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PCA and CFSS: what is changing in Minnesota
Personal care assistance (PCA) is being replaced by a program called Community First Services and Supports (CFSS). Here is the timeline, what stays the same and what is new.
The short version
CFSS is a Minnesota health care program that replaces personal care assistance and the Consumer Support Grant. It helps people with disabilities, chronic illnesses and older adults live in their own homes and communities, with more choice over who provides services and how they are managed.
Eligibility rules and the assessment process are the same for PCA and CFSS. A person who was eligible for PCA is eligible for CFSS unless their condition changes.
People move from PCA to CFSS at their yearly reassessment. Counties, tribal nations and managed care organizations move people at the yearly reassessment, with the aim that services are not interrupted.
Timeline
- February 2024. DHS received final federal approval of the state plan amendment that lets CFSS replace PCA and the Consumer Support Grant.
- October 1, 2024. DHS began implementing CFSS. The preparation phase ended September 30, 2024 and the transition phase began October 1, 2024. On that date a person's spouse, or the parent of a minor, became able to be paid as that person's support worker.
- November 26, 2024. DHS announced that people who use PCA or the Consumer Support Grant receive up to six months of those services while they work through the switch to CFSS.
- July 25, 2025. DHS sent lead agencies instructions on avoiding a gap in services for people who have not finished the move by their next assessment on or after October 1, 2025.
- April 1, 2026. People can no longer use PCA while on the Alternative Care program, so Alternative Care participants must be on CFSS (announced March 25, 2026).
- May 12, 2026. DHS extended the general transition deadline to September 30, 2027. The extension does not apply to people on Alternative Care or to extended PCA.
- June and September 2026. DHS finished revalidating all provider agencies as CFSS providers in June 2026. Extended PCA services ended in September 2026, and nobody can use extended PCA after September 30, 2026.
- Still to come. DHS says it will discontinue PCA and the Consumer Support Grant after everyone has moved, and has not published a final end date.
What stays the same
CFSS covers the same main services as PCA: activities of daily living, instrumental activities of daily living, health-related tasks, and observation and redirection of behavior. Driving is covered in both.
You still need a Minnesota Health Care Program, you still need an assessment from your county, tribal nation or health plan, and you still direct your own care or have a representative who does.
What is new in CFSS
CFSS adds several things that PCA does not have: a consultation services provider who helps you plan, a budget model, paid spouses and parents of minors, people who use CFSS working as support workers for others, purchase of goods and services, a personal emergency response system, and a separate worker training and development budget.
The options are named differently. PCA has two options, traditional PCA and PCA Choice. CFSS has two models, the agency model and the budget model. The consumer-directed options guide explains both.
Flexible use of hours also differs. In PCA, a person who is not on the Minnesota Restricted Recipient Program can use only up to 75 percent of their units in each half of the service plan year. In CFSS, a person can spread units or dollars across the whole service plan year, unless they are on that program.
In PCA, a qualified professional trains and supervises workers. In CFSS, a worker training and development budget replaces the qualified professional units. The agency's supervising professional still has to train the worker, confirm they are competent and supervise them, but the qualifications are more flexible.
Where to go from here
CFSS keeps the main PCA services and adds more choice over who provides your services and how they are managed. DHS says people receive up to six months of PCA or Consumer Support Grant services while they work through the switch.
If you already receive PCA, your county, tribal nation or health plan will move you at your next yearly reassessment. If you are new to home care support, start with the getting started guide. The law that governs CFSS is Minnesota Statutes section 256B.85. Minnesota Aging Pathways, formerly the Senior LinkAge Line, is a free Minnesota Board on Aging service that connects people with community help and services: 800-333-2433.
Common questions
Is PCA going away in Minnesota?
Yes. Community First Services and Supports (CFSS) is replacing PCA and the Consumer Support Grant. DHS began the transition on October 1, 2024, and people move at their yearly reassessment. DHS has not published a final PCA end date; the general transition deadline is September 30, 2027, after DHS extended it in May 2026.
Will my services stop while I switch from PCA to CFSS?
DHS says your county, tribal nation or managed care organization continues to authorize PCA or CSG while you complete the switch. Starting from the November 26, 2024 announcement, people receive up to six months of PCA or CSG while they transition.
Are there people who had to switch sooner than the general deadline?
Yes. People on the Alternative Care program can no longer use PCA as of April 1, 2026, and extended PCA services ended after September 30, 2026. The extension to September 30, 2027 does not apply to those two groups.