PERSONAL CARE SERVICES PROVIDER IN RHODE ISLAND

Fatumata Kaba
Oct 9
3 min read

SUPPORTING INDEPENDENCE, DIGNITY, AND DAILY FUNCTIONING FOR ELDERS AND INDIVIDUALS WITH DISABILITIES THROUGH COMPASSIONATE IN-HOME SUPPORT

Personal Care Services (PCS) in Rhode Island are non-medical supports funded by Medicaid to assist individuals who need help with activities of daily living (ADLs) such as bathing, dressing, mobility, and meal preparation. These services enable individuals to remain safely in their homes and avoid institutional care. PCS are offered through Rhode Island Medicaid’s Long-Term Services and Supports (LTSS) system and may be authorized under State Plan benefits or the Home and Community-Based Services (HCBS) Waiver programs.

1. GOVERNING AGENCIES

Agency: Rhode Island Executive Office of Health and Human Services (EOHHS)

Role: Administers Medicaid programs, including PCS and LTSS authorizations.

Agency: Office of Healthy Aging (OHA)

Role: Manages the state’s Aging and Disability Resource Center (The POINT) and may refer individuals to PCS providers.

Agency: Centers for Medicare & Medicaid Services (CMS)**

Role: Regulates Medicaid LTSS programs under federal HCBS guidelines.

Agency: Rhode Island Department of Health (RIDOH)

Role: Licenses home care agencies and monitors health and safety standards for in-home services.

2. PERSONAL CARE SERVICES OVERVIEW

PCS support individuals who are medically stable but need daily assistance to maintain independence at home.

Approved providers may deliver:

Assistance with ADLs: Bathing, grooming, dressing, toileting, eating, and mobility.
Meal Preparation & Light Housekeeping: Cooking meals, washing dishes, laundry, and tidying the home.
Supervision & Safety Monitoring: Ensuring a safe environment for individuals with memory loss or fall risks.
Medication Reminders (non-clinical): Encouraging adherence to prescribed medications.
Accompaniment to Appointments: Escorting individuals to local appointments or errands (non-medical transport only).
Care Documentation: Visit notes, ADL task checklists, incident reporting, and service verification.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business entity with the Rhode Island Secretary of State.
Obtain a Federal EIN and Type 2 NPI.
Apply for licensure as a Home Care Provider Agency through RIDOH.
Enroll as a Medicaid PCS provider via the Rhode Island Medicaid portal.
Maintain general liability and workers’ compensation insurance.
Develop a Personal Care Services Policy & Procedure Manual aligned with RIDOH and Medicaid requirements.

4. RHODE ISLAND PROVIDER ENROLLMENT PROCESS

Step 1: Form your business entity and obtain EIN and NPI.

Step 2: Apply for Home Care Agency licensure through RIDOH.

Step 3: Enroll in the Rhode Island Medicaid program as a PCS provider.

Step 4: Submit all required documentation, including policy manual, staff credentials, and insurance.

Step 5: Receive approval and begin accepting service authorizations and referrals.

5. REQUIRED DOCUMENTATION

Articles of Incorporation and business registration
EIN and NPI confirmation
RIDOH Home Care license
Insurance certificates (general, workers’ comp)
Personal Care Services Policy & Procedure Manual including:
- ADL task procedures and client intake process
- Emergency protocols and incident response
- Participant rights and consent forms
- Daily visit note and billing templates
- Staff training, supervision, and documentation standards
- HIPAA compliance and abuse prevention policies

6. STAFFING REQUIREMENTS

Role: Personal Care Aide / Homemaker

Requirements: Completion of PCA training (per RIDOH-approved curriculum), background checks, CPR/First Aid preferred.

Role: Registered Nurse (Supervisor)

Requirements: Active RI license; provides initial assessments, oversees care plans, and trains direct care staff.

Role: Scheduler / Program Coordinator

Requirements: Coordinates caregiver assignments, documentation collection, and compliance.

All staff must complete:

HIPAA and confidentiality training
Abuse recognition and mandatory reporting
Documentation and billing training
Annual in-service training (minimum hours required by RIDOH)

7. MEDICAID WAIVER PROGRAMS

PCS are reimbursed under the following programs:

Rhode Island Medicaid State Plan PCS Benefit: For eligible individuals requiring ADL assistance.
Global Consumer Choice Compact Waiver (1115 Waiver): Covers PCS and other HCBS under integrated managed care.
PACE RI & Medicaid Managed LTSS Plans: Provide PCS through contracted agencies.
Temporary Disability Programs (State-funded): May offer PCS for limited durations.

8. TIMELINE TO LAUNCH

Phase: Business Registration & Policy Manual Development

Timeline: 1–2 months

Phase: RIDOH Licensure & Medicaid Enrollment

Timeline: 2–3 months

Phase: Staff Hiring, Credentialing & Training

Timeline: 30–60 days

Phase: Referral Activation & Service Launch

Timeline: Begins upon approval by Medicaid and RIDOH

9. CONTACT INFORMATION

Rhode Island Executive Office of Health and Human Services (EOHHS)

Website: https://eohhs.ri.gov