Get answers to your questions about the PAO and services it supports

A list of program materials, including contact information, announcements, helpful guides and materials, and other resources can be found through the PAO link at: https://www.mass.gov/masshealth-ltss-assessment-pathway.

Yes, the PAO is prepared to support all language needs and will make sure that assessments are done in a culturally appropriate, respectful, and inclusive way. These topics are part of the core training that PAO assessors receive.

If you are a MassHealth member who has MassHealth Standard or CommonHealth and you are seeking Adult Day Health (ADH), Group Adult Foster Care (GAFC), or Personal Care Attendant (PCA) services, you have the choice of having your preferred service provider or the PAO complete your initial assessment. 

If you are seeking Adult Foster Care (AFC), you must have the PAO complete your initial assessment. 

If you are already enrolled in a One Care, Senior Care Options (SCO), or Program for All-Inclusive Care for the Elderly (PACE) plan you will continue to access LTSS through your plan. 

Yes. If you are not sure if you are interested in ADH, AFC, GAFC, or PCA services, the PAO can complete your assessment and talk with you about what services you are eligible for, and you can decide which service you would like to access.

There are a few options to request an assessment from the PAO.

The PAO will complete your assessment within ten business days of collecting all required documentation, which may include an order from your Primary Care Provider (PCP). Gathering this documentation may impact how long it takes to schedule your assessment.  

It can be helpful to talk to your Primary Care Provider (PCP) about your interest in services before reaching out for an assessment. LTSS programs might require a physical exam with your PCP and a form completed by your PCP before you can be approved for services. 

Once you contact the PAO (or someone contacts them on your behalf) to request an assessment, the PAO will confirm your referral information, gather required documentation and then schedule you for an in-person visit with a nurse assessor. 

On your scheduled assessment date, your nurse assessor will talk with you about any conditions or needs you have and will be able to let you know which programs you are clinically eligible for. If you are clinically eligible for one or more programs, you will need to choose the service(s) and provider(s). 

The PAO will contact your preferred provider and once they confirm, your preferred provider will contact you to complete any program-specific next steps to get services started. 

The assessment usually takes place where you are living at the time of the assessment, although you may ask for it to be somewhere else. If you are in a nursing home or hospital, it may take place there. If you are seeking AFC services, the assessment should take place in your or your Caregiver’s home.

Your assessor will have a PAO badge with their name, photo, and their role as a PAO assessor that they will show when they arrive for your assessment.

Yes, you may include anyone of your choice with you during your assessment. If you are seeking AFC services, your Caregiver will need to be with you during your assessment. If you are seeking PCA services and you require a Surrogate, your Surrogate must be present during your assessment.

There is no special preparation you need to do in your home for your assessment. If you have a pet or animal that is not a service animal, your assessor may ask that they are kept in another room during the assessment. If you are seeking AFC, there will be some items the assessor checks in your or your Caregiver’s home to make sure their home meets all safety requirements.   

 

After your assessment, your assessor will explain what program(s) you are clinically eligible to receive. If you are not clinically eligible for the services you were assessed for, you will receive information about your appeal rights. If you are clinically eligible for services, you will need to choose which one(s) you would like to move forward with and choose a service provider. The PAO will let your chosen service provider know you have chosen them and provide them with the information they need to move forward with getting your services started.

If you do not agree with the outcome of your assessment, you can appeal the decision

  • You will get a copy of how to file an appeal with that notice. 
  • You can file an appeal with the MassHealth Board of Hearings by mail, fax, phone, in person, or online. 

More information about how to file an appeal can be found at: https://www.mass.gov/how-to/how-to-appeal-a-masshealth-decision.