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Get paid to care for a family member in Pennsylvania

In Pennsylvania, a Community HealthChoices participant who self-directs can employ a family member as their paid personal assistance worker. The worker must be qualified under Department rules.

Carevo editorial team Updated October 27, 2026 Source checked by Carevo editorial team, October 27, 2026

In Pennsylvania, a family member can be a paid personal assistance worker when the person receiving care is in Community HealthChoices (CHC) and chooses to self-direct. The 2026 CHC agreement lists family members among the workers a participant can employ.

How it works in Pennsylvania

Pennsylvania has no stand-alone paid family caregiver program. The route is self-direction in CHC, the state's Medicaid long-term care managed care program. The 2026 CHC agreement requires plans to give participants who need personal assistance services the chance to self-direct as the first option, and sets out two models.

  • Participant-Directed Employer Authority. The participant employs their own personal assistance or respite provider. The agreement says the provider can be a family member, a friend, a neighbor or any other qualified personal assistance worker as determined by the Department.
  • Services My Way. A budget authority model where the participant hires and manages staff, manages a flexible spending plan and buys allowable goods and services. See Services My Way in Pennsylvania.

The agreement also describes an Agency with Choice model, where the participant selects their own worker, who can be a family member, friend or neighbor, supported by an agency that handles administrative tasks. It applies upon federal approval.

Who can be paid

Family members are named as eligible workers in the self-directed models. The worker must be "qualified" as determined by the Department. We could not read a DHS page that lists specific exclusions, such as spouses or legal guardians, so we do not state any. Before you plan around a particular relative, ask the service coordinator these questions in writing:

  • Is this relative allowed to be a paid worker for me?
  • What background checks, training or paperwork do they need?
  • What is the hourly pay and how many hours are authorized?
  • Who is the fiscal management vendor and how do timesheets work?

Who qualifies for CHC

DHS says CHC serves people eligible for both Medicaid and Medicare, and individuals 21 or older with physical disabilities. The waiver application says the CHC waiver serves adults 21 or older who are financially and clinically eligible for Medicaid long-term services and supports in the community. Services My Way requires an assessment showing nursing facility level of care.

How a family caregiver gets paid

  1. The participant's plan authorizes personal assistance or respite services.
  2. The participant chooses a self-directed model.
  3. The worker is hired under the model chosen.
  4. A fiscal management services vendor processes timesheets and payments, and manages tax withholdings, including FICA taxes.

We do not state pay rates or hours. The pages we read do not set them.

Act 150 for people under 60

DHS's Act 150 Attendant Care program is for people 18 to 59 with a physical disability who meet the skilled nursing facility level of care and are financially ineligible for Medicaid. They must be able to hire, fire and supervise attendant care workers. The page we read does not say who can be a paid worker under Act 150.

How to start

  1. Apply for long-term care services by phone at 1-866-550-4355, online through COMPASS or through your county assistance office. See the Pennsylvania overview.
  2. Complete the assessment.
  3. Tell your service coordinator you want to self-direct and ask about family workers.

Carevo is a connection platform and directory. We do not enroll anyone, set pay or advise on eligibility. If you also want agency support, see home care in Pennsylvania.

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Common questions

Can I be paid to care for my parent in Pennsylvania?

Possibly. If your parent is in Community HealthChoices and chooses to self-direct, the 2026 CHC agreement says the personal assistance or respite provider they employ can be a family member, a friend, a neighbor or any other qualified worker as determined by the Department.

Can a spouse be paid?

We could not find a DHS page that says. The agreement says the worker must be qualified as determined by the Department and does not list excluded relatives in the sections we read. Ask the service coordinator.

Who pays the family caregiver?

A fiscal management services vendor. The agreement says it processes timesheets, makes payments and manages tax withholdings, including FICA taxes, for workers employed under either self-directed model.

Do I have to be on Medicaid?

Yes. The person receiving care must be in Community HealthChoices, which serves people 21 or older who are eligible for Medicaid and either dually eligible for Medicare or have a physical disability needing long-term services and supports.

What if the person is under 60 and not on Medicaid?

DHS's Act 150 Attendant Care program is for people 18 to 59 with a physical disability who are financially ineligible for Medicaid. The page we read does not say whether relatives can be paid workers under Act 150.

How do I start?

Apply for long-term care services, then tell the CHC service coordinator you want to self-direct personal assistance. DHS says the plan must present self-direction first.

Sources

Review status: Carevo checked this page against the primary sources listed above. It has not been professionally reviewed by a registered nurse, licensed social worker, benefits counselor or attorney. See our editorial standards.

This page is general information, not financial, legal or medical advice. Rules and services vary by state and by individual circumstances. Use the official sources and decision-maker named on the page. Carevo is a connection platform, not a care provider.