Get Paid to Care for a Family Member in Pennsylvania: CHC Guide

Yes, you can get paid to care for a family member in Pennsylvania. The main paid family caregiver Pennsylvania route is Medicaid’s Community HealthChoices (CHC) program, which lets an eligible older adult hire an adult child, sibling, grandchild or friend as a paid direct care worker. A spouse, legal guardian or power of attorney cannot be paid. The state Caregiver Support Program and the VA’s caregiver program add a reimbursement or stipend for some families. This guide explains each route, what it pays, and the calls that start it.

How Pennsylvania pays family caregivers: the short version

Pennsylvania does not have a stand-alone “pay the family” program. It pays family caregivers through the same Medicaid benefit that pays home care agencies: personal assistance services under Community HealthChoices, the managed care program for people 21 and older who receive both Medicare and Medicaid, or who qualify for Medicaid long-term services because they need help with daily tasks (PA Department of Human Services, CHC).

Every CHC health plan must offer participants who receive home care “the opportunity to self-direct PAS and employ their own PAS provider, who can be a family member, a friend, a neighbor, or any other qualified personal assistance worker” (CHC Questions and Answers, PA DHS, Q23). That sentence is the legal basis for getting paid to care for a family member in Pennsylvania. The order is fixed: the older adult qualifies for CHC first, then the relative is enrolled and paid.

The three ways CHC delivers care

The state’s Services My Way manual describes three service models, from least to most family control (Services My Way Manual, PA DHS and Tempus).

	Agency model	Participant-directed (Employer Authority)	Services My Way (Budget Authority)
Who hires and schedules the caregiver	A licensed home care agency in the plan’s network	The participant or a Common Law Employer (a relative or friend who acts for them)	Same as participant-directed
Who pays the caregiver	The agency, at the agency’s wage	Tempus Unlimited, the state’s fiscal/employer agent, at a wage the family sets	Tempus, from an individual budget
Can a family member be the caregiver	Only if the agency hires them and the plan authorizes it; ask the service coordinator	Yes, except spouse, guardian, representative payee or POA	Yes, same exclusions
Can the money buy other things	No	No	Yes: approved goods and services tied to a care-plan goal
Family’s paperwork load	Lowest	Hiring, timesheets, EVV compliance	Highest: adds budget management

Who can and cannot be a paid family caregiver

The rules come straight from the waiver. “Family members can provide Personal Assistance Services,” the manual states, with four exclusions: “The CHC Waiver will not pay for services furnished by the Participant’s spouse,” a legal guardian, a Representative Payee, or a Power of Attorney (Services My Way Manual).

Tempus’s employer handbook lists the requirements for any direct care worker: be 18 or older, be able to perform the tasks in the care plan, communicate effectively with the participant, have a valid Social Security number, and agree to a criminal record check (Tempus PA CHC Common Law Employer Handbook, PA DHS). The same document repeats the exclusion: “A DCW cannot be the spouse, power of attorney, legal or designated representative, or guardian of the Participant.”

In practice, a daughter who holds her mother’s power of attorney cannot also be the paid caregiver unless another relative takes over the POA, and a husband caring for his wife has no path through CHC; for him, the Caregiver Support Program and the VA, below, are the routes to look at.

How the family member gets paid, step by step

Pennsylvania’s Independent Enrollment Broker (IEB) publishes a participant rights document that describes the application as five steps: a needs assessment in the home, a physician certification form, a level-of-care assessment, a decision by the Office of Long-Term Living, and a financial eligibility determination by the County Assistance Office. “The process can take as long as 90 days, from start to finish,” and applicants have “the right to have an initial eligibility determination within 90 days of application” (PA IEB, Your Rights as a Participant).

1. Call the IEB at 1-877-550-4227. The broker schedules the in-home assessment and helps with the Medicaid application, which goes to the county assistance office (Apply for CHC, PA DHS). Our CHC waiver guide for the Lehigh Valley walks through the financial side.
2. Choose a CHC plan. In the Lehigh Valley and northeastern Pennsylvania the plans are AmeriHealth Caritas, PA Health & Wellness and UPMC Community HealthChoices; Keystone First serves the Southeast (CHC contact information, PA DHS).
3. Tell the service coordinator you want to self-direct. The plan’s coordinator writes the Person-Centered Service Plan and sets the personal assistance hours. Say at the first meeting that a family member will be the worker.
4. Enroll with Tempus as the employer. The participant, or a Common Law Employer acting for them, signs the employer agreement; the worker completes a W-4, an I-9, direct deposit and background check releases. State criminal checks take 3 to 30 days and an FBI check, when required, 14 to 30 days, according to the handbook.
5. Set the wage and start recording time. Every shift is clocked in and out through the Evvie app or phone system. Since January 1, 2025, each worker must be electronic-visit-verification compliant on at least 85 percent of shifts (Tempus handbook).

Tempus has been the statewide fiscal/employer agent since July 1, 2022, when it replaced Public Partnerships LLC (Pennsylvania Health Law Project). Its worker line is 1-844-983-6787.

How much a paid family caregiver earns in Pennsylvania

There is no single published statewide wage. Under self-direction, “you are responsible for setting the pay rate for the DCW,” and “the pay rate must be within a certain range, between the Pennsylvania minimum wage and the maximum allowable region rate (based on the county that the Participant lives in)” (Tempus CLE Handbook). The ceiling moves with employer taxes and insurance costs, so the only reliable figure is what Tempus’s pay rate calculator returns for Lehigh or Luzerne County on the day you check.

Three things matter more than the hourly rate:

• Hours are assessed, not requested. A parent who needs help bathing and cooking will not be approved for 40 hours a week.
• It is a W-2 job. Tempus withholds taxes; the pay is taxable income for the caregiver.
• Unpaid hours still exist. Most families provide far more care than the authorized hours cover. Our respite care guide for family caregivers is about planning for that.

When the family prefers a home care agency as the employer

Some families do not want to be an employer. They would rather the relative be hired by a licensed home care agency in the plan’s network, with the agency handling payroll, taxes and supervision. The waiver’s rules on who may provide care apply the same way, so a spouse, guardian, representative payee or POA still cannot be paid.

Beyond that, it works like any agency placement: the relative must meet the hiring rules for every direct care worker in Pennsylvania, including a criminal history check, a competency test or training program, and tuberculosis screening (28 Pa. Code Chapter 611); the agency sets the wage; and the plan’s service coordinator must authorize it. Ask the coordinator two questions first: whether the plan permits a relative to be the agency-employed worker, and which network agencies accept that arrangement.

The trade-off: less paperwork and a supervisor to call, but the relative earns the agency’s wage rather than the rate the family would set. Our page on personal care at home lists the tasks a direct care worker performs under either model, and our guide to how to become a home health aide in Pennsylvania covers the training a relative may need.

Two programs that add money without Medicaid

Pennsylvania Caregiver Support Program. Run by the Department of Aging through each Area Agency on Aging, it reimburses a caregiver age 18 or older for out-of-pocket costs of caring for someone 60 or older with functional deficits, or anyone with Alzheimer’s or a related disorder. “The caregiver and care receiver are not required to be related or live in the same residence,” and a spouse can be the caregiver.

Reimbursement is a sliding-scale percentage that “covers care receiver household income up to 380% of the FPL” (Apply for the Caregiver Support Program, PA Department of Aging). The maximum is $600 a month for ongoing costs such as respite and supplies, and $5,000 lifetime for home modifications or assistive devices (Caregiver Support Program, PA Department of Aging). It reimburses expenses; it is not a wage. In Lehigh County, apply through the Office of Aging and Adult Services, 610-782-3200 (Lehigh County Aging and Adult Services).

OPTIONS Program. Also through the Area Agency on Aging, OPTIONS provides personal care, meals, adult day services and care management to Pennsylvanians 60 and older, with no income limit but a sliding co-payment (Apply for the OPTIONS Program, PA Department of Aging). It does not pay family members; it can cover the gap while a CHC application is pending.

VA Program of Comprehensive Assistance for Family Caregivers. For veterans with a VA disability rating of 70 percent or higher who need at least six months of continuous personal care, the VA designates a Primary Family Caregiver: 18 or older, and either a family member or someone who lives, or will live, full time with the veteran. Spouses qualify.

The caregiver receives a monthly stipend, health coverage through CHAMPVA if not otherwise insured, at least 30 days of respite a year, and counseling (VA, PCAFC). The stipend is the federal GS-4, step 1 annual salary for the veteran’s locality divided by 12, paid at 62.5 percent or, if the veteran is “unable to self-sustain in the community,” at 100 percent (VA Monthly Caregiver Stipend Fact Sheet). Apply with VA Form 10-10CG. See our guide to VA home care benefits in Pennsylvania.

Comparing the routes

Route	Who is paid	Spouse allowed	What it pays	First call
CHC participant-directed	Adult child, sibling, grandchild, in-law, friend	No	Hourly wage set by family within county range; W-2 through Tempus	IEB, 1-877-550-4227
CHC agency model	Relative hired by a network agency, if the plan authorizes it	No	Agency wage	IEB, then the plan’s service coordinator
PA Caregiver Support Program	Any caregiver 18+	Yes	Reimbursement up to $600/month; up to $5,000 lifetime for home modifications	Lehigh County Aging and Adult Services, 610-782-3200
OPTIONS Program	Not the family; pays for services	n/a	Services with a sliding co-pay	Area Agency on Aging
VA PCAFC	Primary Family Caregiver of an eligible veteran	Yes	Monthly stipend at 62.5% or 100% of GS-4 step 1 for the locality, plus health coverage and respite	VA Form 10-10CG

Realistic timelines and common delays

Plan on three months from the first call to the first paycheck, longer if the Medicaid financial review is complicated. The steps that most often stall are the physician certification form and the financial determination, which needs bank statements and proof of income. Background checks and Tempus enrollment add two to four weeks after the plan authorizes services. If the parent needs someone present at all hours, our guide to 24-hour home care in Allentown explains what CHC hours can and cannot cover, and the Allentown home care guide lists local costs.

Taxes, overtime and injuries: what the paid relative should know

The wage is only part of the arithmetic. Three rules decide what a family caregiver actually keeps, and all three turn on one fact: whether the worker lives in the participant’s home.

Federal income tax. Under IRS Notice 2014-7, Medicaid waiver payments to a worker who lives in the same home as the person receiving care are “difficulty of care payments excludable from gross income” (IRS, Certain Medicaid Waiver Payments May Be Excludable From Income). The IRS example is precise: a provider who cares for someone five days a week in the recipient’s home but keeps a separate residence cannot exclude the payments; one who lives there permanently can. Since May 2020, an eligible worker may also choose to count all, but not part, of those payments as earned income for the Earned Income Credit or the Additional Child Tax Credit.

Tempus applies the rule through its Difficulty of Care Federal Income Tax Exclusion Form. “If the DCW is eligible, Tempus will not report the payments as income and will not withhold federal income taxes,” and the excluded amount appears in Box 12 of the W-2 (Tempus CLE Handbook, p. 28). A daughter who moves in with her mother files the form. A son who drives over every morning does not qualify and pays tax on the full wage, as described above.

Overtime. The Fair Labor Standards Act requires “overtime at time and a half for all time worked over 40 hours in a work week,” counted Sunday through Saturday, “unless the DCW meets the criteria for the Live-In Exemption.” A worker who “resides on the employer’s premises either permanently or for extended periods of time is exempt from overtime premium pay,” and “if this exemption applies to the DCW, they must take it” (Tempus CLE Handbook, p. 29). Living in helps with taxes and removes overtime; the two go together.

Injuries. Lifting and transfers hurt backs. Direct care workers under CHC self-direction “are covered by workers’ compensation insurance through Tempus.” An injured worker reports it to the employer and files the claim with the administrator, BABB, at 800-892-1015 (Tempus CLE Handbook). No such coverage exists for a relative who is simply helping out unpaid.

Two limits worth repeating. The worker “cannot start working until Tempus has received an authorization from the Participant’s MCO and Tempus has given the DCW a start date” (handbook, p. 18); hours worked before that date are not paid. And since January 1, 2025, DHS requires each worker to be EVV compliant on at least 85 percent of shifts, so a caregiver who forgets to clock in risks the paycheck, not just a reminder. The paid family caregiver Pennsylvania route rewards the household that treats it like the job it is: forms filed, shifts clocked, and the tax question settled before the first paycheck rather than at filing time.

Frequently asked questions