MassHealth Personal Care Attendant Program (PCA)
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What is the MassHealth Personal Care Attendant Program (PCA)?
The Personal Care Attendant Program (PCA) is a MassHealth program that helps people with long-term disabilities live independently at home.
The PCA program gives each eligible MassHealth member funds to hire a personal care attendant to help with activities of daily living (ADLs) such as bathing, dressing, eating, toileting, exercising, taking medications, and moving about inside the home. The MassHealth member becomes the employer, and is in charge of hiring, firing, training, and supervising the PCA.
The MassHealth PCA Program Consumer Handbook explains the eligibility requirements, application process, and PCA program rules.
The regulations regarding personal care attendant (PCA) services are in the Personal Care Manual (130 CMR 422) on the MassHealth web site.
Am I eligible?
To be eligible for the MassHealth Personal Care Attendant (PCA) Program:
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You must be a MassHealth Standard or CommonHealth member. Other coverage types do not cover personal care services.
Note: MassHealth has special income eligibility rules for people age 65 or older who need personal care attendants. The rules allow a PCA deduction that lowers countable income and makes it easier to meet the MassHealth Standard income limits. See MassHealth Financial Eligibility - PCA deduction for details.
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Your doctor or nurse practitioner must prescribe the personal care services for you.
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You must have a permanent or chronic disability that prevents you from taking care of your personal needs yourself.
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You must need physical help with two or more of the following activities of daily living (ADLs): mobility/transfers, bathing/grooming, dressing/undressing, range-of-motion exercises, taking medications, eating, toileting.
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The personal care services must be medically necessary, and you must have prior authorization from MassHealth.
What benefits will I get?
If you are approved for the Personal Care Attendant (PCA) Program, MassHealth will provide funds for you to hire a personal care attendant.
Your PCA will be paid to:
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provide services for the number of daytime and nighttime hours per week approved by MassHealth
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perform the services specified in your PCA evaluation. Approved services may include:
Activities of Daily Living (ADLs): mobility/transfers, bathing/grooming, dressing/undressing, range-of-motion exercises, taking medications, eating, toileting.
Instrumental Activities of Daily Living (IADLs): household tasks such as meal preparation, laundry, housekeeping, transportation to medical appointments, shopping, and other approved tasks
Your PCA will not be paid to:
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help you while you are in a hospital or nursing facility, or in community programs funded by MassHealth
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provide social services such as babysitting, recreation, or educational activities
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provide medical services that are available from other MassHealth providers
You are in charge of your PCA program. You can hire the personal care attendant you want, and you can manage your PCA's training and scheduling as you choose. If you need help, you can name a family member or other responsible adult to be your surrogate. Your surrogate can handle the PCA management tasks that you are not able to do yourself.
Your Personal Care Management (PCM) agency will answer your questions and teach you how to manage your PCA program responsibilities.
How do I apply?
Applying for MassHealth:
To apply for the Personal Care Attendant (PCA) Program, you must be a member of MassHealth Standard or CommonHealth. If you are not a member, you must apply for MassHealth. For information on how to apply, see MassHealth: How do I apply?
Note: MassHealth has special income eligibility rules for people age 65 or older who need personal care attendants. The rules allow a PCA deduction that lowers countable income and makes it easier to meet the MassHealth Standard income limits. See MassHealth Financial Eligibility - PCA deduction for details.
Applying for the Personal Care Attendant Program
If you are a member of MassHealth Standard or CommonHealth, and you need personal care services, you should contact a Personal Care Management (PCM) agency.
To find a PCM agency:
The PCM will evaluate your need for PCA services and submit a prior authorization request to MassHealth for you:
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The PCM will send a registered nurse and an occupational therapist to your home to evaluate your need for personal care services and your ability to hire and supervise a PCA.
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The PCM will complete the MassHealth Evaluation for Personal Care Attendant (PCA) Services. The evaluation will specify the number of daytime and nighttime hours of PCA services you need and the types of services to be performed.
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The evaluation will also determine if you need a surrogate to manage the PCA services for you. A surrogate is a family member or other responsible adult who will handle the PCA management tasks that you are unable to do.
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You and your doctor or nurse practitioner must sign the evaluation form.
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The PCM will submit the signed evaluation and a prior authorization request to MassHealth.
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MassHealth will approve, modify, or deny the request. If MassHealth modifies or denies the request for PCA services, you can appeal their decision.
The evaluation and approval process for the PCA Program may take several months.
Who can be a personal care attendant (PCA)?
The person you hire to be your personal care attendant (PCA):
- must be legally authorized to work in the United States
- must be able to understand and carry out your instructions
- cannot be your spouse, legally responsible relative, or your surrogate (or parent/foster parent if the MassHealth member is a minor)
- must be willing to be trained and supervised by you or your surrogate
Anyone interested in working as a personal care attendant in Massachusetts can sign up for the online PCA Directory. For information, see Are You Looking for Work as a PCA?. To sign up, go to Apply for a job on the Rewarding Work web site.
How do I find a personal care attendant (PCA)?
One way to find and hire a personal care attendant is to use the free online Massachusetts PCA Directory.
The Massachusetts PCA Directory is a listing of personal care attendants who are looking for jobs. The Directory provides contact information, hours and services, experience, education, willingness to travel, and other work-related information about each applicant.
To search the directory, go to:
You must set up an account and enter your MassHealth number to see the PCA listings. Go to PCA Directory - Establish an account to sign up.
The Massachusetts PCA Directory:
- allows users to search for PCAs based on location, language, experience, and other factors
- is free of charge for MassHealth members approved for the PCA Program
- has a toll-free number 866-212-WORK (866-212-9675) for people without Internet access
- allows people looking for work as PCAs to sign up online
- is operated by Rewarding Work Resources, Inc., a nonprofit organization that also runs a subscription web site for non-MassHealth PCA users
Your Personal Care Management (PCM) agency can also help you find a PCA, or you can ask friends, family members, religious leaders, and other community members if they know of anyone looking for PCA work.
Before you decide to hire a PCA, you should carefully check the person's character and employment references. You should also interview the person, and consider doing a criminal background check. See Rewarding Work's Tips for Employers for other things to consider before hiring a PCA.
How do I hire and pay my PCA?
Once you find the person you want to hire, contact your PCM for instructions about paychecks, timesheets, workers' compensation, state and federal taxes, W-2 forms, and other employer-related responsibilities.
Your PCM will connect you with another agency, called a Fiscal Intermediary (FI), that will process your timesheets and issue paychecks from MassHealth. The FI will either give the paychecks to you so that you can pay your PCA directly, or your PCA can get paid through direct deposit.
PCA workers in Massachusetts are represented by the health care workers union 1199SEIU. The union negotiates wages and benefits for more than 25,000 MassHealth PCAs across the state. 1199SEIU recently negotiated a contract for MassHealth PCA workers that increased wages to $11.60 an hour as of January 23, 2009. For more information, see PCA Voice.
Useful links
These links are external links to web sites that are not part of MassResources.org. When you click on these links, you will leave our site. Click "Back" on your browser to return.
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MassHealth Personal Care Attendant Consumer Handbook
Comprehensive information about the MassHealth Personal Care Attendant Program, including eligibility requirements, how to apply, and program rules. The Handbook also includes contact information for PCM agencies, Fiscal Intermediaries, and organizations to help you find PCAs, screen PCAs, report abuse, and provide legal assistance.
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MassHealth Personal Care Provider Manual (130 CMR 422)
Regulations regarding MassHealth personal care services.
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Personal Care Attendant Workforce Council
Official web site of the Massachusetts government council whose mission is to improve the PCA program. Includes information about the PCA Directory and Signing up as a PCA.
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PCA Voice
Information and updates about the health care worker union that represents MassHealth PCA workers throughout the state.
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Massachusetts PCA Directory: How It Works
Information about setting up an account, using the PCA directory, excluded individuals, and hiring tips.
MassHealth Personal Care Attendant (PCA) Program section last updated on 4/19/10
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