Dhs 5856 eng-2026

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The document DHS-5856-ENG outlines the annual Responsible Party Agreement and Plan for Personal Care Assistance (PCA) programs in Minnesota. It details the responsibilities of the responsible party or their delegate in relation to the recipient of PCA services, including participation in assessments, care plan development, monitoring services, and ensuring health and safety. The agreement must be signed and kept on file by the PCA agency.

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Click ‘Get Form’ to open the DHS-5856-ENG in the editor.
Begin by entering the Responsible Party's name in the designated field, ensuring you include their last name, first name, and middle initial.
Next, specify your relationship to the recipient in the provided section.
Fill in the recipient's name and their Minnesota Health Care Programs (MHCP) ID number accurately.
Indicate the time period for which you agree to be responsible for the recipient by entering start and end dates in MM/DD/YYYY format.
Review each responsibility listed and initial next to each item to confirm your agreement.
In the 'Responsible Party Plan' section, detail how you plan to meet these responsibilities. You can attach additional pages if necessary.
Finally, sign and date the form at the bottom, providing your address and phone number as required.

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What requirements are needed for PCA?

How To Become A PCA: Skill Education Requirements Obtain Necessary High School Diploma or Equivalent Education Level. Complete State-Approved Training Programs for Personal Care Aides. Acquire First Aid and CPR Certifications to Enhance Safety Skills. Develop Interpersonal Skills to Connect with Clients Effectively.

How does a person qualify for a PCA?

Personal Care Assistant (PCA) Waiver: Adults aged 18 to 64 with disabilities in need of assistance performing Activities of Daily Living can apply for the Personal Care Assistant Waiver to receive long-term care from a trained, personal care assistant while at home.

What is the PCA program in Minnesota?

PCA SERVICES are a form of HOME CARE ASSISTANCE that supports individuals living in Minnesota with non-medical, health-related needs and daily activities. The goal of PCA services, as with other homecare options, is to help individuals live independently in their homes and community, as opposed to a facility.

How much does PCA get paid in MN?

How much does a Pca make in Minnesota? As of Mar 13, 2025, the average hourly pay for a Pca in Minnesota is $14.16 an hour. While ZipRecruiter is seeing salaries as high as $17.89 and as low as $8.95, the majority of Pca salaries currently range between $12.02 (25th percentile) to $16.01 (75th percentile) in Minnesota.

Who qualifies for a PCA in MN?

Eligibility criteria People who participate in Minnesota Senior Health Options (MSHO) or Minnesota Senior Care Plus (MSC+) receive authorization for PCA services from their health plan. All other people who receive MA or are enrolled in MinnesotaCare receive their authorization from their county or tribal agency.