Personal assistants are individuals who are hired to assist individuals with disabilities and the elderly with eating, bathing, grooming, hygiene, chores, and other services, based on individuals’ needs. Personal assistants allow individuals with disabilities and the elderly to live in the community, rather than at institutions such as nursing homes.
“Personal assistants empower older Idahoans and individuals with disabilties the choice to participate in all areas of community living with our family and friends. Without their assistance many individuals with disabilities and older Idahoans would not have the opportunity to live in our own homes or work in competitive employment,” from Dana Gover’s Idaho’s Personal Assistant Survey Results (December 2011).
The State of Idaho Medicaid authorizes personal assistant services so that eligible participants can enjoy the greatest degree of self-reliance possible and enhance their quality of life, individual choice, consumer control, independence and community integration. Insurance plans also may pay for personal assistance services.
If you are covered by insurance other than Medicaid, contact your insurance company to determine the process for applying for personal assistance services. If you are covered by Medicaid, call your Regional Medicaid Services office (RMS) to request an assessment to see if you qualify for services.
- Participants approved for Medicaid Basic Plan or one of the Medicaid Home and Community Based Services waivers listed below can receive personal assistance services if medical eligibility criteria are met:
- Developmental Disability (DD) waiver
- Aged and Disabled (A&D) waiver
- A Uniform Assessment Instrument (UAI) is completed for adults requesting Personal Care Services (PCS) or A & D waiver services. The Regional Medicaid Services (RMS) nurse reviewer completes the UAI to determine whether the participant meets medical criteria. If the personal care services are authorized by the RMS, the participant (and/or his family) will create a plan of care that outlines how the selected the services are to be delivered.
If the RMS nurse reviewer determines that self-direction of services is a viable option, participants and/or their families can request the self-directed care option. This allows the participant to hire, train and fire his or her own personal assistant. Participants will be able to choose a fiscal intermediary, one of the Centers for Independent Living (CILs), that help with recordkeeping for payroll and liability insurance payments and to bill Medicaid for the personal assistance expenses.