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Medicaid Personal Care Services
Reviewed May 2025
Personal Care Services are a Medicaid benefit that help you care for your child or an adult with special needs in your home by assisting with daily living activities. These activities include:
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- Bathing
- Feeding
- Laundry
- Light Housekeeping
- Meal Preparation
- Toileting
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- (For a complete listing of daily living activities, see Wisconsin Legislature: DHS 107.112)
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Eligibility
To be eligible for personal care services, your child must be enrolled in Wisconsin Medicaid and need services for medical or disability related reasons. Medicaid must also approve your child’s care plan for personal care services before services can begin.
How Do I Start the Process?
1st: Have your child’s primary care provider write a prescription and document that personal care services are medically necessary.
2nd: Contact the personal care agency to set up an in-home visit. To find a personal care agency in your area ask your child’s clinic or service coordinator for help or see the Consumer Guide to Choosing a Personal Care Agency at dhs.wisconsin.gov/guide/pca.htm.
3rd: The agency will use a screening tool to determine if your child qualifies, and the number of hours Medicaid will cover each week. BE REALISTIC! Before your in-home visit, think about all the things that you do for your child and how much time these tasks take. You know your child best and your input is very important in this process.
4th: After your child’s eligibility has been confirmed, a personal care agency representative or nurse will meet with your family to develop a care plan. The agency will also complete prior-authorization paperwork and contact your child’s primary care provider, so Medicaid will approve covering the cost of these services.
What is a Personal Care Agency?
A personal care agency (PCA) may be a home health organization, an Independent Living Center, or it may be a free-standing personal care provider agency. See the Department of Health Services’ statewide listing, PCA Provider Directory.
Tip for Families
Contact your personal care agency to request an evaluation for additional personal care hours if your child’s health or medical needs change. For example, a child who has been hospitalized and has wound care needs may qualify for more personal care hours.
What if the PCA Cannot Find Workers?
Many agencies in Wisconsin are having trouble recruiting and/or retaining enough qualified workers to meet the needs of every family who has a member eligible for personal care services. Many agencies rely on families to find their own workers. Here are a few ideas to help you find a worker:
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- Talk with your child’s school. School aides or other paraprofessionals often want to work extra hours, especially during summer months.
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- Connect with a local university or technical college. Students in health programs like nursing and therapy, social work, or education are good candidates.
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- Ask respite providers, babysitters, summer camp counselors or after-school program staff.
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- Talk to other parents. They may know someone in your area.
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If a child is under age 18, a parent or guardian cannot be paid by Medicaid to provide personal care services. However, when a child turns 18, a parent or guardian can be employed to provide these services. This may be an option for families who have a hard time finding personal care workers.
Is Personal Care the Same as Respite Care?
No. The main difference is that respite care is meant to give you time off from your care giving duties to unwind, while personal care is like having a helper, in your home with you, to do some of your child’s daily living activities. Some families may qualify for both programs. It depends on your child’s care needs. To learn more about respite care see Respite Services for Children with Disabilities.
Do Personal Care Services have to be Provided in Our Home?
Yes. Medicaid requires that personal care services be provided in your home. Personal care staff are not allowed to work with your child in the community.
INFORMATION AND RESOURCES
Wisconsin Wayfinder: Children’s Resource Network, 877-WiscWay (877-947-2929): Wisconsin Wayfinder offers families one name and phone number to find services for children with special health care needs. Wayfinder connects you to a resource guide at one of the five Children’s Resource Centers in your area.
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