4.2.0 Personal Care Attendants (PCA)
Louisiana Statewide Transition Project and Louisiana: Healthy and Ready to Work Fact Sheet Series
	07/28/99

I. WHY IS THIS IMPORTANT?

In today's society, no one is totally independent. Virtually every person depends on others to assist and/or support them in at least some daily tasks. Doing a task oneself is not always the most efficient way of achieving goals. Calling on the expertise and time of others allows young adults to compensate for their inability to perform essential tasks independently or quickly. By using a Personal Care Attendant (PCA), young adults with disabilities can exercise the maximum control over their lives, deciding how services are utilized according to individual needs, capabilities, life circumstances, and aspirations (Ratzka, 1997).

II. KEY POINTS

Personal Care Attendants (PCAs) can provide assistance and/or support to young adults with disabilities by helping with personal care that is related to activities of daily living. Such activities may include, but are not limited to, bathing, dressing, preparing meals, eating, housekeeping, exercising, getting around, and shopping. PCAs may provide this assistance at home, on the job, and/or in the community. By providing such services, a PCA can help foster a more independent lifestyle.

The services of a PCA can either be paid for by the young adult requiring the services or through funds received through various programs and agencies. One funding source for PCA services available to eligible young adults in Louisiana is Louisiana Rehabilitation Services (LRS). Services funded through LRS must be necessary in order to participate in activities listed on the young adult's Individual Plan for Employment or IPE (formerly known as the Individualized Written Rehabilitation Program or IWRP). It is important to remember that the primary focus of LRS and its services is employment. With this in mind, young adults who use the services of a PCA when preparing for or engaging in employment will have a greater chance of receiving funding for services through LRS.

Another funding source, the Office for Citizens with Developmental Disabilities (OCDD), provides PCA services to young adults eligible for funds through the Medicaid Home and Community-Based Waiver. In addition, young adults receiving monthly benefits through the Social Security Administration (SSA) may be eligible for Work Incentive programs called the Impairment Related Work Expense (IRWE) and Plan for Achieving Self Support (PASS). IRWE allows eligible young adults are able to deduct a portion of their PCA expenses from wages. PCA services may qualify as an IRWE if they are performed in the process of assisting someone in preparing for work, the trip to and from work, and after work (e.g., bathing, dressing, cooking, eating, etc.). With an approved PASS, SSI recipients may exclude from earnings any monies paid for equipment, services, training, or education needed for work, including PCA services.

When a PCA is needed, it is very important to carefully select the right person for the job. Conducting a personal needs assessment can help young adults identify and define tasks with which a PCA will provide assistance or support. Once the tasks have been identified and defined, the search for a PCA may begin. Once several applicants have been identified, it is necessary to gather information about them in order to make a selection. It is important to utilize several techniques in order to get a well-balanced view of each applicant. After investigating each applicant, the young adult should choose one or two to hire as PCAs. However, after a PCA is hired, the work is not over. In order to maintain a positive and effective working relationship, it is necessary to have good interpersonal skills. Finally, it should be noted, however, that sometimes conflicts do arise. Young adults must also be able to give feedback to PCAs, and even possibly know when and how to fire them. For more detailed information on interviewing, selecting, and working with a PCA, see the following related fact sheets: 4.2.1 Personal Care Attendants: Assessing Needs and Interviewing Applicants; 4.2.2 Personal Care Attendants: Selecting and Hiring; and 4.2.3 Personal Care Attendants: Working Together Effectively.

PCAs can help young adults achieve greater levels of independence and success. The support and/or assistance provided by a PCA can positively impact virtually every aspect of the young adult's life, including post-secondary education, employment, adult living, and others.

III. ROLES/NEXT STEPS

Students/Young Adults:

Young adults who depend on family members to carry out various personal care tasks should think about whether or not they will want or need the services of a PCA as an adult. As they become more independent as adults, some young adults may no longer feel comfortable relying on family members to assist or support them in personal care. If so, they should begin to investigate resources available to them for personal care assistance.

Self-advocacy and self-determination skills can be very helpful when utilizing the services of a PCA. Young adults must learn how to articulate what they want and/or need, and also how to advocate for themselves to get it. By learning and practicing self-advocacy and self-determination skills while still in high school, young adults can gain the experience needed to be successful employers of PCAs when they are adults.

Young adults should make sure that teachers, family members, and others involved in planning for the transition to adulthood are aware of their desire to utilize the services of a PCA. They should practice requesting services and/or supports, as well as providing feedback to those providing them.

Families:

Families can support young adults in their endeavor to utilize PCA services. It is helpful to give input to young adults when they are conducting a needs assessment. The perspective of those currently providing assistance is very important in this process. Family members can also provide assistance to the young adult when searching for PCA applicants, as well as when interviewing and selecting a PCA.

Families should encourage self-advocacy. Families must recognize that young adults need to develop skills that will enable them to make things happen. By encouraging young adults to speak for themselves and to make decisions for themselves, families can help foster greater independence.

Agencies:

All agency personnel involved in transition planning should support young adults in their quest to be self-determined. By listening to young adults and respecting their thoughts, opinions, and dreams, agency personnel can help young adults advocate for themselves and reach their goals. Local education agencies (LEAs) and adult agencies can offer self-advocacy/self-determination training to young adults. These skills are very useful when working with PCAs.

When requested, all adult agency personnel should attend Individualized Education Program (IEP) meetings at which transition to adulthood is discussed. LRS counselors, OCDD personnel, and others have valuable information that must be shared with teachers, families, and young adults wishing to utilize PCA services. If the young adult is already using the services of a PCA, then he/she should also be invited to be a part of the transition planning process.

IV. RESOURCES/CONTACTS

Department of Health and Hospitals

Division of Home and Community-Based Waiver Services

PO Box 91030

Baton Rouge, LA 70821

225-219-4280

Social Security Administration

Phone: 1-800-772-1213 (voice) or 1-800-325-0778 (TTY)

Internet: http://www.ssa.gov/odhome/

Centers for Independent Living:

New Horizons, Inc. (Shreveport area)

318-865-1000

Resources for Independent Living, Inc. (New Orleans area)

504-522-1955

Southwest LA Independence Center, Inc.

318-477-7194

(Each center has satellite offices in surrounding communities)

Louisiana Rehabilitation Services (LRS)

925-4131 (in Baton Rouge) or 800-737-2958*

Office for Citizens with Developmental Disabilities (OCDD)

225-342-0095*

(*Contact these state offices in order to get the number of the regional office nearest you.)

V. REFERENCES

Ludlow, Catherine D. (1995). Getting From Here to There: A Manual on Personal Assistance, The Training Partnership Project: A. J. Pappakikou Center.

Ratzka, Adolf D., (1997). Personal assistance: Towards an operational definition, Stockholm, Sweden: Personal Assistance Network, Institute on Independent Living. [available via internet: www.independentliving.org/ToolsforPower/Tools15.html]

Ulicny, Gary, R., Jones, Michael, L. (1987). Step by Step Guide for Training and Managing Personal Care Attendants, Research Training Center on Independent Living: University of Kansas.