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Personal Care Assistance

Qualified professional (QP) unit increase

Page posted: 5/26/2011

Page reviewed:

Page updated: 9/27/2011

Legal Authority

Minn. Stat. §256B.0659, subd. 13 and subd. 15

Policy

A limit of 96 units of QP supervision is automatically authorized annually for each person receiving PCA services.

The 96 units are to be used flexibly over the 12 months of the service authorization.

An exception to exceed 96 units during the service authorization may be authorized by DHS when extraordinary needs occur. For example:

  • • Person has increased care needs
  • • Multiple agencies are providing PCAs
  • • Multiple PCAs are providing services
  • Non-Covered Services

    Qualified professional services in excess of the amount indicated on the current service agreement are not a covered service.

    PCA Provider Agency Responsibilities

    To request increased QP units for state plan, fee for service recipients the PCA provider agency must submit a PCA Technical Change Request DHS-4074A (PDF) with:

  • • Request for the specific number of increased units
  • • Documented reason for increase of QP supervision units
  • • Documentation of completed QP visits for the current service agreement
  • To request increased QP units for a waiver recipient, the PCA provider agency must contact the waiver case manager.

    Waiver Case Manager Responsibilities

    Waiver case managers may authorize more or fewer units of qualified professional supervision as needed to meet minimum requirements for qualified professional visits. For fee-for-service waiver services, contact the DSD Resource Center for assistance with forcing edits to authorize more than 96 units of QP supervision annually.

    Health Plan Responsibilities

    PCA provider agencies must work directly with health plans regarding the need for additional QP supervision units when the PCA recipient’s PCA services are managed by a health plan.

    PCA provider agencies must follow the health plan process to request increased PCA units when the PCA recipient’s PCA services are managed by a health plan. If you are unsure of what the health plan process is, contact the health plan for further information. Health plan contact information is available on the Managed Care Organization (MCO) PCA Resources guide (PDF).

    DHS Responsibilities

    DHS reviews the request.

    If approved, DHS notifies PCA provider agency via MN-ITS and issues a new service agreement with additional QP units.

    For fee-for-service waiver services, the DSD Resource Center will force edits to authorize more than 96 units of QP supervision annually at the request of the waiver case manager.

    Additional Information

    Qualified professional services
    Qualified professional visits

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    Updated: 7/31/17 11:37 AM | Accessibility | Terms/Policy | Contact DHS | Top of Page | Updated: 7/31/17 11:37 AM