Pursuant to a Jan 2019 record request, we obtained a copy of two subregulatory documents developed by MassHealth regarding Personal Care Attendant (PCA) services. Neither document is new, but both are currently in use at least as of Jan 2019. One is the Time for Task Guidelines, dated 11-16-11, which provides average times that it would ordinarily take to perform various personal care services. The other document is a 95 pp set of PCA Operating Standards that describe operations of the Prior Authorization Unit (PAU) dated 5-28-15. Currently, Optum is functioning as the PAU with respect to PCA services. These documents should be helpful to advocates with PCA cases.
Update: Aug 2020. We confirmed the Nov 16, 2011 Time for Task Guidelines are still in use. However, more recently, MassHealth revised its forms for the PCA assessment itself which are now filed online. Copies of the PCA assessment forms are attached.
Also attached is the federal regulation relating to PCA services: 42 CFR 440.167 and the MassHealth State Plan definition of covered state plan services obtained via a record request by a colleague in 2019
|PCA Operating Standards.pdf||2.57 MB|
|MassHealth - PCA2 Form rev. 9.5.18 nurse and OT eval with sign offs - time for task tool.pdf||336.99 KB|
|PCA1 Form rev 5.23.19.pdf||385.09 KB|
|Time-for-Tasks Guidelines for the MassHealth PCA Program.pdf||94.88 KB|
|PCA in State Plan.pdf||478.03 KB|
|PCA 42 CFR 440.167.pdf||291.32 KB|