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Personal Care Services (PCW)

 

Prior Authorization Requirements

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Important Update from the Prior Authorization Department!

Effective 11/1/2025, iCare will require all initial Personal Care Worker (PCW) referrals in the SSI or BadgerCare+ programs, that request three or more hours per day, to include a personal needs assessment prior to submitting the Prior Authorization.

 

PCW Personal Needs Assessment Pilot

Frequently Asked Questions (FAQ)          

This personal needs assessment must be conducted by Holistic Home Health Care or Independence First for selected iCare SSI or BadgerCare+ enrollees residing in Kenosha, Milwaukee, Ozaukee, Racine, Washington and Waukesha Counties. 

Holistic Home Health Care

Email: Tessa.Decker@Holistichh.com


Phone Support: 414-231-3130

Holistic Home Health Care Referral Form for Personal Needs Assessment

 

Independence First

Email: IC_Assessments@IndependenceFirst.org 
or copy this address:  IC_Assessments@IndependenceFirst.org

Phone Support: 414-291-7520

Independence First Referral form for Personal Needs Assessment

 

ForwardHealth requires persons who are requesting authorization for Personal Care (PC) service to complete and submit the Personal Care Screening Tool (PCST) form. Please read these instructions prior to completing the PCST form:

 

  PCW Provider Guide and Referral Process

 PCW Provider Guide     PCW Referral Process

 

  iCare PCW Prior Auth Form & Checklist

 PCW PA Fillable Request Form       PCW Provider Fillable Checklist

 

  DHS Personal Care Screening Tool (PCST) Form & Instructions

                   PCST Fillable Form       PCST Instructions

 

  EVV Form (f02717) Live-In Worker Identification 

                                    EVV Fillable Form

 

These documents and others can also be found on the Prior Authorization Main Page or Prior Authorizations Documents page.

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