UPDATE: MassHealth would like to inform you of five upcoming Public Listening Sessions that are being held to discuss general updates related to the Personal Care Attendant (PCA) program, including an update on Electronic Visit Verification (EVV) implementation, and gather stakeholder input related to advancement of program enhancements. Click here for a schedule of Public Listening Sessions.
The Centers for Disease Control and Prevention (CDC), the Massachusetts Department of Public Health (DPH), and other state agencies have issued guidance and directives related to COVID-19 for health care professionals. Click the link above for this important information.
If you or a loved one is a MassHealth member who receives hands-on support from a Personal Care Attendant (PCA) but are struggling to access these services during the COVID-19 outbreak, call the MassOptions hotline at 1-844-422-6277.
What Is the PCA Program?
The Personal Care Attendant (PCA) Program is a MassHealth, consumer-directed program that allows individuals with chronic disabilities to remain in their homes with the support from a PCA whom they hire directly to assist with activities of daily living.
What is the eligibility criteria?
- Must have MassHealth Standard or CommonHealth
- Must have a permanent or chronic disability
- Services must be prescribed by your primary care physician
- Must require daily, hands-on assistance or require assistance with two more activities of daily living, which are: mobility/transfer, medication administration, bathing/grooming, dressing/undressing, bowel/bladder care, passing range of motion, or eating
- Must be able to manage the program independently or identify a surrogate of choice
What is the role of your PCA Agency?
The agency will provide you with a skills trainer who will help you:
- Understand the rules and regulations of the PCA program
- Understand your role as the employer in the PCA program
- Obtain the necessary paperwork to enroll with the fiscal intermediary who will process your employer and PCA employment paperwork
Coastline works with Tempus Unlimited as the identified fiscal intermediary. This benefit is part of the program and is supported through MassHealth.
The agency will provide you with an initial assessment by a Registered Nurse and Occupational Therapist to determine if you meet the criteria for the PCA program and request your PCA hours to MassHealth. MassHealth will make a determination on your approval and final hours approved for the PCA program.
What does the PCA program not cover?
- Supervision or queuing of a task
- Safety sitting
- Any duplication of services that might be provided by another community provider
- Redirection of a task
- Skills services that must be provided by a professional
Who can be a PCA?
A PCA does not need to hold any special certification or license and is an individual identified by consumer choice as they work directly for the consumer not the PCA agency. A PCA cannot be a spouse, legal guardian, surrogate, or parent of a minor child.
How can I make a referral for services?
You can call Coastline and ask to speak with the PCA Coordinator. They will review your eligibility, provide you with more information, and initiate the process for you. Coastline covers the cities/towns of Acushnet, Dartmouth, Fairhaven, Gosnold, Marion, Mattapoisett, New Bedford and Rochester. Our PCA services extend to Fall River and Westport.