The gateway to accessing vital personal care services for children in Colorado under Health First Colorado (Colorado’s Medicaid program) is through the Colorado Home Care Assessment Tool, officially known as the Personal Care Assessment Tool (PCAT). This essential tool plays a crucial role in determining eligibility for the Pediatric Personal Care benefit, ensuring that young individuals receive the support they need in their homes.
What is the Colorado Home Care Assessment Tool (PCAT)?
The Personal Care Assessment Tool (PCAT) is a standardized evaluation method developed by the Colorado Department of Health Care Policy & Financing. It is designed to consistently and objectively assess a child’s need for personal care services. Developed over two years with input from various stakeholders, the PCAT ensures a fair and comprehensive evaluation process for every applicant seeking pediatric personal care benefits.
Who is Eligible for Pediatric Personal Care Services in Colorado?
To be eligible for personal care services under Health First Colorado, children must meet specific criteria. Firstly, they must be 20 years of age or younger. Secondly, they need to qualify for personal care services based on the assessment conducted using the Department-defined Personal Care Assessment Tool (PCAT). It is important to note that the PCAT should only be administered by trained professionals who have completed the Department-provided training on its proper use.
What Personal Care Services are Covered Under this Benefit?
The Pediatric Personal Care benefit in Colorado encompasses a range of essential daily living activities. These are categorized into 17 specific personal care tasks, including:
- Ambulation/Locomotion
- Bathing/Showering
- Dressing
- Meal Preparation
- Feeding
- Hygiene – Hair Care/Grooming
- Hygiene – Nail Care
- Hygiene – Shaving
- Hygiene – Mouth Care
- Hygiene – Skin Care
- Mobility – Positioning
- Mobility – Transfer
- Toileting – Bladder Care
- Toileting – Bowel Care
- Toileting – Bowel Program
- Toileting – Catheter Care
- Medication Reminders
These services are designed to support children with their daily needs, allowing them to live more comfortably and safely at home.
How to Initiate Pediatric Personal Care Services in Colorado
To begin receiving personal care services, a Prior Authorization Request (PAR) process is mandatory. Prospective personal care providers must submit at least two critical documents for pre-approval:
- Personal Care Assessment Tool (PCAT): This assessment must be completed by the personal care provider to evaluate the child’s needs.
- 485 Home Health Certification and Plan of Care Form: Alternatively, another form with equivalent content can be used. This Plan of Care Form must be completed by the child’s physician.
The Plan of Care Form is crucial as it formally orders in-home personal care services and provides detailed information on the medically necessary services and their required frequency. Once completed, the personal care provider submits these forms through an online Prior Authorization Request (PAR) system.
For in-depth information about this procedure, refer to the Pediatric Personal Care Special Provider Bulletin.
Connecting with Personal Care Providers in Colorado
The Colorado Department of Health Care Policy & Financing is actively working to expand the network of personal care providers throughout the state who accept Health First Colorado. This initiative aims to improve access to personal care services for eligible children across all counties. A Provider List is available, categorizing Pediatric Personal Care Providers by county to help families find local support.
Agencies classified as Class A or Class B interested in becoming personal care service providers are encouraged to reach out to the Department at [email protected] for more information on joining the network.
Need More Information?
For further inquiries regarding the Pediatric Personal Care Benefit and the Colorado Home Care Assessment Tool, you can contact the program directly at [email protected]. They can provide additional guidance and support to navigate the process and access these valuable services.
