Effective July 1, 2008, districts may be reimbursed by Medicaid for personal care services. In Wayne County, the recording of personal care services is mandatory for Act 18 programs. Reporting for non-Act 18 programs is at the district's discretion. Note that if a paraprofessional is federally funded, they cannot record personal care services.

I. PERSONAL CARE POLICY:

Definition of Personal Care Services: Personal Care Services are a range of human assistance services provided to persons with disabilities and chronic conditions which enables them to accomplish tasks that they would normally do for themselves if they did not have a disability. Assistance may be in the form of hands-on assistance or cueing so that the person performs the task by him/her self.

Billing Requirements:

  • The service must be medically necessary (needed to attain or retain the capability for normal activity, independence or self care).
  • Personal care services must be authorized by a physician or other licensed practitioner operating within their scope of practice. The "other licensed practitioner" could be of the same discipline as the service in question. For instance, a licensed occupational therapist could authorize the provision of services, as long as doing so is within their scope of practice.  
  • The need for personal care services must be documented in the student's IEP. In order to facilitate this documentation, page 3 of the Wayne RESA IEP form includes wording similar to the following:
    "Is the severity of the student's impairment such that it requires a licensed practitioner's authorization for personal care services?" Yes or No 
  • In addition to the checkbox on the IEP, a Personal Care Authorization form must be completed and placed in the student's file.

    Personal Care Authorization Form  (WORD)

Personal Care Services:

Services may include, but are not limited to, assisting with the following:

  • Eating/feeding;
  • Respiratory assistance;
  • Toileting;
  • Grooming;
  • Dressing;
  • Transferring;
  • Ambulation;
  • Personal hygiene;
  • Mobility/Positioning;
  • Meal preparation;
  • Skin care;
  • Bathing;
  • Maintaining continence;
  • Assistance with self administered medications;
  • Redirection and intervention for behavior; and
  • Health related functions through hands-on assistance and cueing.

Personal Care Paraprofessional Provider Qualifications:

The personal care paraprofessional personnel shall be qualified under the requirements established by their respective ISD plan. Providers must be trained in the skills needed to perform covered services, and must be under the direction of a qualified professional as designated in the IEP/IFSP. Paraprofessional personnel include:

  • Teacher Aides
  • Health Care Aides
  • Instructional Aides
  • Bilingual Aides
  • Program Assistants
  • Trainable Aides
  • Follow That Kid Aides

Documentation:

Personal care services must be medically necessary and the need for the service documented in the student's IEP/IFSP. Each child's school clinical record must contain a completed, signed and dated monthly activity checklist.
All Medicaid documentation must be kept on file for seven years.

Procedure Code:

The following procedure code may be used to bill for personal care services:
T1020 - Personal care services, per diem

II. PROCESS FOR TRACKING AND REPORTING SERVICES

Personal Care Checklist:

A completed, signed and dated activity checklist must be completed for each student for whom personal care services will be reported.  Below are a monthly and a weekly version of the Personal Care checklist.  Districts have the option to use either of these lists or may create their own. 

Personal Care Monthly Checklist (EXCEL)

Personal Care Weekly Checklist (EXCEL) 

The checklist process should works as follows:

1. The district will add the names of the students receiving personal care services to each paraprofessional's checklist so that each has their own checklist for logging encounters.

2. Each para-professional will record the services they render to each student on their checklist on a daily basis.

Data Entry:

 3. At the end of the week (or month), the para-professional will enter their servcies into Service Tracker, and then turn in their signed and dated checklists to the designated person/location in the district.

4. The paper checklists must be filed and kept by the district for seven years in case of an audit.

Training:

 Training is available via "on demand" videos.

Wayne County districts may contact us for the password to access these Personal Care Policy and Data Entry videos.

 

Kathleen Cummins Merry
Executive Director - Legislative Affairs, Medicaid
(734) 334-1820
Lisa Newton
Assistant, Internal Operations
(734) 334-1821
Leanne Smith
Assistant, Internal Operations
(734) 334-1464
Debra Walters
Support
(734) 334-1823
Tia Williams
Special Programs Consultant
(734) 334-1397

Office Hours 7:30 am-4:00 pm

Fax: (734) 334-1824


To help a student or family apply for Medicaid in Michigan, call your local Department of Human Services Office.