The PCA Program
Author
Thomas Wiest
CEO, Aspirience Home Care
You know, I have been asked many times how does one go about getting Personal Care Assistant services in the first place. Who do you talk to? What needs to be done? Where do I go to begin with? It seems there are so many questions regarding this topic so I thought I would write a newsletter about it.
A person can receive PCA Services through one of the programs described below. Think of these as “doors” to starting PCA services, with each program differing in how it is administered.
PCA Programs
There are four different programs you can participate in to access PCA services:
- Alternative Care
- Home Care
- Home and Community-Based Waiver Programs
- Managed Care Programs
Alternative Care
Alternative Care is for people who are over 65 years but whose assets are too high to qualify for the Elderly Waiver.
Home Care
Home care is sometimes called Medical Assistance (MA) home care. PCA services are one of many services people on MA are eligible to receive.
Home and Community-Based Waiver Programs
A home and community-based waiver is an additional service that allows people to live in the community instead of going into or staying in an institutional setting. Types of waivers are:
- Community Alternative Care (CAC)
- Community Alternatives for Disabled Individuals (CADI)
- Elderly Waiver (EW)
- Mental Retardation/Related Conditions (MR/RC)
- Traumatic Brain Injury (TBI) Waiver
Managed Care Programs
Managed Care Programs are mandatory for people over age 65 years but an option for people with disabilities under age 65 years. Examples of managed care programs include the Prepaid Medical Assistant Program (PMAP) or Minnesota Disability Health Options (MNDHO).
Categories of PCA Services
There are four different categories of service you can receive in the PCA program:
1. Assistance with doing Activities of Daily Living (ADLs): These are things you do every day such as dressing, grooming, bathing, eating, positioning, transferring, toileting and mobility.
2. If your PCA assessment determines that you have a need for assistance with Activities of Daily Living, you may also use your PCA services for assistance with Instrumental Activities of Daily Living (IADLs), IADL assistance includes meal planning and preparation, managing your finances, shopping for food, clothing and other items, homemaking tasks, communicating by telephone or other means, getting around and participating in community activities.
3. Assistance in Health Related Functions, which are services that must be delegated or assigned by a licensed health care professional such as a nurse or doctor. Health related functions must be provided under the direction of a qualified professional (QP) or a doctor. Examples of health related functions are special skin care, non-sterile catheter care, tube feedings and respiratory assistance.
4. Redirection and intervention for behavior issues, which require observation and monitoring. For example, reminders to do activities of daily living or redirection of behavior that is potentially harmful to you or others.
PCA Assessment
First things first, an assessment must be completed to determine your need for assistance. The assessment reviews the tasks and assistance that you need and assigns a unit of time for these activities. The home care program you are in determines who will do your assessment. Here is a list of people who can complete an assessment:
- County public health nurse for MA home care or MR/RC Waiver program
- County case manager/service coordinator for CAC, CADI, TBI, EW Waiver programs or AC program
- Someone from your managed care plan (such as PMAP) if you are in a managed care program
This assessment should happen within 30 days after you contact someone about your need for PCA services. The assessment is done before PCA services can start and every year after that. To find out about your eligibility for PCA services, contact your local county agency.
It’s important to know, Aspirience Home Care can help you navigate through the home health care field to secure PCA services for you or your loved ones.