Medicaid self-directed care
Personal Choice Program
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- Who qualifies
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People eligible for Medicaid long-term services and supports who are 65 or older, or 18 or older with a disability, and who have a high or highest need for level of care. They must be able to direct their own care, or have a qualified designated representative to do it, and want to stay in or return to their home.
The participant hires their own Personal Care Aides (PCAs) and is the employer. A fiscal intermediary handles payroll. People with a developmental disability served by BHDDH need approval from BHDDH and EOHHS Medicaid.
Source: 210-RICR-50-10-2, Self-Directed Care (Executive Office of Health and Human Services, effective 02/12/2024)Checked
- Can a family member be paid
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Yes. Yes. Personal Choice participants can hire friends, neighbors or family members as their personal care attendant (PCA), advertise for one, or use the registry. Spouses, legal guardians, financial powers of attorney and participants' representatives cannot be a PCA.
Every PCA must pass a National Criminal Background Check, which the fiscal agency arranges. The participant is the employer and decides the PCA's wage within the range the state sets.
- Can a spouse be paid
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No. No. A person cannot work as a PCA if they are the participant's spouse.
The participant's representative, financial power of attorney or Social Security Representative Payee also cannot be a PCA.
Source: 210-RICR-50-10-2, Self-Directed Care (Executive Office of Health and Human Services, effective 02/12/2024)Checked
- Can a legal guardian be paid
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No. No. Legal guardians cannot be a PCA in Personal Choice, and neither can financial powers of attorney or the participant's representative.
- Pay rate
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The participant decides the PCA's hourly wage, which can range from $15.00 up to $21.00 per hour.
The monthly budget is set by EOHHS from the functional assessment and does not cover companionship, watching or general supervision.
Source: 210-RICR-50-10-2, Self-Directed Care (Executive Office of Health and Human Services, effective 02/12/2024)Checked
- Hours limit
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The participant must make sure each PCA's hours do not exceed 40 hours per week.
Source: 210-RICR-50-10-2, Self-Directed Care (Executive Office of Health and Human Services, effective 02/12/2024)Checked