Hi there, my name is Chris Coleman and I work here at South Shore Elder Services. Today, I will be giving you a brief overview of the PCA program and how it works. The PCA program is a program through MassHealth in which consumers are given a certain amount of hours with which they can use to hire someone to assist with their daily care. This is often a family member or close friend, but a PCA can be just about anyone. PCA is different from many other types of care programs because it is consumer directed. This means that the consumer is responsible for running their own PCA program, or, if they are unable to run the program on their own, they may appoint a surrogate to act on their behalf. This gives the consumer a lot more control over their own self care; allowing the consumer to hire who they want & schedule them when they want. This is especially useful for consumers who are very particular about who they want to have take care of them. However, with this freedom there comes a significant amount of responsibility. Hiring workers can be intimidating, scheduling workers can be difficult, especially if a PCA worker needs to call out due an emergency or illness, and there is a hefty amount of paperwork involved as well. This is where the PCA skills trainer comes in.

In a nutshell, PCA skills trainers are responsible for teaching consumers of the PCA program and their surrogates about the rules and regulations of the PCA program and also making sure that these rules and regulations are being followed properly. PCA skills trainers assist the consumer with filling out all the required paperwork needed for compliance with MassHealth regulations. Skills trainers also assist the consumers by explaining how the PCA workers will go about billing for services and then registering the consumer with the fiscal intermediary. A fiscal intermediary is a payroll company that is responsible for making payments on the consumer’s behalf. The fiscal intermediary processes all of the time sheets sent in by the PCA workers, withholds all necessary taxes and fees, and then sends the workers out a paycheck every two weeks. One common misconception with the PCA program is about who the PCA workers are actually working for. Since the program is consumer directed, it is important to note that the PCA workers actually work for the consumer, not the fiscal intermediary nor the personal care management agency.

Another important duty of a PCA skills trainer is to act as a gatekeeper for all new referrals. Once a referral is made for PCA services, the skills trainer will call the consumer or the surrogate to get an idea of the current situation and to see if the consumer would be appropriate & eligible for PCA services. One tenant of eligibility is that a consumer must require hands on assistance with at least two activities of daily living, or ADLs; these are things like bathing, dressing, and eating. Things like laundry, shopping, meal preparation and house keeping are known as instrumental activities of daily living, or IADLs. A consumer can get PCA time for IADLs, however, IADLs are not factored into a consumer’s eligibility for PCA services. A key part in determining a consumer’s eligibility is that the assistance required must be hands on. If a consumer only requires someone to keep an eye on them and make sure they don’t slip while getting around the house they would not meet the eligibility requirements, as this is not considered hands on assistance. Furthermore, the consumer must be able to be appropriately cared for in their own home. PCA services are not intended to replace skilled nursing and should not be used to do so.

Finally, skills trainers are there to be a point of contact for all of their PCA consumers. Skills trainers have a very wide knowledge base; we know a bit about all of the different programs and services that are available, and we are more than happy to assist our consumers in finding out what the best and most appropriate care plan is for them, even if it isn’t PCA.

There is one common question that I often ask when I meet a new consumer or family for the first time, and this is “Why am I just meeting you now”? I say this because, for so many families, taking care of an elder or disabled family member is something that they have been doing for a quite a long time, and they have never asked for anything in return. The common answer that I get is that they didn’t know that the PCA program even existed. So, it is my hope, that by writing this article, someone in need may be one step closer to finding the help that they need.

If PCA sounds like a good program for you or a loved one, please give us a call here at South Shore Elder Services, and we can talk about it.

Chris Coleman has been a PCA skills trainer at South Shor e Elder Services for 2 years. Prior to that, he was a PCA worker himself for 5 years, caring for his grandfather. Chris has been a south shore local his whole life and loves working and living in the community.