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Family-to-Family Health Information Center

To learn more about PCA changes and services, contact PACER's Family-to-Family Health Information Center at (952) 838-9000 or (800) 53-PACER, toll free in Minnesota.

 


PCA Assessment & Appeals Tips

  • Understand PCA eligibility requirements! In order to receive PCA services, applicants must already be receiving Medical Assistance (MA) or be eligible to receive MA services. Read the DHS Instruction & Guidelines document to prepare.
  • Be prepared! Keep a record of aggressive, Level 1 behaviors and any need for assistance with ADLs.
  • Gather support! Get documents from doctors, teachers, therapists, care providers, etc. that demonstrate the person’s need for PCA services.

PCA Transition Toolkit

Making the Move to Managing Your Own Personal Assistance Services (PAS) is a toolkit for youth with disabilities transitioning to adulthood (available in PDF and Word formats). The toolkit helps youth develop skills to manage their own PAS, both personal and job-based. This toolkit was developed by the National Collaborative on Workforce and Disability.

Minnesota Personal Care Assistant (PCA)

PCA Eligibility Requirements:

Persons with:

  • Level  1 behavior, or
  • 1 activity of Daily Living (ADL) dependency, or
  • 1 ADL dependency and Level 1 behavior

are only eligible for 2 units (30 minutes) of PCA services per day.
Persons who qualify as dependent in at least 2 activities of daily living (ADLs) will continue to receive services as they did prior to July 1, 2011, unless their condition or assessment changes.

To qualify you must be assessed as having :

  • a dependency in 1 Activity of Daily Living and/or level 1 behavior  is required to qualify for 30 minutes per day for PCA services; or
  • a dependency in 2 ADLs is required to receive more than 30 minutes of PCA services per day under the home care rating system in effect since January of 2010.

See the Department of Human Services Assessment chart to learn how it calculates the amount of PCA services a person with a disability qualifies for.

The Department of Human Services’ Consumer Information link provides online resources that can help you find: 

  • Assessment
  • Training PCAs
  • Role of the PCA
  • Traditional PCA vs PCA Choice
  • Appeals
  • Consumer safeguards

To find a list of PCA providers in your area, search under “Personal Care Services” in the Minnesota Health Care Program's Provider Directory.

Definition of Dependency and ADL:

  • Dependency requires hands-on physical assistance, cuing, or constant supervision to complete the task.
  • Activities of Daily Living (ADLs) include:
    • Grooming
    • Dressing
    • Bathing
    • Transferring
    • Mobility
    • Positioning
    • Eating
    • Toileting

Definition of Level 1 Behavior:
Level I Behavior is behavior that requires the immediate response of another person, has occurred in the last 12 months with supporting documentation from professionals such as doctors, nurses, teachers, therapists, etc., and involves at least one of the following:

  • Physical aggression towards self
  • Physical aggression towards others
  • Destruction of property

PCA Reassessment:
Face-to-face reassessments are scheduled annually. DHS will send a letter of notification to PCA recipients explaining the reassessment process. If the recipient’s medical or behavioral status changes prior to the annual review date, contact the county Disability services office and ask to speak with a person regarding reassessing PCA services.

Remember, you have the right to appeal any decision (whether termination or reduction of PCA services) within 30 days of receiving a decision from DHS. You may also request to have a Long-term Care Consultation (LTCC) at your reassessment to help you identify other services to meet your needs.

PCA Appeals:
Staff from PACER’s Health Information Center and the MN Disability Law Center recently presented “PCA Services: Assessment, Eligibility and Appeals.” An outline of the presentation is available here.


Additional PCA Resources:

Minnesota Department of Human Services

Personal Care Assistance (PCA) Program – gives an overview of PCA services.

PCA Phase II Project – provides details of the legislative changes, including timelines for reassessment and new criteria for eligibility.

PCA Assessment and Service Plan Instruction and Guidelines – outlines questions and details that determine eligibility and explains the assessment process to receive PCA services. This document is helpful for parents or guardians to read prior to an assessment.

DHS Frequently Asked Questions (FAQs)

Minnesota Disability Law Center

MN Disability Law Center:  PCA Changes Web Resource – provides information and links to more information and legislation for PCA services.

Other

2010 Minnesota Statues involving PCA Services: 256B.0625 and 256B.0659

 

To learn more about PCA changes and services, contact PACER’s Health Information Center at (952) 838-9000 or (800) 53-PACER, toll free in Minnesota.

 

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