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Medicaid Personal Care
Purpose: To explain a Medicaid program called Medicaid Personal Care (MPC) for individuals eligible for a non institutional CN program and meeting the functional criteria for personal care services.
HCS financial staff
All Classic Medicaid receiving MPC services through HCS
Indicate M for MPC service in ACES under the HCB type field. Indicate the start date of the service and the approving agency under the approval source. Indicate the payment authorization date. For MPC the start date of the service and the payment authorization date is the same date.
If the individual is living in an alternate living facility, the facility section must be completed. A provider number is not needed for an alternate living facility, but the entry date, level of care, payment authorization date and state rate are needed.
DDA and HCS financial staff responsibilities
If MPC services end, indicate the service end date on the HCBS field in the month services ended.
If in an ALF/residential setting indicate the end date under the facility line.
If the individual is not eligible for a noninstitutional Classic CN program, notify the agency authorizing MPC services that the individual is not financially eligible for MPC. The individual may be considered for a CN institutional Waiver program such as COPES.
An individual going from MPC to waiver must qualify under the rules for the waiver program including transfer of asset and excess home equity rules, income and resource rules that apply to waiver/institutional programs.
Social service specialists and case managers must consult financial service staff prior to switching a MPC case to a waiver case to make sure the individual is eligible under waiver rules.