What are Personal Care and Personal Assistance Services?

Personal care services are non-medical services that are offered in your home. These services include help with Activities of Daily Living (ADLs), such as:

• bathing
• dressing
• eating
• getting out of bed
• walking
• using the bathroom

They may also include help with Instrumental Activities of Daily Living (IADLs), such as:

• light housekeeping (dusting, vacuuming, bed making)
• grocery shopping
• meal preparation
• laundry

What programs and services are available for Personal Care or Personal Care Assistance?

These services are offered by many home care agencies, which are licensed by the Virginia Department of Health. Providers may be for-profit or non-profit organizations. Many provide both skilled services and non-skilled services, while some provide only non-skilled services.

The Virginia Department for Aging and Rehabilitative Services offers personal assistance services to individuals with physical disabilities who do not qualify for Medicaid.

You can hire personal care assistants on your own to provide care in your home.

You may also contact your local Area Agency on Aging, Community Services Board or Center for Independent Living. A doctor's order is not required for these services.

What costs are associated with Personal Care or Personal Assistance?

Home care agencies charge a per hour or per visit rate for personal care services in your home. With hourly rates, there may be a minimum number of hours that will be billed.

If you meet the eligibility criteria for Medicaid, you may also be eligible for personal care services paid for by Medicaid. You must meet the criteria for nursing facility placement. These services may be agency-directed or consumer-directed.

If you qualify for skilled services under the Medicare home health benefit, you may also receive brief visits from a home health aide to assist with ADLs.

If you have long-term care insurance, your policy may pay for personal care services. Check your policy to see what it covers.

How do I qualify?

To qualify for personal care or personal assistance services under Medicaid, you must first be eligible for Medicaid, or you must be using a Medicaid waiver. You must also meet criteria for placement in a nursing facility or an Intermediate Care Facility for Individuals with a developmental disability and/or Related Conditions. You will be seen by a Pre-Admission Screening Team. Your local health department and department of social services offer the screening. The screening can be requested by you, a family member, or a healthcare professional. Anyone who is concerned about you can ask for a screening.

To receive personal care from a home health aide under Medicare, you must meet the requirements under the Medicare home health benefit. You must be receiving a physician-ordered skilled service and have difficulty leaving your home.

If you are 60 years of age or older, contact your local Area Agency on Aging. If you have a disability, contact your local Community Service Board (CSB) or Center for Independent Living (CIL). These agencies may be able to provide assistance with personal care or assistance services.

Where do I apply?

To receive personal care or personal assistance services from Medicaid contact your local department of social services. If you do not have Medicaid, you can also contact your local department of social services to get help. If you are currently using a waiver, contact your support coordinator, case manager, or services facilitator.

To receive home health services from Medicare, your doctor must write an order.

To apply for personal assistance services offered by the Division of Rehabilitative Services, visit the DRS Personal Assistance Services website.

Where can I find out more?

To find services in your area, go to VirginiaNavigator and type in "personal care" in the 'What do you need?' box and put in your zip code. You may also put in your zip code on VirginiaNavigator and select one of these topics to find your local:

• Community Services Boards
• Area Agency on Aging,
• Centers for Independent Living

Medicaid Long-term Care and Waiver Services

Local Departments of Social Services

If you are paid Direct Support Professional and are interested in the association that supports you, visit the Virginia Association of Personal Care Providers.