Minnesota Community First Services and Supports (CFSS), Replacing PCA
Community First Services and Supports (CFSS) is replacing Minnesota’s Personal Care Assistance (PCA) program and the Consumer Support Grant. DHS began CFSS on October 1, 2024, and people move over at their yearly reassessment. People who have not yet moved have until September 30, 2027. For the wider picture, see our Minnesota Long-Term Care Medicaid guide.
Figures change periodically. Double-check current amounts before relying on them.
At a glance
| Item | Details |
|---|---|
| Type of program | Community First Choice (state plan home care benefit) |
| Who runs it | Minnesota Department of Human Services (DHS) |
| Age | Any age |
| Care need | Assessed need for help with daily activities |
| Minnesota 2026 income rule (long-term care) | $1,330 a month (MA for people 65+, blind or disabled), with a spenddown above it. Elderly Waiver special income standard: $2,982 |
| Minnesota 2026 asset limit (single applicant) | $3,000 |
| Waiting list | No |
CFSS in brief
In short, CFSS is run by Minnesota Department of Human Services (DHS). Who it is for: any age. Care need required: Assessed need for help with daily activities. As for waiting: No. The sections below repeat these points with more detail, and our state guide covers the Minnesota rules that apply to every long-term care program. Families weighing CFSS against other Minnesota options can use the related pages at the end to compare programs side by side.
What the program is
CFSS covers the same main services as PCA. It offers two models: an agency model, where a provider agency employs the worker, and a budget model, where the person (or a representative) employs the worker and manages a budget with help from a financial management services provider. A consultation services provider helps the person plan. CFSS can include the person’s relatives as workers, with rules that differ for spouses and parents of minor children. Counties, tribes and managed care plans move people from PCA to CFSS at their yearly reassessment.
Federal law lets states add Community First Choice to regular Medicaid in exchange for a higher federal match, and Minnesota has done so. There are no slot limits, because it is not a waiver. It usually covers hands-on help with daily activities, help learning skills to do more on one’s own, and backup supports such as emergency response.
Who qualifies in 2026
To get CFSS, a person generally has to meet each of these:
- Lives in the community
- Can direct care or has a representative
- Is enrolled in MA, an MA waiver, or some MinnesotaCare
- Has an assessment showing eligibility
- Is not using the Family Support Grant
Income and assets. The person must be enrolled in Medical Assistance, an MA waiver or some MinnesotaCare. Minnesota’s rules are in our state guide. The table’s figures are Minnesota’s 2026 long-term care numbers, taken from our state guide. The home (up to the equity limit, when the person or a spouse lives there or plans to return), one vehicle, belongings and a small burial fund are generally not counted by Minnesota DHS. When one spouse applies for CFSS and the other stays at home, the spouse at home keeps a protected share of the couple’s assets and may receive part of the applicant’s income. See Spousal impoverishment rules.
About the level-of-care assessment. The care test looks at how much help a person needs with everyday activities such as bathing, dressing, eating, using the toilet, moving around and taking medicines, and at memory problems and supervision needs. A nurse or social worker working with Minnesota DHS usually does it in person, wherever the person is living. Families should describe the worst days honestly and bring a list of conditions and medicines. See Nursing home level of care and Activities of daily living.
What services it can pay for
Services depend on the person’s assessed needs and written care plan. Depending on the plan, they can include:
- Activities of daily living
- Health-related tasks
- IADLs such as shopping and cooking
- Observation and redirection of behavior
The menu is broad, but the plan is built from need, and unpaid family help is factored in. A change in health is a reason to request a reassessment.
How to apply
There are two tracks, a financial one and a care one, and both must say yes. The usual path for CFSS is:
- Contact your county, tribe or health plan.
- Assessment.
- Choose a model.
For the paperwork, use our documents checklist before applying for CFSS; Applying for a waiver explains the general process.
Waiting lists
CFSS is a state plan benefit with no waiting list.
More on how lists work: Waiver waiting lists.
How it relates to nursing home Medicaid
CFSS helps people stay in their own homes. It does not require a nursing facility level of care. People on the Elderly Waiver can also receive CFSS. DHS ended extended PCA services on September 30, 2026, and people still on PCA must finish moving to CFSS by the transition deadline.
What is the same as nursing home Medicaid. Most money rules carry over from nursing home Medicaid. The five-year look-back for gifts generally applies, so a gift or transfer for less than fair value can cause a period when Medicaid will not pay for long-term care services. Estate recovery also applies: the state can seek repayment from the estate of a person who received long-term care services after age 55. Some participants pay a monthly share of income toward services.
Personal needs allowance. If the person does move to a nursing home, Minnesota’s 2026 personal needs allowance is $132 a month (clothing and personal needs). Most of the rest of their income goes toward the cost of care. Details are in our state guide.
Tips for families
- Start early. If there is a waiting list or a slow assessment, the clock usually starts when you ask, not when the crisis comes.
- Keep a paper trail: copies of forms and notices, plus the names and dates of every call to Minnesota DHS.
- Use your appeal rights. Notices that deny or reduce services explain how to request a fair hearing; acting quickly can protect current services.
- Report changes in income, assets, address or living situation to Minnesota DHS when they happen.
- Mark renewal dates. Eligibility and the care plan are usually reviewed annually; see Renewals.
- Get help with complex CFSS cases, such as a spouse at home or past gifts. A certified Medicaid planner or a legal aid office can review how Minnesota’s rules fit a family’s situation.
Common questions
Is PCA ending? Yes. CFSS is replacing PCA and the Consumer Support Grant, with a final transition deadline of September 30, 2027.
What about extended PCA? Extended PCA ended on September 30, 2026.
What about Alternative Care? People on Alternative Care could no longer use PCA after April 1, 2026, and moved to CFSS.
Can a relative be my worker? Yes, in many cases.
Related pages
- Minnesota Long-Term Care Medicaid guide
- Minnesota Elderly Waiver
- Three kinds of Long-Term Care Medicaid
- PACE programs
Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.