Personal Care Services Program (PCS)

Generated from the gc-benefits catalog. It lists what the owner record states. It is not an eligibility decision; confirm current rules with the program.

Provides services such as housekeeping, meal preparation, bathing, toileting, and grooming.

• Owner record: ny/personal-care-services-program
• Jurisdiction code: NY
• Frame: care_recipient
• Review by: 2026-11-11
• Also called: Personal Care Services (PCS)

Offering 1: personal_care

Provides services such as housekeeping, meal preparation, bathing, toileting, and grooming. This program is available through Medicaid, private payment, and some health insurers.

• Availability (owner codes): {"checked": null, "intake": "unknown", "type": "unknown"}
• Amounts (as stated by the owner): []

Conditions:

• All of these:
• Any one of these:
  • Not:
  • All of these:
    • Stated condition, not checked automatically: "individuals in receipt of Medicaid"
    • Any one of these:
    • Fact rule: recipient.age ≥ 21
    • All of these:
      • Fact rule: recipient.age ≥ 18
      • Stated condition, not checked automatically: "who want to enroll in a Medicaid Advantage Plan (MAP) or Managed Long Term Care Plan (MLTCP)"
    • Stated condition, not checked automatically: "initial assessments and subsequent reassessment that occurred on or after September 1, 2025."
  • Stated condition, not checked automatically: "The Minimum Needs Requirement does not apply to the Program of All-Inclusive Care for the Elderly (PACE) enrollment."
  • Stated condition, not checked automatically: "This requirement does not apply to individuals who were authorized or receiving PCS/CDPAS and/or were continuously enrolled in an MLTC plan as of September 1, 2025. These individuals continue to be eligible under the previous criteria."
  • Any one of these:
  • Stated condition, not checked automatically: "assessed as needing at least limited assistance with physical maneuvering with more than two Activities of Daily Living"
  • Stated condition, not checked automatically: "for individuals with a Dementia or Alzheimer's diagnosis, assessed as needing at least supervision with more than one Activity of Daily Living."
• Any one of these:
  • All of these:
  • Fact rule: recipient.age ≥ 18
  • Stated condition, not checked automatically: "18 years of age and over can receive services, they must have a community health assessment and clinical appointment completed by the New York Independent Assessor Program (NYIAP) to determine whether they are eligible for PCS."
  • All of these:
  • Fact rule: recipient.age ≤ 17
  • Stated condition, not checked automatically: "under 18 years of age can receive services, their doctor must send a completed Physician's Order for Services to the local social services district or their Managed Care Plan, which then completes a community health assessment to determine whether they are eligible for PCS."

Access route 1.1

• Where: Medicaid access: New York Independent Assessor (NYIA); local social services district
• How: The Medicaid access section says that before a person aged 18 or over can receive services, they must have a community health assessment and clinical appointment completed by the New York Independent Assessor (NYIA). For a person under 18, that section says their doctor must send a completed Physician's Order for Services to the local social services district, which then completes a community health assessment to determine whether they are eligible for PCS. The eligibility section gives a different destination for the under-18 order: the local social services district or their Managed Care Plan.
• Url: https://healthweb-back.health.ny.gov/health_care/medicaid/program/longterm/pcs.htm
• Phone: null

Access route 1.2

• Where: Immediate need for personal care services: information
• How: Go to Frequently Asked Questions for more information on getting eligibility processed more quickly if you think you have an immediate need for personal care services.
• Url: https://healthweb-back.health.ny.gov/health_care/medicaid/how_do_i_apply.htm
• Phone: null

Evidence

• /name: "# Personal Care Services Program (PCS)" (source, capture fc4ef3f39656839cb60fa269d159af94777105f651138d87d49b0a24fe0dd790)
• /caregiving_effect: "* Provides services such as housekeeping, meal preparation, bathing, toileting, and grooming" (source, capture fc4ef3f39656839cb60fa269d159af94777105f651138d87d49b0a24fe0dd790)
• /offerings/0/summary: "* Provides services such as housekeeping, meal preparation, bathing, toileting, and grooming" (source, capture fc4ef3f39656839cb60fa269d159af94777105f651138d87d49b0a24fe0dd790)
• /offerings/0/summary: "This program is available through Medicaid, private payment, and some health insurers." (source, capture fc4ef3f39656839cb60fa269d159af94777105f651138d87d49b0a24fe0dd790)
• /offerings/0/rules: "For individuals in receipt of Medicaid, the Minimum Needs Requirements must be met as of September 1, 2025." (source, capture fc4ef3f39656839cb60fa269d159af94777105f651138d87d49b0a24fe0dd790)
• /offerings/0/rules: "The Minimum Needs Requirement apply to Medicaid recipients aged 21 or older, seeking Personal Care Services (PCS) and Consumer Directed Personal Assistance Services (CDPAS). This requirement also applies to all Medicaid recipients aged 18 and older who want to enroll in a Medicaid Advantage Plan (MAP) or Managed Long Term Care Plan (MLTCP). The Minimum Needs Requirements applies to initial assessments and subsequent reassessment that occurred on or after September 1, 2025." (source, capture fc4ef3f39656839cb60fa269d159af94777105f651138d87d49b0a24fe0dd790)
• /offerings/0/rules: "To meet the Minimum Needs Requirements individuals must be:" (source, capture fc4ef3f39656839cb60fa269d159af94777105f651138d87d49b0a24fe0dd790)
• /offerings/0/rules: "* assessed as needing at least limited assistance with physical maneuvering with more than two Activities of Daily Living; or\n* for individuals with a Dementia or Alzheimer's diagnosis, assessed as needing at least supervision with more than one Activity of Daily Living." (source, capture fc4ef3f39656839cb60fa269d159af94777105f651138d87d49b0a24fe0dd790)
• /offerings/0/rules: "The Minimum Needs Requirement does not apply to the Program of All-Inclusive Care for the Elderly (PACE) enrollment. This requirement does not apply to individuals who were authorized or receiving PCS/CDPAS and/or were continuously enrolled in an MLTC plan as of September 1, 2025. These individuals continue to be eligible under the previous criteria." (source, capture fc4ef3f39656839cb60fa269d159af94777105f651138d87d49b0a24fe0dd790)
• /offerings/0/rules: "Before a person:" (source, capture fc4ef3f39656839cb60fa269d159af94777105f651138d87d49b0a24fe0dd790)
• /offerings/0/rules: "* 18 years of age and over can receive services, they must have a community health assessment and clinical appointment completed by the New York Independent Assessor Program (NYIAP) to determine whether they are eligible for PCS.\n* under 18 years of age can receive services, their doctor must send a completed Physician's Order for Services to the local social services district or their Managed Care Plan, which then completes a community health assessment to determine whether they are eligible for PCS." (source, capture fc4ef3f39656839cb60fa269d159af94777105f651138d87d49b0a24fe0dd790)
• /offerings/0/access/0: "### Who provides the services and how do Medicaid-eligible persons access them?" (source, capture fc4ef3f39656839cb60fa269d159af94777105f651138d87d49b0a24fe0dd790)
• /offerings/0/access/0: "* 18 years of age and over can receive services, they must have a community health assessment and clinical appointment completed by the New York Independent Assessor (NYIA) to determine whether they are eligible for PCS.\n* under 18 years of age can receive services, their doctor must send a completed Physician's Order for Services to the local social services district, which then completes a community health assessment to determine whether they are eligible for PCS." (source, capture fc4ef3f39656839cb60fa269d159af94777105f651138d87d49b0a24fe0dd790)
• /offerings/0/access/0: "* 18 years of age and over can receive services, they must have a community health assessment and clinical appointment completed by the New York Independent Assessor Program (NYIAP) to determine whether they are eligible for PCS.\n* under 18 years of age can receive services, their doctor must send a completed Physician's Order for Services to the local social services district or their Managed Care Plan, which then completes a community health assessment to determine whether they are eligible for PCS." (source, capture fc4ef3f39656839cb60fa269d159af94777105f651138d87d49b0a24fe0dd790)
• /offerings/0/access/1: "Click here and go to Frequently Asked Questions if you think you have an immediate need for personal care services and would like more information on how to get your eligibility processed more quickly for these services." (source, capture fc4ef3f39656839cb60fa269d159af94777105f651138d87d49b0a24fe0dd790)