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Personal Care Assistance

Provider wage and benefit requirements

Page posted: 11/04/13

Page reviewed:

Page updated:

Legal Authority

Minn. Stat. §256B.0659, subd. 20(6)(b), 21(12) and 24(9)

Policy

All PCA agencies enrolled with Minnesota Health Care Programs must pay personal care assistants wages and benefits equal to 72.5 percent of the revenue from the Medical Assistance rate for:

  • • Personal care assistance (non-PCA Choice)
  • • PCA Choice services
  • The 72.5 percent calculation is determined in the aggregate amount.

    PCA Provider Agency Responsibilities

    Each PCA agency is responsible to:

  • • Determine 72.5 percent of their revenue from the MA rate for PCA services
  • • Pay PCA wages and benefits equal to or greater than the sum total of 72.5 percent of the revenue from the MA rate for PCA services
  • The employer portion of PCA wages and benefits that can be included in the 72.5 percent may include but are not limited to the following.

  • • Insurance (health, dental, vision, life, health care savings account, long term care, short and long term disability)
  • • PCA benefits of vacation, sick and overtime
  • • PCA wages for their time providing PCA services, attending training and transportation between PCA recipients
  • • Retirement benefits
  • • Taxes (FICA, FUTA, SUTA, Medicare and worker's compensation)
  • • Tuition reimbursement/continuing education benefits
  • • Wellness program benefits
  • PCA wages and benefits that are program related costs and cannot be included in the 72.5 percent may include but are not limited to the following:

  • • Administrative staff wages and benefits
  • • Consultation services (information technology, human resources, legal accounting)
  • • Cost of providing training (materials and paying/hiring trainer) and recruitment
  • • Fees (licenses, background checks, trade association fees, organization memberships, city charges fees, rental property inspection costs)
  • • Non-direct care staff training
  • • Non MA state plan supplies and equipment
  • • Provider agency insurance and bonding (liability, property, vehicle, fidelity and surety)
  • Documentation

    The provider must be able to show at least 72.5 percent of all paid claims for procedure codes T1019 (excluding UA modifier) for the time period, were spent on PCA wages and benefits.

    The provider must document:

  • • Procedures used to determine and assure 72.5 percent of revenue from the MA rate from PCA services are used for PCA wages and benefits
  • • Wages and benefits paid to individual PCAs
  • The provider must be able to provide documentation to the Minnesota Department of Human Services upon request.

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    Updated: 11/8/13 3:11 PM | Accessibility | Terms/Policy | Contact DHS | Top of Page | Updated: 11/8/13 3:11 PM