North Carolina Medicaid covers Personal Care Services (PCS) for patients who are unable to perform two or more activities of daily living (ADLs) and do not have an available caregiver who can help with these ADLs. These services account for $ 229 million per year in North Carolina.
For the past few years there has been a process by which a physician/provider fills out a “Request for Service” form that orders an assessment by a nurse in the a patient’s private home, Group Home, or Adult Care Home. That nurse assessor then evaluates whether the patient requires PCS, and advises the number of hours of services they should receive. As it stands currently, that patient could potentially receive PCS services forever after with no more input from or to a physician or primary care provider.
There is currently a draft PCS policy open for public comment until 11/15/13. Click here to read the policy. To comment email with the subject line “Policy 3L – PCS”
Consider asking that the policy be amended to:
- Require a medical visit to the referring physician or primary care provider every 12 months to discuss medical issues and review need for PCS services.
- Require that the Nurse’s in-home / in-facility assessment summary be communicated back to the referring physician and/or primary care provider.