Intro to Personal Assistance Services

Personal Assistance Services (PAS) are services that another person provides to a person with a disability. These services can include help with:

• Home activities, such as bathing, dressing, cooking, toileting, and remembering things
• Community activities, such as shopping, going to the doctor, and help getting around
• Work activities, such as reading, sign-language interpretation, and lifting or reaching

The key thing about all of these services is that they can allow you to live your day-to-day life.

Finding Personal Care Assistants

Generally, you have three options for finding a Personal Care Assistant (PCA):

1. Through a PAS agency
2. By getting a personal recommendation or looking online
3. By having a family member or friend provide you with these services

If your PCA is funded by a Medicaid waiver program, usually your waiver case manager will find and hire your PCA through an agency. If you already know a PCA at the agency who you would like to have as your attendant, you can ask for that specific PCA. Or you might tell the agency some preferences you have, like a female assistant or one who speaks Spanish, and the agency can find somebody who has those qualifications.

If you are getting your services through a Medicaid waiver, you may have the option to self-direct your personal support services, which means you could hire a PCA on your own without going through an agency. However, even if you choose to self-direct, you won’t have to worry about handling the PCA’s paycheck or doing tax withholding, because Medicaid provides those financial services.

If you have Medicaid waiver funding for PAS and would like to hire your family member as your PCA, Medicaid may pay for it—it depends on your situation. Read more about when Medicaid may pay for a family member to be your PCA.

If you do not have a Medicaid waiver and are paying for your PCA yourself, or if you have a waiver and choose to self-direct your services, you will have to find and hire your own PCA, do any necessary training, and also handle firing the PCA if they are not doing a good job.

If you’re paying for your PCA yourself, you’ll also have the responsibility of paying your attendant and doing other paperwork, such as dealing with Social Security taxes.

Ensuring a Good Relationship

You will be spending a lot of time with your Personal Care Assistant (PCA) and it is very important that you communicate well with each other and have a good relationship. You’ll also need to learn about how to hire somebody, train the person, handle payments and payroll taxes, and more. A lot of responsibilities come with having paid assistance, although you can avoid some of them if you get your PCA through an agency.

Personal Assistance Services can be crucial to your ability to live independently. For more information on how to hire and communicate well with your personal assistant, as well as other tips, take a look at the following resources:

• Making the Move to Managing Your Own Personal Assistance Services (PAS): A Toolkit for Youth with Disabilities Transitioning to Adulthood is a complete guide with fact sheets and tips about the same topics, but with a focus on youth.
• A Good Job is a six-minute animated video that talks about how to improve your relationship with a Personal Care Assistant.