Personal Care Attendant (PCA) vs Home Health Aide (HHA)

We operate two businesses, ComForCare Home Care and ComForCare Home Health, under one legal name, RHM Services, LLC.  The two businesses are separate, unique and very different from each other.  ComForCare Home Care operates as a personal service agency (PSA or home care agency) and provides personal services for clients.  ComForCare Home Health operates as a home health agency (HHA or home health agency) and provides home health services for clients in addition to personal services.    

  Under a personal service agency (or home care agency), you will work as a personal care attendant or PCA.  Under the home health agency (home health agency), you will work as a home health aide or HHA.  Below are state statutes that explain the difference between the two types of businesses.  Additionally, we have included the statutes that list the tasks and responsibilities for each position, below.  There are certain duties that you can perform as a home health aide (HHA) under the home health agency license (home health agency) that you cannot perform under the personal service agency license (home care agency) as a personal care attendant (PCA).  

  As an employee of either Company, you are required to strictly follow your assigned duties and you must not perform tasks that exceed the boundaries of your role and responsibilities for the client.  PCAs must never perform prohibited home health services or tasks when they are providing personal services as a PCA notwithstanding the fact that they may also have credentials as an HHA.  You are also required to make it clear to your clients your assigned role with them as either a PCA from ComForCare Home Care or an HHA. from ComForCare Home Health.  If a client insists that you perform HHA duties (i.e. home health aide) when you are assigned to serve the client as a PCA through your employment with ComForCare Home Care, you must contact your Supervisor immediately.  Violating this policy and other related policies and procedures will subject you to disciplinary action up to and including termination.  If you have any questions regarding the differences between the two job descriptions, immediately contact a Supervisor for clarification before performing duties or tasks that cause you uncertainty.  

Personal Services Agency State Statute

IC 16-27-4-5 "Personal services agency" Sec. 5. (a) As used in this chapter, "personal services agency" means a person that provides or offers to provide a personal service for compensation, whether through the agency's own employees or by arrangement with another person. (b) The term does not include the following: (1) An individual who provides personal services only to the individual's family or to not more than three (3) individuals per residence and not more than a total of seven (7) individuals concurrently. As used in this subdivision, "family" means the individual's spouse, child, parent, parent-in-law, grandparent, grandchild, brother, brother-in-law, sister, sister-in-law, aunt, aunt-in-law, uncle, uncle-in-law, niece, and nephew. (2) A local health department as described in IC 16-20 or IC 16-22-8. (3) A person that: (A) is approved by the division of disability and rehabilitative services to provide supported living services or supported living support to individuals with developmental disabilities; (B) is subject to rules adopted under IC 12-11-2.1; and (C) serves only individuals with developmental disabilities who are in a placement authorized under IC 12-11-2.1-4. As added by P.L.212-2005, SEC.18. Amended by P.L.141-2006, SEC.83

Home Health Agency State Statute

IC 16-27-1-2 "Home health agency" Sec. 2. (a) As used in this chapter, "home health agency" means a person that provides or offers to provide: (1) nursing services; or (2) nursing services and at least one (1) home health service; for compensation. (b) The term does not include the following: (1) An individual health care professional who provides professional services to a patient in the temporary or permanent residence of the patient. (2) A local health department as described in IC 16-20 or IC 16-22-8. (3) A person that: (A) is approved by the division of disability and rehabilitative services to provide supported living services or supported living supports to individuals with developmental disabilities; (B) is subject to rules adopted under IC 12-11-2.1; and (C) serves only individuals with developmental disabilities who are in a placement authorized under IC 12-11-2.1-4. (4) A person providing services under the Program of All-Inclusive Care for the Elderly (PACE) described in IC 12-15-43. (5) A person that only administers home infusion therapy based on a specialty medication prescription received from a pharmacy.

As added by P.L.2-1993, SEC.10. Amended by P.L.37-2003, SEC.1; P.L.141-2006, SEC.80; P.L.210-2021, SEC.1.

Personal Services State Statute

IC 16-27-4-4 "Personal services" Sec. 4. (a) As used in this chapter, "personal services" means: (1) attendant care services; (2) homemaker services that assist with or perform household tasks, including housekeeping, shopping, laundry, meal planning and preparation, and cleaning; and (3) companion services that provide fellowship, care, and protection for a client, including transportation, letter writing, mail reading, and escort services; that are provided to a client at the client's residence. (b) The term does not apply to the following: (1) Incidental services provided by a licensed health facility to patients of the licensed health facility. (2) Services provided by employers or membership organizations for their employees, members, and families of the employees or members if the services are not the predominant purpose of the employer or the membership organization's business. (3) Services that are allowed to be performed by a personal services attendant under IC 12-10-17.1. (4) Services that require the order of a health care professional for the services to be lawfully performed in Indiana. (5) Assisted living Medicaid waiver services. (6) Services that are performed by a facility described in IC 12-10-15. As added by P.L.212-2005, SEC.18. Amended by P.L.141-2006, SEC.82.

Home Health Services State Statute

IC 16-27-1-5 "Home health services" Sec. 5. (a) As used in this chapter, "home health services" means services that: (1) are provided to a patient by: (A) a home health agency; or (B) another person under an arrangement with a home health agency; in the temporary or permanent residence of the patient; and (2) either, are required by law to be: (A) ordered by a licensed physician, a licensed advanced practice registered nurse, a licensed physician assistant, a licensed dentist, a licensed chiropractor, a licensed podiatrist, or a licensed optometrist for the service to be performed; or (B) performed only by a health care professional. (b) The term includes the following: (1) Nursing treatment and procedures. (2) Physical therapy. (3) Occupational therapy. (4) Speech therapy. (5) Medical social services. (6) Home health aide services. (7) Community based palliative care (as defined in IC 16-225-4.7-1). (8) Other therapeutic services. (c) The term does not apply to the following: (1) Services provided by a physician licensed under IC 25-22.5. (2) Incidental services provided by a licensed health facility to patients of the licensed health facility. (3) Services provided by employers or membership organizations using health care professionals for their employees, members, and families of the employees or members if the health or home care services are not the predominant purpose of the employer or a membership organization's business. (4) Nonmedical nursing care given in accordance with the tenets and practice of a recognized church or religious denomination to a patient who depends upon healing by prayer and spiritual means alone in accordance with the tenets and practices of the patient's church or religious denomination. (5) Services that are allowed to be performed by an attendant under IC 16-27-1-10. (6) Authorized services provided by a personal services attendant under IC 12-10-17.1. As added by P.L.2-1993, SEC.10. Amended by P.L.146-1996, SEC.2; P.L.255-2001, SEC.14; P.L.212-2005, SEC.10; P.L.141-2006, SEC.81; P.L.207-2021, SEC 12; P.L.147-2023, SEC 1.

Home Health Aide Services State Statute

IC 16-27-1-4 "Home health aide services" Sec. 4. As used in this chapter, "home health aide services" means only home health services that may be performed by a home health aide.  As added by P.L.2-1993, SEC.10.

Attendant Care Services State Statute

IC 16-18-2-28.5 Attendant Care Services Sec. 28.5. (a) "Attendant care services", for purposes of IC 16-27-1 and IC 16-27-4, means services: (1) that could be performed by an impaired individual for whom the services are provided if the individual were not impaired; and (2) that enable the impaired individual: (A) to live in the individual's home and community rather than in an institution; and (B) to carry out functions of daily living, self-care, and mobility. (b) The term includes the following: (1) Assistance in getting in and out of beds, wheelchairs, and motor vehicles, including the use of lift equipment. (2) Assistance with routine bodily functions, including: (A) bathing and personal hygiene; (B) using the toilet; (C) dressing and grooming; and (D) feeding, including preparation and cleanup. (3) The provision of assistance: (A) through providing reminders or cues to take medication, the opening of preset medication containers, and providing assistance in the handling or ingesting of medications, including controlled substances, prescription drugs, eye drops, herbs, supplements, and over-the-counter medications; and (B) to an individual who is unable to accomplish the task due to an impairment and who is: (i) competent and has directed the services; or (ii) incompetent and has the services directed by a competent individual who may consent to health care for the impaired individual. As added by P.L.255-2001, SEC.12. Amended by P.L.212-2005, SEC.3; P.L.86-2014, SEC.1. P.L.77-2021, SEC. 1.