CFSS and 245D: What’s the Difference?

Choosing the right type of support can feel confusing, especially when services sound similar. CFSS (Community First Services and Supports and formerly PCA) and 245D Individualized Home Supports all help people live safely and independently at home, but they offer different levels of support, flexibility, and oversight.

Here’s a simple breakdown to help you understand each option.

A Quick Flashback: What PCA Used to Be

For many years, PCA (Personal Care Assistance) was Minnesota’s primary program for people who needed help with daily living tasks. PCA services focused on hands-on support such as dressing, grooming, eating, mobility, and behavior redirection.

As the needs of individuals and families grew, Minnesota redesigned the program to offer more flexibility, control, and person-centered planning.

CFSS is the modern version of PCA, created to better fit the way people want to live, hire, and direct their care. PCA will fully phase out as everyone transitions to CFSS.

CFSS (Community First Services and Supports)

CFSS offers all the traditional PCA-type supports, plus more choice and control for the person receiving services.

CFSS includes:

Help with daily living tasks
Mobility and positioning assistance
Health-related tasks with delegation
The ability to hire your own worker
More flexibility in training, scheduling, and service design
Options for both agency-directed and self-directed models

Best for: People who want hands-on support with daily tasks and prefer more independence in how their care is delivered.

245D Individualized Home Supports

Often called “245D Waivered Services,” these unit-based supports provide skill-building, community inclusion, and assistance with areas of daily living.

245D services can include:

Skill development (cooking, budgeting, transportation, communication, etc.)
Support to build independence at home and in the communit
Assistance with areas of daily living
Support in gaining community inclusion by the way of community activities, appointments, and social opportunities
Training and goal-oriented support based on the person’s CSSP/outcomes
Built-in supervision, documentation, and regulatory oversight

Best for: People who want to live independently and avoid facilitation by growing independent living skills, participating in daily life activities, or who need structured support beyond basic personal care.

Similarities:

Differences:

We’re Here to Help

Understanding the differences between CFSS and 245D Individualized Home Supports can feel confusing — and you don’t have to figure it out alone. Every person’s needs are unique and choosing the right service matters. That’s where we come in. Our team listens, explains options in plain language, and helps you select the support that fits your life, your goals, and your level of independence. No matter which path you choose, we’ll walk with you every step of the way.