When mom starts to need help getting dressed in the morning, preparing her meals, or keeping her medications straight, it’s often a daughter or another family member or friend who steps in to help. Spending time helping with these activities of daily living can be very rewarding, but for a caregiver, it can also mean missed time at work and a strain on resources. That’s where the Personal Care Attendant (PCA) Program can help. Paid for by MassHealth and administered by AgeSpan, this program allows older adults and people with disabilities to choose their own PCA worker, so those family members can be paid for caregiving.
“The PCA program is really meant to empower the consumer to be independent in their daily care,” says Director of Managed Care Programs Luilly Vasquez. “It gives them the ability to hire a family member or a friend, someone they know and trust to take care of their personal needs.”
With training and guidance from AgeSpan Skills Trainers, consumers in the program learn what it takes to be employers and how to hire and manage their own PCA workers. Following a comprehensive assessment, AgeSpan Skills Trainers help them understand their care plan and how to hire, schedule, and pay their PCA worker.
“We want the consumer to feel as independent as possible,” says Skills Trainer Rosa Falette. “This program is all about giving them a voice in their own care and who comes into their home.”
Trust and understanding
Whether they are hiring a family member or friend, or need to search for someone to provide care, Skills Trainers give them the tools to manage the responsibilities of the program. Consumers cannot hire a spouse, guardian, or surrogate to be their PCA worker, but they can hire anyone else they would like, if the worker meets employment requirements in Massachusetts.
Having the choice of caregivers also means older adults can choose someone who makes them feel comfortable, which can be especially important for culturally and linguistically diverse communities.
“To have someone who speaks their language and understands their culture, it helps the consumer take that leap of trust,” Vasquez says. “This program lets them hire that family member or that person who really understands them.”
If an older adult is unable or unwilling to manage their own care, they can appoint someone to manage it for them.
“It’s a self-managed program so we do an assessment to see if they can manage it,” says Falette. “Even if they have a surrogate to administer the entire program, they still have a say. We want them to feel as independent as possible.”
Ongoing support
Skills Trainers offer one-on-one support to their consumers, especially in the first year. But once they become comfortable with the program, most consumers require very little ongoing support to stay independent. If anything comes up, a staff member of the PCA program is always available during business hours to answer questions.
“Every case is different, but we always start with compassion and patience,” Falette says. “With a little assistance, consumers can manage things on their own. It’s a wonderful feeling when that lightbulb goes off and the consumer gets it.”
Filling a gap in care
In order to qualify for the PCA program, an older adult must be on Medicaid with MassHealth Standard or CommonHealth or be enrolled in a Senior Care Options (SCO) or OneCare plan. They must be living with a chronic condition or disability and need help with at least two daily activities such as bathing, dressing, or mobility.
The program accepts people of all ages, with current participants ranging from age 3 to over 100. It continues to grow, with more than 4,200 consumers currently enrolled. At a time when many agencies struggle to hire care workers, the PCA program fills an important gap by allowing consumers to hire someone they know and trust.
“Our whole philosophy with consumers is that yes, you can do it,” says Vasquez. “We’re here to support you every step of the way to ensure that you are successful.”
At its heart, the PCA program is about dignity, choice, and independence. If you or someone you love could benefit, visit the Care Options & Services page on our website to learn more.
