MassHealth funds a Personal Care Attendant (a/k/a Personal Care Assistant), or PCA, program in order to help recipients with long-term disabilities manage their own in-home day-to-day personal care. Under this program, a PCA is hired at a rate of $14.12 an hour (in 2016) to physically assist with both activities of daily living, or ADLs (mobility, bathing, dressing, passive range-of-motion exercises, taking medications, eating, and toileting), and instrumental activities of daily living, or IADLs (laundry, meal preparation and clean up, shopping, housekeeping, traveling to medical appointments, and other special needs).To get started, the recipient or his or her parents must contact a Personal Care Management agency, go to www.findpca.org, helpful Massachusetts resources, PCA resources. For an evaluation (by a registered nurse and an occupational therapist) of the physical assistance needed to perform ADLs and IADLs. The agency assesses the needs of the recipient and determines how many hours per week of PCA care the person is entitled to receive. For more severe cases, the person may receive 80 or more hours of care per week, whereas the less severe cases may receive 3 or 4 hours per week.
The recipient can choose his or her own PCA because, while MassHealth funds this program, it is participant-directed. This means that the recipient is the employer of the PCA and is responsible for logistics including hiring, scheduling, and training. With the exception of certain family members (spouse, legal guardian, or parent if child is under 18), anyone legally eligible to work can qualify as a PCA.
In order to be eligible for the program, you (or your child) must:
- Be eligible for MassHealth Standard or CommonHealth (usually when the child with special needs turns 18, although earlier if purchased through CommonHealth or if the family is low-income);
- Have approval from your doctor for PCA services;
- Have a chronic or permanent disability;
- Have a need for physical assistance with at least two of the ADLs listed above.
The PCA program is not available to recipients in a hospital, nursing facility or in various day or foster programs (MassHealth-funded Adult Day Health, Day Habilitation, Adult Foster Care, or Group Adult Foster Care). This program differs from the MassHealth Adult Foster Care, or AFC, program which offers 24-hour live-in support eligible MassHealth recipients. The AFC program is detailed in the blog post Adult Foster Care: Valuable Help for the Parents of Disabled Children, and may be better suited for certain MassHealth recipients.
For legal assistance in connection with PCAs, contact Karen B. Mariscal.