What is a PCA?

“PCA” stands for Personal Care Attendant.  A PCA is a person who is hired to assist the disabled person with Activities of Daily Living (ADLs).  The PCA is hired by the disabled person.    What are the seven activities of daily living that a PCA can assist with?

  1. Bathing
  2. Dressing/Undressing
  3. Toileting
  4. Mobility (transfers and assistance in getting from one place to another)
  5. Passive range of motion
  6. Eating
  7. Taking Medications


If you have a traumatic brain injury and if you need help in at least two of the seven areas above, then you may qualify for a PCA.    You may also need help with grocery shopping, laundry, housekeeping – these areas are called Instrumental Activities of Daily Living (IADLs) and PCAs may help with these tasks as well.

Here is a icon PCA Consumer Handbook that you may find helpful. This handbook is distributed by MassHealth.


Let’s say you do need a PCA, then:

  1. Who is going to do this work for you, and

  2. How are you going to pay for it? 



Who Can Be a PCA and how do I find one?  Anyone who you decide that you want to hire can be your PCA, except a spouse.  The candidate does need to have a social security number, does need to be of working age, and does need to be legal-to-work.  You could hire a family member, a neighbor, a person who you found on the Rewarding Work website (www.rewardingwork.org) or someone who you heard about by word-of-mouth.  Rewarding Work is a website where you can find people in your area who are looking for work as PCAs.  Simply enter your zipcode and a list of persons can be found along with information about the individual seeking work.

Being that you are the employer, then you are the person who recruits, interviews, trains and hires your PCAs.   You are also the person who “vets” your PCAs including doing a CORI (or iCORI) if needed.  A CORI is a Criminal Record Offender Information review. Doing a CORI for a potential PCA is of no cost to you as a MassHealth consumer and is recommended by the Rewarding Work website.  For further information, you can go to the Rewarding Work website or you can go to the Massachusetts Department of Criminal Justice Information Services.


How Do I Train My PCA?  If you are a patient at Spaulding Hospital, we will assist you in training your potential PCA.  Together, we will schedule a time for your potential PCA to come into Spaulding and to spend the morning with your nurse, PT and OT and you. If you are not a Spaulding patient, you will need to work 1:1 with your PCA to show them the level of assistance that you will need, and how he/she can help you complete these tasks. MassHealth will deterimine for which activities you need help, and for how long they will take. 


Paying for a PCA:  In Massachusetts, we have the MassHealth PCA Program.  If you have MassHealth, then MassHealth will pay for the PCA.  It works like this:  the disabled person would be evaluated by MassHealth as to the number of hours per day of help that they need.  The average number of hours that a disabled person would be evaluated for is about 4 -6 hours per day.  The disabled person then becomes an Employer through the Program.  The disabled person then hires people to work, keeps track of the hours that each of his/her employees does work, submits timesheets (just like any employer would), and the employees are paid by MassHealth. The rate of pay is $12.68 per hour.  

The obvious next question is:  how do I get MassHealth?  In Massachusetts, there is a program called MassHealth CommonHealth.  It is a part of health care reform in Massachusetts which allows for an individual who has a disability, to have access to MassHealth coverage; coverage which will pay for a PCA.  Note that no other insurance pays for PCA help.  At Spaulding Rehabilitation Hospital, we know how to help people get MassHealth in an efficient way so that by the time of discharge, the disabled person has MassHealth and has the PCA Program in place.


We hope that you find this information helpful.  If you need further information, you may speak with your Case Manager.