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The Personal Care Services Program (PCS), also referred to as the Personal Care Assistance Services Program, is a funded option through Alaska’s state Medicaid plan. Via this program, in-home personal care services are provided to qualified Alaskan seniors and individuals with disabilities. Personal care services are defined as providing assistance with Activities of Daily Living (ADL), such as eating, dressing, and toileting, and Instrumental Activities of Daily Living (IADL), such as meal preparation and assistance with medications.
Services under Alaska’s PCS program can be obtained using the state agency personnel to manage the program: this is referred to as the Agency-Based PCA Program or ABPCA. The state is responsible for hiring, supervising and making payments to the care providers. Alternatively, program participants can manage their own care services: this is referred to as Consumer-Directed PCA Program or CDPCA. Less formally, this type of program is sometimes referred to as Cash and Counseling, participant direction or self-directed care.
Under CDPCA, participants or their legal representatives hire, schedule and manage the individual(s) who provide personal care services. The state agency continues to be responsible for making payments to the care providers. Participants are able to hire friends and some family members to provide care. Spouses and legal guardians are not eligible to be care providers. However, other relatives including the adult children are eligible to be paid caregivers.
For eligibility, an individual must be an Alaskan resident and require assistance with a minimum of one ADL or IADL. This is determined via a functional assessment completed by a nurse. One’s disability must be verified with supporting medical documentation. However, one cannot require a level of care that is consistent to that which is provided in a nursing home facility. In addition, one must be financially qualified to receive regular Medicaid in Alaska, which is called Denali Care, as opposed to nursing home Medicaid or Home and Community Based Services (HCBS) Waivers.
The 2018 Alaska Medicaid income and asset rules for aged, blind, or disabled persons are as follows. Monthly income for unmarried, divorced, or widowed applicants cannot exceed 59% of the Federal Poverty Level (FPL). (Alaska is unique in that the state’s Federal Poverty Levels are different from the other states). As of January 2018, the FPL for a single individual in Alaska is $15,060. Therefore, the income limit is approximately $740 / month. For married couples (with both spouses applying for Medicaid), the FPL is $20,290, which at 59% of the FPL, the income limit is approximately $998.
Alaska Medicaid allows single applicants up to $2,000 in liquid assets (cash or assets that can easily be converted to cash). While that number may seem low, some high value assets are exempt, meaning they do not count towards Medicaid eligibility purposes. For example, as long as the homeowner lives in their home, or intends to return to their home, and if the home is valued under $572,000, it is exempt. A vehicle, burial trusts, household items, and personal effects may also be exempt. Married applicants, in which both spouses are applying for services, are permitted countable resources valued at $3,000.
Families who are financially ineligible for Medicaid but still cannot afford to care for a loved one might consider working with a financial advisor to re-structure their resources so that they become Medicaid compliant. This is called Medicaid Planning and thousands of families benefit from it each year. Find assistance qualifying for Medicaid in Alaska.
The types of physical assistance covered by this program include aid with the following ADLs: Mobility, such as moving from a bed to a wheelchair or repositioning of the individual in a chair, personal hygiene, such as grooming and oral care, bathing, dressing, toileting, and eating. Physical assistance is also provided with IADLs, such as help with meal preparation, housework, shopping, medication monitoring, monitoring of vitals, and transportation assistance to medical appointments.
Services can be provided in one’s home or the home of a relative. Program rules explicitly prohibit care being provided to persons who reside in assisted living residences or adult foster homes.
The PCA Program is administered by Alaska’s Department of Health and Social Services via the PCS Unit of Senior and Disabilities Services. However, the application process is managed by private agencies: A list of providers can be searched here. Select an agency from the list and contact them to begin the application process. One can also download the Personal Care Services application here.
To learn more about this program, which is available throughout Alaska, click here. Be forewarned the language on the webpage is technical and not consumer oriented. For a consumer, friendly brochure, click here.