolled providers to assist participants in making choices about CFSS services overall and choices regarding self-directed tasks specifically. Consultation services will assist in development of a person-centered service delivery plan aimed at achieving individualized quality service outcomes for the participant. Consultation services requirements include 16 specified duties plus “any other duties assigned by the Commissioner.” The consultation service provider must enter into a written agreement
with the participant, provide orientation to CFSS services, assist the individual to access financial management services or agency-provided services and help develop the service delivery plan.
Financial management services will be provided by a separate qualified organization for participants who use the budget model. Seven specified services have been added to the financial management services section of the CFSS statute. Detailed participant responsibilities for those who use either the agency model or the budget model are described in the new law.
Participants in the budget model will be responsible for nine specific types of activities, including hiring and supervision, communication with the financial management service provider about changes, developing a support worker training and development plan, verifying and maintaining evidence of support worker competency, providing periodic written performance reviews and evaluation of CFSS services.
Worker training and development services must be arranged by an agency provider or purchased by a participant employer under the budget model. The purpose of worker training and development services is to expand the knowledge and skills of a support worker. This is to ensure competency in services provided. Worker training and development services must be provided to a new support worker, except for a time limited substitute and are paid for outside of the participant’s service allotment or budget. The funding for worker training and development is the funding now used for qualified professionals under the current PCA program.
Other changes to the CFSS statute include written notice of recipient service rights and due process rights when services are to be changed or terminated, protection-related rights for participants using either an agency provider or a financial management services provider for the budget model. Also, new provisions add participant protections when agency or financial management services providers decide to terminate services to a participant. The new provisions also detail the responsibility of the commissioner when an agency is sanctioned or has payments withheld which could lead to service interruptions for participants.
These changes were sought after PCA participants were left without any payment for their staff when a large agency declared bankruptcy. These and many others changes can be found in HF 1535 (Laws of 2015, Chapter 78, Article 6, Section 22).
-Anne Henry is an attorney with the Minnesota Disability Law Center