You must:

1. Enroll with Medical Assistance (MA), Minnesota Care expanded benefits, Alternative Care or a waiver program

2. Request an assessment from the county in which you live, the tribe of which you are a member or the managed care organization you are enrolled in to see if you qualify for PCA services

3. Make decisions about your care or have someone to make decisions for you

4. Provide for your own health and safety or have a responsible party that is able to do so

5. Live in a home or apartment, not in an institution

6. Meet access criteria

7. Have a PCA assessment to see if you qualify for services

PCAs provide services and supports to help you with:

1. Activities of daily living

2. Health related procedures and tasks

3. Observation and redirection of behaviors

4. Instrumental activities of daily living

1. PCA services are designed to be flexible and driven by you. Keep the following in mind.

2. You, your responsible party, or your other providers (examples include your clinic doctor, hospital staff, or social worker) must request an initial assessment for PCA services. PCA Providers cannot do this for you.

3. You must have a PCA assessment to receive PCA services.

4. The assessment is done by the county or tribal public health department.

5. Review and sign accurate time sheets.

6. Keep track of the hours of PCA services you have used.

You must have an evaluation of your needs to see if PCA services are right for you. An assessor visits your home and reviews your daily needs and health. During the evaluation, the assessor completes the PCA Assessment and Service Plan form.

Depending on what health care program you are with, different people do the assessment. Your

assessment should happen within 30 days of contacting one of the following:

1. If you are on state plan Medical Assistance, and not on a managed care plan, you must contact your county or tribal public health agency

2. If you are on a waiver, you must contact your county or tribal case manager

3. If you are on Alternative Care, you must contact your county or tribal case manager

4. If you are using managed care you must contact your health plan

Contact your county or tribal public health agency to help you figure out who you need to call.

The assessment is done in your home and takes about one hour. The assessment includes

questions:

1. To see if you need a responsible party

2. About the types of help you need on an average day

3. About your medications

4. About your health

5. About your behavior

6. If PCA services are right for you, the assessor will ask if you are interested in:

7. Traditional PCA services or PCA Choice

8. Using your hours flexibly

9. Sharing services with someone in your household who also gets PCA services

The assessor will also let you know about a variety of other programs and services that may help you. You are responsible for following up on the assessor’s suggestions.

1. You will get a copy of your PCA Assessment and Service Plan within 10 days.

2. You will also receive a service agreement letter that tells you how much PCA time you can get.

3. You need to contact your provider agency to schedule your services.

4. If you are using PCA Choice, you need to recruit a PCA.

A new evaluation is needed yearly, or when your health changes. Contact your assessor or your qualified professional if you have a significant change in your health.

The following cannot be your responsible party:

1. Your personal care assistant

2. PCA provider agency owners or managers

3. Your PCA provider agency staff unless related to you by blood, marriage or adoption

4. Your qualified professional

5. Your county worker if they are acting as an employee

The amount of time you receive for PCA services is called the service authorization.

If you qualify, you could get from one hour and 15 minutes a day to 24 hours a day, depending on your needs.

You will get a letter indicating how many 15-minute units of PCA services you may use. This

letter is called the service agreement letter and it tells you about your service authorization

amount. Instructions for understanding this letter are on page one of the PCA Assessment and Service Plan.

Your letter includes the effective date of service. You can begin receiving services on that date, if you have named a provider. You have 60 days to choose a provider agency. See Choosing an Agency for more information.

1. Find, hire, train, schedule and fire staff

2. ind back up staff

3. Hire your qualified professional (QP)

4. Monitor and evaluate staff

5. Bill the State for PCA services

6. Bill the State for QP supervision

7. Pay and withhold taxes

8. Get criminal background checks

9. Make an agreement with your responsible party

10. Assure your staff have completed required training

11. Maintain enrollment with the State

1. Under traditional PCA, you must sign time sheets and work with your QP to:

2. Evaluate staff

3. Make sure your health and safety needs are met

4. Develop your care plan

Your care plan details the type and frequency of assistance you need. Your care plan must follow the PCA Assessment and Service Plan you get from the assessor.

Under traditional PCA, you and your qualified professional (QP) develop the care plan together. Under PCA Choice, you develop your care plan, with help from your QP if needed. You must use your PCA provider agency’s care plan template. The following information summarizes what PCAs can and cannot do for you. These are called covered and non-covered services.

PCAs can help you with covered services including:

1. Dressing

2. Grooming/hygiene

3. Bathing

4. Eating

5. Transfers

6. Mobility

7. Positioning

8. Toileting

9. Health related procedures and tasks

10. Observing and redirecting behaviors

For adults, PCA may also help with instrumental activities of daily living (IADL) such as:

1. Meal planning and preparation

2. Basic assistance with paying bills

3. Shopping for food, clothing and other essential items

4. Performing household tasks integral to PCA services

5. Communication by telephone and other media

6. Traveling to medical appointments and community events

7. PCAs can assist children with instrumental activities of daily living (IADL) ONLY under the following conditions:

8. Light housekeeping and laundry for health and hygiene reasons integral to PCA services

9. Sole benefit of the child

10. Listed on the PCA Assessment and Service Plan

Under the direction of you or your responsible party, your PCA can:

1. Remind you to take your medications

2. Bring you your medication

3. Assist with opening medication

PCAs cannot:

1. Decide you need for medication

2. Set-up your medication

3. Evaluate the effectiveness of your medication

4. Inject medications

PCAs cannot:

1. Assist with sterile procedures

2. Inject fluids and medications into veins, muscles or skin

3. Complete home maintenance or chore services

4. Complete homemaker services that are not an integral part of assessed needs

5. Apply restraints

6. Assist with most instrumental activities of daily living for children under 18

7. Provide services in lieu of other staffing options in a residential or childcare setting

8. Cannot work solely as a childcare or babysitting service

9. Provide services in the PCA’s home

10. Sleep on the job

PCAs cannot:

1. Assist with sterile procedures

2. Inject fluids and medications into veins, muscles or skin

3. Complete home maintenance or chore services

4. Complete homemaker services that are not an integral part of assessed needs

5. Apply restraints

6. Assist with most instrumental activities of daily living for children under 18

7. Provide services in lieu of other staffing options in a residential or childcare setting

8. Cannot work solely as a childcare or babysitting service

9. Provide services in the PCA’s home

10. Sleep on the job

There are some differences between what PCAs can do for adults and children. Details are

available at PCA Services For Children Under Age 18 (below).

Most PCA services are delivered in your home. You can use your PCA services at work,

shopping, medical appointments, worship services, school or any place you would normally go in the community. The PCA cannot provide services in the PCA’s home, unless the PCA lives with you. If the location of services includes a fee or other costs, discuss this with your PCA prior to event. PCAs are not required to pay for expenses related to providing services.

You must schedule a PCA assessment to determine if PCA services are available for your child.

1. Children under age 18 must have a responsible party

2. PCA services depend on the age of the child and what parents do for a child that age

3. A parent, stepparent or paid legal guardian cannot be a child’s PCA

4. PCAs cannot help children with most instrumental activities of daily living (IADLs).

There are activities that all children of a particular age are unable to do on their own. For

example, no infants can bathe themselves. The assessor looks at what activities of daily living children without disabilities can do independently.

PCAs can help your child with:

1. Activities of daily living

2. Health-related procedures and tasks

3. Observation and redirection of behaviors

4. PCAs can assist children with instrumental activities of daily living (IADL):

5. Light housekeeping and laundry for health and hygiene reasons integral to PCA services

6. Sole benefit of the child

7. Listed on the PCA Assessment and Service Plan

8. Visit PCA services for details.

1. Child care or babysitting

2. Assist with most IADLs

3. Assist other family members unless under the shared service option

Parents and family members are responsible for:

1. Basic care, nurturing and supervision

2. Most IADLs, like shopping, cooking, laundry, cleaning, transportation

3. Giving medication

PCAs must:

1. Be 18 or older (16 and 17-year-old PCAs must meet additional requirements)

2. Pass a background study

3. Complete training requirements

4. Able to communicate with you and your provider

5. Be employed by a PCA provider

6. Able to provide the services you need based on your care plan

PCAs cannot be:

1. Spouses

2. Parents or stepparents of minors

3. Paid legal guardians

4. Owners or controllers of your living arrangement (unless related by blood, marriage or adoption)

Some relatives cannot be your PCA. They are:

1. Spouses

2. Parents or stepparents of minors

3. Paid legal guardians of adults

4. Legal guardians of minors

Note: The 2012 Legislature clarified that a paid legal guardian for an adult cannot be that

recipient’s PCA. No legal guardian of a minor can be that recipient’s PCA. All other relatives

can be your PCA.

PCAs are required to complete two types of training:

1. Online training

2. Training specific to your needs

Within the first seven days of working for you. Under traditional PCA you and your qualified

professional train your PCA on your specific needs. Under PCA Choice you train your PCA on your needs, with help from your qualified professional if you request it. If your needs change, your qualified professional can help you train your PCAs on new tasks. If you have a

tracheostomy or use a ventilator, your PCA needs specialized training from a nurse, doctor or respiratory therapist.

There is more than one way to orient and train PCAs. Some people respond well to oral

directions while others may prefer hands-on demonstrations. Some people may prefer written information. You may feel comfortable training your own PCA by yourself or you may like one of your experienced PCAs to assist with the training. Some people prefer to have their qualified professional do the training. You may consider writing down your expectations so they are clear and you and your PCAs can refer back to them.

Give PCAs a tour of their new work site. Include:

1. Location of care plan

2. Spaces where they will be working

3. Location of supplies or equipment they will be using

4. Restrooms

5. Emergency escape locations

6. Fire detectors and alarms

7. Fire extinguishers

8. Place where they can put their coat, belongings

Boundaries

Different people have different boundaries. What one person is comfortable with or thinks is

appropriate may not be what someone else considers appropriate. Here are examples of issues

that you may want to address when you meet with new PCAs:

• Personal property. PCAs should respect your personal property and ask permission if

they want to use it. For instance, you may or may not want to share food and beverages

with your PCAs.

• Personal phone calls. PCAs should ask to make or answer a call (either on your phone or

their cell phone). Placing a time limit on the calls may be beneficial. Also, be aware that

long distance phone calls may happen. Talk to your PCA about costs prior to the phone

call.

• Smoking. You should discuss whether it is okay for a PCA to smoke in your house, or in

a designated area outside of your house. Let them know about how to dispose of butts.

• Live-in PCAs. There will be additional issues to discuss with PCAs who live with you.

Issues can include free time, common spaces used by everyone, cleaning schedules, use

of personal items and payment of bills.

• Use of vehicles. Things you might want to consider if you ask PCAs to drive for you

include insurance and liability. There are issues whether the PCAs use your vehicle or

theirs. Check with the PCA provider agency about their vehicle policies and procedures.

PCA provider agencies are not required to offer transportation by the PCA.

• If you have a traditional provider agency, there may already be agency policies for these issues. Check with your provider for more information.

Your needs

• Talk about your disability and how it affects your life. The more your PCA knows about

your disability, the better they will be able to meet your needs.

• Give a lot of examples and explain any technical terms you use.

• Talk about any symptoms or health concerns they need to be aware of. Include anything that may arise and how to handle the situation. For example, if you have epilepsy, what can the PCA do when you are having a seizure?

• As you go through your routine, explain why tasks need to be done. This will help PCAs realize the importance of these tasks. For example, if you get range of motion exercises, explain that this helps you maintain movement and flexibility.

• Provide training on how to operate any life support equipment (i.e. feeding tubes, ventilators, etc.) you have. Include how to properly handle and clean this equipment or any other medical supplies you use.

• Conduct specific training on your cares. For example, how to transfer from a bed to a chair or how to style your hair.

• Be patient. Learning how to do new things takes a while. Don’t become frustrated if your

• PCA does not catch on right away.

• Ask for feedback about how you are explaining things. Maybe there is a way you could be clearer in your explanations.

• Stress the importance of documentation of tasks and times.

Qualified professionals supervise PCA services. Your QP works for your PCA provider agency.

QPs can be:

1. Registered nurses

2. Licensed social workers

Mental health professionals

If your PCA is performing health-related tasks, your QP must be a registered nurse.

1. Develop your care plan (traditional PCA, PCA Choice by request)

2. Develop and oversee your month-by-month plan (traditional PCA, PCA Choice by request)

3. Train, orient and evaluate new PCAs (traditional PCA, PCA Choice by request)

4. Supervise 16 and 17 year old PCAs

5. Train PCAs who assist with tracheostomy suctioning and people using ventilators

6. Oversee the delivery of PCA services

7. Ensure your health and safety needs are met

8. Document changes in condition and request reassessments

To help ensure:

1. The quality of PCA services

2. That your health and safety are protected

3. PCA services are funded by state and federal taxes and supervision helps:

4. Prevent and identify fraud

5. Provide greater accountability for the use of public funds

Traditional PCA

If you are getting traditional PCA services the QP will visit your home:

1. Within the first seven days to orient and train new, regularly scheduled PCAs (these first two visits may be combined)

2. Within the first fourteen days to evaluate new PCAs (these first two visits may be combined)

3. Every sixty days to evaluate 16 and 17 year old PCAs

4. Every 90 days to oversee the delivery of PCA services, during the first year of service

5. Every 120 days to oversee the delivery of PCA services, after the first year of service

6. Every 180 days, at the shared services site, if you are using shared services