Evaluating the MassHealth Personal Care Attendant Program

Dates: 2008-2009

State: Massachusetts

Client(s): MassHealth

Services: Health Care & Public Health Planning, Applied Research & Evaluation

Technical Expertise: Aging


There is a growing need for personal care assistance services (PAS) in the delivery of home- and community-based care, which helps elderly and disabled groups to maintain independence and avoid institutionalization. Personal care attendants provide a range of PAS services to consumers, including help with activities of daily living (ADLs) such as bathing and dressing, and instrumental activities of daily living (IADLs), such as shopping and preparing meals. Home-based PAS is an alternative to institutionalized care that has been shown to have positive effects on quality of life and is vitally important for the health and well-being of these populations. While family members may provide some necessary care, there is a crucial need for paid, trained care that can be delivered in the consumer’s home.

In 2008, JSI conducted a comprehensive evaluation of the MassHealth Personal Care Attendant Program to gauge the experience of both consumers and PCA workers participating in the program. JSI surveyed consumer and PCA workers, as well as conducted small focus groups and interviews with key stakeholders, to elicit opinions about the program and recommendations for improvement. The results showed high degrees of satisfaction among consumers, recognizing the important relationships between consumers and their PCA, and high degrees of satisfaction among PCA workers, although some workforce issues persisted, such as lack of benefits and low wages.

The results of the study are currently being prepared for publication and have important implications for the expansion of home- and community-based services under the Patient Protection and Affordable Care Act.

This evaluation was funded by the MassHealth PCA Workforce Council.