However, some people, particularly individuals with higher levels of support needs, felt they had not been allotted a sufficient number of hours of PCA support by the county. In addition, because state regulations limit the tasks of PCAs to a list of Medicaid allowable tasks, some participants reported that they do not receive the type of su pport they need and desire, such as assistance with child care, community activities, and transportation. Participants have a high degree of dissatisfaction with other traditional home health care agencies . One of the major complaints they had of other agencies was that they had no choice about who was sent as a PCA and little choice as to when th is person would come. When assistants did not show up, the agencies were often unable to find back-up support.
Many people use their own networks or informal contacts for PCAs .
A few participants have found assistants through advertising in the newspaper, but most have selected friends, relatives, neighbors, or people they knew as human service workers at other agencies. PCAs receive a higher rate of pay than in most other home care agencies in the area . Participants feel that this enables them to both obtain and retain higher quality support. In addition, full-time PCAs appreciate the health insurance and ot her benefits offered to them. For some people, this works well, and they are assisted to make their own decisions and take control of their own lives.