Washington Autism Alliance & Advocacy
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MTE v. DSHS – Orders DSHS to authorize MPC hours for eligible children

Medicaid Personal Care

The Medicaid Personal Care Program includes hands-on, in-home services provided to those who aremedically and financially eligible. A medical assessment is completed. Services are provided by Personal Care agencies; these agencies must have an approved certificate of need, (not all have well qualified providers for ASD’s).

Services provided in Personal Care include assistance with(more details at the end of this post):

  • Personal Hygiene (includes toilet training)
  • Dressing
  • Feeding
  • Nutrition
  • Environmental Support (Light Housekeeping)
  • ALL Health-Related Tasks (Behavioral Health tasks may be provided)

There are some children who are not DDD eligible(ASD’s & PDD-NOS) who receive MPC services.  All of those services are administered by DDD.  Parents/guardians of  any child with Medicaid can request an MPC assessment – as I understand it.  DSHS refusals to provide such an assessment should be obtained in writing so that the refusal can be appealed. Many parents of young children with Autism use ABA therapy assistants as their MPC providers to implement programming of essential personal care tasks.

Families who are Medicaid eligible due to income who are having problems with getting MPC can call the CLEAR line for free legal assistance.

Please distribute widely.  Here’s the latest signed order on the MPC case {Order (signed)} – Judge Casey said her November 4 Order meant what it said and has ordered DSHS to authorize MPC hours to child MPC recipients without the presumptions in WAC 388-106-0213 as of November 4.

Temporary Restraining Order is scheduled for Dec. 2nd.

Services provided in Personal Care include:

Activities of Daily living (ADL):

Toileting: Help you received getting on and off the toilet, bedside commode, or bedpan, wiping or cleansing yourself, changing pads or briefs, and adjusting clothing. It also includes help you received to toilet even if you do not use a bathroom, including help with a catheter, colostomy, commode, or urinal.

Eating: Help you received to eat and drink. This means getting food or liquids from the dish or cup to your mouth or eating by other means such as tube feeding.

Dressing: Help you received to put on, fasten, and take off all items of clothing, including sleepwear, socks and shoes, and clothes you wear when you go outside. It also includes putting on and taking off braces, artificial limbs, and compression (TED) hose.

Personal Hygiene: Help you received to take care of your grooming and personal hygiene needs, including combing your hair, brushing your teeth, denture care, shaving, applying makeup, washing/drying your face and hands, fingernail care and help with your period (menses care).

Bathing: Help you received to take a full-body bath, shower or sponge bath. It also includes help you received to get in and out of the tub/shower.

Medication Management: Help you received to take or use prescription medications, over-the-counter medicines, vitamins, or herbal supplements.

 

Instrumental Activities of Daily Living (IADL):

Instrumental Activities of Daily Living (IADLs) are routine activities performed around the home or in the community. IADLs include fixing meals, housework, shopping, travel to medical appointments. Wood supply is also included if your only source of heat is wood.

Fixing meals is also called meal preparation. It includes: planning meals; and assembling ingredients; and cooking; and setting out food and utensils.

It must include cooking or actual meal preparation.

Housework includes: doing dishes; dusting; making and changing beds; vacuuming; cleaning bathrooms and other rooms; taking out garbage; tidying up; and laundry.

Shopping includes getting food, medical necessities, and other household items. It also includes going to and from the store along with putting items away.

Transportation is limited to traveling to and from health care providers. It includes driving you to and from appointments. It also includes accompanying you to appointments if your paid caregiver does not use his or her vehicle to take you to your appointment.

 

Feb 1 DSHS client MPC letter template.- this change has to do with off-site laundry and living more than 45 minutes to essential services.

 

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