www. alliedgroup . org

Personal Care Assistance
(PCA) Medicaid Waiver Program

Download the following forms in Adobe Acrobat PDF format:

• CT W-4 Form
  
• Federal W-4 Form
  
• I-9 Form
  
• Employee Packet Cover Sheet
  

• Employee Status Form
  
• Employee Check List Form
  
• Direct Deposit Application
  
• PCA/Eldercare Provider Application &Agreement
  

• Complete PCA Employee Packet (15 pages total)
  
• PCA Registry Application
  

Allied Community Resources, Inc. is the fiscal intermediary for the CT Personal Care Assistance Medicaid Waiver Program. The PCA Program provides assistance with activities of daily living for individuals with severe disabilities.  Personal assistance includes hands-on activities and tasks such as bathing, dressing, eating, transfers and other personal care.  The consumers make their own choices about the people they will hire to provide the assistance they need to be able to stay in their own homes and community.

Consumers in the PCA programs receive training and assistance from Allied on becoming a household employer.  Training includes recruiting, hiring, training and supervising their personal care assistants.  Allied also assists the consumer in filing all of the necessary IRS applications and paperwork to become an employer.  Allied recruits PCAs statewide and maintains a registry of PCAs which is updated monthly and used for recruiting purposes.

CT Home Care Program for
Elders Personal Care Assistance Pilot Program

The PCA Pilot Program provides home care assistance for individuals over the age of 65 who meet eligibility criteria with the CT Department of Social Services.   The Pilot Program is funded by the State of Connecticut for up to 250 individuals.

PCAs provide assistance with activities of daily living for individuals with severe disabilities who would not be able to live at home without the assistance of the program. 

Personal assistance includes hands-on activities and tasks such as bathing, dressing, eating, transfers and other personal care.  The consumers are able to make their own choices about the people they will hire to provide the assistance they need.

Consumers in the PCA programs receive training and assistance from Allied on becoming a household employer.  Allied staff travel to the consumer's home and provide training on recruiting, hiring, training and supervising personal care assistants.  Allied assists in filing all of the necessary IRS applications and paperwork.  Allied recruits PCAs statewide and maintains a registry of PCAs which is updated monthly and used for recruiting purposes.

Other
Allied Community Resources programs:

• ABI Waiver Program
• Fiduciary Services