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PERSONAL CARE SERVICES PROVIDER IN PENNSYLVANIA

  • Writer: Fatumata Kaba
    Fatumata Kaba
  • Oct 8
  • 4 min read

DELIVERING ESSENTIAL DAILY SUPPORT TO HELP INDIVIDUALS LIVE SAFELY AND INDEPENDENTLY IN THEIR HOMES AND COMMUNITIES

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Personal Care Services in Pennsylvania are Medicaid-funded supports that help individuals with disabilities, chronic conditions, or age-related limitations perform activities of daily living (ADLs). These services are designed to promote independence, reduce institutionalization, and support safe, stable living arrangements in the community. Personal care is authorized through Pennsylvania’s HCBS Waivers under the Office of Long-Term Living (OLTL) and the Office of Developmental Programs (ODP), as well as the Community HealthChoices (CHC) managed care program.

 

1. GOVERNING AGENCIES

Agency: Pennsylvania Department of Human Services (DHS) – Office of Long-Term Living (OLTL)

Role: Administers personal assistance services for individuals with physical disabilities or age-related needs.

Agency: DHS – Office of Developmental Programs (ODP)

Role: Oversees personal care supports for individuals with intellectual or developmental disabilities.

Agency: Community HealthChoices (CHC) Managed Care Organizations (MCOs)

Role: Authorize and coordinate services under Pennsylvania’s mandatory managed long-term services and supports (MLTSS) program.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight of Medicaid-funded personal care services.

Agency: Pennsylvania Department of State

Role: Registers provider businesses and oversees healthcare-related licensing.

 

2. PERSONAL CARE SERVICES OVERVIEW

These services support individuals who require hands-on assistance with daily living tasks. Providers help clients maintain their health, hygiene, and safety within their home environments.

Approved providers may deliver:

  • Activities of Daily Living (ADL) Support: Bathing, dressing, grooming, toileting, eating, and mobility assistance.

  • Instrumental Activities of Daily Living (IADL): Light housekeeping, laundry, shopping, meal preparation, and medication reminders.

  • Companionship & Monitoring: Ensuring client safety, providing supervision, and preventing isolation.

  • Transfer Assistance: Helping individuals safely move between beds, chairs, or mobility devices.

  • Documentation: Daily service logs, care plans, attendance sheets, and EVV (Electronic Visit Verification) records.

 

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

  • Register your business with the Pennsylvania Department of State.

  • Obtain an EIN from the IRS and a Type 2 NPI.

  • Enroll as a Medicaid provider via PROMISe™.

  • If operating a home care agency, obtain a Home Care Agency License from the PA Department of Health (DOH).

  • Carry liability insurance, workers’ compensation, and bonding (if applicable).

  • Develop a Personal Care Services Policy & Procedure Manual aligned with OLTL, ODP, and CHC standards.

 

4. PENNSYLVANIA PROVIDER ENROLLMENT PROCESS

Step 1: Register your legal entity, acquire EIN, NPI, and appropriate insurances.

Step 2: Apply for a Home Care Agency License through the Pennsylvania DOH (if applicable).

Step 3: Enroll in the PROMISe™ system as a Medicaid provider.

Step 4: Contract with CHC Managed Care Organizations (e.g., UPMC, Keystone First, PA Health & Wellness).

Step 5: Upload policies, staff credentials, and documentation tools for compliance review.

Step 6: Begin accepting service authorizations and managing EVV.

 

5. REQUIRED DOCUMENTATION

  • Articles of Incorporation and business registration

  • EIN and NPI documentation

  • Home Care Agency License (if providing hands-on care)

  • Insurance certificates (liability, workers’ comp, bonding if applicable)

  • Personal Care Services Policy & Procedure Manual including:

    • ADL/IADL service delivery protocols

    • Staff supervision and delegation policies

    • HIPAA and client rights materials

    • Incident reporting and emergency procedures

    • Service tracking templates and shift logs

    • EVV compliance workflows

    • Quality assurance systems and audit readiness tools

 

6. STAFFING REQUIREMENTS

Role: Personal Care Aide / Direct Care Worker

Requirements: Background check, TB testing, CPR/First Aid certification, and completion of state-mandated training.

Role: Agency Administrator / Program Coordinator

Requirements: Oversees scheduling, compliance, and staff supervision; must complete designated training modules.

Role: RN Supervisor (optional/required depending on client needs and license type)

Requirements: Active PA nursing license; responsible for client assessments and oversight of non-medical care.

All staff must complete:

  • Orientation on abuse prevention, HIPAA, and safety protocols

  • EVV system training

  • Competency assessments and annual refresher courses

  • Documentation and timekeeping compliance

 

7. MEDICAID WAIVER PROGRAMS

Personal Care Services are available through:

  • Community HealthChoices (CHC): Managed long-term services for older adults and people with physical disabilities.

  • OBRA Waiver (OLTL): For adults with physical disabilities who began services before age 60.

  • Aging Waiver (OLTL): For individuals age 60+ requiring long-term services.

  • Consolidated & P/FDS Waivers (ODP): Personal care supports for individuals with intellectual/developmental disabilities.

  • Act 150 Program (non-Medicaid): State-funded alternative to waivers for individuals not financially eligible for MA.

 

8. TIMELINE TO LAUNCH

Phase: Business Formation & Licensing Application

Timeline: 1–2 months

Phase: Medicaid Enrollment & MCO Contracting

Timeline: 2–3 months

Phase: Staff Hiring, Credentialing & Training

Timeline: 30–60 days

Phase: Referral Coordination & EVV Implementation

Timeline: Begins once authorization agreements and systems are approved

 

9. CONTACT INFORMATION

PA Department of Human Services – OLTL

PA Department of Health – Home Care Licensing

PROMISe™ Provider Portal

Community HealthChoices MCO Contacts:

Centers for Medicare & Medicaid Services (CMS)

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PENNSYLVANIA PERSONAL CARE PROVIDER

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — PENNSYLVANIA PERSONAL CARE PROVIDER

WCG helps providers in Pennsylvania launch compliant and compassionate personal care service agencies that support dignity, safety, and independence at home.

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Scope of Work:

  • Business registration, Medicaid enrollment, and Home Care licensing support

  • Policy & Procedure Manual development and compliance checklist

  • EVV system onboarding and training tools

  • Staff hiring templates, training trackers, and credentialing logs

  • MCO contracting support and documentation review

  • Referral-building strategies and quality assurance systems



Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements. 

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