Also known as “Natural Support”

• Provides natural support to the Medicaid member.
• Must be 18 years or older.
• Must see the Medicaid member regularly.
• Is an unpaid role, and an unpaid PCG qualifies the Medicaid member to receive respite hours.
• Handles medications as part of daily care.
• In some cases, the PCG can also be the Personal Care Attendant (often referred to as the Attendant or the Aide); however, if the PCG is paid as the attendant, the Medicaid member will no longer qualify for respite hours.

Backup

• This is an uncompensated role.
• Assures that someone is available if the Primary Care Giver (PCG) or the attendant cannot be with the individual.
• Cannot be a Paid Attendant.
• Cannot be the Primary Care Giver (PCG).
• Can be the Employer of Record (EOR) IF the EOR is NOT also the Primary Care Giver (PCG).
• Can be a Family Member or Friend.

The Personal Care Attendant (PCA), sometimes called an aide, is employed by the Employer of Record (EOR) to provide care and support for the Medicaid member.

• Must be 18 years or older with a valid Social Security Number (SSN)
• Must pass a background screening
• Must be able to perform the duties required to provide personal care or supports for the Medicaid member
• Hired by the EOR and reports directly to the EOR
• If the attendant is the parent of a minor or the spouse of the Medicaid member, they are considered a Legally Responsible Individual (LRI) and can only work a maximum of 40 hours per member and the member is not eligible for respite hours
• The EOR or backup can never be the attendant

All DD waivers (CL/FIS) require that EORs attempt to hire attendants outside of the home first before hiring a live-in attendant. Objective Written Documentation (OWD) shows what efforts were made to hire externally but were unsuccessful. Personal preference alone cannot be used as justification.

You must select at least one of the following justifications and provide supporting evidence/documentation.

Unable to Hire Staff

• Interview notes or summaries showing attempts to hire
• Documentation showing high staff turnover
• Copies of job advertisements (with location/images) posted by the EOR
• Please ensure you use language descriptive of “attendant care” “personal care” and avoid language such a “babysitting
• Employment ad must be fair in requirements to hire, and inclusive of EOR contact information (name/email/phone number)

Special Behavioral Needs

• Active behavioral support plan (provide copy or SC verification)
• Referral for behavioral support (SC to verify)

Special Medical Needs (Non-Skilled)

• Physician letter outlining medical needs requiring care by a family member/live-in attendant

Language Barriers

• Evidence of trying to hire someone fluent in the needed language (ads or postings)
• Physician letter explaining language barriers, training provided to the live-in family member, and why only they can provide care

Other (Must Meet Regulatory Compliance)

• Physician letter explaining extenuating circumstances and why care must be provided by a live-in family member

⚠️ Important: All advertisements or postings must come directly from the EOR.

To make your intake appointment run smoothly, it’s best to have all required roles set up before your comprehensive visit. If you already have these roles in place, you can go ahead and begin the registration form below.

Please have the following information ready to complete your registration successfully:

1. Employer of Record (EOR)

• Address
• Phone Number
• Social Security Number
• Email Address
• Relationship to the Medicaid Member

2. Primary Caregiver (PCG)

• Address
• Phone Number
• Email Address
• Relationship to the Medicaid Member

3. Backup Person

• Phone Number
• Relationship to the Medicaid Member

4. Primary Care Doctor

• Doctor’s Name
• Practice Name
• Phone Number
• Fax Number
• Address

5. List of Diagnoses

• Have a list of all the Medicaid member’s current diagnoses.

6. List of Medications

• Include all current medications.

7. List of Other Providers

These are other people or agencies helping provide services for the Medicaid member. Examples include:

• Agency-Directed Care: Agencies that provide aides/attendants.
• Respite Provider: e.g. Jill’s House, Camp Baker
• PERS Provider: “Life Alert” or similar emergency buttons.
• Adult Day Support

✅ When you have this information ready, you can begin your client profile questionnaire by using the link that was emailed to you!