PCA Program: Best Kept Secret

The Personal Care Attendant (PCA) program is one of the best kept secrets in the state. The PCA program is for people on MassHealth (Medicaid) who have a chronic disability that requires them to have help living independently at home. Someone who needs help with two or more supports--like bathing and dressing--would qualify. One of the unusual features of this program is that the individual with disabilities gets to hire the person who helps take care of them. This "attendant" can be a friend, or even a family member. Spouses, however, are currently not allowed to be a paid PCA.

These workers are able to provide for a wide range of personal care needs, like eating, bathing, dressing, walking, taking medications, etc. They can also help with shopping, cooking and cleaning.

The consumer has the power to hire and fire their worker, but the details of payroll and taxes are handled by an outside agency. This program is especially good for someone who wants to play a direct role in selecting the person who will provide their personal care support at home.

We say this is a "secret" program, because of the total enrollment, only 1 in 4 consumers are over the age of 65. The PCA program has been around since the 1970s, but today there are only 15,000 people using this help-and less than 4,000 of them are seniors. As the program become better known, more elders are enrolling.

The MassHealth program pays for this service, and around $265 million in salaries are paid to PCAs in the Commonwealth. Today there are 28 agencies that manage this program for consumers---but the service is available regardless of where you live in Massachusetts. The average annual benefit under the PCA program is $17,500-which is roughly 6 times higher than the annual benefit in the state's home care program. Yet there are 8 times as many elders in the home care program than in the PCA program.

In the spring of 2006, the state allowed family members for the first time to become paid caregivers under the PCA program. Today, more than 2,000 family members are being paid to be personal care attendants. One of the most significant changes in the PCA program came in early November, when it was announced that 94% of the 22,000 PCA home care workers had voted to form a union. The state currently pays personal care assistants $10.84 an hour, with no benefits or health insurance coverage, and no sick days or vacation time. This means that PCA workers will now negotiate wages directly with the state. Higher wages and benefits should improve the availability of workers, and make it easier for the disabled to find someone to care for them.

Somerville-Cambridge Elder Services offers the PCA Program in a number of communities in the Greater Boston area. For more information, call the Aging Information Center at SCES at 617-628-2601 ext. 3201