What are CDCS and CFSS?
Minnesota offers two Medicaid (Medical Assistance) options that let you hire and pay your own caregiver, including family members. Consumer Directed Community Supports (CDCS) is a self-directed service available through Minnesota home and community-based services (HCBS) waivers and the Alternative Care program. It gives you a flexible yearly budget that you control to buy the supports, goods, and services you need to live in your community, including paying family and friends who provide your care.
Community First Services and Supports (CFSS) is Minnesota's personal care benefit. It replaced the older Personal Care Assistance (PCA) and PCA Choice programs and the Consumer Support Grant, with the transition running from October 2024 through 2025 as people moved over at their yearly reassessment. CFSS covers help with activities of daily living, health-related tasks, and staying safe at home, and it is available to Medical Assistance members even without a waiver.
The single biggest change for families came on October 1, 2024, when Minnesota began allowing a person's spouse — or the parent of a minor child — to be paid to provide PCA/CFSS services. Previously spouses and parents of minors were blocked from being paid. CDCS has long allowed people to hire the workers they want, including spouses and parents. Together, these programs make Minnesota one of the broadest states in the country for paying a close family member to be a caregiver.
Both programs are consumer-directed: you (or a designated representative) decide who provides your care, train them, set their schedule, and can let them go. The county or your managed care plan acts as the lead agency that authorizes services, and a Financial Management Services (FMS) provider handles payroll, taxes, and paperwork so your caregiver gets paid correctly.
CDCS and CFSS eligibility requirements
The person receiving care must be enrolled in Minnesota Medical Assistance and have an assessed need for help at home. The caregiver does not need to meet income or asset limits — only the person receiving care does. CFSS is available to any qualifying Medical Assistance member, while CDCS requires eligibility for a waiver or the Alternative Care program.
Who can — and cannot — be paid
Minnesota is unusually flexible about who you can hire. In both CDCS and CFSS you can choose a family member or friend as your paid worker. As of October 1, 2024, that includes a spouse or the parent of a minor child, which used to be prohibited. There are still a few limits and some hour caps for legally responsible relatives.
- A spouse (paid worker allowed as of Oct. 1, 2024, in CDCS and CFSS, with weekly hour limits)
- A parent of a minor child receiving care (allowed as of Oct. 1, 2024, with weekly hour limits)
- Adult children of the person receiving care
- Siblings, grandchildren, nieces, nephews, aunts, uncles, and in-laws
- Friends, neighbors, and other trusted community members
- A person who lives in the same household as the member
- The member's own paid worker if that person is also the member acting as their own employer (one person cannot be both)
- A worker who has not passed the required Minnesota background study
- A representative or responsible party who is barred by the program from also being the paid worker in certain arrangements
- Anyone not legally authorized to work in the United States
CDCS and CFSS pay, hours, and limits
Pay for self-directed workers in CFSS (budget model), PCA Choice, CDCS, and the Consumer Support Grant follows a tiered wage floor negotiated between the state and the SEIU home care union. Rates rise with a worker's experience and are updated most years. The number of hours is set by your assessment and your budget.
Hourly pay
Starting January 1, 2025, new self-directed home care workers must be paid at least about $20.00 per hour, and the tiered wage scale rises to roughly $22.50 per hour for the most experienced workers (based on hours worked since July 2017). Effective January 1, 2026, each wage tier increased by about $0.40 per hour, and workers on the "enhanced rate" (for members needing 10 or more hours of care per day) earn several percent above the listed rate. So in 2026, most family caregivers earn in the range of about $20 to $23.50 per hour. In CDCS, you set your worker's wage within your annual budget, above the required wage floor. Workers are paid through your FMS provider, which withholds taxes.
Hours and scheduling
Your authorized hours (or CDCS budget) are based on your MnCHOICES assessment of need — some people receive a few hours a week, others receive many hours a day. Minnesota caps how many hours certain legally responsible relatives can be paid: in CFSS, a spouse or a single parent of a minor cannot be paid for more than 60 hours in a 7-day period. Where two parents provide care, they cannot be paid for more than 80 hours combined in a 7-day period (no more than 40 hours each). If someone in the same household uses CDCS while another uses CFSS, those hour limits apply to the combined CFSS and CDCS hours.
Overtime rules
Self-directed home care workers in Minnesota are covered by state and federal labor law and are generally entitled to overtime pay of 1.5 times their regular rate for hours worked beyond the applicable overtime threshold in a workweek. Because spouses and single parents are capped at 60 paid hours per 7-day period in CFSS, families often plan schedules to stay within those limits or add a second worker. Your FMS provider tracks hours and handles overtime and tax withholding.
How to apply for CDCS or CFSS in Minnesota
- Confirm the person receiving care has (or applies for) Minnesota Medical Assistance. You can apply through your county or tribal human services office, or online using the Minnesota "Application for Certain Populations" form. Processing can take up to about three months.
- Call the DHS Disability Hub / member help line at 800-657-3739 or 651-431-2670
- Have income, asset, and residency documents ready
- Ask specifically about home care and waiver options
- Request a MnCHOICES assessment through your county or tribal lead agency. A certified assessor meets with the person, reviews needs with activities of daily living and health-related tasks, and determines eligibility for CFSS and for any waiver that offers CDCS.
- Choose your program and service model. Decide whether CFSS (personal care) or CDCS (a flexible waiver budget) fits your situation. In CFSS, choose the agency-provider model (an agency employs your worker) or the budget model (you employ your worker and use an FMS provider). CDCS always uses a budget you direct with an FMS provider.
- Work with your support planner, consultation services provider, or case manager to build your plan and budget. This is where you set your caregiver's wage, decide how many hours to plan for, and get the plan approved by the lead agency.
- Select a Financial Management Services (FMS) provider and enroll your caregiver.
- Your worker completes a Minnesota background study
- Employment paperwork: I-9, W-4, and direct deposit
- The FMS provider sets up payroll and tax withholding
- Start services and submit time worked. Your caregiver records their hours; you (or your representative) approve them; and the FMS provider processes pay. Your services and budget are reviewed at least once a year at your reassessment, and CFSS requires a semiannual review when a spouse or parent of a minor is the paid worker.
Minnesota CDCS and CFSS frequently asked questions
Can my spouse be paid to care for me in Minnesota?
Yes. This is a big change and one of the main reasons families choose Minnesota. Effective October 1, 2024, a person's spouse can be paid to provide PCA/CFSS services, in both the CFSS agency-provider model and the CFSS budget model. Before that date, spouses were blocked from being paid. CDCS has long allowed you to hire the workers you want, including a spouse. There is one important limit in CFSS: a spouse cannot be paid for more than 60 hours in a 7-day period, and if someone in the same household also uses CDCS, the hour limits apply to the combined total. Minnesota also requires a semiannual review of services when a spouse is the paid worker. Even with those limits, being able to pay a husband or wife makes Minnesota one of the most spouse-friendly states in the country.
How much do CDCS and CFSS pay in 2026?
Pay follows a tiered wage floor negotiated between the state and the SEIU home care union, and it rises with a worker's experience. Starting January 1, 2025, new self-directed home care workers had to be paid at least about $20.00 per hour, with the scale reaching roughly $22.50 per hour for the most experienced workers. Effective January 1, 2026, each tier went up by about $0.40 per hour, so in 2026 most family caregivers earn in the range of about $20 to $23.50 per hour. Workers who qualify for the "enhanced rate" (used when a member needs 10 or more hours of care per day) earn several percent above the listed rate. In CDCS, you set the wage yourself within your yearly budget, as long as it meets the wage floor. Your caregiver is paid through an FMS provider that withholds taxes.
How long does it take to get approved?
Plan for a couple of months from start to finish. If the person is not yet on Minnesota Medical Assistance, that application alone can take up to about three months to process. Once Medicaid is in place, you request a MnCHOICES assessment through your county or tribal lead agency, which can take a few weeks to schedule and complete. After the assessment confirms eligibility and sets your hours or budget, you choose a service model, pick an FMS provider, and enroll your caregiver, which usually adds another two to four weeks while the background study and payroll setup are completed. You can speed things up by gathering documents in advance: proof of Minnesota residency, identification, Social Security information, and proof of income and assets.
What training or certification does the caregiver need?
One of the best features of CDCS and CFSS is that your caregiver does not need to be a Certified Nursing Assistant, Home Health Aide, or any other licensed professional. You train your worker on the specific help you need. There are a few requirements before they can start being paid: every paid worker must pass a Minnesota background study, complete employment paperwork (I-9 and W-4), and, for CFSS, complete a standardized worker orientation or training that covers their role, reporting time, and recognizing abuse and neglect. Workers can also complete optional training to help their employer qualify for the enhanced rate. But there is no clinical exam or skills test to pass. This makes the programs especially welcoming to family members who have already been providing care informally and want to finally be paid for it.
What is the difference between CDCS and CFSS?
They are two different Medicaid options that overlap but serve different needs. CFSS is Minnesota's personal care benefit that replaced the old PCA and PCA Choice programs. It pays for hands-on help with daily living and health-related tasks and is available to Medical Assistance members even without a waiver. CDCS is a self-directed option inside Minnesota's HCBS waivers and the Alternative Care program. Instead of paying only for personal care hours, CDCS gives you a flexible yearly budget you control to buy a wider range of supports, goods, and services — including paying family caregivers. If you only need personal care and do not have a waiver, CFSS is usually the path. If you qualify for a waiver and want maximum flexibility over how your budget is spent, CDCS may be the better fit. Some households use them together.
What is the difference between the CFSS agency model and budget model?
CFSS offers two ways to receive services. In the agency-provider model, a CFSS agency is the employer of your worker — the agency hires, handles payroll, and shares supervision with you, while you still choose and direct your worker. In the budget model, you are the employer: the lead agency authorizes a dollar amount, you hire and direct your own worker (often a family member), and you use a Financial Management Services (FMS) provider to handle payroll, taxes, and paperwork. Budget-model participants also work with a consultation services provider who helps write the service delivery plan, set worker wages, and plan hours for the year. The budget model gives families the most control and is the usual choice when you want to pay a specific relative. Both models pay the same tiered wage floors.
Can I be paid to care for my parent or my adult child?
Yes. Adult children caring for aging parents can be paid in both CDCS and CFSS, and there is no special hour cap for an adult child caring for a parent the way there is for spouses. As of October 1, 2024, the parent of a minor child receiving care can also be paid, which was not allowed before. Parents of minors do face hour limits in CFSS: a single parent cannot be paid for more than 60 hours in a 7-day period, and where two parents both provide care they cannot be paid for more than 80 hours combined (no more than 40 hours each). Other relatives — siblings, grandchildren, nieces, nephews, aunts, uncles, and in-laws — can be paid without those legally-responsible-relative caps. Everyone still needs to pass a background study and complete onboarding before being paid.
Who handles payroll and taxes, and does this affect other benefits?
In the CFSS budget model and in CDCS, a Financial Management Services (FMS) provider handles the financial side — it processes payroll, withholds and files taxes, tracks your budget, and sends monthly spending reports to you, your case manager, and your consultation services provider. You choose your FMS provider from the ones DHS has enrolled. In the CFSS agency model, the agency handles payroll instead. Enrolling in CDCS or CFSS does not reduce the person's other Medical Assistance benefits — they keep their doctor visits, hospital coverage, prescriptions, and other services. These programs sit alongside the rest of the Medicaid benefit package. If the person is also on Medicare, Medicare continues to cover acute care while Medical Assistance covers the long-term personal care through CDCS or CFSS.
See also: Minnesota caregiver guide
For all the ways to get paid to care for a family member in Minnesota — including CDCS & CFSS, VA programs, long-term care insurance, and more — read the full Minnesota guide.