Shared Care

Shared care is an option where two or three members choose to share PCA services in the same setting at the same time from the same PCA worker. If the member is using PCA Choice Option, the same PCA Choice provider must be used for all of the members’ shared care. The member can select the shared care option at any time by contacting his/her PHN or county case manager if on waivers. Providers do not select the shared care option for their clients.

Members may use one-to-one PCA services for part of the hours and shared PCA services for the remaining time.

Shared Care PCA services are covered in the following locations:

1. Member’s home
2. Foster care home
3. Outside the home or shared care site when normal life activities take the members outside the home, such as the following:
   1. Enrichment classes
   2. Before and after school programs
   3. Child care program operated by a local school district/private school. Please note the following:
      1. PCA cannot replace/supplement required child care center staff
      2. PCA cannot provide services to other non-PCA members in child care setting
      3. Required child care staff ratios for licensure must be met
4. Home day care programs
5. Integrated licensed child care

Any setting providing care to children must meet State licensing standards. PCAs do not count toward the required child-staff ratios for any setting.

Shared care cannot be billed when there are more than three people receiving services at the same time, in the same setting.

Shared Care Provider Responsibility

When the member requests shared care:

1. PHN conducts a face-to-face assessment to establish this option
2. PHN assesses and approves the shared care option only if shared care is appropriate and safe based on:
   1. Each member’s health status and psychosocial needs
   2. Site suitability
   3. Compatibility of the members’ age and needs
   4. Each member sharing care must use same agency for shared care units
3. PHN will offer shared care option during assessment/service update process
4. Member does not have to receive all PCA services in a shared care setting

When shared care is approved:

1. The Service Authorization will state, “shared care option selected”^*
2. Shared care payment rates apply if a PCA is caring for two or three members in the same place* at the same time

^*Shared care rates DO NOT apply when the individual PCA provides services to members residing in separate apartments.

After the county PHN authorizes shared care for a member, but before starting services, the provider must work with the member to arrange shared PCA services by determining the following:

1. If all members are approved for and agree to shared PCA services
2. If the ages, psychosocial needs, service expectations, and geographical location of all potential shared care members are compatible
3. The amount of PCA units shared by members
4. If a suitable, a safe environment is available based on involved members’ needs and preferences
5. If there is alternative plan in place for days shared care is not appropriate (e.g., during an illness)
6. If individual PCAs are fully trained to meet each shared care member’s needs
7. If individual PCAs are retrained as needed/required
8. That the service outcome of each member is evaluated

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