Personal Care Provider Program Update

PDF Version of DQA 10-010  (PDF, 47 KB)

Personal Care Provider Program Update

The purpose of this memo is to provide updated information on the personal care provider rule and processes. On December 16, 2009, the emergency rule for DHS 105.17 and DHS 106.06 went into effect creating certification standards for persons wanting to directly bill and be reimbursed by the Medical Assistance (MA) program for personal care services. 

These rules include new provisions that all personal care providers must follow. At that same time the Division of Quality Assurance (DQA) began accepting applications from individuals for approval for certification as a personal care provider. As noted in DLTC Info Memo 2010-01 http://www.dhs.wisconsin.gov/dsl_info/
InfoMemos/DLTC/CY2010/IMemo2010_01.pdf regarding Personal Care Agency Certification, entities, including counties, Tribes and Independent Living Centers, that are already Medicaid certified personal care providers under the prior statutory provisions, can remain personal care providers without initiating or going through the new application process.

This memo contains information on the emergency rule, how to obtain an application for DQA approval and Medicaid certification as a personal care provider and the names and contact information of persons who can answer your questions. This is the first in a series of memos designed to answer your questions and assist providers to understand their responsibilities under the personal care rule. In addition, the Department of Health Services (DHS) website at http://www.dhs.wisconsin.gov/rl_DSL/PCAs/PCAintro.htm is updated to reflect this information. Highlights include:

Regulatory Requirements - This section includes the DHS Emergency Rules - Revisions to chs. 105.17 and 106.06 and the status of the permanent rule. This section also includes Wisconsin Statutes 49.45 (42), Personal care services and the Wisconsin Medical Assistance Administrative Code for personal care services, chs. 105.17, 106 and 107.112. To view these rules and statutes, visit: http://www.dhs.wisconsin.gov/rl_DSL/PCAs/PCAregs.htm

Updated Frequently Asked Questions (FAQs) - The DHS website also contains a section called Frequently Asked Questions (FAQs). The site is regularly updated and is a good resource for answers to the most common questions the Department has received. To view the current FAQ Document, visit: http://www.dhs.wisconsin.gov/rl_dsl/Publications/pdfmemos/10-010attch.pdf

Questions - Contacts in the State of Wisconsin - Listed below are the names, contact information and program area of individuals in DHS who are able to answer your questions about the application process, Medicaid certification, PCA rules, waiver requests, Family Care and Medicaid policy.

• PCA application and how to obtain an application for Medicaid certification. To obtain application/attestation forms and answers to questions regarding the application process, contact:  lisa.imhof@wisconsin.gov
• Medicaid certification questions, contact:  www.forwardhealth.wi.gov or call Provider Services at (800) 947-9627.
• DHS 105.17, DHS 107.112. For questions regarding rule compliance and interpretation, contact:  marianne.missfeldt@wisconsin.gov
• Medicaid policy questions, contact:  marlia.moore@wisconsin.gov
• Family Care questions, contact:  marjorie.pifer@wisconsin.gov
• Request for waivers of DHS 105.17 or DHS 107.112, contact: jason.helgerson@wisconsin.gov
• Medication, drug administration questions, contact: douglas.englebert@wisconsin.gov

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Last Updated: May 08, 2013