Personal Care Attendant (PCA) Program

The PCA program provides funding for people with disabilities to hire personal care attendants who help with tasks such as bathing, dressing, meal preparation, and other activities of daily living. The program promotes independence and autonomy for individuals with disabilities by allowing them to choose and direct their own care.

What is the PCA Program?

The Personal Care Attendant (PCA) program is a valuable resource that can provide essential support to parents of adults with disabilities living at home. This program aims to enhance the individual’s ability to live independently by offering assistance with activities of daily living (ADLs) and instrumental activities of daily living (IADLs).

The duties of a personal care attendant may include:

  • Assisting with bathing, grooming, and personal hygiene.
  • Helping with dressing and undressing.
  • Providing assistance with mobility, such as transferring from bed to wheelchair.
  • Assisting with toileting and incontinence care.
  • Helping with meal preparation and feeding.
  • Making medical appointments and bring individuals to the appointments

How does the PCA program differ from other in-home assistance programs?

The PCA Program is a participant-directed program in which the person with the disability becomes the “employer”. Participants in the program receive funds to recruit, train, arrange schedules, oversee, and if necessary, dismiss the personal care attendant they select. Once the evaluating team figures out how many personal care hours are needed, it’s up to the individual to hire and schedule their care attendants. A fiscal intermediary handles the financial aspects of employment responsibilities, such as processing time sheets, withholding taxes, and issuing caregiver payments for payment through Medicaid.

Transition tip

PCA services can be used in combination with some other services, such as visiting nurses, occupational/physical therapy, and home health care services. However, some other services may not be used together with PCA, for example you cannot participate in the Adult Foster Care program and the PCA program at the same time. Check with your applicable state agency.

Who can be hired as a PCA?

As a parent, you can! Personal Care Attendants may be any individual including a friend, parent of adult children, or family member (excluding spouses, surrogates, or legal guardians).

No special license or certification is needed; the agency will conduct required trainings such as CPR and the individual, family or current caretaker will train on specifics for the person being served. The Personal Care Attendant must be legally eligible for employment.

Secondary student Brian uses an electric razor to shave. It's one of many everyday tasks children and young adults who are blind must be explicitly taught.
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Need to know

 While friends and select relatives, such as adult children or grandchildren, can be hired, a spouse or legal guardian cannot be hired as the caregiver.

Who pays for PCAs?

In most states, the PCA model is paid for by state Medicaid. This means that Medicaid-managed care organizations and local departments of social services partner with home-care agencies. These home-care agencies hire aides who provide personal care services paid for by Medicaid.

A community health assessment is conducted by an established and designated agency in the community to determine need and eligibility. 

How to Apply for PCA services

To apply for PCA services, contact an agency authorized to assess your family’s needs. Your case manager, social worker or physician can provide referrals to the appropriate agencies. Each state usually has several agencies designated to provide this service. In Massachusetts, the agency will evaluate your need for PCA services and submit a prior-authorization request to MassHealth for you. If you have Medicaid in another state, your local office will have referrals for agencies that can provide an assessment.


Here are some helpful article to learn more about Adult Foster Care:

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