PERSONAL CARE ASSISTANT (PCA) SERVICES PROVIDER IN CONNECTICUT

Fatumata Kaba
Jul 8
3 min read

EMPOWERING INDEPENDENCE THROUGH HANDS-ON SUPPORT FOR INDIVIDUALS WITH PHYSICAL AND COGNITIVE DISABILITIES IN THEIR OWN HOMES

Personal Care Assistant (PCA) Services in Connecticut allow individuals with disabilities to live independently at home by providing assistance with daily tasks such as bathing, dressing, and mobility. These services are primarily authorized under the Connecticut Medicaid Personal Care Assistance (PCA) Waiver, as well as through State Plan Medicaid and Community First Choice (CFC).

1. GOVERNING AGENCIES

Agency: Connecticut Department of Social Services (DSS)

Role: Administers the PCA Waiver, CFC program, and Medicaid State Plan services, including provider enrollment and reimbursement

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight and ensures services meet Home and Community-Based Services (HCBS) waiver requirements

2. PCA SERVICE OVERVIEW

PCA services are designed to assist eligible Medicaid beneficiaries with activities of daily living (ADLs) and instrumental activities of daily living (IADLs), while promoting autonomy and community living. Participants often select and direct their own assistants through self-directed models or may work with agency-based providers.

Approved providers may deliver:

Bathing, dressing, grooming, and toileting assistance
Mobility and transfer support
Meal preparation and feeding
Medication reminders and health-related task support
Light housekeeping and laundry (related to personal care)
Documentation of tasks completed, hours worked, and individual satisfaction

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Connecticut Secretary of the State (if operating as an agency)
Obtain EIN from the IRS and NPI (Type 2)
Agency Providers must enroll as Medicaid providers with DSS
Individual PCAs working under a participant-directed model must pass background checks and be authorized by the Financial Management Service (FMS)
Maintain general liability and/or worker’s compensation insurance (agency-based)
Ensure PCAs meet training, documentation, and supervision requirements

4. PROVIDER ENROLLMENT PROCESS

Option A: Individual PCA (Self-Directed Model)

Participant selects the PCA
PCA completes background check and onboarding through the Financial Management Service (e.g., Sunset Shores, PCG)
Must meet eligibility and employment verification requirements

Option B: PCA Agency Provider

Apply through the DSS Medicaid Provider Enrollment Portal
Submit agency documentation, staff roles, policies, and task logs
Enroll under the PCA Waiver and/or Community First Choice (CFC) programs

5. REQUIRED DOCUMENTATION

Articles of Incorporation or sole proprietorship filing (for agencies)
IRS EIN Letter
NPI confirmation
DSS Medicaid enrollment confirmation
Background check clearance (for all direct care staff)
Policy & procedure manual including:
- Client intake and individual care planning templates
- Daily log sheets for ADL/IADL support
- Grievance and incident reporting policies
- Supervision and quality control measures
- Emergency procedures and abuse prevention policies
- Staff orientation, timekeeping, and training logs
- Participant rights and consent forms

6. STAFFING REQUIREMENTS

Role: Personal Care Assistant (PCA)

Requirements:

High school diploma or equivalent (preferred)
Background check and TB screening
CPR/First Aid certification (recommended)
On-the-job training or experience in caregiving

Role: Program Supervisor / Scheduler (for agencies)

Requirements: Experience in home care coordination, personnel management, and documentation oversight

Training Requirements for All Staff:

Infection control and safety procedures
Confidentiality, client rights, and HIPAA
Elder and disability abuse reporting (mandated reporter training)
Annual review of PCA roles and service documentation

7. MEDICAID WAIVER SERVICES

PCA services are reimbursed under:

Personal Care Assistance (PCA) Waiver
Community First Choice (CFC) (State Plan HCBS option)
Connecticut Home Care Program for Elders (CHCPE) – for related ADL services
Money Follows the Person (MFP) for transitional PCA support

Approved providers may deliver:

In-home assistance with ADLs/IADLs
Self-directed care models (individual PCA) or agency-based staffing
Documentation aligned with participant care plans and DSS billing requirements
Coordination with care managers and interdisciplinary teams

8. TIMELINE TO LAUNCH

Phase: Business Formation (Agency Model)

Timeline: 1–2 weeks

Phase: Medicaid Enrollment (Agency or FMS for Individual PCA)

Timeline: 30–60 days

Phase: Staff Hiring and Background Checks

Timeline: 2–4 weeks

Phase: Care Plan Assignment and Service Delivery

Timeline: Ongoing, based on referrals

9. CONTACT INFORMATION

Connecticut Department of Social Services (DSS)

Email: dss.ctmedical@ct.gov

Website: https://portal.ct.gov/DSS

Connecticut Medicaid Provider Enrollment Portal

Website: https://www.ctdssmap.com

Financial Management Services (FMS) Providers for PCA Waiver

Contact information varies by region and participant; DSS or the assigned case manager can assist

Personal Care Assistant Services in Connecticut

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — CONNECTICUT PERSONAL CARE ASSISTANT (PCA) SERVICES PROVIDER

We help individuals, family caregivers, and home care agencies launch Medicaid-compliant PCA services under Connecticut’s waiver and self-directed care programs.

Scope of Work: