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Personal Care Attendant Program

The Personal Care Attendant (PCA) Program is a MassHealth program designed to give individuals with long-term disabilities both control over how their own personal care needs are met and the choice to live at home independently.
The PCA Program is consumer-directed, meaning that the individual with the disability (consumer) is the employer. This is different from more traditional home health care programs in which an agency provides the worker.

Personal Care Attendants (PCAs) are hired, trained and supervised by the consumer. PCAs do not work for Springwell, or any other agency, rather, they work for the consumer. As the employer, a consumer chooses who to hire, sets up a PCA schedule and trains PCAs to meet his or her own personal needs. PCAs are paid based on timesheets that are sent to a Fiscal Intermediary.

If the consumer cannot independently manage his or her PCA program, the consumer may have the help of a surrogate. The surrogate is often a family member but may be any other person identified by the consumer who has the ability to manage the program.

PCAs can help with Activities of Daily Living (ADLs) such as:

  • Mobility/transfersBathing or grooming
  • Dressing/undressing
  • Passive Range-of-Motion exercises
  • Eating
  • Toileting
  • Taking medications

PCAs can also help with Instrumental Activities of Daily Living (IADLs) such as:

  • Laundry
  • Shopping
  • Housekeeping
  • Meal preparation and clean-up
  • Transportation to medical appointments
  • Maintaining adaptive equipment
  • If a consumer needs help at night, such as for repositioning, toileting etc., PCA time can be approved for up to 2 hours of Night Attendant services.

PCA time is NOT approved for:

  • Babysitting
  • Recreation
  • Advocacy
  • Cueing, prompting, guiding or coaching
  • Supervision
  • Safety

Payroll and tax filing and reporting are usually handled by the Fiscal Intermediary, although some consumers do choose to handle this function themselves. PCAs are covered by Workers Compensation and Unemployment Insurance.

Referral Process

Referrals to Springwell’s PCA Program can come from:

  • Consumers
  • Visiting Nurse Agencies
  • Hospitals
  • Doctors
  • State and local agencies
  • Community organizations
  • Friends
  • Families

Each Springwell consumer is assigned to a Skills Trainer, who helps the consumer through the application process, and gives the consumer and/or surrogate the training they need to manage their PCA program. A Springwell RN conducts the initial evaluation, which results in a recommendation as to the number of hours the consumer is eligible for. PCA services are approved and paid for by MassHealth, which makes the final approval on whether a consumer is eligible for the PCA program, and if so, on the number of hours per week which a consumer may use. Approvals are generally for one year. Annual re-evaluations are completed by a Springwell RN.

It takes about two to three months to complete the evaluation and approval process. During this time, consumers may continue receiving services from other sources.

If you would like to find out more about the PCA Program please call (617) 926-4100.

Eligibility

The Personal Care Attendant program is available to people with disabilities who meet the following conditions:

  • A chronic disability or illness that impairs individual’s ability to perform ADLs and IADLs without physical assistance.
  • Physical, hands-on assistance is needed with two or more ADLs (see list above)
  • Personal Care services are prescribed by a physician or nurse practitioner
  • Determination by MassHealth that PCA services are medically necessary.

MassHealth coverage type must be Standard or Commonhealth.
Consumers must be able to manage the PCA program themselves, or have someone available to help them as surrogate. There is no age limitation