Medicaid State Plan Personal Care Services 

State Plan Personal Care Services (PCS) is a Medicaid benefit for eligible members of the Vaya Health Behavioral Health and Intellectual/Developmental Disabilities Tailored Plan (Vaya Total Care). These services help members who require assistance with Activities of Daily Living (ADLs), including bathing, dressing, toileting, eating, and transferring/functional mobility in the home.

Members must participate in an independent assessment to determine PCS program eligibility.

To request a PCS Independent Assessment (e.g., new request, change of status, change of provider, or disenrollment), providers should complete and submit the Request for Independent Assessment for Personal Care Services: Attestation of Medical Need Form.

Any Medicaid beneficiary referred to or seeking admission to an adult care home licensed under N.C.G.S. § 131D-2.4 must be referred to a Tailored Plan for the Referral Screening Verification Process (RSVP). Adult care home providers licensed under N.C.G.S. § 131D-2.4 will not receive a PCS assessment or prior approval without verification of a Referral Screening Identification (RSID).

If you have questions about your status in this process, please contact Vaya’s Diversion RSVP Manager at 1-800-893-6246, ext. 6564.