Guides → Pennsylvania

Getting paid to care for a parent in Pennsylvania

Updated 2026-08-10 · Every figure below is dated and sourced · Rules change — confirm with the agency
The short answer: Pennsylvania's door is Participant-directed services (also called self-directed services or Employer Authority) inside the Community HealthChoices (CHC) waiver - this is the option where your parent becomes the employer and hires you directly, with Tempus Unlimited handling payroll. Services My Way is a related but separate add-on (Budget Authority) that additionally lets your parent manage a spending budget for goods and services; useful, but not required to put you on the payroll. Both are also available through the OBRA waiver and the state-funded Act 150 program., run by Pennsylvania Department of Human Services, Office of Long-Term Living (OLTL); day-to-day services run through three CHC managed-care plans (AmeriHealth Caritas/Keystone First, PA Health & Wellness, UPMC). Pay: You and your parent agree on the hourly wage, up to a maximum that depends on BOTH the county your parent lives in and which of the three CHC health plans they picked. This is your actual take-home wage, not the plan's billing rate - the rate sheet says the maximum is what the worker receives after employer taxes and workers' comp are taken out of the region's bill rate. For new employers, effective 1/1/2026, the maximum Direct Care Worker wage for Personal Assistance Services (code W1792) runs $14.42-$18.50/hr. By region, listed as AmeriHealth Caritas/Keystone First / UPMC / PA Health & Wellness: Region 1 (Allegheny, Armstrong, Beaver, Fayette, Greene, Washington, Westmoreland) $15.05 / $16.12 / $16.59. Region 2 (the 35 northern and rural counties - Erie, Luzerne, Lackawanna, Centre, Butler, Cambria, Monroe and the rest) $14.42 / $17.25 / $18.06. Region 3 (Adams, Berks, Carbon, Cumberland, Dauphin, Franklin, Fulton, Huntingdon, Juniata, Lancaster, Lebanon, Lehigh, Northampton, Perry, Schuylkill, York) $15.76 / $16.12 / $17.29. Region 4 (Bucks, Chester, Delaware, Montgomery, Philadelphia) $17.67 / $17.36 / $18.50. Note that the highest single rate in the state is not in Philadelphia - it is $18.50 in the southeast under PA Health & Wellness, but rural Region 2 under that same plan pays $18.06, more than most southeastern rates. So it is worth asking which plan pays best in your county before your parent chooses. Respite (code S5150) pays less and is the same across all three plans: $11.83 Region 1, $11.33 Region 2, $12.40 Region 3, $13.92 Region 4. Figures read directly off the fiscal agent Tempus Unlimited's official 'New CLE Maximum DCW Hourly Pay Rate Sheet,' Rev. 2026-03, effective 1/1/2026, checked 2026-08-09.

Who can be the paid caregiver

Adult children, siblings, grandchildren, in-laws, other relatives, friends, and neighbors can all be hired as the paid Direct Care Worker. The caregiver must be 18 or over, have a valid Social Security number, pass a criminal background check, and clear the exclusion registries Tempus checks every month (federal OIG/LEIE, Medicheck, SAM.gov) - being listed on any of them means you cannot be hired, and an existing worker who lands on one is terminated. Here is the part that trips families up: the paid worker cannot also be the person speaking or signing for your parent. Under the DHS-approved Services My Way manual and the Tempus Common Law Employer Handbook, the Direct Care Worker cannot be the participant's spouse, legal guardian, power of attorney, representative payee, designated representative, or the common-law employer. If you want the paycheck, someone else - ideally your parent themselves - has to hold the employer and representative roles. Sort this out before anyone signs the enrollment forms.

The spouse question

No - Pennsylvania Medicaid will not pay a spouse. During the pandemic, OLTL used a temporary Appendix K waiver amendment to let a small number of spouses, legal guardians, representative payees, and power-of-attorney holders be paid caregivers case by case. That ended with the federal public health emergency: no payment for hours worked after May 11, 2023, and the pre-pandemic ban is back with no exceptions. The rule lives in the Community HealthChoices waiver and OLTL policy - it is spelled out in the DHS-approved Services My Way manual and the Tempus Common Law Employer Handbook, not in the Pennsylvania Code chapter on home and community-based services, which says nothing about spouses. If you see the state regulation cited for this, it is being cited wrongly. The realistic paid-spouse routes in PA are federal VA programs: Veteran-Directed Care and the VA PCAFC caregiver stipend, both for veterans only.

Waitlist reality

Community HealthChoices is the main door for adults 21 and over who are dual-eligible (Medicare plus Medicaid) or need long-term services and supports - not just people 60+. Enrollment is generally not waitlisted in practice: if your parent meets nursing-facility level of care and the financial limits (2026: income about $2,982/mo, which is 300% of the federal SSI rate, and countable assets about $8,000 for a single person - Pennsylvania's usual $2,000 plus an extra $6,000 exemption), they get in. Expect roughly 60-90 days for the application itself. Neither the state's waiver policy manual nor the DHS CHC page currently describes a waiting list, though the waiver technically has enrollment slots, so one could form; priority would go to people leaving a nursing home or at immediate risk of entering one. The state-funded programs are where lines actually form: the Caregiver Support Program's cash reimbursement can hit funded-capacity interest lists at some Area Agencies on Aging, and Act 150 runs on a capped state appropriation.

Worth knowing: Disqualifiers to state plainly: spouses and legal guardians cannot be paid through any PA Medicaid or state-funded route; neither can a power of attorney, representative payee, designated representative, or the common-law employer - so if you want the paycheck, do not sign up to be your parent's representative or employer, and make sure someone else holds those roles before the forms go in. The parent must need nursing-facility level of care (needing only light help won't qualify); income above ~$2,982/mo (2026) or assets above ~$8,000 (single, home exempt) blocks CHC unless spend-down/trust planning applies; a caregiver who fails the criminal background check or turns up on the OIG, Medicheck, or SAM.gov exclusion lists can't be hired, and Tempus rechecks those lists monthly. The quoted wage maximums are the participant-directed (common-law employer) caps for NEW employers - if you instead work through a home-care agency's family-caregiver program (very common in PA), the agency sets your wage out of its own reimbursement, and it is typically well below the participant-directed cap; ask for the number in writing. Rates changed 1/1/2026, and an existing employer's exact maximum varies with their own state unemployment insurance rate, so use the Tempus pay rate calculator for your plan rather than the new-employer sheet. PA taxes IRS Notice 2014-7 difficulty-of-care wages at its 3.07% flat rate even when they're federal-tax-free. The whole intake, honestly, takes 2-3 months before the first paycheck - plan finances around that gap.

Other doors in Pennsylvania

ProgramWhat to know
Caregiver Support Program (PA Dept. of Aging)State program paying caregivers back up to $600/month for caregiving expenses plus up to $5,000 lifetime for home modifications (amounts set by Act 20 of 2021). Reimbursement, not a wage; sliding scale — 100% reimbursed at/below 200% of poverty, nothing above 380%. Apply through your county Area Agency on Aging (find yours via PA Link, 1-800-753-8827).
Act 150 Attendant Care ProgramState-funded twin of the Medicaid attendant-care benefit for ages 18-59 with a physical disability whose income is too high for Medicaid — not a fit for most parents 60+, but relevant for younger care recipients. Includes Services My Way self-direction; small income-based copay. Apply via the IEB, 1-877-550-4227; OLTL info line (717) 787-8091.
OBRA WaiverFor adults 18-59 with severe developmental physical disabilities; same Services My Way option and same family-hire rules as CHC. Apply via the IEB.
Veteran-Directed Care (VDC)Available in Pennsylvania through participating VA medical centers with local AAAs/Centers for Independent Living; the veteran gets a flexible monthly budget and may hire family — including a spouse. Ask the veteran's VA social worker; availability varies by VA facility.
VA caregiver benefits (PCAFC and Aid & Attendance)PCAFC pays a monthly stipend to a family caregiver of an eligible veteran (VA Caregiver Support Line 1-855-260-3274). Aid & Attendance adds up to roughly $2,424/mo (2026, single veteran) to a wartime veteran's pension, which can informally fund family care. Use free county Veteran Service Officers, never paid consultants.
Structured Family CaregivingPennsylvania does NOT have a Georgia/Indiana-style structured family caregiving per-diem model in its Medicaid waivers; the hourly Services My Way route is the mechanism here.

Wartime veteran or surviving spouse in the family? VA Aid & Attendance stacks on top of state programs — see the national guide.

How to apply — step by step

  1. 1. Call the PA Independent Enrollment Broker (IEB) at 1-877-550-4227 (TTY 1-877-824-9346) to start a Community HealthChoices application, or apply online at pa.gov/services/dhs/apply-for-community-healthchoices.
  2. 2. The IEB arranges the functional assessment (must meet nursing-facility level of care); the County Assistance Office decides financial eligibility (2026: about $2,982/mo income, roughly $8,000 countable assets for a single person; the house is exempt while lived in).
  3. 3. Once approved, your parent picks a CHC plan (AmeriHealth Caritas/Keystone First, PA Health & Wellness, or UPMC) and tells the plan's service coordinator they want PARTICIPANT-DIRECTED services, so they can hire their own Direct Care Worker instead of using an agency. That is the option that lets you get paid. Services My Way is a separate, optional add-on (it gives your parent a budget to spend on goods and services); you do not need it just to be hired and paid.
  4. 4. Decide up front who holds which role, because one person cannot hold both. Your parent should stay the common-law employer if they are able - if they cannot, someone OTHER than you must be named common-law employer or designated representative. The rule is strict: the common-law employer, the designated representative, the power of attorney, the representative payee, and the legal guardian all cannot be the paid Direct Care Worker. Sign the paperwork the wrong way around and you lose the paycheck.
  5. 5. The common-law employer enrolls with the fiscal agent, Tempus Unlimited (1-844-983-6787), and you complete your Direct Care Worker hiring paperwork, criminal background check, and exclusion-registry checks (OIG, Medicheck, SAM.gov).
  6. 6. Set your hourly wage up to the county-and-plan maximum, log hours through electronic visit verification, and Tempus issues your paychecks. First payment typically lands 60-90 days after the initial application.

Where to start: PA Independent Enrollment Broker (IEB) — 1-877-550-4227, paieb.com (the single front door for CHC, OBRA, and Act 150 enrollment)

Do it yourself vs. get help

Free, accredited help first, always: your Area Agency on Aging (eldercare.acl.gov) walks families through these applications at no charge, and your county Veterans Service Officer files VA claims free. Where Resbit fits: if you're working a job and don't have hours for hold music, Resbit finds what your family qualifies for, fills out the paperwork down to the signature line, and does the chasing — flat $49/month, and the screener that starts it is free.

Find out what your family qualifies for

Free · 10 questions · No account needed · Honest when the answer is "not yet"

Try the free screener Join the waitlist
No spam. Unsubscribe anytime.
You're on the list. 🌿
Sources & dates checked: Program rules and payment rates change. Everything here is educational — real eligibility is decided by the agencies, based on your family's details.