PASA Agencies in Delaware: Hiring Non-Medical Home Care for an Aging Parent

What a PASA Actually Does

A Personal Assistance Services Agency — PASA — is Delaware's licensing category for non-medical home care providers. These are the agencies that send aides to your parent's home for hands-on help with daily living: bathing, dressing, grooming, toileting, meal preparation, light housekeeping, and companionship.

PASAs do not provide skilled nursing care. No IV medications, no wound care, no physical therapy. If your parent needs clinical services ordered by a physician, that's a Home Health Agency (HHA) — a different license category under Delaware law. The distinction matters because it determines what services Medicaid will authorize, what insurance will cover, and what the aide in your parent's home is trained and legally allowed to do.

Both PASAs and HHAs are licensed by the Division of Health Care Quality (DHCQ) under the Office of Health Facilities Licensing and Certification. PASAs fall under 16 Del. Admin. Code § 3345.

Cost and Who Pays

The 2026 median cost for non-medical home care from a PASA in Delaware is $6,673 per month, based on roughly 44 hours per week of aide time at approximately $35 per hour. That aligns closely with the national average, though rates vary by county — New Castle County agencies tend to charge at or slightly above the state median, while Kent and Sussex County agencies may run a few dollars per hour lower.

Three payment pathways exist:

Private pay — The family pays the agency directly. Most PASAs bill hourly with a weekly minimum (often 12-20 hours). Rates typically range from $28 to $42 per hour depending on the agency, the level of care needed, and whether the hours fall on weekdays or weekends/holidays.

DSHP Plus (Medicaid) — If your parent qualifies for Delaware's Medicaid managed care program, personal care services from an in-network PASA are a covered benefit. The MCO case manager authorizes a specific number of hours per week as part of the member's Plan of Care. The family pays nothing out of pocket for authorized hours, though the MCO's reimbursement rate to the agency is lower than private-pay rates, which means some agencies limit their Medicaid client load.

Long-term care insurance — Many policies cover home care aide services, though they typically require a benefit trigger (inability to perform 2+ ADLs) and may impose waiting periods. Check the policy language carefully — some require the aide to be employed by a licensed agency (which a PASA qualifies as), while others don't.

How to Choose a PASA

Delaware has dozens of licensed PASAs, concentrated in New Castle County with thinner options downstate. Here's what to evaluate:

Verify the license. Every PASA must maintain an active DHCQ license. Ask for the license number and verify it through the DHCQ licensing database. An unlicensed agency operating as a PASA is illegal and exposes your parent to unvetted caregivers with no regulatory oversight.

Check MCO network status. If your parent is or may become a DSHP Plus member, ask whether the agency is in-network with the three MCOs: AmeriHealth Caritas, Delaware First Health, and Highmark Health Options. An agency that's in-network with one MCO may not be in-network with another, and switching MCOs later to match the agency isn't always straightforward.

Ask about caregiver screening. Ask specifically: Do they run state and federal criminal background checks? Do they check the nurse aide registry for substantiated abuse findings? Do they verify prior employment references?

Understand the supervision structure. Ask who supervises the aides, how often supervisory visits occur, and how the agency handles caregiver performance issues or complaints.

Ask about continuity. Aide turnover in home care is notoriously high. Ask the agency about their average aide tenure and their policy on assigning consistent caregivers. For aging adults — especially those with cognitive impairment — having different strangers appear in their home each week is distressing and counterproductive.

PASA vs. HHA: When You Need to Upgrade

The line between PASA and HHA services blurs when a parent's needs straddle both non-medical and clinical care. Some families start with a PASA for daily living assistance and later add a Home Health Agency for specific clinical needs (wound care, medication management, post-surgical rehabilitation).

Under DSHP Plus, both PASA and HHA services can coexist in the same Plan of Care — the MCO case manager coordinates both. For private-pay families, you may end up contracting with two separate agencies, which adds complexity but keeps costs lower than facility placement in most scenarios.

The trigger to consider an HHA or evaluate whether the home setting remains viable: your parent's physician starts ordering treatments that require a licensed nurse, the parent needs significant assistance with at least two ADLs, or safety incidents (falls, medication errors, wandering) become frequent despite adequate aide coverage.

If you're evaluating whether home care from a PASA can sustain your parent's current situation or whether a higher level of care is needed, the Delaware Care Decision Toolkit includes the clinical assessment framework and care-setting comparison worksheets that help you make that determination systematically.

See more Delaware guides →