Family Guidelines for Selecting a Personal Support Worker

To help people with developmental disabilities avoid unneeded and unwanted placement in institutions, the Division of Developmental Disabilities' Home-Based Support Services program can pay for services that assist individuals in their own homes.  Home-Based Support Services provide a variety of services including:

• Service Facilitation (Qualified Support Professional or QSP) at an accredited human services provider, excluding Independent Service Coordinator (ISC) or Individual Service and Support Advocacy (ISSA)
• Personal Support
• Developmental Training
• Supported Employment
• Adult Day Care
• Regular Work/Sheltered Employment (available but not claimable under the Medicaid waiver)
• Nursing
• Behavioral Intervention, Counseling and Therapy
• Occupational Therapy
• Physical Therapy
• Speech and Communication Therapy
• Personal Emergency Response Systems
• Transportation (limited to no more than $500 per month)

1. What is a Personal Support Worker (PSW)?

   Someone you and your family select to assist you with daily activities. A PSW can come to your home for a few hours each week or several hours daily.

   Supports can be provided in areas such as eating, bathing, dressing, personal hygiene, community integration, preparing meals, transportation, and other activities of daily living. 

2. What Personal Support Services do I need?

   How much assistance you need depends on many factors. For example:

   • What skills do you need help to learn?
   • How accessible is your home?
   • How much can you and your family do for yourselves (shopping, getting in and out of a wheelchair, operating appliances, cooking, housekeeping, personal hygiene, paying bills, etc.)?
   • What other assistance is already available for you?

     It is a good idea to make a list of the things with which you need assistance. You and your family can also use the list later when conducting interviews.

     Your service facilitator will help you decide which services you and your family will need and is also the first person to contact if problems arise.

3. Where can I find a Personal Support Worker (PSW)?

   Sources to help you find an PSW include your friends, neighbors, community bulletin boards, other people with disabilities, and your service facilitator.

4. How do I choose the right person?

   There are several steps you and your family should follow to find an PSW who can work well with you and your family. These include deciding what you want in an PSW, interviewing applicants, and choosing a PSW.

   1. You should consider several things when selecting a PSW:

      • What kinds of things do my family and I want my PSW to do?
      • How many hours of assistance are needed daily or weekly?
      • When do I require the most assistance?
      • Do I prefer a male or female PSW?

   2. When you and your family are ready to begin the selection process:

      • For face-to-face interviews, choose several people who seem to be what you want in an PSW.
      • Arrange a time and place for the interview.

   3. You and your family should discuss certain issues during the interview:

      • Do not ask questions that can be answered yes or no. You will learn more with open-ended questions using words like what, why and how. For example: "What kinds of personal care have you given people in the past?" "Why would you make a good personal support worker?"
      • Reliability is an important consideration, so ask potential workers about their previous work record: Are they working? If not, why not? How long have they stayed on past jobs? How much responsibility did they have? How did they get along with other employees and supervisors?
      • Ask the potential workers to tell you about themselves, especially things that they feel you should know, and assure them that you will keep this information confidential.
      • Discuss transportation: Is their transportation reliable? How far away do they live? Is there mass transit from their home to yours?
      • Be specific about parts of the job that require intimate contact. Explain how some duties and unexpected problems can cause changes in the daily routine. Pay close attention to their reactions as you describe the duties. Ask how they feel about the responsibilities of the job. Also, make sure your PSW is strong enough to lift or transfer you, if needed.
      • Discuss hours, rate of pay and weekend duties. Your PSW cannot work more hours than the Service Agreement permits, unless the Service Agreement is changed by the service facilitator.
      • Make sure your PSW has a social security number and is enrolled as a provider with the Division of Developmental Disabilities.
      • One of the most important things you should do is ask for references, that is, the names and phone numbers of people who can vouch for the applicant's ability and trustworthiness. Then be sure you contact those people to get their opinions of the applicant.

   4. As you have questions for the applicants, they may also have questions for you and your family. Be prepared to answer such questions as:

      • How will the hours I work be tracked?

        Your PSW will be responsible for filling out and turning in to the Home-Based Support Services facilitator bills for personal support hours worked and transportation provided, if any, during each calendar month. Your PSW is also responsible for keeping any additional records that support the hours worked, miles traveled, and transportation provided, if any. These supporting documents, and copies of Home-Based Support Services bills are called an "audit trail" and must be sufficiently detailed and complete to verify the information sent to DHS. The Home-Based Support Services facilitator will verify that the rates submitted on monthly bills match the rate in the Service Agreement.

      • How many hours will I work?

        This is different for each person. The Service Agreement sets the maximum amount of hours that can be worked.

      • Will I be paid for travel time to and from your home?

        No.

      • Will I be reimbursed for mileage for driving my personal car to transport you?

        Yes. The reimbursement rate for the use of the PSW's personal transportation is 36 cents per mile (effective on 7/01/03).

      • Are there any Social Security taxes, etc., to be paid?

        Home-Based Support Services views the PSW as a private contractor and therefore will not withhold any taxes from payments. The PSW must pay taxes on all payments received. DHS will provide a 1099 Miscellaneous Income form at the end of the calendar year, usually at the end of January.

   5. After finishing the interviews, review the potential workers and ask yourself:

      • How did they react to job duties?
      • How was their personal appearance?
      • Where do they live?
      • Do they have dependable transportation?
      • Do you have common interests?
      • What was your first impression of each person?
      • Do they have acceptable, recent references?

   6. You should now be ready to select your PSW.

      In addition to qualifications, also take into account the potential workers' personalities. You want someone with whom you and your family will be able to get along.

      You may want to select more than one PSW. For example, if you need assistance in the morning getting up, the PSW who works in the morning may not be available at night to help you go to bed. So you may need one person for morning and another at night. Also, PSWs who are available during the week may not be available on weekends.

   7. Remember, each new PSW must provide your Home-Based Support Services facilitator with the following items before they start providing services:

      • A copy of his or her Social Security card or other document that verifies the number.
      • You and each of your PSWs must sign a Service Agreement. A copy of the agreement will be provided to you by your Home-Based Support Services facilitator.
      • Waiver Provider Enrollment forms.

5. Who can help me train and manage my Personal Support Worker?

   Since you and your family know what you want, in most cases, the best people to train your PSW are you and your family. But, if you and your family would like some guidance, talk to your service facilitator.

6. What are our responsibilities to each other?

   You and your family have the right to privacy, to make your own decisions and to manage your own lives.

   Be firm and assertive, but also let your PSWs know you appreciate their efforts. Try to understand their feelings. If there is a problem, tell your PSW as soon as possible. Be clear and honest about what you like and dislike. Let your PSW know your needs, expectations and routine. It is a good idea to have a monthly meeting with your PSW to discuss any problems.

   Respect your PSW's time off and privacy. Do not require your PSW to take on duties not previously agreed on.

    You will both have to be flexible, especially with those things that come up unexpectedly.

   Some of the things expected of PSWs are:

   • To arrive on time and be ready to work.
   • To call you if they are going to be late.
   • To give as much notice as possible when asking for time off.
   • To tell you if the time allowed is enough to complete the job.
   • To keep track of the number of hours worked.
   • To know what to do in case of a medical emergency.
   • To expect that some duties require intimate physical contact.

7. What if I'm having problems with my Personal Support Worker?

   If you have a problem with your PSW, you should talk to that person about how you feel. Consider your PSW's feelings too. Both of you may come up with ideas to solve the problem. Discuss the solutions and choose the one that is best for both of you.

   Without getting angry, you will need to let your PSW know in a very direct way that you have the right to make your own decisions. Tell your PSW exactly what you didn't like and what you would like done in the future.

   If you and your PSW cannot come up with a solution, you should find someone else who fits your needs better. If possible, give your PSW one to two week's notice that you are letting him or her go. Sometimes your PSW will choose to leave sooner. In that case, you have to rely on your planned back-up system.

   Remember, if you want your PSWs to be happy working for you, you should let them know you appreciate their work.

   If you need help with any problem, you can call:

   Your Home-Based Support Service Facilitator

   Your Individual Service and Support Advocate

   Be sure to keep a list of emergency numbers close to the telephone.

8. Who pays for Home-Based Support Services?

   If you are eligible for Home-Based Support Services, DHS will pay for your PSW's salary up to the maximum stated in the Service Agreement and within the overall monthly service cost maximum.

9. How does my PSW get paid?

   Your PSW will be paid once or more each month, depending on how frequently bills are submitted. You and your PSW should make sure the hours are correct on the bills and submit them to Home-Based Support Services Facilitator. Staff of the Service Facilitation agency enter the bills onto the computer and mail diskettes to DHS. Your PSW should receive his or her payment approximately four weeks after the bills have been submitted.