Providing Services for all Disabilities

Personal Care Attendant Program

The Personal Care Attendant (PCA) Program is a MassHealth program that assists people with long-term disabilities live at home independently. This is a consumer-directed program, which provides personal care services for people with disabilities.

Through our PCA Program, the Options program serves about 3,500 individuals living in Massachusetts, including Cape Cod and the Islands. This program serves people of all ages, disabilities and backgrounds. Options has staff who speak Spanish, Portuguese, Cape Verdean Creole, Arabic, Russian, and English.

Personal Care Attendants are hired, trained and supervised by the person with the disability (consumer). PCAs do not work for OPTIONS, or any other agency - they work for the consumer. As the employer, a consumer chooses who to hire, sets up a PCA schedule and trains PCAs to meet his or her own personal needs. PCAs are paid based on timesheets that are sent to the Fiscal Intermediary.

If the consumer cannot independently manage his or her PCA program, the consumer may have the help of a surrogate. The surrogate is often a family member but may be any other person identified by the consumer who has the ability to manage the program.

For the Official Website of the Personal Care Attendant Quality Home Care Workforce Council please click here

PCAs can help with Activities of Daily Living (ADLs) such as:
  • mobility/transfers
  • passive range of motion
  • taking medications
  • bathing or grooming
  • dressing or undressing
  • eating
  • toileting

PCAs can also help with Instrumental Activities of Daily Living (IADLs) such as:
  • laundry
  • shopping
  • housekeeping
  • meal preparation and clean-up
  • transportation to medical appointments
  • maintaining adaptive equipment

If a consumer needs help at night, such as for repositioning or toileting etc., PCA time can be approved for Night Attendant services.

PCA time is NOT approved for:
  • babysitting
  • recreation
  • advocacy
  • cueing, prompting, guiding or coaching
  • supervision
  • safety

Payroll and tax filing and reporting are usually handled by the Fiscal Intermediary, although some consumers do choose to handle this function themselves. PCAs are covered by Workers Compensation and Unemployment Insurance.


The Personal Care Attendant program is available to people with disabilities who meet the following conditions:

  • Personal Care Services are prescribed by a physician or nurse practitioner
  • Have a permanent or chronic disability that impairs their ability to perform activities of daily living without physical assistance.
  • Needs physical assistance with two or more activities of daily living

Consumers must be able to manage the PCA program themselves, or have someone available to help them as surrogate of legal age.


If an individual is not eligible for the PCA program, Options’ staff will help the consumer to identify other services that might meet their needs. These services might include:

  • Home Health Aides
  • Elder Services – for more information, go to
  • Homemakers – for more information, go to:
  • Respite
  • Flexible family support
  • Hospice
  • Group Adult Foster Care
  • Resource Department


Options works with individuals referred to us by:

  • Consumers themselves
  • Visiting Nurse Agencies
  • Hospitals
  • Doctors
  • State and local agencies
  • Community organizations
  • Friends
  • Families

Each Options consumer is assigned to a Skills Trainer, who helps the consumer through the application process, and gives the consumer and/or surrogate the training they need to manage their PCA program. Options provide the initial evaluation, which results in a recommendation as to the number of hours. PCA services are approved and paid for by MassHealth, which has the final approval on whether a consumer is eligible for the PCA program, and if so, on the number of hours per week which a consumer may use. Approvals are usually good for one year. Annual re-evaluations are done by our RN consultants.

It takes about two to three months to complete the evaluation and approval process. During this time, consumers may continue receiving services from other sources.

If you would like to find out more about the PCA Program please call the program office, toll free at: (800) 924-7570