Pennsylvania:
Community HealthChoices (CHC)

Choose the correct participant-direction model

CHC distinguishes agency-delivered services from participant-directed employment. Under employer authority, the participant or eligible representative acts as common law employer and takes responsibility for recruiting, supervising and directing the worker. Financial management supports the employment arrangement without taking over decisions about the person’s needs.

Services My Way adds a budget-authority approach with its own requirements and permitted services or goods. It should not be described as a cash allowance to spend without restrictions. Ask the service coordinator to explain which model fits the authorized plan, how the budget works and what responsibilities the family would accept.

Check legal roles as well as family ties

The CHC waiver permits eligible relatives to provide certain services but expressly excludes spouses, legal guardians, representative payees and people holding power of attorney. An adult child may therefore face a restriction because of a legal role, even though the family relationship itself is allowed. Disclose both facts during worker screening.

Do not change legal arrangements simply to fit an internet eligibility summary. Ask the plan to review the actual documents and proposed worker. Other relatives must still meet the applicable qualifications. The recipient also needs the relevant financial, functional and service eligibility; dual Medicare and Medicaid enrollment is not itself authorization for paid family care.

Track enrollment and service approval separately

For a new application, use the state’s CHC entry information and enrollment assistance route. For someone already enrolled, begin with the CHC service coordinator. These are different starting points: one may still need eligibility determinations while the other needs a review of existing services and participant-direction options.

Keep copies of notices and ask which office must act next. A completed Medicaid application, a plan choice and an approved worker file are separate milestones. Request a written explanation if services are denied or reduced, including the available review process; do not treat a payroll registration confirmation as the service decision.

Coordinate the plan, employer and Tempus

The state-published common law employer handbook identifies Tempus Unlimited as the fiscal/employer agent. The participant’s CHC plan remains involved in service coordination and authorization. Ask the coordinator to connect the approved plan to the employer and worker enrollment process so names, dates and authorized services match.

Before the relative begins payable work, confirm required checks, training, wage documents and the effective start date. Discuss backup staffing with the coordinator. A proposed wage must fit the approved arrangement; neither the amount billed to Medicaid nor a recruitment advertisement establishes what this particular worker will receive.

Authorization controls the payable time

The fiscal/employer agent checks service authorizations against reported work. Use the current timekeeping and visit-verification instructions and ask how any live-in arrangement is recorded. Keep employer approvals and worker records distinct. If the care plan changes, verify that the updated authorization reaches the payroll process before assuming additional shifts can be paid.

Your next steps

1. Identify whether the person is applying for CHC or already enrolled.
2. Request the relevant eligibility assessment and service-plan discussion.
3. Disclose the worker’s family relationship and legal roles.
4. Choose the appropriate participant-direction model and complete employer and worker enrollment.
5. Confirm authorization, pay, start date and timekeeping with the plan and fiscal agent.

Explore a pay scenario

The table uses a hypothetical amount of $18.00 per hour. This is not a rate verified for this state. Approved units depend on the assessment and written plan; the table does not establish a maximum or entitlement.

Monthly average = weekly × 52 ÷ 12. Overtime and taxes are not calculated.

Does caregiver pay qualify for IRS Notice 2014-7?

IRS Notice 2014-7 can exclude certain qualifying Medicaid waiver payments from federal gross income when the care recipient lives in the provider’s home. Sharing a home alone is not enough: the payment and program must qualify. This is not an exemption for all caregiver wages, all taxes or all state programs. Ask payroll which payments are covered and check the IRS guidance or a qualified tax adviser. Our calculator does not apply a tax exemption.

Questions families ask

Official sources and review notes

• Pennsylvania DHS: Community HealthChoices
• Pennsylvania DHS: 2026 CHC agreement
• Pennsylvania DHS: Tempus common law employer handbook
• Pennsylvania DHS: approved CHC waiver renewal
• Pennsylvania DHS: 2026 CHC Appendix C
• Pennsylvania DHS: participant-direction workgroup report

Sources describe the named programs; they do not endorse this website. Rules and provider arrangements can change. Check the linked agency before making a financial decision.