Case Studies of Six State Personal Assistance Service Programs Funded by the Medicaid Personal Care Option. I. Program Overview: Size of Population and Expenditures, Program Objectives


Personal Care Assistance (PCA) is administered by the Massachusetts Department of Public Welfare (DPW). It served 1,775 people in 1990, at a total cost of $24,531,262. The program utilizes independent providers, and services are coordinated through nine PCA agencies, six of which are independent living centers (ILCs). There is an emphasis on consumer control and consumer training. Recipients meet income eligibility through either regular income limits or through the state's Medicaid buy-in, and require at least 10 hours of ADL assistance per week, or 14 hours of ADL and IADL assistance.

The program goal is "to enable people with permanent or chronic disabilities to live in the community who might otherwise be institutionalized." The program serves primarily younger people (over 90% of consumers are under 65) with physical disabilities who are capable of self management. There is an explicit commitment to consumer control, and program recipients expressed high levels of satisfaction with program services. Changes in program guidelines promulgated in 1988 allowed PCA services under the management of a consumer designated surrogate for people with mental retardation, but this population makes up only a small percentage of PCA recipients.

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