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Personal Care Option (PCO) Program

Victoria Parrill, Program Manager, 505-476-4763

Monica Madrid, PCO Consumer Liaison, 505-476-4780

Sue Burgess, PCO Provider Enrollment Liaison, 505-476-4530

Click on the appropriate link above to email Ms. Parrill, Ms. Madrid, or Ms. Burgess

 

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What is Personal Care Option?

 

The Medicaid Personal Care Option (PCO) program is for qualified consumers 21 years of age or older who are eligible for full Medicaid coverage, and meet the medical necessity requirements.

 

A Third-Party Assessor does an assessment and decides if a consumer qualifies to receive services through the PCO Program.

 

The PCO program offers a range of services to consumers who are unable to perform some or all activities of daily living because of a disability or functional limitation.

 

PCO services permit a consumer to live in his or her home rather than an institution and allow him or her to maintain or increase their independence.

 

Why does The Personal Care Option program have the word “Option” in it?

 

The program has the word “Option” in the title because consumers have an option of two different service delivery models.

 

The two models are: the Consumer-Directed model and the Consumer-Delegated model.

 

In both models the consumer:

• May pick an attendant, which may be a family member.

• Must work with a Medicaid approved provider.

• Remains in the community and maintains their independence.

 

In both models the provider is responsible for:

• Submitting all billing to Medicaid.

• Making sure that all attendants have passed a Caregiver Criminal History Screening test.

Power of Attorney*

justification form

 

PCO Provider Directory

Updated October 2009

 

PCO Provider Training

is scheduled from

9 a.m. to 4 p.m. on 

January 28, 2009

For information, contact Sue Burgess (link and phone number is listed at the top of this page)

PCO Medical Assistance Forms:

 

Personal Care Service Plan*

 

Medical Assessment Form MAD075*

 

Transfer-Closure Form MAD062*

 

Personal Care Provider Information*

 

 Files marked with an asterisk (*) are Adobe Acrobat pdf files. If necessary, click here to download the Adobe Acrobat Reader at no charge.

 

For information on how to enroll in the PCO program,

call 866-364-3310

(toll free in New Mexico).

CONSUMER-DIRECTED MODEL

 

This model is ideal for consumers who want to and are able to direct their own care.

 

The Consumer-Directed model is designed to allow the consumer to be in charge of the delivery of services. The consumer advertises if necessary, interviews and selects his/her own attendants, supervises the attendant in providing services, and fires the attendant if necessary.

 

The Medicaid approved provider in this model is the “Fiscal Intermediary Agency” that helps the consumer with all business related responsibilities.

 

The consumer decides how the program can best fit their needs by setting their own hours, deciding how their services are provided and deciding how their attendants should be trained.

 

 

CONSUMER-DELEGATED MODEL

 

This model is ideal for consumers who do not want to or are not able to direct their own care.

 

The Consumer-Delegated model is designed for the consumer to “delegate” the delivery of services to the Medicaid approved provider.

 

The Medicaid approved provider in this model is the “PCO Agency.”

 

The PCO Agency is responsible for advertising and recruiting prospective attendants, interviewing, hiring and training according to program regulation.

 

The PCO Agency is responsible for quality assurance and is expected to closely monitor the consumer’s services through monthly home visits and 24-hour emergency telephone access.