A personal care attendant (PCA) is an independent caregiver who can help with activities of daily living (like getting in or out of bed, bathing, dressing, and going out into the community).

It is your responsibility to hire, train, supervise, and pay for a PCA for your child. Since this process can sometimes be more challenging than families expect, here are some suggestions on hiring and working with a PCA. Check with your child's health plan about other ways to pay for a PCA. Also, make sure to get legal and tax guidance from appropriate sources before accessing PCA services.

Steps to Success with a Personal Care Attendant (PCA)*

1. List tasks
Identify the kinds of assistance your child needs from the PCA. Describe how much time it takes to do each task. Ask for input from other people who care for your child.

2. Make a budget
Determine how you will pay the PCA. If another party is paying, learn about the policies and guidelines. If you are paying yourself, determine how much you will pay. Contact your local Independent Living Center for more information (see the Independent Living Center section of the Family TIES Resource Directory for a listing in Massachusetts).

3. Create a job description
Write a description of what you expect the PCA to do. Be specific when you describe the tasks. Develop a sample daily schedule that lists what the tasks are and when they are done. Make a list of the kinds of training and work experience that you wish the PCA to have. This may include special training and/or certification, such as First Aid or CPR. Keep in mind that the more qualified the PCA, the more the services will cost. Sometimes training an inexperienced PCA to do things the way you want them done is better than retraining a PCA with experience.

4. Find a PCA
You may decide to consult your local Independent Living Center (see the Independent Living Center section of the Family TIES Resource Directory for a listing in your area), an employment agency, or another source to find a PCA. If you decide to place an advertisement in a local paper, newsletter, or bulletin board, list the minimum qualifications for the PCA. You may also want the candidate to tell you what kind of transportation he or she has. Provide a phone number or email for responses (for safety reasons, don't include your home address).

5. Get information from a PCA candidate before an interview

  • Legal name, address, phone number
  • Social security number, driver's license number
  • Date the applicant can begin working
  • Previous work experience, including name, address, and phone number of employers
  • Education and training
  • Disclosure of previous criminal convictions
  • Names and phone numbers of references

6. Interview your candidate
Prepare a list of questions before the interview. Discuss the list of tasks you made in Step 1. Describe your child's daily schedule. If your child is old enough to participate, bring him or her to the interview. You and your child need to be comfortable with the PCA, because some of the tasks may be very personal.

For safety reasons, you might think about holding interviews some place other than your home. Also, think about requesting a CORI (Criminal Offender Record Information) report for a PCA. Contact the Criminal History Systems Board at 617-660-4600 or 617-660-4606 (TTY) or visit your local police department. Request or download a Publicly Accessible CORI Form and send it to the Criminal History Systems Board. A fee is charged for each report you request.

7. Train the PCA
Take the time to train any PCA you hire. Make it clear what you expect. Let the PCA know if there is personal information that is confidential. Make sure to tell the PCA about your (and your child's) needs, feelings, and decisions.

8. Be a good employer

  • Show the PCA respect. You and the PCA have the right to different feelings, opinions, or points of view. Remember that you are in charge.
  • If there is a problem, don't put off dealing with it. Make sure that you explain the problem clearly to the PCA and tell him or her what needs to change.
  • Provide the PCA with feedback about the work, including what is done well and what needs improvement. Be sure to thank the PCA for their work.

9. Keep a list of backup PCAs in case of illness or emergency.

*Adapted from the Kentucky TEACH Project. Kentucky Commission for Children with Special Health Care Needs.