A personal assistant (sometimes called a personal care attendant or PCA) provides the support necessary for someone with a disability to live and work in the community. Typically, a personal assistant works directly for the person with a disability, although similar services may be provided by home health aides who work for an agency.
At one time, personal assistants mainly performed hands-on activities such as bathing, dressing, using the bathroom and transferring between bed and wheelchair. Other activities included cleaning the home, running errands, and driving the person with a disability wherever he or she needed to go.
Over the years, personal assistance has come to mean any support a person needs to maintain his or her independence. This can include caring for children, using a checkbook, or translating speech that might be difficult to understand. A person with an intellectual disability who has good physical function may need verbal coaching to accomplish the tasks of the day.
The definition of a personal assistant has continued to expand as people with disabilities increasingly join the workforce. A personal assistant may come into the workplace at lunchtime to assist their employer (the person with a disability) with lunch and using the restroom. Or a personal assistant may accompany the employer all day, driving him or her to meetings, assisting with paperwork, note-taking, and phone calls as well as personal tasks.
What does getting a personal assistant involve?
Hiring a personal assistant is a big undertaking, and people often become overwhelmed before they even start. But not to worry! Many excellent guides have been developed to give employers with disabilities the support they need in hiring personal assistants. A list of resources appears at the end of this section.
Here are the steps involved in hiring a personal assistant:
- Self-assessment - Determine how much assistance you need and what kind. For example, do you just need support getting up in the morning, or assistance throughout the day? Someone to drive? Someone to provide support at work?
- Recruitment - You may choose to put up flyers; place an ad in the newspaper; purchase a subscription to www.rewardingwork.org, which has a searchable database with hundreds of resumes; or use several methods at once.
- Interviewing - Telephone interviews are the first step in screening out undesirable candidates. In-person interviews are important in making hiring decisions.
- Checking - Contacting applicants' references helps you narrow down the choices. Many employers don't take this step seriously enough, but it is critical.
- Hiring - Choosing the right assistant is a skill that develops over time. Don't be alarmed if you hear an occasional horror story. There are many dependable, patient, and caring people out there. Your job is not to settle for anything less.
- Training - Teach your assistants what you want them to know about you and how you like things done.
- Supervising - You are the boss. Use this power wisely as you supervise each assistant. Make gentle corrections where needed.
- Terminating - Nobody wants to fire an employee. But if you have a personal assistant whose performance is poor and repeated warnings have not caused improvement, you may have no choice.
How will I pay for personal assistance services?
Most people end up using a combination of resources to pay for personal assistance. It is important to plan ahead so you know how much assistance you will need and can plan for a way to fund those needs.
Connecticut has several waiver programs that make it possible for people to hire personal assistants:
- Personal Care Assistance Waiver - A Medicaid program that provides funding for individuals - who would otherwise be at risk for institutionalization - to hire, schedule, and fire their own personal assistants. Depending upon the level of care needed, an individual could be eligible for up to 72 hours of personal assistance per week. These personal assistants could work with you in your home and community, including driving.
- Acquired Brain Injury Waiver - A Medicaid program which pays for personal assistants to provide hands-on care. Depending on the needs of the individual, this program can also provide up to 20 other services that can include cueing, independent living skills training, and other supports.
- Department of Mental Retardation Waiver - This program provides funding to individuals eligible for Dept. of Mental Retardation services to hire personal assistants to support them in their homes and communities. Assistants can provide hands-on support as well as general guidance.
- Bureau of Rehabilitation Services college support - If you are working with BRS and your employment plan includes college; BRS may pay for some personal assistance to provide transportation and support on campus associated with your education. This would be developed on an individual basis depending upon your needs, your educational requirements, and your employment plan.
For more information about federal and state benefits, contact a Community Work Incentive Coordinator at the DSS/BRS Connect to Work Center at 1-800-773-4636 or click here to find a benefits counselor in your area.
But don't I have to be Medicaid eligible for these programs? I hope to be working...
In the past, people had to choose between employment and receiving the health and support services they needed. This has changed. Go to Medicaid for the Employed Disabled to learn more.
Will my employer pay for my personal assistance at work?
Some larger employers will provide personal assistance on the job as an ADA accommodation. For most moderate and small employers, this is not considered a "reasonable" accommodation. Transportation to and from work and personal care on the job are usually considered the responsibility of the employee.
A hidden benefit of hiring personal assistants.
If you receive Social Security Disability Insurance benefits and you are working, some personal assistance costs can be used to reduce your countable earnings (wages) and may allow you to keep some or all of your cash benefit. Out-of-pocket expenses for personal assistants can be used as Impairment Related Work Expenses, Blind Work Expenses or, in some cases, as part of a Plan for Achieving Self-Support (PASS).
Where can I go for more information?
We have only scratched the surface in this section. There is so much more information available.
Under a federal grant, Connecticut developed a 7-part manual on hiring
personal assistants. It is called "You Are the Employer: A Guide to
Hiring and Managing Direct Support Staff." Look at it online or
download the PDF documents:
http://www.hcbs.org/search.php?glbSearchBox=You+are+
the+employer&ft=fa&glbSearchGo.x=0&glbSearchGo.y=0
This document, called "Personal Assistance Services in the Workplace,"
was developed by the United States Department of Labor, and includes
examples of coworkers providing informal supports to their peers:
http://www.dol.gov/odep/pubs/ek97/personal.htm
This long report from the Job Accommodation Network is targeted at
employers, but contains some information that might be useful for
employees as well:
http://www.jan.wvu.edu/media/PAS.html
What if I need just a little help at work?
If you need a lot of support during the day, it is best to hire a personal assistant. But if you need something small like help setting up your lunch or reaching something that you only need to access once or twice a day, perhaps support from a coworker may be sufficient.
Like everything else, it all depends on your particular situation and on the environment and people you come into contact with.
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