Attachment D -PCA ID Card Model Contract - Required Card Specifications.docx

Attachment D is a specification document for Personal Care Attendant (PCA) identification card services issued by the Massachusetts Executive Office of Health and Human Services (EOHHS) through a Request for Responses (RFR) process governed by 801 CMR 21.00. The document establishes the required specifications for PCA identification cards to be processed, printed, and mailed by qualified bidders. The front of each card must display the PCA's name, designation as a MassHealth PCA Program provider, a photo of the PCA, the Fiscal Intermediary unique ID number, and the issue date. The back of the card must include a statement indicating that the holder is a MassHealth provider of personal care attendant services who may be required to work during a State of Emergency or Shelter-in-Place order, along with a validity period of two years from issuance and disclaimer language protecting the MassHealth Program, the PCA Quality Homecare Workforce Council, the Executive Office of Health and Human Services, and the Commonwealth of Massachusetts from liability for the cardholder's actions.

The RFR does not specify quantities, response dates, due dates, site visits, bidder's meetings, award dates, pricing terms, set-asides, or funding amounts within this attachment. The document functions as a technical specification reference for bidders responding to the identification card services procurement, ensuring standardized card design and content across all PCA providers participating in the MassHealth program.