CFSS Series Part 1: The Agency Model – Podcast

Jason Dorow 

Hi everyone. Thanks for joining us for another episode of the Champions of Homecare podcast. David, it’s so good to see you again.

David Hancox 

It’s nice to see you again too. Jason, it seems like it’s been a little while.

Jason Dorow 

It’s been a little bit, but we have something exciting cooking here for the fall.

David Hancox 

We do. You know, on October 1, which we’ve mentioned in previous podcasts, on October 1, the transition to CFSS will begin. No more delays, so people who receive services through the PCA or the Consumer Support Grant or CSG programs will transition to CFSS during their regularly scheduled annual reassessment. And so what we’re hoping is that through this little mini-series of our podcast, we hope to help clients, their family members, caregivers, case managers, really everyone connected to home care in Minnesota. We hope to help them prepare for this transition to these new programs.

Jason Dorow 

Yeah, it’s a big new deal here, transitioning to CFSS. And for the uninitiated, under CFSS, there are going to be two different delivery models: the Agency Model, and the Budget Model. Today we’re going to dive specifically into the Agency Model. We’ll get to some of those other elements in future podcasts. Luckily, we have two amazing guests lined up today, ready to tell us about it. They’ve already joined us for one CFSS episode, and they’re back to get specific on the Agency Model.

David Hancox 

They are back by popular demand. So let’s welcome Rochelle Wodarz, our Accra Senior Program Director of CFSS and Compliance, and Amanda Whitmore, who is Accra’s CFSS Director. How are you two doing today?

Rochelle Wodarz 

I’m doing great.

Amanda Whitmore 

Great. Thanks for having us.

Rochelle Wodarz 

Yeah, thanks for joining us.

David Hancox 

Yeah. I’m so glad you were able to come back again. We know that this is such a critically important transition for folks who need and use the services, either CSG or PCA, and it’s just so important for us to do anything that we can to make this as smooth a transition for those individuals and their families as possible. So and Rochelle and Amanda, whoever would like to answer this, or kind of get us started here answering this first question for people who don’t know much about CFSS, we’ll skip past some of the basics. But can you remind us quickly what kind of services are available through CFSS, and what programs that CFSS is actually replacing?

Amanda Whitmore 

Yeah, so I can take that one. So let’s start with what CFSS is replacing. So it’s replacing traditional PCA and Choice PCA services and the Consumer Support Grant services for individuals. So what CFSS will provide is really much of the same services you provide. Really, if you were utilizing PCA services we’ll really just focus on the Agency Model. Today, those in home supports that were available with PCA services, such as ADL support and health related tasks, are still going to be offered much the same as they were with the Agency Model under CFSS. There’s still going to be some new things that are going to be available with the Agency Model that were not available for individuals previously under PCA services such as some things that you could use your budget for to purchase items such as assistive technology or environmental modifications that would reduce your need for human assistance. And then there’s also going to be a budget for workers to acquire some skills needed to complete your cares. So those are just a couple of things that are going to be new under that agency model. But otherwise your cares are going to be much the same available to you that they were under PCA services.

David Hancox 

Well, I know that one of the questions that have come up in conversations with friends of mine who happen to use PCA services is that, whether they choose the Agency Model, can they keep their same caregiver? And I know that that’s critically important for a lot of people.

Amanda Whitmore 

Yeah, they sure can. They can transition those caregivers right over into the Agency Model of services, and they would just need to make sure that they check with whatever company that they’re working with right now to  check with what those requirements are. But it should be a pretty seamless transition.

David Hancox 

And if I’m not mistaken, under the Agency Model, the provider agency like Accra will have a different kind of role or responsibility in helping to support the availability of caregivers. 

Amanda Whitmore 

Yeah, so there will be a little bit more support from your agencies to help with some of that. It still will be a little bit limited what they can do, but there will be a little bit more support from agencies than what you may have had in the past if you were using a choice model. But you may notice a little bit of change if you were using a traditional model for what support you were receiving. So kind of meeting in the middle between traditional and choice services.

David Hancox 

Okay. And Rochelle, how do clients go about the process to pick an agency to work with and, equally important, especially for our listeners who are very likely Accra clients. Can they continue to work with Accra?

Rochelle Wodarz 

Yes, they absolutely can continue to work with Accra. You know, the way that they would go about choosing really starts with their consultation services provider, you know, there may be some discussion about it at the assessment, but then after the assessment, they will meet with their consultation services provider who is really going to be helpful in educating them about the models. And once the model is chosen, if they’re choosing Agency, they certainly will get a list of different options of where they can choose their services. If they’re an Accra client, they absolutely can stay with Accra, and whether they choose the Agency or the Budget model, we will be there to provide whichever they prefer. 

David Hancox 

Wonderful. That’s great, and I’m sure that will be good news for many of our listeners to know that they don’t necessarily have to change agencies. They can stick with not only, as Amanda pointed out, they can stick with their same caregivers that they have probably formed a relationship with, of sorts, and they can stay with the same agency. So hopefully that’ll give some of our listeners some degree of comfort around that as well. So but now we know that there’s additional responsibilities for the agency to do some of the hiring and training in that. But will they be directing directly? Well, that sounds awkward – directly directing the client cares as well. And will they be responsible? Would the agency be responsible for writing the care plan?

Rochelle Wodarz 

Yeah, you know, very similar to current PCA services, they will be a part of creating the plan of care, which is called the service delivery plan in CFSS. So yes, they will definitely be a part of that. They will be doing that with their supervising professional currently in PCA services, that we call those qualified professionals. When we switch over to CFSS, they’ll be called supervising professionals. So they will be part of writing the plan, they will definitely have input. We will need their input into that. And they’ll also be starting that plan. They’ll be starting writing that plan with the consultation services provider as well. They will be directing their care. That will not change. And as far as a little bit of a difference with the Agency Model, with the hiring and the training in CFSS, the participant or their representative, they have a significant role in choosing their own worker, and they must direct their worker as they deliver the services. So in the Agency Model, providers will make a reasonable effort to fulfill the request of a person or a participant’s preferred support worker, which we used to, we call PCA currently, but I will say, from an Accra standpoint, in our over 30 years of experience, we found that most participants have greater success with quality and consistency of care when they choose their own preferred support worker or their own person, their own PCA. So as a resource, we provide access to our job board. We’ve also seen people have great success when they reach out within their own communities, including their friends, family or faith based communities. So those have been very successful. Those can certainly continue to be options and resources for people, and they certainly can keep their current workers as well. So we will make that transition as smooth as possible.

David Hancox 

Fantastic. I’m sure that would be a great relief to many of our listeners. Jason, you have a question or a thought you want to pose to our guests? 

Jason Dorow 

Yeah. Well, when I’ve gone through the CFSS information on the website, people will notice the distinction between the Budget Model and the Agency Model, that the Agency Model, you have service units, and of course, at the Budget Model, you are managing a budget. Why does that distinction exist? And what does it mean for people who choose the Agency Model? 

Rochelle Wodarz 

Well, I can definitely speak to the agency side of that, and that, again, is very similar to to PCA services currently, and what will continue to happen is, when people have their assessment, their annual assessment, or if they’ve never had services before, an initial assessment, that that assessment really determines the person’s needs, and it also documents those needs and determines the authorized hours and the authorized services, so that equates to what is approved. So currently, somebody has an assessment they are identified with, you know, which ADLs or IDLs are considered assessed needs or dependencies, and that turns into, this equates to X number of hours per day. And so that will continue. One thing that does sometimes confuse people, which I don’t think is going to change, is that on your service agreement, you see it in units, and one unit equals 15 minutes. So, and we are always here to help do the math, to help you figure out how many hours a day does that mean, and that will also be something that you would see on your assessment or reassessment. So in addition in CFSS, something that is going to be new, so we’ll have the service units on the authorization, but each client will also have a worker training and development budget, which Amanda did allude to when she was doing her overview.

David Hancox 

Wonderful, great. So if you have four units that equals one hour of service, yes, to kind of make the map a little easier for people like me. 

Yes, yes. Sorry, I meant to put it all together, but yes.

Jason Dorow 

We’re obviously arming people today with a lot of information about the Agency Model, and we’ll do this again for the Budget Model. But for folks who watch these and are still like, I’m not sure they want some more direct help on figuring out which model to choose. Are they going to have additional assistance? Amanda referred to consultation services earlier that kind of helps people decide which model they want to go with, right?

Rochelle Wodarz 

Yes, absolutely. That will be a key time to have those conversations and to learn about the different options. But one thing people can do to prepare themselves as you know, as they know when their reassessment is going to take place, maybe before the reassessment, doing a little bit of research. There are wonderful resources that DHS has provided people. They have provided some online trainings. They’re broken up into sections. They’re very short and easy to follow. So if you wanted to just look at one for a few minutes, and maybe on another day you look at another one if you don’t have a lot of time. Those are wonderful resources. We do have those resources on our website at accrahomecare.org as well as so we have, we have links to those resources, and we also have tried to provide some information that’s just easy to follow on our website, but we’re also here and available at Accra for people that you know want to make a phone call and ask some questions. So preparing is huge if you have the time and you want to learn a little bit more about it before your assessment, but again, you’ll learn more about it in the assessment. And those consultation services providers are going to be those key people to have those really important conversations, to help educate and help make that decision on which model is the best fit for you.

David Hancox 

And that’s very, very helpful. And the one takeaway out of what you just shared that I wanted to kind of reemphasize or really stress, is that ultimately, this really it is the client’s choice of which model they choose. It’s not up to the agency to pick that for them, or the provider agency to pick that for them. It really is the client’s choice, and earlier in the conversation, Rochelle, I think it was you that mentioned that you know clients have more confidence in their services when they’re choosing their caregiver, whether it be a family member or from their faith based community or whatever. And that kind of leads to the question: under CFSS, are clients able to use family members, like spouses, in some cases, maybe their guardian or a parent as their caregiver?

Rochelle Wodarz 

Yes. Yeah, that’s a great question, and it’s a wonderful benefit to CFSS. That is something currently in PCA that is not allowable. As far as if having your spouse be your PCA, or you’re a parent of a minor, that is something that will happen in CFSS, it is an option. But the other good news is, as of October 1, that is allowable under PCA services as well. So that people won’t necessarily have to wait until their reassessment to have that opportunity. So everybody has that option as of October 1. 

David Hancox 

That’s fantastic. I’m really, really pleased to know that, and it does kind of lead into the next question very nicely, because we know that again, as we’ve been emphasizing, CFSS initiates on Cctober 1, but not everybody switches to CFSS automatically on that date. So Amanda, could you take us through, I know you mentioned this previously, but could you kind of take us through that again. About the transition process for individuals?  Yeah. Thank you.

Amanda Whitmore 

So if your assessment date for renewal of services falls on or after October 1, then you would start your process of moving into CFSS services. So you would go through that annual renewal process that you normally would for your services now, and you would find out what your authorized units are, just like you would now. And then you would start the process of working with your consultation provider to choose which model is going to work best for you. And then you would choose your agency that you’re going to work with for either Budget or Agency Model, and then start your services. So it just is going to depend on your renewal date for your services.

David Hancox 

So if your, just to be really clear, so if your renewal date is, say February 1 of 2025, you wouldn’t start your transition to CFSS now, you would do that in February, correct?

Amanda Whitmore 

Yep, whatever your assessment period is.

David Hancox 

And I think that’s also really, really helpful to reemphasize for folks that they don’t have to rush out and make sure this is all in place on October 1, that it is sequential. And if I’m not mistaken, the Department of Human Services has even estimated that this will probably take somewhere between 15 and 18 months to transition everybody over to CFSS, yep, they’re estimating about 15 months. Okay, let me ask another follow up question then. So let’s say that on October 1 it’s the reassessment time for a particular client but that particular client is like, Yeah, I’m not quite ready yet. Can they delay that start? I mean, it’s not something we probably want to encourage, you know, right? 

Amanda Whitmore 

Yeah, it’s a great question. So DHS has said that everybody will have an automatic three month extension of their services because they realize that the process will take some time to work through that assessment period, getting your consultation services, provider, your plan, everything going. But beyond that three month extension of services, you won’t be able to delay moving into CFSS, unless you were to choose another program, such as like a waiver service, like CDCs, if you were able to move on to a waiver service, but if you’re working with PCA or CSG, you would have to move into CFSS.

David Hancox 

So you get one opportunity to delay, to facilitate the process, yeah, you only get one.

Amanda Whitmore 

Yeah, and it’s an automatic three months. You don’t have to ask for it. It’s just going to be an automatic.

David Hancox 

But people should be aware that when that three months is up, now it’s time. Yeah, you can’t kick the can down the road in perpetuity, you know? So, yeah, great. Is there anything else related that we’ve missed that our questions haven’t touched on, that Jason and I unwittingly overlooked, that you want to make sure that our listeners are aware of?

Jason Dorow 

I’d say, if not, if we’ve covered everything, could you give the listeners again the 30 second synopsis of what they need to know about the Agency Model? We’ve covered a lot of ground in 20 minutes, but if we’ve covered everything, can we just remind people this is the need to know. This is the Agency Model in like 60 seconds or less.

Amanda Whitmore 

I would say, don’t be too nervous about the change. It’s a very positive change. Your services really aren’t changing much. If they are changing, it’s for the positive. This is really not a negative change. I know change is really scary, but the services really are remaining much the same, with a few added benefits under the PCA model that once was.

David Hancox 

Great. Wonderful. Rochelle, any final words from you? Thank you, Amanda, that was very helpful. Any final words from you, Rochelle, that we want to make sure the listeners are aware of?

Rochelle Wodarz 

No, I think just I would reiterate what Amanda has said. We will help you through the process. We’ll be here to answer questions. We’ll do everything we can to make it as comfortable as possible, and just knowing, you know, we’re all going to be learning along the way. You know, I think we’ve done a lot of work to be prepared, to be as expert as we can, but until we actually all get into it, we’re all in it together. So we will be here to go through it with you and keep things as much in place as you want, and also to take advantage of the additional benefits that you will have in CFSS. So I think it’ll be like Amanda said, it’s a very positive change. It’s just, it’s a change. So we’ll be here to do it together.

David Hancox 

Great. And that, you know, like, like grandma used to say, we’re all in this alone together, right? So thank you for framing it up that way. Rochelle, I think that’s very encouraging for folks and Jason, could we pop up the website again, please, real quick, just to remind people that they can go to accrahomecare.org to get more information, to watch the little video clips that Rochelle referred to in her comments that provide explanation and detail about CFSS and the Agency and Budget Model, but that is a resource that’s available on that website as well. Additionally, I just want to say thank you to both Amanda and Rochelle for joining us today, and Jason for your continued skill and competency in editing and keeping us on track. I really appreciate it. I think this will be very, very helpful for the listeners and as they begin the process of trying to decide which model they want to move to, either the Agency Model or the Budget Model. So again, thank you both for being here today to provide some additional information for the listeners, and I hope you have a wonderful weekend, and thank you again, Jason.

Jason Dorow 

Thanks for wrapping up, David. Thank you, Amanda, Rochelle, we appreciate your insights and expertise. As David said, make sure to follow the Champions of Homecare podcast wherever you get your podcast, because we’ll have that Budget Model podcast coming up really soon, and that will help you know the differences between the two different models under CFSS. Otherwise, thanks for listening, and we’ll see you again soon.

Rochelle Wodarz 

Thank you so much for having us. 

David Hancox 

You’re welcome, goodbye.