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Last updated: 17 October 2026
If you need help at home in Pennsylvania, Community HealthChoices may pay for approved care. Services My Way lets some members direct a care budget and hire workers. You must qualify for the right Medicaid long-term care services first.
Bottom Line
Community HealthChoices (CHC) is Pennsylvania’s Medicaid managed care program. Its long-term services and supports (LTSS) can include help with bathing, dressing, moving, and other daily needs. Services My Way (SMW) is a budget-directed way to arrange some authorized CHC waiver services, not a separate cash grant. New applicants should call the Pennsylvania Independent Enrollment Broker at 1-877-550-4227. People already approved for CHC LTSS should ask their CHC service coordinator about employer-directed care and Services My Way.
Start Here
- Not yet approved for home care? Call the Independent Enrollment Broker, 1-877-550-4227, and ask to start the LTSS screening.
- Already receiving CHC long-term care? Contact your CHC health plan. Ask the service coordinator for a review of self-directed options.
- Want to hire a relative? Before anyone starts paid work, ask about the worker’s relationship to the member, required enrollment, approved hours, and the payroll agent.
Who May Qualify for CHC Home Care?
Pennsylvania’s CHC program covers eligible adults age 21 or older. One group has both Medicare and Medicaid. Another group qualifies for Medicaid LTSS because of a need for nursing-facility-level care. But being enrolled in CHC does not by itself approve paid daily home care. The person must also be assessed and approved for the long-term services in their care plan.
For LTSS, a state-approved assessment looks at daily care needs. The county assistance office also decides Medicaid financial eligibility. Pennsylvania’s long-term care eligibility rules consider income, resources, and other factors. The state publishes 2026 limits, but rules can differ for a married couple or a different Medicaid category. Do not move or give away assets without advice. Medicaid’s look-back rules can affect a case.
The program serves Pennsylvania statewide, yet the worker network, service coordinator, and time needed to set up care can differ. CHC is not the right route for everyone, including certain people receiving developmental-disability services through a different state office. The official CHC application page explains the screening groups and exclusions.
Three Ways to Arrange Approved Care
A CHC member with approved home and community-based services can discuss how the care will be delivered. These are service models, not three separate checks. Pennsylvania’s 2026 participant-direction materials explain employer authority and budget authority.
| Model | Who arranges care? | Important limit |
|---|---|---|
| Agency-managed care | A participating home-care agency assigns and pays its workers. | Ask the agency whether it can hire your preferred person. That is not automatic. |
| Employer authority | The member or approved representative recruits, trains, schedules, and supervises a worker. | A fiscal agent processes payroll, but the member still has employer duties. |
| Services My Way | The member manages an approved spending plan and may direct workers and approved goods or services. | Purchases must be allowed and authorized; it is not spending money for anything. |
Example: A man needs help getting dressed each morning. His CHC plan approves personal assistance. He could ask for agency workers or explore hiring a qualified worker himself. If he wants to use budget authority, he must ask the coordinator what spending plan and support services would be allowed. Neither choice creates more hours without approval.
Do not confuse a normal licensed home-care agency with a proposed model called Agency with Choice. A state 2026 CHC agreement document was labeled pending approval and made Agency with Choice subject to federal approval. Ask your health plan whether that specific model has been approved and is operating before relying on it.
How to Enroll Before Hiring Anyone
- Start the LTSS request. Call the Independent Enrollment Broker, 1-877-550-4227. The broker can help arrange a care assessment and guide the Medicaid paperwork. You can also request a long-term care application by phone through the Consumer Service Center at 1-866-550-4355, as shown on the state’s long-term care application page.
- Complete the care and financial reviews. Explain what happens on a hard day: bathing, toileting, transfers, meals, safety, or mobility. A doctor may need to supply medical information. The county assistance office reviews financial records.
- Choose the CHC plan. The broker explains plan choices. A plan is not the same as a Medicare Advantage policy. Ask which provider and service-coordination options are available where you live.
- Build the person-centered service plan. The CHC service coordinator works with the member to identify necessary services. Ask what service, how many units, and what start date the plan authorizes.
- Choose how to direct care. Ask in writing for a comparison of agency care, employer authority, and Services My Way. Then complete the model-specific forms with help from the coordinator and fiscal agent.
For an online Medicaid application, the state’s Medicaid application service points to COMPASS. If you are already in CHC but have no LTSS authorization, ask for a needs assessment rather than applying for SMW as though it were a stand-alone benefit.
Hiring a Family Member or Another Attendant
Many adult children, siblings, grandchildren, friends, and neighbors may work if they meet the rules. But Pennsylvania’s CHC family-worker rules exclude payment for services by the member’s spouse, legal guardian, representative payee, or person holding power of attorney. Ask the coordinator to check the exact proposed worker’s roles before you make plans. A family member who already handles money or legal paperwork may face a conflict.
The care member remains central to the choice. If they need help directing workers, ask how an authorized representative can take on employer tasks. A representative’s authority to help manage care is not proof that the same person can receive caregiver wages.
| Step | What to confirm |
|---|---|
| Eligibility | Worker’s age, identity, work authorization, clearances, and relationship to the member. |
| Employer papers | Who signs as the common-law employer and who may act as representative. |
| Worker enrollment | Forms, training, background checks, and any needed health or driving records. |
| Paid start | Approved service, work schedule, allowed pay rate, payroll setup, and time-entry method. |
State financial-management guidance describes how a vendor fiscal/employer agent helps with tax withholding, payroll, timesheets, and workers’ compensation. Keep copies of signed forms. Do not assume care provided before authorization and worker enrollment will be paid later.
Workers must record actual approved care. Pennsylvania’s electronic visit verification rules cover many personal assistance services. Ask the fiscal agent which current timekeeping tool applies to your case; an old online instruction may name the wrong vendor.
Pay, Services My Way Budgets, and Records
There is no guaranteed statewide family-caregiver wage. Pay depends on the approved service, pay rules, the CHC plan, and the worker setup. Pennsylvania announced participant-directed worker pay increases during 2026, retroactive to 1 January 2026 for affected workers. That announcement does not mean each new family worker gets a set hourly rate. Ask for the rate and effective date in writing.
Services My Way uses budget authority. The coordinator helps turn approved services into a spending plan, while the fiscal agent tracks payments. An authorized budget may cover certain worker services or other allowed supports tied to the care plan. It is not a personal bank account, and unused funds cannot simply be taken as cash. The state’s Services My Way page provides enrollment, representative, backup-worker, and withdrawal forms.
Ask the coordinator what would happen if the chosen worker is sick or quits. The state waiver materials describe help making a backup plan and, when changing models, avoiding a break in services. Ask what interim agency care is possible while a new worker finishes checks. Review service hours and spending statements rather than waiting for a missed paycheck.
Reality Check
Family care already being provided is not automatically billable. Only documented, approved services from an eligible enrolled worker are candidates for payment. A shortage of workers or a delayed financial review can still slow the start of care.
CHC Is Not Medicare Advantage or Community Aging Aid
CHC is a Medicaid program. Medicare and Medicare Advantage may cover certain medical home-health services, but a Medicare card alone does not enroll a person in paid Medicaid LTSS. A dual-eligible person may have both programs, with different rules for which one pays first. Pennsylvania’s Medicare and Medicaid coordination page explains the separate roles of Medicare special-needs plans and CHC.
Need a broader comparison of skilled nursing, daily personal care, and private pay? Our Pennsylvania home-care payment guide explains those routes. For the wider question of which relatives might earn wages, see Pennsylvania family caregiver pay.
If Medicaid is not approved, ask your local Area Agency on Aging about OPTIONS or caregiver support. These programs provide services or approved cost help; they are not the same as a CHC family-worker paycheck. Use our Pennsylvania aging-agency guide to find the right local route. For a short break from caregiving, our respite care guide explains what to ask.
When the Application, Hours, or Pay Gets Stuck
| Problem | First action |
|---|---|
| Financial decision pending | Ask the county assistance office what proof is missing and get a receipt when you submit it. |
| Care assessment pending | Call the enrollment broker and ask which assessment or medical report is outstanding. |
| Worker cannot start | Ask the coordinator and payroll agent which enrollment or clearance step is still open. |
| Hours reduced or denied | Read the written notice, ask for the plan’s complaint or grievance route, and check appeal instructions right away. |
Pennsylvania’s official hearing process covers Medicaid benefit disputes and care-level decisions. The right deadline and filing address depend on the notice and the type of decision. A CHC plan service denial may involve a plan complaint or grievance before a state fair hearing. Do not use a deadline from a different kind of Medicaid notice.
Keep the decision letter, service plan, a dated log of calls, and proof of submitted papers. If care is being cut off, ask at once whether services can continue while a timely challenge is reviewed. If you need help sorting out where to file, call the CHC participant line at 1-800-757-5042. For a lost benefit or other application problem, our Pennsylvania benefits portals guide may help you find the right state account or application route.
Common Mistakes to Avoid
- Asking a Medicare Advantage plan to enroll a family member in CHC paid-caregiver work.
- Choosing a relative to be paid before checking power-of-attorney or guardian roles.
- Thinking a Services My Way budget is an unrestricted grant or direct payment to the senior.
- Starting shifts before the care plan, worker forms, and timekeeping process are approved.
- Waiting until an appeal deadline has passed because a phone call seemed enough.
If the older adult needs help now, tell the coordinator or enrollment broker about the immediate safety issue. Ask the local aging agency about temporary home support while the Medicaid case moves forward. If the person has other disability-related needs, our Pennsylvania disability help guide lists related starting points. Do not leave a person without necessary care based on an expected approval date.
Phone Scripts You Can Use
For the enrollment broker
“My parent needs daily help at home. We want a CHC long-term services assessment. What is the next step, and which medical and financial papers should we gather?”
For a CHC service coordinator
“Our care plan includes personal assistance. Please explain employer-directed care and Services My Way. Can we choose a worker, and what forms must we complete first?”
For the fiscal agent
“Our chosen worker has not been paid. Can you tell us whether enrollment, time records, authorization, or payroll is holding up the check?”
Resumen en español
En Pensilvania, Community HealthChoices (CHC) es un programa de Medicaid. Algunas personas aprobadas para cuidado a largo plazo en casa pueden elegir trabajadores y usar Services My Way para administrar un plan de gastos autorizado. No es dinero en efectivo para uso libre. Para solicitar una evaluación, llame al 1-877-550-4227. Si ya recibe servicios CHC, pida hablar con su coordinador. Antes de contratar a un familiar, confirme las reglas, los formularios, las horas aprobadas y la forma de pago. Si recibe una negativa, revise pronto las instrucciones de apelación.
Frequently Asked Questions
Is Services My Way a separate cash grant?
No. It is a way for eligible Medicaid long-term care members to manage approved services and a spending plan. It is not unrestricted cash.
Can my adult child be my paid worker?
Possibly, if the worker meets the program rules and does not hold an excluded role, such as spouse, legal guardian, representative payee, or power of attorney.
Does Medicare Advantage pay for Services My Way?
No. Services My Way is part of Pennsylvania Medicaid long-term services, not a Medicare Advantage benefit. Medicare coverage may still work alongside Medicaid.
Who do I call when approved hours are denied?
Call your CHC plan, read the written notice, and follow its complaint, grievance, or appeal instructions. Deadlines depend on the decision, so act promptly.
About This Guide
This guide uses official federal, state, local, and other high-trust nonprofit and community sources mentioned in the article.
Editorial note
This guide is produced based on our Editorial Standards using official and other high-trust sources, regularly updated and monitored, but not affiliated with any government agency and not a substitute for official agency guidance. Individual eligibility outcomes cannot be guaranteed.
Corrections
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Disclaimer
This article is for informational purposes only and is not legal, financial, medical, tax, disability-rights, immigration, or government-agency advice. Program rules, policies, and availability can change. Readers should confirm current details directly with the official program before acting.
Last updated: 17 October 2026 · Next review: 15 January 2027
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