California’s Medicaid Personal Care Assistants: Characteristics and Turnover among Family and Non-Family Caregivers

Personal care assistants (PCAs) provide supports and services that enable older adults and individuals with disabilities to remain in their homes and community settings. State Medicaid Home and Community-Based Services programs facilitate use of alternatives to institutional care by paying for personal care assistance. This study characterizes the personal care assistance role played by both family members and non-family in California, one of the nation’s largest consumer-directed Medicaid personal care assistance program. We describe factors that affect turnover among PCAs, as turnover is associated with lower quality of care and adverse outcomes for recipients.