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NC Department of Health and Human Services
NC Division of
Medical Assistance
 
 

Personal Care Services (PCS)

EFFECTIVE DATE: January 1, 2013

The Personal Care Services (PCS) program is a Medicaid State Plan benefit designed to provide personal care services to individuals residing in a private living arrangement, or a residential facility licensed by the State of North Carolina as an adult care home, or a combination home as defined in G.S. 131E-101(1a).G.S. 131E-101(1a); or resides in a group home licensed under Chapter 122C of the General Statutes and under 10A NCAC 27G .5601 as a supervised living facility for two or more adults whose primary diagnosis is mental illness, a developmental disability, or substance abuse dependency.

Personal Care Services (PCS) are available to individuals who have a medical condition, disability, or cognitive impairment and demonstrates unmet needs for, at a minimum three of the five qualifying activities of daily living (ADLs) with limited hands-on assistance; two ADLs, one of which requires extensive assistance; or two ADLs, one of which requires assistance at the full dependence level. The five qualifying ADLs are eating, dressing, bathing, toileting, and mobility.

PCS program eligibility is determined by an independent assessment conducted by the Division of Medical Assistance or its designee; and shall be provided in accordance with an individualized plan of care.

DMA Clinical Policy & Programs
Home and Community Care-Personal Care Services
Phone 919-855-4340
E-Mail: PCS_Program_Questions@dhhs.nc.gov



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Additional Information

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Important Links

Frequently Asked Questions

Announcements

  • Shared Savings Plan – Session Law 2013-360
    www.ncdhhs.gov/dma/plan
  • Release of Change of Status (COS) Notifications - April 28, 2014
  • On April 24, 2014, DMA approved release of approximately 700 notifications for beneficiaries that submitted Change of Status (COS) requests for additional hours. COS notifications were released based on the assessments conducted for the COS additional hours request because annual assessments are currently in queue for reassessment. The assessment for COS additional hours was used to determine the results for the annual assessment.
  • Note: Assessments released on April 24, 2014 will be re-evaluated for additional hours upon approval of PCS SPA 13-009. Upon the Centers for Medicare and Medicaid Services (CMS) approval of State Plan Amendment (SPA) 13-009 notification of results for COS requests submitted for additional hours per SL 2013-306 will be released.
  • If you have additional questions contact:
  • Adult Day Care FL-2
  • QIReport
    Licensed facility PCS providers who are registered on the QIReport provider interface will see notices for Maintenance of Service (MOS) if CCME has received notification of a beneficiary appeal. Providers do not need to respond to these notices. If a beneficiary’s appeal was resolved prior to January 1, 2013 through mediation, the MOS notice will be followed immediately by a notice of settlement. However, settlements reached prior to January 1, 2013 will be effective January 1, 2013 and MOS will not apply. Providers who are not registered for the provider interface will receive only the notice of settlement with the hours agreed to by the beneficiary at the time of the mediation. Neither the MOS notice nor the settlement notice require provider response to CCME.
  • Supplemental Short-Term Assistance for Individuals Living in Group Homes
  • Update PASRR Process

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Personal Care Services (PCS) Stakeholder Information 

Purpose:

To provide the opportunity for stakeholders in North Carolina who have an interest in the development and implementation of the Personal Care Services to collaborate and share their recommendations. The NC Department of Health & Human Services (DHHS) convenes on a monthly basis with community stakeholders to engage and seek their input. The meetings are designed to share project status, gather input and identify next steps.

Stakeholder Meeting Format Change:

To get involved:

Call 919-855-4340

Meeting Dates:

(Click year to expand)

2014

July 17, 2014

June 19, 2014

  • Meeting Cancelled for Medicaid LTSS Reform Meeting

May 15, 2014

April 24, 2014

March 20, 2014

February 20, 2014

January 16, 2014

2013

December 19, 2013

 

October 24, 2013

 

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