Community HealthChoices Pennsylvania: Get Paid To Care For A Family Member

No. In Pennsylvania, a spouse is treated as a "legally responsible relative," and legally responsible relatives cannot be paid as Direct Care Workers under Services My Way or the broader Community HealthChoices participant-directed model. The participant's legal guardian is also excluded. Pennsylvania, like most states, assumes spouses already provide care to one another, so Medicaid dollars are reserved for other family members and helpers. The good news is that almost everyone else can be paid: adult children, siblings, grandchildren, nieces, nephews, in-laws, and even friends or neighbors are all eligible to be hired as the participant's worker. If you specifically need a spouse to be paid, the participant may want to explore VA Veteran-Directed Care (if they are a veteran), which can allow spouses to be paid in some situations. But under standard CHC Medicaid rules, a spouse cannot receive a Services My Way paycheck.

Under Services My Way, the participant (as the "Common Law Employer") and the Direct Care Worker agree on an hourly wage, which must fall between Pennsylvania's minimum wage and a maximum set by the state. Thanks to investments in Governor Shapiro's 2025-26 budget — retroactive to January 1, 2026 — participant-directed direct care worker rates now support roughly a $15-per-hour wage, and most workers earn between about $15 and $19 per hour. The exact maximum depends on the county the participant lives in and, for the first time in 2026, on which of the three CHC managed care plans they are enrolled in: PA Health & Wellness generally offers the highest maximums, while AmeriHealth Caritas offers the lowest. Tempus Unlimited, the Financial Management Services vendor, publishes plan-specific pay-rate calculators so you can see the exact ceiling for your situation. Workers are W-2 employees, so income taxes, Social Security, and Medicare are withheld from each paycheck.

Plan for roughly two to three months from start to first paycheck, though it varies. If the participant already has Pennsylvania Medicaid and only needs the long-term-care piece, the Independent Enrollment Broker typically schedules the in-home level-of-care assessment within a few weeks; after that, enrolling in a CHC plan and setting up Services My Way with the service coordinator takes another few weeks. If the participant is not yet on Medicaid, add 30-90 days for the County Assistance Office to process financial eligibility. Onboarding the worker through Tempus adds time too: budget four to six weeks for the criminal background check and abuse-registry clearances alone, since a worker cannot be paid until those clear. You can speed things up by gathering documents early — proof of residency, ID, Social Security cards, and income and asset records for the participant, plus identification for the worker.

One of the biggest advantages of Services My Way is that no formal certification or license is required. The Direct Care Worker does not need to be a Certified Nursing Assistant (CNA), Home Health Aide (HHA), or any other licensed professional. Because this is a participant-directed program, the participant (or their representative) trains the worker on exactly the tasks they need — bathing, dressing, transfers, meals, medication reminders, and so on. There is no clinical skills exam. What the worker does have to complete is enrollment paperwork through Tempus Unlimited: a criminal background check, Pennsylvania child-abuse and elder-abuse registry clearances, federal I-9 and W-4 forms, and a signed pay-rate agreement. This makes Services My Way especially welcoming to relatives who have been informally caring for a family member for years and simply want to be paid for that work.

Yes. An adult child (18 or older) is one of the most common Direct Care Workers under Services My Way. As long as the parent qualifies for Community HealthChoices — meaning they are 21 or older, financially eligible for Pennsylvania Medicaid, and assessed as needing a nursing-facility level of care — the adult child can be hired, trained by the parent, and paid through Tempus Unlimited. The only close relatives Pennsylvania excludes are the participant's spouse and legal guardian. Adult children, stepchildren, siblings, grandchildren, and in-laws are all eligible. Many families use this to formalize care that was already happening: an adult child who moved home to help an aging parent can now receive a real paycheck, tax withholding, and workers' compensation coverage for the same work. The child can even continue living in the parent's household while being paid.

Tempus Unlimited is the statewide Financial Management Services (FMS) vendor for Community HealthChoices participant-directed services; it took over CHC in 2022 (Public Partnerships / PPL still handles the OBRA waiver and Act 150 program). In the Services My Way model, the participant is the legal employer of their worker, but handling payroll and taxes on your own would be a burden — so Tempus acts as the fiscal agent. It issues paychecks, withholds and files federal and state payroll taxes, processes timesheets, runs the required criminal background and abuse-registry checks, and manages workers' compensation. Importantly, Tempus does not choose your worker, set their schedule, or supervise the care — those decisions stay entirely with the participant and their CHC service coordinator. Tempus also provides online tools such as pay-rate calculators and an employee self-service portal where workers can view their pay stubs.

Every Pennsylvania county is covered by all three Community HealthChoices managed care organizations: AmeriHealth Caritas (branded Keystone First Community HealthChoices in the five southeastern counties around Philadelphia), PA Health & Wellness, and UPMC Community HealthChoices. All three cover the same core Medicaid long-term-care benefits, including Services My Way, so you cannot go wrong on the basics. The differences show up in the "extras": each plan offers different supplemental benefits, has different provider networks in your area, and — new for 2026 — sets different maximum Direct Care Worker pay rates. If paying your worker as much as possible matters to you, compare the plans' maximum rate sheets (PA Health & Wellness tends to be highest). If you have a preferred doctor or specialist, check which plan includes them. You can call the CHC Helpline at 1-844-824-3655 for help comparing, and you can switch plans if your first choice is not a good fit.

No. Choosing Services My Way is simply choosing how personal assistance is delivered — you self-direct your own worker instead of using an agency — and it does not reduce or change the participant's other coverage. They keep their doctor visits, hospital care, prescription drugs, durable medical equipment, and every other benefit in their Community HealthChoices package. For participants who are "dual eligible," Medicare continues to cover acute and short-term care (hospital stays, physician visits, short-term skilled home health), while CHC Medicaid covers the ongoing long-term personal assistance that Services My Way provides. The two programs coordinate through the CHC managed care plan but do not cancel each other out. The only thing Services My Way changes is who employs and directs the worker — putting the participant, rather than an agency, in control of their day-to-day care.