Personal Care Assistant (PCA) Services

PCA services are non-emergent, on-going health related tasks performed by qualified staff in a NJ FamilyCare eligible beneficiary’s home. The purpose of the program is to accommodate long-term/chronic or maintenance health care, as opposed to short-term skilled care as is provided under NJ FamilyCare's home health program. The number of hours authorized is based upon medical necessity, as determined by a nursing assessment. An estimated 22,000 people receive this service at any given time.

Services Provided

PCA services may include assistance with the following:

Activities of Daily Living (ADLs)
May include, but are not limited to:

  • care of teeth and mouth
  • grooming, such as care of hair, including shampooing
  • shaving, and the ordinary care of nails (can only file)
  • bathing in bed, in the tub or shower
  • using the toilet or bed pan
  • assistance with feeding
  • assistance with dressing
  • ambulation indoors and outdoors, when appropriate
  • helping the beneficiary in transferring from bed to chair or wheelchair, in and out of tub or shower

Instrumental Activities of Daily Living (IADLs)
May include, but are not limited to:

  • planning, preparing and serving meals
  • relearning household skills
  • accompanying the beneficiary to clinics, physician office visits and/or other Medicaid reimbursed service trips made for the purpose of obtaining medical diagnosis or treatment to otherwise serve a therapeutic purpose (cannot use aide’s personal car)

Household Duties (essential to the beneficiary's health and comfort)
May include, but are not limited to:

  • care of the beneficiary’s room and areas used by the beneficiary (sweeping, vacuuming, dusting)
  • care of kitchen, including maintaining general cleanliness of refrigerator, stove, sink and floor, dishwashing
  • care of bathroom, including maintaining cleanliness of toilet, tub, shower and floor
  • care of beneficiary’s personal laundry and bed linens
  • necessary bed-making and changing of bed linen with beneficiary in or out of bed
  • rearranging of furniture to enable the beneficiary to move about more easily in his or her room
  • listing food and household supplies needed for the health and maintenance of the beneficiary
  • shopping for above supplies, conveniently storing and arranging supplies and doing other essential errands

Please note:

Assistance with household duties can not be performed as a stand-alone service. Such assistance is only available when the beneficiary also requires assistance with ADLs or IADLs.

Eligibility

In order to qualify for PCA services, recipients must:

  • Obtain a doctor's order to receive the service (do not have to be permanently disabled)
  • Live in a community-based residence (private home, apartment, rooming house, or boarding home) or group home, skill development home, supervised apartment or other congregate living program where personal care is not provided as a part of the service package included in the living arrangement
  • Have a documented need for hands-on personal care

Accessing Services

PCA services are administered directly through a members NJ FamilyCare managed care organization (MCO). To apply for services, please contact your MCO directly.

Not Yet Enrolled in an MCO?

For those NJ FamilyCare members who are not yet enrolled in an MCO, PCA services are available on a fee-for-service basis.

To use fee-for-service PCA benefits, contact the Medical Assistance Customer Center (MACC) serving your county for assistance.

Related Links

Related Links