Design Features for Employment-Supportive Personal Assistance Services in Medicaid Programs

To support the employment of persons with disabilities, state Medicaid programs are allowed to offer personal assistance services (PAS) at work as well as at home. These employment-supportive personal assistance services (EPAS) can be used to help persons with disabilities obtain or retain employment. This article explores Medicaid-funded EPAS through examination of programs in seven states and analysis of results from PAS user focus groups and employer interviews. Medicaid policy recommendations include: link EPAS with existing PAS programs in Medicaid state plans or waivers, distinguish EPAS from job- or task-related assistance that is the responsibility of the employer, and specify explicit coverage for personal care services at home, at the work site, and for work-related transportation

The relationship of personal assistance service utilization to other Medicaid payments among working-age adults with disabilities

This study examined changes in Medicaid provider payments prior to and following approval for personal assistance services (PAS) among 471 PAS users compared to 295 nonusers who qualified for but did not use PAS, adjusting for differences between users and nonusers using propensity scores. PAS users showed a significantly greater increase in total monthly payments from pre- to post-PAS approval compared to nonusers (35% vs. -9) due to high average monthly payments for PAS ($1325). However, users showed a decrease in non-PAS payments compared to nonusers (1%-9% vs. -9%), with significant decreases in payments for both acute/rehabilitation hospitalizations and for nursing home/other long-term residential stays among users. While costly, savings in other areas may help reduce the net cost of PAS