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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:

  1. 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;
  2. provided by a qualified individual who is not a member of the individual's family; and
  3. 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.


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