Evaluation form (PCA-2) or the MassHealth PCA Reevaluation (No Change) form (PCA-R), as appropriate. IFTs are pre-paid funeral and burial expense trusts that Medicaid does not count as assets. The first step in applying for MassHealth (Massachusetts Medicaid) Long Term Care coverage is deciding which of the three coverages discussed above you or your loved one wants to apply for nursing home, Home and Community Based Service (HCBS) Waivers or Aged Blind and Disabled (ABD) Medicaid, which is also called MassHealth Standard. Home and Community Based Service (HCBS) Waivers will pay for long term care services and supports that help MassHealth (Massachusetts Medicaid) recipients who require a Nursing Facility Level of Care, but choose to remain living in the community instead of moving to a nursing home. Top-requested sites to log in to services provided by the state. Philip Donahue Your Next Star Employment Center. Use this button to show and access all levels. We hope you find everything you're looking for. Consumers can access the online directory at www.masspcadirectory.org. Mass.gov is a registered service mark of the Commonwealth of Massachusetts. While the AFC Program will pay for these benefits in a private home, it will not pay for the costs of living in the home (mortgage, rent, etc.) Eligibility for health care benefits for MassHealth, the Health Safety Net, and Children's Medical Security Plan, You live in Massachusetts and either intend to reside in Massachusetts, with or without a fixed address, or have entered Massachusetts with a job commitment or seeking employment, For personal pleasure, such as for vacation, or, To receivemedical care in a setting other than a nursing facility. Learn how to register, post a job and manage messages. Adult Day Health (ADH) Program beneficiaries can live at home, the home of a relative, an adult foster care home or an assisted living residence. For married applicants with both spouses applying, the 2023 asset limit for nursing home coverage through MassHealth (Massachusetts Medicaid) is $3,000 combined, and the income limit is $1,643 / month combined. time of day that the worker is available to work; whether the PCA has access to a car and/or has a valid driver's license; and. We will use this information to improve this page. Use these services to enroll as a MassHealth provider, manage your profile information, and submit and retrieve transactions. An official website of the Commonwealth of Massachusetts, This page, MassHealth Personal Care Attendant (PCA) Program, is. Bathing includes grooming and personal hygiene This means the state will look back into the previous five years of the applicants financial records to make sure they have not given away assets. Individuals can also drop off their completed applications at the MassHealth Enrollment Center at The Schrafft Center, 529 Main Street, Suite 1M, in Charlestown. A lock icon ( However, applicants must require hands on assistance with a minimum of two of seven Activities of Daily Living (ADLs). The live-in caregiver for the Adult Foster Care (AFC) Program participant can be a friend or family member, such as an adult child, grandchild, niece, nephew or sibling, but the caregiver can not be program participants spouse. This is a consumer-directed program, which provides personal care services for people with disabilities. Note: To ensure the P rior Authorization Unit (PAU) is able to follow through on . family support, day program, etc.) You must be financially eligible to qualify for MassHealth, the Health Safety Net, or the Children's Medical Security Plan. Adult Foster and Family Care. Use this button to show and access all levels. Must have MassHealth Standard or CommonHealth Massachusetts Group Adult Foster Care (GAFC) Program provides long term care services and supports in group living settings for MassHealth Standard (Massachusetts ABD Medicaid) beneficiaries who are at risk of nursing home placement and need help with at least one of the Activities of Daily Living (mobility, bathing, dressing, eating, toileting). The MFP-CL Waiver is for people who are leaving the nursing home (or hospital) and will move into their own home or the home of someone else in the community. Massachusetts residents have to meet an asset limit and an income limit in order to be financially eligible for nursing home coverage through MassHealth (Massachusetts Medicaid). Program of All-Inclusive Care for the Elderly (PACE) An official website of the Commonwealth of Massachusetts. Toileting Personal Care Attendant Workforce Council Become a PCA Today offered by Personal Care Attendant Workforce Council What is a MassHealth PCA A PCA is a person recruited and hired by an individual (PCA Consumer-employer) They can also contact the MassHealth Customer Service Center at 1-800-841-2900 or their areas PCM Agency. Consumers can also get answers to their questions by dialing 1-866-212-9675. Is the PCA program for you? We will use this information to improve this page. Medicaid planning strategies should ideally only be implemented with careful planning and well in advance of the need for long-term care. If you need completing the application, you canfind assistance in your area. Behaviors that can be typical in people with Alzheimers disease and other related dementias (wandering, inappropriate language, physical abuse) may also meet the criteria of requiring a skilled nursing service, and some of the ADH day care centers have staff trained in Alzheimers / dementia care. MassHealth has proposed rules to exclude only family members who are legally liable for the support of the MassHealth recipient, such as a. This means that all eligible PCA applicants are guaranteed by law to receive benefits. This site is for information purposes; it is not a substitute for professional legal advice. Timesheets can be sent to Tempus Unlimited by. FEW program participants who are also eligible for Medicare (dual eligible) can receive both their Medicaid and Medicare benefits through the SCO plan, although SCO applicants are not required to be Medicare eligible. The three fiscal intermediaries are Stavros, Northeast ARC or Tempus Unlimited. As more extensive Medicaid-funded care might be required in the future, it is vital that one not violate the Look Back Rule. The Personal Care Attendant (PCA) Program is a MassHealth, consumer-directed program that allows individuals with chronic disabilities to remain in their homes with the support from a PCA whom they hire directly to assist with activities of daily living. In 2023, the income limit for a single applicant is $1,616 / month. 04 77 44 34 39. Instead, there are a limited number of enrollment sots. Example: Yes, I would like to receive emails from MDSC. The group living setting may be an assisted living residence or subsidized group housing that is approved by MassHealth to provide GAFC Program benefits. To apply for MassHealth, seniors must complete the Application for Health Coverage for Seniors and People Needing Long-Term Care Services, which can be found here. An official website of the Commonwealth of Massachusetts, Call Department of Public Health, Main at. My disability is progressing, how can I get more help? PCM agencies can provide information about the PCA Program and answer questions about how to get started. Having income and / or assets over Medicaids limit(s) does not mean an applicant cannot still qualify for MA Medicaid. Thank you for your website feedback! You can return to the directory as many times as you wish and can update your information at any time. Financial Requirements Adult Day Health (ADH) Program This hold true whether one or both spouses are applicants. Inadequate planning or improperly implementing a Medicaid planning strategy can result in a denial or delay of MassHealth benefits. So, even if an applicant is eligible for an HCBS Waiver program in Massachusetts, they are not guaranteed by law to receive the benefits. MassHealth mayconduct information matches with state and federal agencies. Take the Medicaid Eligibility Test. Functional Requirements We will use this information to improve this page. The ADH Program, like MassHealth Standard itself, is an entitlement. You must be financially eligible to qualify for MassHealth, the Health Safety Net, or the Children's Medical Security Plan. You can learn more about signing up for eTimesheet attempusunlimited.org/etimesheet/. Moving Forward Plan Waiver participants must require a Nursing Facility Level of Care, and they must have been at the nursing home (or chronic disease, rehabilitation, or psychiatric hospital) for at least 90 days before applying. What is required to be a PCA in Massachusetts? This can include friends and certain relatives, like adult children and grandchildren, but not the beneficiarys spouse. The PCA's employer (the PCA consumer) must submit this form to the FI, along with all other paperwork required by the FI and MassHealth. They might eventually need Nursing Home Medicaid, or an HCBS Waiver, and those programs will deny or penalize the applicant for giving away assets. Thank you for your website feedback! Please limit your input to 500 characters. As the employer, a consumer chooses who to hire, sets up a PCA schedule and trains PCAs to meet his or her own personal needs. Countable assets include bank accounts, retirement accounts, stocks, bonds, certificates of deposit, cash and any other assets that can be easily converted to cash. If you would like to continue helping us improve Mass.gov, join our user panel to test new features for the site. If you or someone you know would like to get more information about the PCA program or enroll in PCA services, please contact a Personal Care Management (PCM) Agency in your area. Transportation to medical appointments. The functional needs assessment, which is completed by an occupational therapist or registered nurse via a Personal Care Management Agency, must be approved and signed by ones doctor indicating that personal care assistance is required. Please remove any contact information or personal data from your feedback. PCA provides program participants with hands on assistance with their Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). In addition to care coordination and management, SCO Program benefits include 24/7 nurse phone line, adult day care, acupuncture, dental/hearing/vision and podiatry services, medical equipment, Personal Emergency Response Systems, hospice care, housekeeping assistance, transportation and personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting). PACE program participants are required to need a Nursing Facility Level of Care, but they must live in the community. Personal Care Management / PCA. The PCA Program is a participant-directed program in which the program participant becomes the employer. The feedback will only be used for improving the website. You must be a resident of Massachusetts to get MassHealth orother health care benefits that are funded by the Commonwealth. What is the Personal Care Attendant (PCA) Program? Persons already enrolled in Medicaid should contact a Personal Care Management (PCM) Agency for a functional evaluation. A PCA is a person recruited and hired by an individual (PCA Consumer-employer) to physically assist in performing tasks, such as: PCA Consumer-employers are responsible to hire, train, manage, and, if needed, terminate the PCA. MassHealth (Massachusetts Medicaid) will conduct an assessment of ABD Medicaid applicants and their ability to perform Activities of Daily Living (mobility, bathing, dressing, eating, toileting) to determine the kind of long term care services the beneficiary needs and the state will cover. Nursing home coverage includes payment for room and board, as well as all necessary medical and non-medical goods and services. Unlike with many Medicaid long-term care programs, a Nursing Facility Level of Care (NFLOC) is not required. The three fiscal intermediaries are Stavros, Northeast ARC or Tempus Unlimited. What you need The directory is a searchable database where consumers can search for a PCA by reviewing the responses that PCAs have given to a series of employment questions.