Pennsylvania pays family caregivers through Community HealthChoices (CHC), a Medicaid waiver program — but it's worth knowing upfront that PA is more restrictive than many neighbouring states on one key point: spouses generally cannot be paid caregivers here.
What Community HealthChoices is
CHC is Pennsylvania's Medicaid managed care program for adults who need help with daily living activities and would otherwise require nursing-facility-level care. It allows an eligible care recipient to receive services through a managed care organization's network, or to instead choose their own caregiver — including a family member — through a self-directed option.
Who qualifies — the care recipient
- Must be enrolled in Pennsylvania Medicaid (Medical Assistance)
- Must be 21 years of age or older
- Must require a nursing-facility level of care
- Must reside in the community, not a nursing home or institution
- Must meet Medicaid's income limits (being modestly above the limit doesn't automatically disqualify someone — Pennsylvania has planning tools for those close to the threshold)
Who qualifies — the caregiver
- Adult children, siblings, grandchildren, and other relatives can generally be paid
- Spouses and legal guardians of minors generally cannot be paid — one of the more restrictive rules among nearby states
- Must be at least 18, legally able to work, and pass required background checks (Pennsylvania State Police, FBI fingerprinting, and ChildLine clearances)
How pay works
As of 2026, paid family caregivers through CHC typically earn in the range of $13–$16 per hour, though this varies by managed care organization and individual circumstances.
How to apply
- Confirm the care recipient's Medicaid status, or apply via COMPASS, by phone, or at your local County Assistance Office
- Request a Long-Term Services and Supports (LTSS) assessment through the Pennsylvania Independent Enrollment Broker
- Choose a CHC managed care organization once approved
- Work with the assigned service coordinator to select the self-directed caregiver option and identify the qualifying family member
- Complete required background checks and employment paperwork
If you're a spouse
Since spouses generally can't be paid directly through CHC, the common path is identifying another eligible relative who can take on the paid caregiver role instead.
What you'll need to keep track of once approved
- Care hours and tasks documented for the managed care organization
- Ongoing compliance with the approved care plan
- Background check and employment records
Keeping this organized
Once approved through CHC, staying on top of documentation and care-plan compliance is an ongoing responsibility. FeatherKeep organizes this automatically as you go.