PCA Choice

Personal Care Assistance

PCA Choice option

Page posted: 11/04/13

Page reviewed:

Page updated:

Legal Authority

Minn. Stat. §256B.0659, subd. 18, 19, 20

Definition

PCA Choice Option: Option where the consumer is responsible for hiring, training, scheduling and terminating their personal care assistants.

Policy

The PCA Choice option offers greater control and choice for the consumer. Unless otherwise noted, all other statutory and regulatory provisions relating to PCA services apply to a recipient using the PCA Choice option.

Exceptions specific to this option include:

• Assessment requirements

• Consumer responsibilities

• Provider responsibilities

• Supervision requirements

• Use of only one agency

• Written agreements

Covered Services

Covered services are PCA services identified in the service plan and PCA care plan.

The commissioner may allow a consumer to use a fiscal intermediary (PCA Choice provider agency) to assist the recipient in paying and accounting for medically necessary covered PCA services.

Recipient Responsibilities

If using PCA Choice, the consumer is responsible to:

1. Choose a PCA Choice agency during the assessment process or during the service authorization period.
2. Recruit, hire, train and supervise their PCAs.
3. Terminate employment of their PCAs if necessary.
4. Recruit and hire a qualified professional.
5. Verify the credentials of the qualified professional.
6. Enter into a written agreement with the PCA Choice agency, PCAs and qualified professional.
7. Work with the qualified professional to assure the consumer’s health and safety needs are met.

The consumer must:

1. Participate in an annual face-to-face assessment.
2. Assure own health and safety with training, scheduling and monitoring of PCAs.
3. Develop and revise a PCA care plan with the assistance of the qualified professional.
4. Monitor and verify the hours worked by the PCA(s).
5. Sign time sheets.
6. Communicate a change in condition or need for additional services at the time the change occurs.

PCA Choice Provider Agency Responsibilities

For employment law and related regulations, the PCA Choice provider agency is considered the:

• Employer of the personal care assistant and

• Qualified professional

The PCA Choice provider agency must:

1. Meet all enrollment requirements for PCA provider agencies.
2. Enter into a written agreement with the person, PCA(s) and qualified professional before services are provided.
3. Ensure arm’s length transactions without undue influence or coercion with the consumer, PCA or qualified professional.
4. Meet all of the PCA Choice agency responsibilities.

Assessor Responsibilities

The assessor is responsible to inform the consumer about the PCA Choice option. If the option is selected, the assessor must:

1. Document the choice on the service plan.
2. Enter a Y in the MMIS field named fiscal intermediary.
3. Complete annual face-to-face assessments.

Denial of PCA Choice Option

The commissioner shall deny, revoke or suspend the authorization to use the
PCA Choice option if:

• DHS terminates the PCA Choice option

• Parties have failed to comply with the written agreement

• Qualified professional or public health nurse determines the use of this option jeopardizes the consumer’s health and safety

• Use of the option has led to abusive or fraudulent billing for PCA services

The consumer may appeal the commissioner's decision. The denial, revocation or suspension to use the PCA Choice option must not affect the consumer’s authorized level of PCA services.

Additional Information

PCA Choice provider list at MinnesotaHelp.info


Page posted: 11/04/13		Page reviewed:	Page updated:
Legal Authority	Minn. Stat. §256B.0659, subd. 18, 19, 20
Definition	PCA Choice Option: Option where the consumer is responsible for hiring, training, scheduling and terminating their personal care assistants.
Policy	The PCA Choice option offers greater control and choice for the consumer. Unless otherwise noted, all other statutory and regulatory provisions relating to PCA services apply to a recipient using the PCA Choice option. Exceptions specific to this option include: • Assessment requirements • Consumer responsibilities • Provider responsibilities • Supervision requirements • Use of only one agency • Written agreements
Covered Services	Covered services are PCA services identified in the service plan and PCA care plan. The commissioner may allow a consumer to use a fiscal intermediary (PCA Choice provider agency) to assist the recipient in paying and accounting for medically necessary covered PCA services.
Recipient Responsibilities	If using PCA Choice, the consumer is responsible to: 1. Choose a PCA Choice agency during the assessment process or during the service authorization period. 2. Recruit, hire, train and supervise their PCAs. 3. Terminate employment of their PCAs if necessary. 4. Recruit and hire a qualified professional. 5. Verify the credentials of the qualified professional. 6. Enter into a written agreement with the PCA Choice agency, PCAs and qualified professional. 7. Work with the qualified professional to assure the consumer’s health and safety needs are met. The consumer must: 1. Participate in an annual face-to-face assessment. 2. Assure own health and safety with training, scheduling and monitoring of PCAs. 3. Develop and revise a PCA care plan with the assistance of the qualified professional. 4. Monitor and verify the hours worked by the PCA(s). 5. Sign time sheets. 6. Communicate a change in condition or need for additional services at the time the change occurs.
PCA Choice Provider Agency Responsibilities	For employment law and related regulations, the PCA Choice provider agency is considered the: • Employer of the personal care assistant and • Qualified professional The PCA Choice provider agency must: 1. Meet all enrollment requirements for PCA provider agencies. 2. Enter into a written agreement with the person, PCA(s) and qualified professional before services are provided. 3. Ensure arm’s length transactions without undue influence or coercion with the consumer, PCA or qualified professional. 4. Meet all of the PCA Choice agency responsibilities.
Assessor Responsibilities	The assessor is responsible to inform the consumer about the PCA Choice option. If the option is selected, the assessor must: 1. Document the choice on the service plan. 2. Enter a Y in the MMIS field named fiscal intermediary. 3. Complete annual face-to-face assessments.
Denial of PCA Choice Option	The commissioner shall deny, revoke or suspend the authorization to use the PCA Choice option if: • DHS terminates the PCA Choice option • Parties have failed to comply with the written agreement • Qualified professional or public health nurse determines the use of this option jeopardizes the consumer’s health and safety • Use of the option has led to abusive or fraudulent billing for PCA services The consumer may appeal the commissioner's decision. The denial, revocation or suspension to use the PCA Choice option must not affect the consumer’s authorized level of PCA services.
Additional Information	PCA Choice provider list at MinnesotaHelp.info