Using Medicaid to Cover Services for Elderly Persons in Residential Care Settings: State Policy Maker and Stakeholder Views in Six States. Service Criteria


To be eligible for the Personal Care Assistance program, a person must require services that are medically necessary and ordered by a physician; and be able to make decisions about their own care or live with someone who can make decisions for them.

The services include assistance with:

  • Activities of daily living, including eating, toileting, grooming, dressing, bathing, transferring, mobility and positioning.

  • Health related functions, that, under state law, can be delegated or assigned by a licensed health care professional to be performed by a Personal Care Assistant.

  • Instrumental activities of daily living, including meal planning and preparation, managing finances, shopping for essential items, performing essential household chores, communication by telephone and other media, and getting around and participating in the community.

  • Redirection and intervention for behavior, including observation and monitoring.

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