Case Studies of Six State Personal Assistance Service Programs Funded by the Medicaid Personal Care Option. VI. Attendant Issues: Family Providers, Wages, Benefits, Withholding


A. Family Provider Regulations

SDSD clients who wish to use family providers would be transferred from PCS to the waiver programs. SDSD generally does not allow the spouse or parent of minor to be designated as a provider, although new legislation now allows for spousal pay in some circumstances paid for by the state general fund.

CSD allows reimbursement of foster parents, but natural and adoptive parents, step parents, siblings, step-siblings, and grandparents cannot receive PCS reimbursement for PAS provision. A separate state-funded program apparently does reimburse some family providers.

B. Attendant Wages

Wages for PCS attendants used by SDSD vary between private agencies, but they receive an average of $6-7 per hour. Foster parents in the CSD program receive approximately $5 per hour for providing personal care.

C. Attendant Benefits

Private agencies under contract with SDSD offer FICA, worker's compensation, and unemployment compensation for their CNAs. No benefits are offered by CSD to foster parents through PCS.

D. Withholding and Liability Issues

Oregon has a high worker's compensation rate, which has impacted the overall employment cost for PCS. Private agency administrators complain that the SDSD reimbursement rate is too low to offer additional benefits, and consequently they have difficulty recruiting and retaining qualified attendants. Employer based health insurance will be mandated in 1994. Private agencies have insurance for negligence.

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