TL;DR. Pennsylvania Community HealthChoices (CHC) is the state’s Medicaid managed care program for adults age 21+ who need help with activities of daily living (ADLs). For a Pennsylvania family caring for an aging parent on Medicaid, CHC is the funding mechanism that turns unpaid caregiving into paid, supervised home care. This guide walks through CHC eligibility, the three managed care organizations (MCOs) A-Team Home Care is in-network with — Keystone First CHC, UPMC Community HealthChoices, and PA Health & Wellness — and how to enroll a family member as the paid caregiver for an adult Medicaid recipient.
What is Pennsylvania Community HealthChoices?
Pennsylvania Community HealthChoices is the Commonwealth’s mandatory Medicaid managed care program for long-term services and supports (LTSS). It covers older adults, people with physical disabilities, and individuals who are dually eligible for both Medicare and Medicaid. CHC consolidated three earlier waiver programs (the Aging Waiver, the Attendant Care/Act 150 Waiver, and the Independence Waiver) when it was phased in statewide between 2018 and 2020.
CHC is the funding source most Pennsylvania families use when they want to be paid to care for an aging parent at home. A-Team Home Care is the licensed home care agency that handles employment, payroll, and clinical supervision; CHC is the program that pays the bill.
Who qualifies for CHC?
To enroll in Community HealthChoices, the person receiving care must meet three requirements set by the Pennsylvania Department of Human Services:
- Age and residency. Age 21 or older, and a Pennsylvania resident.
- Medicaid financial eligibility. Income and assets within Pennsylvania Medicaid limits. Many participants are dually eligible for Medicare and Medicaid; specific income and asset thresholds change annually, so confirm current numbers with the PA DHS CHC application page or the Independent Enrollment Broker.
- Nursing-facility clinical level of care. Needs hands-on help with three or more activities of daily living — bathing, dressing, toileting, transferring, continence, or eating — or has a cognitive impairment requiring supervision. The Independent Enrollment Broker conducts an in-home assessment to certify this.
If your parent already has Pennsylvania Medicaid and meets the clinical criteria, they are likely eligible. A-Team’s intake team confirms eligibility free of charge before any paperwork starts.
Quick reference
| Who qualifies | Pennsylvania residents age 21+ on PA Medicaid with a nursing-facility clinical level of care |
| Income limit | Pennsylvania Medicaid LTSS thresholds — confirm current year with PA DHS or the Independent Enrollment Broker |
| How to apply | Apply through COMPASS, the PA Consumer Service Center (1-866-550-4355), or the local County Assistance Office; LTSS applicants get an in-home assessment from the Independent Enrollment Broker |
| Cost to family | No out-of-pocket cost for covered LTSS once enrolled in CHC |
| Timeline | Typically 30–90 days from application to active CHC enrollment, depending on Medicaid status |
The three CHC managed care organizations
CHC participants choose one of three MCOs (also called health plans). Each MCO has its own provider network, care manager, and member services. A-Team Home Care is in-network with all three plans available in the Southeast zone (Philadelphia, Bucks, Montgomery, Delaware, and Chester counties):
1. Keystone First Community HealthChoices
Keystone First CHC is the Southeast-zone CHC plan operated by the AmeriHealth Caritas family of companies, headquartered in Philadelphia. Pennsylvania DHS lists AmeriHealth Caritas as one of the three statewide CHC MCOs; Keystone First is the Southeast-zone brand under that umbrella. Keystone First CHC serves the largest share of CHC participants in the Greater Philadelphia region.
2. UPMC Community HealthChoices
UPMC Community HealthChoices is operated by UPMC Health Plan, the insurance arm of the University of Pittsburgh Medical Center. UPMC CHC covers all five CHC zones, and is a strong fit for families whose existing primary care or specialists already accept UPMC.
3. PA Health & Wellness
PA Health & Wellness is the Pennsylvania CHC plan operated by Centene Corporation. PA Health & Wellness serves all five CHC zones and is often selected by participants whose other Centene-network providers are already in place.
All three MCOs cover the same core CHC benefits: personal assistance services, home health, adult day services, home modifications, durable medical equipment, and the participant-directed option that lets a family member be paid as the caregiver.
How a family member gets paid through CHC
The core mechanism is participant-direction. The Centers for Medicare & Medicaid Services (CMS) has supported participant-directed care for more than two decades through programs like Cash & Counseling and 1915(c) Home and Community-Based Services waivers. Inside CHC, the participant has the right to choose who provides their personal care — including most adult family members.
Once enrolled, the family caregiver becomes a W-2 employee of A-Team Home Care, not a contractor. That means:
- Bi-weekly paycheck direct deposited every other Friday (A-Team pays bi-weekly, not weekly)
- Federal, state, and local tax withholding handled automatically
- Workers’ compensation and unemployment insurance coverage
- Paid time off accrual
- Free training, RN supervision, and continuing-education hours
- Health benefits available for caregivers who meet hours thresholds
A-Team handles every payroll, tax, and compliance step in the background — the family member focuses on providing care.
Which family members can be paid?
Federal Medicaid rules let most adult relatives be paid caregivers. Eligible relatives include adult children, stepchildren, grandchildren, adult siblings, nieces, nephews, aunts, uncles, cousins, and in-laws.
Under federal rules, the following are generally not eligible to be paid as caregivers for an adult CHC participant:
- The participant’s spouse
- A parent of a minor participant (legally responsible relative)
- Anyone serving as legal guardian of the participant
For families considering the program, A-Team confirms eligibility for both the participant and the family caregiver at the first intake call.
How to enroll: step-by-step
- Confirm Medicaid status. If your parent already has Pennsylvania Medicaid, skip to step 2. If not, apply via COMPASS, by phone at 1-866-550-4355, or in person at your local County Assistance Office.
- Request an LTSS assessment. Call the Pennsylvania Independent Enrollment Broker at 1-877-550-4227 to request an in-home Functional Eligibility Determination. The IEB assessor confirms nursing-facility clinical level of care.
- Choose your CHC plan (MCO). Once approved, select Keystone First CHC, UPMC Community HealthChoices, or PA Health & Wellness. The MCO assigns a service coordinator.
- Contact A-Team Home Care. Call A-Team at (215) 490-9994. A-Team coordinates with your service coordinator, handles the family caregiver employment paperwork, and schedules the home assessment and initial care plan.
- Begin paid caregiving. The family member starts working as a W-2 caregiver. Hours, training, and supervision are all managed by A-Team.
What CHC pays for in the home
Beyond paying a family caregiver, CHC covers a wide range of in-home services that make it possible for a senior to age in place:
- Personal assistance services (ADL help: bathing, dressing, toileting, transferring, feeding)
- Home health services (skilled nursing, therapy)
- Adult day services
- Home-delivered meals
- Home modifications for safety (grab bars, ramps, stairlifts)
- Durable medical equipment and medical supplies
- Personal Emergency Response Systems (PERS)
- Service coordination and care planning
- Respite care for the primary family caregiver
A-Team’s clinical team builds a personalized personal care plan for each participant covering all of the above as needed.
CHC vs. the other family caregiver paths
CHC is the largest of the three eligibility paths into A-Team’s Family Caregiver Program. The other two paths serve different populations:
- If your parent is age 60+, is a Philadelphia resident, and does not qualify for full Medicaid, the PCA Philadelphia OPTIONS Program may be the right fit.
- If your family is seeking case management plus paid caregiving (Greater Philadelphia, all faiths), the JFCS Enrollment partnership is an option.
The A-Team Family Caregiver Program hub explains how all three paths work together.
Frequently asked questions
How much does a family caregiver earn through CHC?
A-Team’s caregiver pay is set by the rates each CHC MCO pays for personal assistance services, and is above the Pennsylvania industry average. Specific hourly rates depend on the caregiver’s role, hours, and skills; A-Team confirms the rate during intake.
Can two siblings split caregiving and both be paid?
Yes. Multiple family members can each work scheduled hours as paid caregivers for the same participant, as long as the combined hours fit within the participant’s authorized service plan.
Does my parent have to switch doctors when enrolling in CHC?
Not for Medicare services. CHC manages long-term services and supports; original Medicare or your parent’s Medicare Advantage plan continues to cover doctors, hospitals, and prescriptions for dually eligible participants.
What if my parent’s Medicaid application is still pending?
A-Team’s intake team can help coordinate with the County Assistance Office and the Independent Enrollment Broker to keep the application moving and schedule the LTSS functional assessment as soon as Medicaid is approved.
Can I change CHC plans after enrolling?
Yes. CHC participants can change MCOs at any time through the PA Enrollment Services site. A-Team is in-network with all three Southeast-zone plans, so the caregiver employment continues uninterrupted if the participant switches.
Do I need any certifications to be a paid family caregiver?
No prior certification is required for the participant-directed personal assistance role. A-Team provides all required training, including the Pennsylvania Direct Care Worker orientation, before the family caregiver starts.
What if I don’t pass a background check?
Pennsylvania requires a clean criminal background check for all Direct Care Workers. If the family member does not qualify, A-Team can place a non-relative caregiver in the same home while the family explores other roles.
How to get started
A-Team Home Care handles the entire CHC enrollment and family-caregiver employment process. Call (215) 490-9994 or visit the A-Team Family Caregiver Program page to begin. Intake is free and takes about 15 minutes by phone.
Resources and sources
- Pennsylvania DHS — Community HealthChoices program overview
- PA DHS — Apply for Community HealthChoices
- Pennsylvania Independent Enrollment Broker — Enrollment for LTSS
- Keystone First Community HealthChoices
- UPMC Community HealthChoices
- PA Health & Wellness — Long-Term Services and Supports
- CMS — Self-Directed Services
- Wikipedia — Medicaid managed care
- Wikipedia — Activities of daily living
