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Minnesota Department of Human Services PCA Manual
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Personal Care Assistance – Eligibility

Responsible Party

Page posted: 08/21/09

Page reviewed: 12/29/17

Page updated: 12/29/17

Legal Authority

Minn. Stat. §256B.0659, subd. 9 &10

Definition

Responsible party: A person who is at least 18 years old and capable of providing the support necessary to help the person receiving PCA services to live in the community when the person is assessed as unable to direct his or her own care.

Policy

A responsible party is required by the PCA program when the person is:

  • • A minor
  • • An incapacitated adult who has a court-appointed guardian
  • • Determined through the assessment process to need a responsible party
  • Responsible parties:

  • • Must be listed on the person’s service agreement and PCA care plan
  • • Must be identified at the time of assessment
  • • May be parents of a person needing care
  • • May be a licensed family foster parent
  • • May be two people, such as divided households and court-ordered custodies.
  • A responsible party must not be the:

  • • Personal care assistant
  • • Qualified professional
  • • Home care agency owner or manager
  • • Home care agency staff unless related by blood, marriage or adoption
  • • Lead agency staff (or contractors) acting as employees
  • Responsible party responsibilities

    The responsible party is responsible for all of the following:

    Participate with the person

  • • Attend assessments with the person
  • • Actively participate in planning and directing of PCA services
  • • Help make choices within the PCA program
  • • Request changes as needed
  • • Sign required forms, including all worker time and activity sheets
  • • Sign responsible party agreement
  • Provide monitoring

  • • Be available when services are provided in a communication method agreed upon by the person or the person’s legal representative and documented in the PCA care plan and on the responsible party agreement
  • • Monitor PCA services to ensure providers follow the person’s care plan, and care outcomes are being met
  • • Communicate with provider agency as needed
  • • Monitor the delivery of services to ensure they are provided
  • Assure recipient’s health and safety

  • • Develop the care plan with the qualified professional
  • • Determine if the person’s health and safety are met with current PCA services or if a change is needed
  • Responsible party agreement and plan

    A responsible party shall enter into a written agreement with a personal care assistance provider agency by completing the PCA Program Responsible Party Agreement and Plan (DHS-5856) (PDF) form.

    1. Responsible party signs the form to indicate his or her understanding of his or her role and responsibilities.

    2. Responsible party completes and signs a new responsible party agreement annually.

    When there are two people identified as the responsible party, each person must sign the responsible party agreement.

    The responsible party is the only person who may request to change providers. DHS will confirm that all requests for change of provider are from the named responsible party in MMIS.

    The responsible party named must be the one signing the PCA timesheets, with one exception: When there are two biological or adoptive parents living with the minor, DHS will accept either parent’s signature on the timesheets.

    Responsible party delegation

    The following individuals may delegate their role of responsible party during a temporary absence of at least 24 hours but not more than six months:

  • • Guardians of minors
  • • Guardians of people who are incapacitated
  • • Parents of minor children
  • The responsible party must communicate to the PCA provider agency about the
    need for a delegated responsible party, including the following information:

  • • Contact numbers
  • • Name of the delegated responsible party
  • Delegated responsible parties must:

  • • Be identified at the time of the assessment, if possible
  • • Be listed in the PCA care plan
  • • Meet all criteria and perform the functions of the responsible party
  • • Complete and sign the PCA Program Responsible Party Agreement and Plan (DHS-5856) (PDF) with the provider agency.
  • PCA provider agency responsibilities

    The PCA provider agency must:

  • • Review and complete the PCA Program Responsible Party Agreement and Plan (DHS-5856) (PDF) to obtain the name of the identified responsible party.
  • • Meet with the responsible party to:
  • o Discuss the roles and responsibilities
  • o Obtain the signature of the responsible party on the PCA Program Responsible Party Agreement and Plan (DHS-5856) (PDF)
  • o Provide a copy of the agreement to both the recipient and the responsible party
  • • Retain documentation between the provider agency and the responsible party in the agency file including:
  • o Name and information of the responsible party added to the PCA care plan
  • o A plan on how responsible party will be accessible
  • o How monitoring will occur
  • o Process for responsible party to sign timecards
  • o Name and information of delegated responsible party if applicable, and his or her signature on the responsible party agreement.
  • Lead agency responsibilities

    State plan assessor

    The public health nurse identifies the need for a responsible party during the assessment process. If the person is a minor or cannot direct his or her own care, a responsible party must be present.

    To complete the responsible party information during the assessment process, the public health nurse must:

  • • Add the name, address and phone number(s) of the responsible party(ies) to the PCA service plan, responsible party section.
  • • Complete the appropriate MMIS fields following MMIS instructions, including the responsible party name(s)
  • Waiver and AC case manager

    The waiver case manager identifies the need for a responsible party during the assessment and service-planning process.

    The case manager must:

  • • Add the name, address and phone number(s) of the responsible party to the PCA service plan, responsible party section, or.
  • • Complete the MMIS fields following MMIS instructions for waivers and Alternative Care, including adding the name of the responsible party on the ASA2 screen.
  • Additional Information

    PCA Program Responsible Party Agreement and Plan (DHS-5856) (PDF)
    Supplemental PCA Assessment and Service Plan (DHS-3428D) (PDF
    )
    PCA Assessment and Service Plan (DHS-3244 PDF)

    Using CSP DHS-6791B with a MnCHOICES Assessment

    DSD MMIS Reference Guide

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    © 2018 Minnesota Department of Human Services Updated: 12/29/17 3:41 PM | Accessibility | Terms/Policy | Contact DHS | Top of Page | Updated: 12/29/17 3:41 PM