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Home care programs · Pennsylvania

Pennsylvania home care programs

Pennsylvania pays for care at home through 8 programs. Consumer-directed care is available through CHC Participant-Directed Personal Assistance Services and In-Home and Community Support (ODP intellectual disability/autism waivers) (IHCS). Family members can be paid caregivers in 4 of them.

Verified Oct 9, 2026Sources: official state and federal agencies

Every state
Programs
8
Consumer-directed
Yes
Family can be paid
Yes
Structured family caregiving
No
On this page
Programs

Every way Pennsylvania pays for care at home

Pennsylvania pays for care at home through 8 programs. Consumer-directed care is available through CHC Participant-Directed Personal Assistance Services and In-Home and Community Support (ODP intellectual disability/autism waivers) (IHCS). Family members can be paid caregivers in 4 of them.

ProgramTypeCan family be paidHow it differs
Home Health Services (Medical Assistance)State Plan home health (42 CFR 440.70)Home healthNoSkilled home health: nursing, therapy and aide visits under a plan of care from a licensed home health agency; run as a Medicaid State Plan benefit, available through fee-for-service and managed care.
Community HealthChoices Personal Assistance Services (agency model) (CHC)1915(c) waiver PA.0386 operated concurrently with 1915(b) (Community HealthChoices)Agency personal careYesAgency personal care: non-medical daily help from aides a licensed agency employs; run as a 1915(c) home and community-based services waiver, delivered through managed-care plans.
CHC Participant-Directed Personal Assistance Services1915(c) waiver PA.0386 (Appendix E participant direction)Consumer-directedYesConsumer-directed care: the participant hires and directs their own aide, with payroll handled for them; run as a 1915(c) home and community-based services waiver, delivered through managed-care plans.
In-Home and Community Support (ODP intellectual disability/autism waivers) (IHCS)1915(c) waivers PA.0147 (Consolidated), PA.1486 (Community Living), PA.0354 (P/FDS)Consumer-directedYesConsumer-directed care: the participant hires and directs their own aide, with payroll handled for them; run as a 1915(c) home and community-based services waiver, paid fee-for-service.
OBRA Waiver1915(c) waiver PA.0235Waiver in-homeYesWaiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as a 1915(c) home and community-based services waiver, paid fee-for-service.
Living Independence for the Elderly (LIFE) (PACE)Medicare/Medicaid PACE (42 CFR 460)PACENot statedPACE: one organization covers medical care, a day center and home care for people 55 and over; run as the PACE benefit, delivered through managed-care plans.
Act 150 Programstate-funded (Attendant Care Services Act, 62 P.S. 3051 et seq.)State-fundedNot statedState-funded home care: paid outside Medicaid, usually for people who do not qualify for it; run as state funds outside Medicaid, paid fee-for-service.
OPTIONS Program (Help at Home)state-funded (PA Lottery / Department of Aging)State-fundedNot statedState-funded home care: paid outside Medicaid, usually for people who do not qualify for it; run as state funds outside Medicaid, paid fee-for-service.
Guide

Home health vs home care vs consumer-directed care in Pennsylvania

What each kind of program is, who employs the caregiver and when a family member can be paid.

Home health: the medical benefit

In Pennsylvania, skilled home health is Home Health Services (Medical Assistance). It is a medical benefit: a doctor or other practitioner orders nursing, therapy or home health aide visits under a written plan of care, and the visits stop when the skilled need ends.

Only a licensed home health agency enrolled with Pennsylvania Medicaid can bill it, and the agency's own nurses, therapists and aides make the visits. Family members are not paid under this benefit.

Home care: non-medical personal care through an agency

Help with bathing, dressing, eating, toileting and household tasks is "home care" or personal care. In Pennsylvania the agency route is Community HealthChoices Personal Assistance Services (agency model) (CHC). No skilled need is required; the person qualifies on functional need, usually measured by an assessment of daily activities.

The agency recruits, trains, schedules and pays the aides, and it is the employer. Community HealthChoices Personal Assistance Services (agency model) (CHC) lets the agency hire a family member as the aide, with the agency still the employer.

Consumer-directed care: the person hires their own aide

Pennsylvania's consumer-directed option is CHC Participant-Directed Personal Assistance Services and In-Home and Community Support (ODP intellectual disability/autism waivers) (IHCS). The person receiving care, or a representative, recruits, hires, trains, schedules and supervises the aide, and can let go of one. A fiscal intermediary runs payroll, taxes and background checks, so the person never handles wages directly.

This is the route most families use to be paid: CHC Participant-Directed Personal Assistance Services and In-Home and Community Support (ODP intellectual disability/autism waivers) (IHCS) allow a relative to be hired as the paid aide. Which relatives qualify (adult children, parents of adults, spouses, legal guardians) and how a live-in caregiver is treated are set program by program.

Structured family caregiving: a paid live-in family caregiver

Pennsylvania has no structured family caregiving program. A family caregiver is paid instead through consumer-directed care (CHC Participant-Directed Personal Assistance Services and In-Home and Community Support (ODP intellectual disability/autism waivers) (IHCS)), by the hour, as the participant's chosen aide.

Other ways Pennsylvania pays for care at home

Waiver in-home services: OBRA Waiver. These pay for in-home supports for people who meet a nursing-home or similar level of care, often with more services than state plan personal care and, in some programs, a waiting list or enrollment cap.

PACE: Living Independence for the Elderly (LIFE) (PACE). One PACE organization covers medical care, a day center and home care for people 55 and over who need nursing-home level care.

State-funded: Act 150 Program and OPTIONS Program (Help at Home). Paid from state funds outside Medicaid, for people who do not qualify for Medicaid or are waiting for it.

Which one fits

  • Needs nursing, wound care, injections or therapy at home: home health (Home Health Services (Medical Assistance)).
  • Needs daily help and wants an agency to supply and manage the aide: Community HealthChoices Personal Assistance Services (agency model) (CHC).
  • Wants to choose the aide, including a relative where allowed: CHC Participant-Directed Personal Assistance Services and In-Home and Community Support (ODP intellectual disability/autism waivers) (IHCS).
  • Meets nursing-home level of care and needs more than personal care: OBRA Waiver.
In the workspace

Pennsylvania program rules, side by side

Eligibility, the family caregiver rules (spouses, parents, live-in caregivers), employer of record, fiscal intermediary, caregiver training, provider requirements, how to enroll, published pay, EVV and waiting lists: 99 details across 8 programs.

ProgramFamily rulesEmployerEligibilityPay
See Pennsylvania's program rules — start free

Who can be paid, who employs the caregiver, what each program requires of agencies and caregivers, how to become a provider and what it pays, for all 8 programs.

  • Family caregiver rules
  • Provider requirements
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Program by program

Pennsylvania's programs

What each program is and how it differs from the others. Locked details open in the workspace.

Home Health Services (Medical Assistance)

Home health

State Plan home health (42 CFR 440.70) · PA Department of Human Services, Office of Medical Assistance Programs

Skilled home health: nursing, therapy and aide visits under a plan of care from a licensed home health agency; run as a Medicaid State Plan benefit, available through fee-for-service and managed care.

Can family be paid?No
How to get set up
Provider track · 7 steps
  1. Form the entity and get an NPI
  2. 6 more steps: forms, fees, timelines and links
Family / participant track · 4 steps
  1. Get Medical Assistance coverage
  2. 3 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredFamily caregiver rulesEmployer of recordCaregiver requirementsProvider requirementsHow to become a providerEVVWaiting list or capManaged-care plansHow it differs, in detailSetup checklistUnlock the details →

Community HealthChoices Personal Assistance Services (agency model) (CHC)

Agency personal care

1915(c) waiver PA.0386 operated concurrently with 1915(b) (Community HealthChoices) · PA DHS, Office of Long-Term Living (OLTL)

Agency personal care: non-medical daily help from aides a licensed agency employs; run as a 1915(c) home and community-based services waiver, delivered through managed-care plans.

Can family be paid?Yes
How to get set up
Provider track · 9 steps
  1. Form the entity and get FEIN
  2. 8 more steps: forms, fees, timelines and links
Family / participant track · 8 steps
  1. Call the Independent Enrollment Broker
  2. 7 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetFamily caregiver rulesEmployer of recordCaregiver requirementsProvider requirementsHow to become a providerPay rateEVVWaiting list or capManaged-care plansRecent changesHow it differs, in detailSetup checklistUnlock the details →

CHC Participant-Directed Personal Assistance Services

Consumer-directed

1915(c) waiver PA.0386 (Appendix E participant direction) · PA DHS, Office of Long-Term Living

Consumer-directed care: the participant hires and directs their own aide, with payroll handled for them; run as a 1915(c) home and community-based services waiver, delivered through managed-care plans.

Can family be paid?Yes
How to get set up
Provider track · 2 steps
  1. No separate FMS enrollment route
  2. 1 more step: forms, fees, timelines and links
Family / participant track · 7 steps
  1. Become CHC eligible
  2. 6 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetFamily caregiver rulesEmployer of recordFiscal intermediaryCaregiver requirementsProvider requirementsHow to become a providerPay rateEVVWaiting list or capManaged-care plansRecent changesHow it differs, in detailSetup checklistUnlock the details →

In-Home and Community Support (ODP intellectual disability/autism waivers) (IHCS)

Consumer-directed

1915(c) waivers PA.0147 (Consolidated), PA.1486 (Community Living), PA.0354 (P/FDS) · PA DHS, Office of Developmental Programs (ODP) with county Administrative Entities

Consumer-directed care: the participant hires and directs their own aide, with payroll handled for them; run as a 1915(c) home and community-based services waiver, paid fee-for-service.

Can family be paid?Yes
How to get set up
Provider track · 8 steps
  1. Complete ODP Provider Applicant Orientation
  2. 7 more steps: forms, fees, timelines and links
Family / participant track · 8 steps
  1. Apply for ODP eligibility
  2. 7 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetFamily caregiver rulesEmployer of recordFiscal intermediaryCaregiver requirementsProvider requirementsHow to become a providerEVVWaiting list or capRecent changesHow it differs, in detailSetup checklistUnlock the details →

OBRA Waiver

Waiver in-home

1915(c) waiver PA.0235 · PA DHS, Office of Long-Term Living

Waiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as a 1915(c) home and community-based services waiver, paid fee-for-service.

Can family be paid?Yes
How to get set up
Provider track · 8 steps
  1. Form the entity, get NPI and FEIN
  2. 7 more steps: forms, fees, timelines and links
Family / participant track · 7 steps
  1. Contact the Independent Enrollment Broker
  2. 6 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetFamily caregiver rulesEmployer of recordFiscal intermediaryCaregiver requirementsProvider requirementsHow to become a providerEVVRecent changesHow it differs, in detailSetup checklistUnlock the details →

Living Independence for the Elderly (LIFE) (PACE)

PACE

Medicare/Medicaid PACE (42 CFR 460) · PA DHS, Office of Long-Term Living

PACE: one organization covers medical care, a day center and home care for people 55 and over; run as the PACE benefit, delivered through managed-care plans.

Can family be paid?Not stated
How to get set up
Provider track · 4 steps
  1. Get the State's assurance
  2. 3 more steps: forms, fees, timelines and links
Family / participant track · 4 steps
  1. Find a LIFE provider
  2. 3 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredEmployer of recordProvider requirementsHow to become a providerHow it differs, in detailSetup checklistUnlock the details →

Act 150 Program

State-funded

state-funded (Attendant Care Services Act, 62 P.S. 3051 et seq.) · PA DHS, Office of Long-Term Living

State-funded home care: paid outside Medicaid, usually for people who do not qualify for it; run as state funds outside Medicaid, paid fee-for-service.

Can family be paid?Not stated
How to get set up
Provider track · 2 steps
  1. Agencies enroll with OLTL
  2. 1 more step: forms, fees, timelines and links
Family / participant track · 5 steps
  1. Contact the Independent Enrollment Broker
  2. 4 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetEmployer of recordFiscal intermediaryProvider requirementsHow to become a providerEVVWaiting list or capHow it differs, in detailSetup checklistUnlock the details →

OPTIONS Program (Help at Home)

State-funded

state-funded (PA Lottery / Department of Aging) · PA Department of Aging through 52 Area Agencies on Aging

State-funded home care: paid outside Medicaid, usually for people who do not qualify for it; run as state funds outside Medicaid, paid fee-for-service.

Can family be paid?Not stated
How to get set up
Provider track · 2 steps
  1. Hold a Home Care Agency license
  2. 1 more step: forms, fees, timelines and links
Family / participant track · 6 steps
  1. Contact your Area Agency on Aging
  2. 5 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetFamily caregiver rulesEmployer of recordProvider requirementsHow to become a providerEVVWaiting list or capHow it differs, in detailSetup checklistUnlock the details →
FAQ

Frequently asked questions

Can family members get paid to be caregivers in Pennsylvania?

Yes. Community HealthChoices Personal Assistance Services (agency model) (CHC), CHC Participant-Directed Personal Assistance Services, In-Home and Community Support (ODP intellectual disability/autism waivers) (IHCS), and OBRA Waiver let a family member be the paid caregiver. Which relatives qualify, including spouses and parents of minor children, is set program by program.

Does Pennsylvania have consumer-directed care?

Yes: CHC Participant-Directed Personal Assistance Services and In-Home and Community Support (ODP intellectual disability/autism waivers) (IHCS). The person receiving care hires and directs their own aide, and a fiscal intermediary handles payroll.

Does Pennsylvania have structured family caregiving?

No. Pennsylvania does not run a structured family caregiving program. Family caregivers are paid through consumer-directed care instead.

What is the difference between home health and home care in Pennsylvania?

Home health (Home Health Services (Medical Assistance)) is medical: nursing, therapy and aide visits ordered by a practitioner and delivered by a licensed home health agency. Home care (Community HealthChoices Personal Assistance Services (agency model) (CHC)) is non-medical help with daily activities, based on functional need.

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