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CFSS in Minnesota: eligibility, worker rules and family limits

Community First Services and Supports (CFSS) is Minnesota's Medicaid personal care option that replaces PCA upon federal approval. The statute lets a spouse or a parent of a minor be a support worker within hour limits.

Carevo editorial team Updated October 27, 2026 Source checked by Carevo editorial team, October 27, 2026

Community First Services and Supports (CFSS) is Minnesota's Medicaid personal care option that, under the statute, replaces the personal care assistance (PCA) program upon federal approval. A spouse or a parent of a minor can be paid as a support worker within hour limits. We could not read DHS's pages, so check current status with DHS.

What the statute says CFSS is

Minnesota Statutes section 256B.85 defines CFSS as the assistance and supports program needed for accomplishing activities of daily living. It provides for a state plan option and says upon federal approval CFSS replaces PCA. The page we read does not say whether federal approval has happened, and the recent history lists amendments in 2025 and 2026. Dates for some rate changes are tied to "January 1, 2026, or upon federal approval, whichever is later."

Eligibility

Under subdivision 3, a person must be determined eligible for medical assistance, or be a participant in the alternative care program, a waiver participant, or have medical services identified in an individualized education program. The person must require assistance and be determined dependent in one activity of daily living or Level I behavior, and must not be a participant under a family support grant.

Two ways to get CFSS

  • Agency-provider model. A qualified agency provides services through its own employees. The support worker is a qualified and trained employee of the agency.
  • Budget model. A service delivery method that uses a service budget. The participant employs the worker directly and uses an FMS provider enrolled with the department, chosen from its list.

The statute also covers items, services, supports, environmental modifications and goods including assistive technology, observation and redirection for behaviors, back-up systems, and worker training and development.

Support worker rules

Before enrolling, a support worker needs a background study under chapter 245C and a notice that they are not disqualified or have a set-aside. They must complete training and pass a certification test. They may not independently decide medication doses or times. A support worker must not provide or be paid for more than 310 hours of CFSS per month.

Family as paid workers

The statute lets a participant's spouse, and a parent, stepparent or legal guardian of a participant under age 18, be a support worker, subject to subdivision 7b.

  • Single parent of a minor: up to 60 hours in a seven-day period.
  • More than one parent working: up to 40 hours each in a seven-day period, and no more than 80 hours combined.
  • Spouse: up to 60 hours in a seven-day period.
  • Wage: a parent or spouse must not receive a wage that exceeds the current CFSS support worker rate, including wages, benefits and payroll taxes.
  • Budget: these limits do not increase total authorized budgets or units.

CFSS delivered by the participant's representative or a paid legal guardian is excluded from coverage in the statute's list of excluded services, even though it also names legal guardians of minors as possible support workers. Ask DHS how the two fit together. A semiannual consultation review is required when the support worker is a paid parent of a minor participant or the participant's spouse.

Pay

The statute does not set the support worker wage in the text we read. We state no figure. Ask DHS or your agency.

Where to start

Call DHS on 800-657-3672, the consumer number Medicaid.gov lists, or your county human services office. Ask whether you are on PCA or CFSS, how to get an assessment and what the current limits are. See also the Minnesota program overview, paid family caregiver in Minnesota, home care in Minnesota, home health in Minnesota, nursing homes in Minnesota and developmental disability services in Minnesota.

Carevo is a connection platform and directory. We do not run CFSS, decide eligibility or set hours. This page is marked noindex until we can read DHS pages that confirm the current status.

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Common questions

What is CFSS?

Minnesota Statutes section 256B.85 defines it as the assistance and supports program needed for accomplishing activities of daily living. The statute says upon federal approval CFSS replaces the personal care assistance program.

Who is eligible?

A person determined eligible for medical assistance, or an alternative care, waiver or IEP participant, who is determined dependent in one activity of daily living or Level I behavior and who is not a participant under a family support grant.

Can my spouse be paid?

Under the statute, a spouse who is a support worker may provide up to 60 hours of medical assistance home and community-based services in a seven-day period, and must not receive a wage above the current CFSS support worker rate.

Can a parent be paid to care for a minor child?

Yes within limits. A single parent may provide up to 60 hours in a seven-day period. Where more than one parent works, each may provide up to 40 hours and together no more than 80 hours.

Is there a monthly cap on a support worker's hours?

The statute says a support worker must not provide or be paid for more than 310 hours of CFSS per month.

What checks does a support worker need?

A chapter 245C background study with notice that they are not disqualified or have a set-aside, training, and a certification test, according to the statute.

Is this in force now?

The statute page does not say whether federal approval has occurred, and DHS pages were not readable by our tools. Ask DHS.

Sources

Review status: Carevo checked this page against the primary sources listed above. It has not been professionally reviewed by a registered nurse, licensed social worker, benefits counselor or attorney. See our editorial standards.

This page is general information, not financial, legal or medical advice. Rules and services vary by state and by individual circumstances. Use the official sources and decision-maker named on the page. Carevo is a connection platform, not a care provider.