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Personal Care I Application Process

The links below should be used to get materials to complete an application for Personal Care I. In addition, a completed an approved application would also qualify the provider agency as a provider of Companion services.

Application Form:

Print out a copy of the application. This should be completed and sent to
the address listed.

Scope of Services:

The objectives of PC I Services are to preserve a safe and sanitary home environment, assist participants with home care management duties and to provide needed supervision of Medicaid Home and Community-Based waiver participants.

Approved In-Service Training List

Print a copy of the scopes of services. This does not need to be included with the application, but does give information of what is required of your agency in providing services for the CLTC/DDSN programs.