Frequently Asked Questions

The Personal Support Attendant (PSA) Program is a Georgia Medicaid Waiver Program that helps people with permanent or chronic disabilities live at home by providing funds to hire The Personal Support Attendant (PSA) The Personal Support Attendant (PSA) can help with Activities of Daily Living (ADLs) such as:

• Mobility/Transfers
• Medications
• Bathing or grooming
• Dressing or undressing
• Range of Motion exercises
• Eating
• Toileting

The Personal Support Attendant (PSA) can also help with Instrumental Activities of Daily Living (indirect activities of Daily Living) such as:

• Shopping
• Laundry
• Meal Preparation
• Housekeeping

The Personal Support Attendant (PSA) time is not approved for activities such as recreation, babysitting, or vocational training. Nor is The Personal Support Attendant (PSA) time allowed for verbal prompting or cuing, or supervision.

You may be eligible for The Personal Support Attendant (PSA) services if you are a US citizen and a resident of Georgia, who is on Medicaid or eligible for Medicaid and:

• You have a permanent or chronic disability that impairs your ability to perform Activities of Daily Living and Indirect Activities of Daily Living without physical assistance.
• You need physical assistance with two or more Activities of Daily Living (see list above)
• Personal support services are prescribed by your physician
• A case manager from CCSP or Source Waiver Programs determines that PSA services are medically necessary.

A case manager from CCSP or Source Waiver Programs will provide an evaluation to help DFACS decide whether you qualify for Personal Support Attendant (PSA) services. The evaluation will describe your personal care needs in detail, and recommend how many hours of Personal Support Attendant (PSA) services you need each week. After approval by your physician or nurse practitioner, this evaluation is sent to Medicaid, which makes the final decision about whether you are eligible and how many hours of Personal Support Attendant (PSA) services will be approved for you. Personal Support Attendant (PSA) services are usually approved for one year at a time.

Personal Support Attendant (PSA ) services can be used in combination with some other services, such as Visiting Nurse, Occupational or Physical Therapy, or Home Health Care services. Some other services that may be used together with Personal Support Attendant (PSA ) include Adult Day Care and Home Delivered Meals, and 24 hours Electronic Monitoring Services founded through the Georgia Medicaid Waiver Program.

Our evaluation, and eventually your approval, will take into consideration your disability and your living situation, as well as your daily routine. If you live with family members they will be expected to assist with most household chores. For example, routine laundry, housekeeping, shopping and meal preparation should only include the needs of the family member with the disability.

Personal care services are based on needs that arise because of a disability which impairs an individual’s ability to perform activities of daily living independently. For very young children, who would not normally be independent in their activities of daily living (for example bathing, dressing, eating, toileting), Personal Support Attendant (PSA) services will not generally be approved for activities that are considered routine child care. A case manager from CCSP or Source Waiver Programs evaluation teams will take the child’s age into consideration when evaluating the need for Personal Support Attendant (PSA) time.

The Personal Support Attendant (PSA) program should reflect your current needs, so you should contact Caring Hands United, Inc or Your Assigned case manager if your personal care needs change at any time. A change in your personal care needs might be due to your disability, or may be due to some other event, such as graduating from school, or moving into your own home.

If Caring Hands United approves Personal Support Attendant (PSA) services for you, Caring Hands United, Inc staff will recruit, hire, fire, train and schedule your own Personal Support Attendant (PSA).

The Personal Support Attendant (PSA ) is scheduled according to the number of hours approved by A case manager from CCSP or Source Waiver Programs , which is based on your evaluation. Your Personal Support Attendant (PSA ) schedule may change slightly from week to week, depending on whether you might have medical appointments that week, or other activities that do not take place every week. Please be aware that your Personal Support Attendant (PSA ) will not be paid for any work they do if there is no approval in place for that date, or if you have used up all your approved Personal Support Attendant (PSA ) hours. Personal Support Attendant (PSA ) services cannot be used while you are a resident in a hospital or rehabilitation facility.

The Personal Support Attendant (PSA) hours would be scheduled to provide the care that A case manager from CCSP or Source Waiver Programs has authorized, at the time that you need that care. We suggest you use your Personal Support Attendant (PSA) evaluation as the basis for a daily schedule, for example, combining morning care tasks into a block of time that meets your needs. It is up to you as to what time you want your Personal Support Attendant (PSA) to come to work, when to shower or go to bed, or when to do your shopping or laundry. Your Personal Support Attendant (PSA) schedule should be set up to meet your own daily needs. The Caring Hands United, Inc admitting, assessment nurse will work with you in this area to help you learn how best to schedule your time.

As a client of Caring Hands United, you are responsible for:

• Reviewing and signing the Personal Support Attendant (PSA) work report sheets and activity forms verifying the Personal Support Attendant (PSA) duties performed and time spent in the home
• Following the rules of the Waiver Program
• Letting Caring Hands United, Inc office and supervisory staff know if your personal care needs change
• Letting Caring Hands United, Inc know if you unexpectedly need extra hours for one of your Personal Support Attendant (PSA)
• Letting Caring Hands United, Inc know if you move, change your phone number, or change your doctor.

If a case manager from CCSP or Source Waiver Programs approves Personal Support Attendant services for you at night, it will pay the Personal Support Attendant for at least 2 hours of time for providing you with direct assistance with ADLs at night. Night hours are from 12:00 midnight to 6:00 a.m.
Call Caring Hands United , Inc if you:

• Would like to set up a lunch and learn session for your staff, if you are providing care and assistance to the elderly or disabled in the community
• Know anyone that can benefit from this Personal Support Assistance program
• Have questions about our hiring, firing, training or scheduling of Personal Support Assistants
• Have questions about the process of requesting services for yourself or a family member

As your personal care agency, Caring Hands United, Inc is responsible for:

• Assessing your eligibility for the Personal Support Attendant (PSA) program
• Evaluating the kind and amount of services you need
• Asking Personal Support Attendant (PSA) performance in the home during the supervisory visits
• Working out a service agreement with you that describes your rights and responsibilities, as well as the responsibilities of the Personal Support Attendant (PSA) and Caring Hands United, Inc and A case manager from CCSP or Source Waiver Programs
• Reviewing your service plan with you periodically
• Conducting re-evaluations as needed, and submitting them to the case manager from CCSP or Source Waiver Programs every two months.

A Caring Hands United employee or office staff member will initially gather your financial information and submit it to either a case manager from CCSP or Source Waiver Programs , who must meet with you in person for initial assessment . The case manager from CCSP or Source Waiver Programs will also be assigned to you as an advocate and will meet with you at least quarterly in your first year of service Also a registered nurse and licensed practical nurse will be assigned to you when you apply for Personal Support Attendant (PSA) services. All caring Hands United, Inc office staff have voice mail, and e-mail and this is usually the best way to reach them.

Caring Hands United, Inc Personal Support Attendant (PSA) program has a process for dealing with any complaints or concerns. Your assigned staffing coordinator or assigned RN or Lpn will explain the process to you and make every effort to help you resolve your complaint or problem.

When you are approved by the CCSP or Source Waiver Programs, Medicaid pays for Personal Support Attendant (PSA) services you will receive paperwork showing the number of hours of service you are approved for, and the start and ending dates of your approval. Every two weeks your Personal Support Attendant (PSA ) will submit time sheets to Caring Hands United, Inc office that you have signed verifying that you have received the Personal Support Attendant (PSA ) Services and the hours worked. Each payroll period begins on a Sunday and ends on a Saturday. The Personal Support Attendants (PSAs ) will normally receive their paychecks the following Friday.

If A case manager from CCSP or Source Waiver Programs has approved more than 40 hours per week of Personal Support Attendant (PSA ) services for you, Caring Hands United, Inc will hire at least two Personal Support Attendants (PSAs ) so that none of your Personal Support Attendants (PSAs ) have to work for you more than 40 hours in one week. Caring Hands United, Inc also have a back-up list of Personal Support Attendants (PSAs ) in case your scheduled Personal Support Attendant (PSA ) cannot work that day.

If you are scheduled for a doctor’s appointment and need the Personal Support Attendant (PSA ) to accompany you. You must contact A case manager from CCSP or Source Waiver Programs immediately to request more hours if needed from a Personal Support Attendant (PSA ). Caring Hands United , Inc can not pay out more time than is allotted to your care plan.
The following information is needed to request more hours:

• The work week for which the hours is requested
• The total hours of hours requested
• What was the unforeseen event that caused the need for more hours?

Caring Hands United is responsible for training Personal Support Attendants and will provide required general training session. For example, new PSAs orientation to Caring Hands United, Inc policy and procedures, basic first aid and CPR and universal precautions. You may also need to do the training on your cares. For example, how to transfer from a bed to a chair or how to style your hair.

Caring Hands United, Inc is responsible for scheduling staff for you and work with you and your assigned care providers to develop a provider to meet your needs. You the client help to make the schedule. The schedule will be developed to meet your needs and will be developed with you during the initial assessment.

• Staff is scheduled on a monthly basis so if changes need to happen, there is time to work out the details.
• Caring Hands United, Inc has the schedules posted two weeks ahead of the time on the HHC staff scheduling software and your schedule can be given to you in advance.
• Give your staffing coordinator advance notice for schedule changes (both you and the PCAs). For example, if you are going on vacation, tell your Personal Support Attendant and Caring Hands United, Inc ahead of time about the change in the work schedule Personal Support Attendant Task Scheduling.
• Task scheduling is an activity that you direct. Tasks are the activities that Personal Support Attendants do to assist you in maintaining your independence. Examples of tasks include assistance with bathing, driving, cleaning and cooking. Tasks can be scheduled on a daily basis and or on a weekly basis.

Here is an example of a morning schedule:

6:00 to 6:30am	Get up, assistance with showering, dressing and brushing hair and teeth.
6:45 to 7:15am	Make breakfast, assistance with eating, clean up dishes.
7:15 to 7:45am	Assist with toileting, make lunch, take medications
8:00am	Wait and assist with Metro Mobility (if necessary). Shift ends when client leaves for Adult day care. PSA assists client to get on bus .

Here is a sample of a weekly schedule Monday Daily task pool therapy Tuesday Daily task, ironing, clean bathroom Wednesday Daily task, clean kitchen and refrigerator Thursday Daily task, and pool therapy Friday Daily task, clean bedroom and living room Saturday Daily task, laundry and clean medical equipment Sunday Daily task, grocery shopping and errands Here are some hints for PSA task scheduling: Try to schedule things that can be done in the same block of time. For instance, the PSA can start laundry when he/she arrives, help you with your morning cares, put laundry in the dryer, get meals ready and clean the kitchen and put the laundry away just before leaving. This way you will use the hours you have most efficiently Figure out the PSAs’ strengths and what they do well. For instance, some PSAs may be better at cooking meals and some are better at helping with baths or showers

Clear communication is the most important thing about supervising PSA(s). Be clear about what you need when giving directions. Encourage the PSA(s) to ask questions if they do not understand something. Do not assume they know what you want. Be consistent in your communication. The more consistent you are in your decisions and requests, the better the PSA(s) will meet your needs. Your PSA(s) may prefer to do things one way and you prefer another. The choice is yours and the PSA(s) need to follow your directions.

Here are some tips that may help both of you communicate more effectively:

• Explain any technical words or terms you use. Even an experienced PSA may not know the terms you use. Understanding terms helps the PSA(s) better understand your disability and meet your needs
• Be clear about your expectations. For example, if your PSA leaves dishes in the sink and you want them put in the dishwasher, you need to tell your PSA to do this instead of getting angry when the dishes are in the sink
• Be pleasant, patient and fair. Even thought you get to make decisions about your care and schedule, sometimes you may need to compromise with your PSAs so they can also meet their needs. For example, they may have children, which could prevent them from having a flexible schedule.
• Avoid gossiping about other PSAs. Also, do not criticize another PSA’s work but instead address issues directly with PSAs
• Treat your PSA the way you would like to be treated.

PSA(s) who quit often say they are leaving because of poor communication with their client. Evaluations can give you and your PSAs the opportunity to talk openly with each other about things that might be frustrating. Over time, small irritations, hurt feelings and misunderstandings can build up and destroy what could have been a good working relationship. Give feedback on a daily basis on which tasks are being done well and which tasks need improvement If there is a serious conflict between you and your PSA(s), you may decide to call the staffing coordinator at the Caring Hands United, Inc. to try to resolve the situation rather than fire the PSA. Talking openly can clear the air. Here are some suggestions on how to approach the conversation:

If there is serious conflict between you and your PSA you need to notify the staffing coordinator or supervisory nurse and maybe this conflict can be resolved rather than firing the PSA. Talking openly can clear the air. Here are some suggestions on how to approach the conversation:

1. Set aside time when both of you are not rushed.
2. Give full attention to the PSA
3. Describe the PSA actions, not the person
4. Define the conflict as a mutual problem that you want to solve. This is not a contest in which one person wins and the other loses.
5. Talk about the problem in specific terms. Give examples . Do not accuse
6. Describe your feelings and reactions.
7. Describe how you might have contributed to the problem.
8. Let your PSA go through these steps.

It is important that neither of you feel accused of doing something wrong. If you can work through the problem together, it can make a stronger and better working relationship.