Personal Care Services

To be eligible for PCA services in school, the child or youth must be dependent and need assistance for one or more of the activities of daily living (ADL), or require intervention or redirection from another person for level 1 behaviors.

Activities of Daily Living (ADLs)

Dependent in an ADL means the child requires cuing and stand-by supervision or hands-on assistance from a personal care assistant to begin and complete an activity of daily living.

ADLs include the following:

Dressing: Assistance with choosing, putting on and changing clothing and with application of special appliances, wraps or clothing

Grooming: Assistance with basic hair care, oral care, shaving, applying cosmetics and deodorant; ensuring clothes are clean and properly fastened; and care of eyeglasses and hearing aids (confirming batteries work, positioning aids). Nail care is included, except for a child or youth who has diabetes or poor circulation

Bathing: Assistance with basic personal hygiene and skin care

Eating: Assistance with hand washing and applying orthotics required for eating, as well as transfers and feeding

Transfers: Assistance with transferring the child or youth from one seating or reclining area to another

Mobility: Assistance with ambulation, including use of a wheelchair. Mobility does not include providing transportation for a child or youth

Positioning: Assistance with positioning or turning a child or youth for necessary care and comfort

Toileting: Assistance with bowel or bladder elimination and care, including transfers, mobility, positioning, feminine hygiene, use of toileting equipment or supplies, cleansing the perineal area, inspection of the skin and adjusting clothing

Level 1 Behaviors

A child or youth qualifies as having the need for assistance from a personal care assistant through observation, redirection or intervention of a behavior episode if the episode is due to a medical or mental health condition and requires the immediate response of another person to prevent injury to self or others, or damage to property.

Behaviors may occur at different levels and in different situations. To qualify for PCA services, the display of a level 1 behavior must be current, and determined to be either daily or episodic and ongoing (for example, four times a week).

Level 1 behaviors are defined as:

Physical aggression toward self (self-injurious behaviors)

Physical aggression toward others (physical injury to others)

Destruction of property.

Once a child or youth qualifies for PCA services, he or she may also receive assistance from a personal care assistant for redirection or intervention during a behavioral episode, when the child or youth displays increased vulnerability due to cognitive deficits or socially inappropriate behaviors, verbally aggressive and for other delegated health-related procedures and tasks.

Other Health-Related Procedures and Tasks

Health-related procedures and tasks may be delegated or assigned by a licensed health care professional under state law to be performed by a person providing PCA services.

Document delegation of health-related procedures and tasks and training in the PCA plan of care for the child or youth and in the file of the person providing the PCA services. These PCA services include, but are not limited to the following:

Range of motion and passive exercise to maintain a child’s or youth's strength and muscle function

Assistance with self-administered medication, including reminders to take medication, bringing medication to the child or youth, and assistance with opening medication containers;including medications given through a nebulizer. A PCA must not determine the medication dose or time for medication.

Interventions for seizure disorders that occur more than two times per week and require physical assistance to maintain safety

Procedures for complex health-related needs, including tracheostomy suctioning, services to a child or youth needing ventilator support and other direct cares. These are covered PCA services if delegation, training and supervision is by a registered nurse (RN), the service can be competently and safely completed, training is specialized and individualized to the needs of the child or youth, and delegation and training are documented