What is PCA Service?

A Personal Care Assistant, or PCA, is employed by an agency that provides personal care assistance to elderly and disabled citizens of all ages. While some PCAs may be responsible for providing care for many people who are not relatives, it is possible for family members to become a PCA solely for the purpose of caring for a relative. There are exceptions to which relatives can provide care. Those not eligible to be a PCA for a relative are:

  • Parents and stepparents caring for underage children
  • Paid legal guardians for adults
  • Foster parents
  • Spouses

  • As well, people who are themselves receiving PCA services are not eligible to become PCAs for others.

    Once the background study has cleared and the person is hired by the agency, the PCA may provide a variety of assistance to their client. This typically involves help with Activities of Daily Living like bathing, dressing, eating, and mobility (not an all-inclusive list). Some PCAs accompany the client to doctor's appointments and to run errands. They may provide mental stimulation and physical exercise, like taking walks and assisting with range of motion exercises. The tasks that the PCA performs are determined by the Lead Agency's assessment according to the needs of the recipient.

    How to Become a PCA

    Anyone who wants to become a PCA is required to complete DHS Individualized Personal Care Assistance training. The test is offered online for free and consists of approximately 25 multiple choice questions. One cannot get more than 6 questions wrong in order to pass. This test can be taken over immediately if not passed, and as many times as necessary to pass it. There are modules that can be read before taking the training, however, these are not required, though can be very helpful. Registration is necessary in order to take the training and a valid email address will be required so that the certificate can be emailed to the PCA. The agency will also need to get a copy of this certificate from the PCA in order to enroll the PCA with DHS. It's recommended that the PCA keeps the email with the certificate for their records.

    After applying with the agency to work as a PCA, the applicant must pass a background check and provide the PCA Training Certificate to the agency in order to be hired. This certificate is required to enroll with the State of MN as a PCA. Enrollment is required in order to bill for the services provided to the client and to compensate the PCA for the work they've provided.

    Minnesota PCA Program

    The Minnesota Department of Human Services (DHS) offers two PCA programs: PCA Choice and PCA Traditional. The recipient/client must be enrolled in at least one of Medicaid, Elderly Waiver, Minnesota Alternative Care or Minnesota Senior Health Options to be eligible. Qualifying for one of these programs means that the individual has low income and is over the age of 65 or disabled, or a child with diagnosed conditions that requires additional help. The recipient must have an assessment done by a Lead Agency to determine eligibility and then once this is completed, the recipient is responsible to choose an agency to provide services.

    If the recipient elects to be under the PCA Choice Program, the recipient must find their own PCAs to work for them, to have adequate backup plans, be able to self-schedule and manage their total amount of hours for each 6 month service period, and be comfortable in discipline and possible termination of their PCA. Some recipients (mostly those under 18) have a Responsible Party designated to them. The RP is then responsible for all the Choice program requirements. If the recipient chooses to be under the PCA Traditional Program, then the agency is responsible for staffing the client's hours.
    Minnesota law requires that the PCA be able to effectively communicate with the recipient and the agency and have the skills necessary to provide the required help to the recipient. PCAs are required to keep daily written records and to report any changes in the condition of the recipient to the agency.

    A PCA can provide a maximum of 275 hours of care each month per the Department of Human Services. This number does not change regardless of how many clients and/or agencies the PCA works for. The PCA, if they work for more than one agency, must keep close track of the monthly hours worked between all employers, to make sure not to exceed the 275 monthly hours. DHS does enforce consequences if the employee exceeds the 275 hourly maximum number of hours.

    Eligibility Guidelines

    In order to work as a PCA for Heartland PCA, an employee must be at least 18 years of age. Prior to becoming a PCA in Minnesota, one must first complete the required training and pass the certification test. Without passing this test and providing a certificate to Heartland PCA, an individual cannot enroll as a PCA in the state of Minnesota.

    A criminal background check will be conducted prior to beginning employment. This background study is a requirement of the state and includes in-state, out-of-state and FBI checks. Anyone who cannot pass this background check will not be able to become a PCA. Because the qualifications and disqualifications are determined by the State of MN, Heartland PCA cannot make any exceptions in order to allow someone to work as a PCA. Upon clearing the background check and being hired, the individual must enroll as a PCA with the Minnesota Department of Human Services. This process is done by Heartland PCA after the enrollment application is completed by the employee.

    What services can a PCA provide?

    Much of what the PCA can assist the client with depends upon what the recipient has been assessed for by a Lead Agency. A care plan is created between the client and the Qualified Professional (QP) at Heartland PCA. Among tasks often included in the care plan are:

  • Dressing
  • Toiletring
  • Bathing
  • Grooming
  • Meal Prep
  • Transfers
  • Mobility
  • Behavior Redirection

  • For people 18 years and older, Instrumental activities of daily living (IADLs) are also often included. IADLs include:

  • Accompany to medical appointments
  • Accompany to participate in the community *
  • Shop for food and other essential items
  • Assist with paying bills
  • Plan and prepare meals
  • Complete household tasks

  • *A PCA may accompany a person to a community activity if the activity is included in the care plan. Accompany means to "ride along" if the person uses public transportation, medical transportation, or other ride share services, and will need help upon reaching the location. PCA agencies must approve any other transportation prior to the attending of the activity. There is no PCA reimbursement for mileage for transportation.

    What can a PCA not do?

    PCAs are not allowed to transport minors (under 18 years old). This applies even for those working under the Choice program. When transporting clients over 18 years of age, after receiving approval from the agency, only the PCA and the client are allowed to be in the vehicle. No other passengers must be present. Overtime (over 40 hours in 1 week) is not permitted unless it's been preapproved by Administration at Heartland PCA. Do not ask the recipient to sign blank timesheets. The hours being worked belong to the recipient, not the PCA.

    Fraud

    You are breaking federal law if you:

  • Provide false information by claiming hours that you did not actually work.
  • Sign the name of someone else such as the person receiving services.
  • Complete and sign a timesheet for another PCA.

  • Some examples of fraud investigated by DHS include the following:

    1. A person complained that she had not received services from her PCA agency for three months. However, the PCA agency received payment for more than 700 hours of service for those same three months. The individual stated that she signed blank timesheets on some occasions.

    2. A mother had a child receiving PCA services. The mother admitted to the Surveillance and Integrity Review Section (SIRS) that she proposed an arrangement where she and the PCA shared the state's payment for services. The mother signed the timesheets even when the PCA did not provide services. DHS recovered over $4,500 in fraudulent payments.

    3. A PCA agency claimed hours for services to seven people on dates when all seven people were in the hospital. People receiving services are not eligible for PCA services during a hospital stay. Under Minnesota law, theft of any amount of public funds is a felony. PCA service is paid with public funds through the state's Medical Assistance program. You are breaking the law if you claim even one hour of PCA services on your timesheet that you did not provide. This means you must be accurate in the hours of service you report on your timesheet.
    To avoid fraudulent behavior, only document hours of work when you are present in your role as a PCA and when you engage in PCA work activity based on the care plan.

    Do not:
  • Accept money when you have not done the work
  • Add hours of PCA service after the person has signed the timesheet
  • Ask the person to sign a partially completed timesheet so the person is unable to verify the hours worked before the timesheet is submitted
  • Claim more hours of work with the understanding that the hours will be made up at a later date
  • Fill out a timesheet for days you do not provide any PCA services (for example, the person receiving services is in the hospital or a nursing home).

  • A PCA cannot claim hours for work if the client is at the PCA's home. If the client chooses to visit the PCA in the PCA's home, the visit must occur outside of the PCA's hours of work for that person. The PCA cannot claim hours worked if the PCA is in the client's home but taking care of the client or PCA's own children. The PCA cannot claim hours worked if the client is not in the home; this includes for hospitalization, being at a doctor appointment, or simply going for a walk. The client must always be in their home when the PCA is working.

    There are severe penalties for falsely claiming hours worked: You may be:
  • Disqualified from working at a job that receives Medicare and Medicaid funding which includes Minnesota Medical Assistance for five (5) years
  • Fired by your employer
  • Prosecuted and convicted of fraud which may affect other jobs in the future
  • Required to repay the money
  • Sent to jail
  • Unable to apply for and receive low-income housing assistance, food assistance or state medical assistance

  • The Minnesota Department of Human Services has an area responsible to look for and investigate suspected fraud. The Surveillance and Integrity Review Section (SIRS):
  • Conducts post-payment review of claims to determine the accuracy of the payment
  • Investigates reports received on the SIRS Hotline
  • Measures performance and quality of services provided by DHS.

  • When you enroll as a PCA with DHS, you must sign a Provider Agreement for Individual Personal Care Assistant form. Your signature indicates you are agreeing to help the Medicaid Fraud Control Unit and to give details on payments claimed for services under the Medical Assistance program. You should always report any suspected improper billing practices to the SIRS Hotline and you will remain anonymous to those who are being investigated.

    Above all, to be a PCA, one must want to care for those who need help to remain in the place they love the most: their home!