Skip To: Main content|Subnavigation|
Minnesota Department of Human Services PCA Manual
Advanced Search|  

Personal Care Assistance

Responsible party

Page posted: 08/21/09

Page reviewed:

Page updated: 11/6/12

Legal Authority

Minn. Stat. §256B.0659, subd. 9


Responsible party: An individual who is capable of providing the support necessary to assist the person receiving PCA services to live in the community when the person is assessed as unable to direct his or her own care.


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
  • All responsible parties must be:

  • • 18 years of age or older
  • • Identified at the time of the assessment
  • • Listed on the person’s service plan, service agreement and PCA care plan
  • A licensed family foster parent who lives with the recipient may be the responsible party.

    Two persons may be identified as the responsible party for reasons such as, but not limited to, divided households and court-ordered custodies.

    A responsible party cannot be the:

  • • Personal care assistant
  • • Qualified professional
  • • PCA provider agency owner or manager
  • • PCA provider agency staff unless related by blood, marriage or adoption
  • • Lead agency staff (or contractors) acting as an employee
  • Responsible Party Responsibilities

    The responsible party is responsible for all of the following.

    1. Participate with the person:

  • • Attend all assessments for the person
  • • Make choices within the PCA Program
  • • Request changes as needed
  • • Sign forms if required
  • • Sign responsible party agreement
  • 2. Provide monitoring:

  • • Be available when services are provided in a 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 weekly to ensure the person’s care plan is followed
  • • Review and sign PCA time sheets after services are provided for verification of the services
  • 3. Assure recipient’s health and safety:

  • • Actively participate in planning and direction of PCA services
  • • Develop the care plan with the qualified professional
  • • Determine if the person’s health and safety are assured with current PCA services
  • • Assure care outcomes are met and the person and responsible party are satisfied with them
  • • Report suspected abuse/neglect to the local county common entry point
  • Responsible Party Agreement and Plan

    The PCA provider agency is responsible to complete the PCA Program Responsible Party Agreement and Plan (DHS-5856) (PDF).

    1. Responsible party signs the form to indicate their understanding of their role and responsibilities timeframe.
    2. Assessor adds the name of the person signing this form to the recipient’s DHS service agreement.
    3. Responsible party completes and signs a new responsible party agreement annually.

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

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

    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, either parent’s signature will be accepted on the timesheets.

    Responsible Party Delegation

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

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

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

  • • Be identified at the time of the assessment if possible
  • • Be listed in the PCA care plan
  • • Meet criteria and perform the functions of the responsible party, as determined by the person’s responsible party
  • • Sign the responsible party agreement
  • PCA Provider Agency Responsibilities

    The PCA provider agency is responsible for the following.

    1. Provider reviews the PCA Assessment and Service Plan (DHS-3244) (PDF) to obtain the name of the identified responsible party. The PCA provider agency staff must meet with the responsible party to:

  • • Review the roles and responsibilities and
  • • Obtain a signature on the responsible party agreement
  • 2. Documentation between the provider agency and the responsible party must be in the agency file and include:

  • • A plan on how responsible party will be accessible
  • • How the weekly monitoring will occur
  • • Process for responsible party to sign timecards
  • • Name of delegate responsible party if applicable
  • 3. Add responsible party name and information to PCA care plan.
    4. If there is a delegated responsible party, the PCA provider agency must obtain the signature of the delegate responsible party if not obtained following the assessment process.

    Lead Agency PHN 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 their own care, a responsible party must be present.

    To complete the responsible party information during the assessment process the PHN must:

    1. Add the name, address and phone number(s) of the responsible party (ies) to the PCA Assessment and Service Plan (DHS-3244) (PDF), responsible party section.
    2. Complete the appropriate MMIS fields per the MMIS instructions.

    Waiver and AC case manager

    The waiver case manager identifies the need for a responsible party during the Long-Term Care Consultation or Developmental Disability Screening assessment and service planning process.

    The case manager must:

    1. Add the name, address and phone number(s) of the responsible party to the Supplemental PCA Assessment and Service Plan (DHS-3428D) (PDF) or PCA Assessment and Service Plan (DHS-3244 PDF).
    2. Complete the MMIS fields per the MMIS instructions for waivers and Alternative Care including adding the name of the responsible party on the ASA2 screen.

    Rate/Report this pageReport/Rate this page

    © 2017 Minnesota Department of Human Services Updated: 9/13/13 11:48 AM | Accessibility | Terms/Policy | Contact DHS | Top of Page | Updated: 9/13/13 11:48 AM