Case Studies of Six State Personal Assistance Service Programs Funded by the Medicaid Personal Care Option. V. Support Services Available

12/01/1991

A. Attendant Management

1. Attendant Recruitment

Recipients or surrogates are responsible for recruitment after being trained by the ILCs. Some ILCs maintain a list of people interested in working as attendants.

2. Attendant Screening

The recipient or surrogate is responsible for screening.

3. Attendant Interviewing

The recipient or surrogate is responsible for inter-viewing.

4. Attendant Certification

No attendant certification is required.

5. Attendant Hiring

The recipient or surrogate is responsible for hiring.

6. Attendant Training

The recipient or surrogate is responsible for training.

7. Attendant Supervision

The recipient or surrogate is responsible for attendant supervision.

8. Attendant Payment

Recipients or surrogates submit a monthly invoice to the ILC, which issues individual reimbursement checks to consumers. The ILCs maintain extensive accounting departments which are responsible for coordinating processing of PCA billing.

9. Attendant Termination

Recipients or surrogates are responsible for attendant termination.

10. Conflict Resolution

Recipients are generally responsible for conflict resolution, although ILC staff are frequently called for advice.

B. Consumer Support

1. Consumer Advocacy

Recipients are considered their own advocates, but ILCs are clearly an advocacy resource.

2. Consumer Training

Extensive consumer training is probably the most unique feature of the PCA program. There is no individual cap or prior approval requirement for training, and the ILC can continue to work with the consumer until they consider the recipient sufficiently skilled to live independently with PCA services. Training has usually been a short term effort, but inclusion of people with cognitive disabilities will probably require longer periods of skills training.

3. Consumer Outreach

No real consumer outreach is done for PCA services, and this is considered a major shortcoming by aging and DD advocates. The PCA program has historically been limited to populations and geographic areas served by the ILCs.

4. Quality Monitoring

There is no programmatic mechanism for assessing the quality of PCA services the individual recipient receives, but consumers have been trained to recognize what satisfactory PAS is, and trained to insist on quality PAS. This seems quite effective, according to the recipients interviewed.

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