Personal Care Services
Personal care services are an optional Medicaid benefit provided
to individuals who are not inpatients or residents of a hospital,
nursing facility, intermediate care facility for the mentally
retarded, or institution for mental disease. This program should
not be confused with long term care insurance. Personal care
services must be:
- authorized for an individual by a physician in accordance
with a plan of treatment or (at the State's option) otherwise
authorized for the individual in accordance with a service plan
approved by the State;
- provided by a qualified individual who is not a member of
the individual's family; and
- furnished in a home or other location.
Personal care services may include a range of human assistance
provided to persons with disabilities and chronic conditions
of all ages which enables them to accomplish tasks that they
would normally do for themselves if they did not have a disability.
Assistance may be in the form of hands-on assistance or cueing
so that the person performs the task by him/herself. Such assistance
most often relates to performance of activities of daily living
(ADLs) and instrumental activities of daily living (IADLs), which
includes assistance with daily activities such as eating, bathing,
dressing, toileting, transferring, personal hygiene, light housework,
medication management, etc. Personal care services can be provided
on a continuing basis or on episodic occasions. Skilled services
that may be performed only by a health professional are not considered
personal care services.
March 11, 2010
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