Services My Way: Pennsylvania's Self-Directed Community HealthChoices Program

Services My Way is the self-directed care option within Pennsylvania's Community HealthChoices Medicaid waiver. Instead of receiving home care through an agency that assigns workers on its own schedule, the participant (or their authorized representative) hires, trains, schedules, and manages their own direct care workers — including certain family members.

For families who want more control over who cares for their parent and when, Services My Way replaces agency-mediated care with a model where the family runs the hiring and the state handles payroll.

How Services My Way Works

Once enrolled in Community HealthChoices and approved for home and community-based services, the participant can request the self-directed option from their managed care organization. The MCO's service coordinator develops a Person-Centered Service Plan that authorizes a specific number of care hours per month based on the participant's functional needs.

With Services My Way, the participant uses those authorized hours to:

• Recruit and hire their own direct care workers
• Set the schedule — shifts, hours, and days that work for the participant's routine
• Train workers on the participant's specific care needs
• Supervise and dismiss workers who aren't performing

The critical constraint: spouses and legal guardians cannot be paid as direct care workers. Adult children, siblings, friends, and neighbors are all eligible, making this the primary pathway for families where an adult child wants to get paid for caregiving.

Tempus Unlimited: The Financial Management Service

Pennsylvania contracts with Tempus Unlimited as the Financial Management Services (FMS) vendor for Services My Way. Tempus handles the employer-side logistics that would otherwise make self-direction impractical:

• Payroll processing — workers submit timesheets, and Tempus issues payment
• Tax withholding and reporting — federal, state, and local payroll taxes, W-2 issuance
• Workers' compensation insurance — coverage for on-the-job injuries
• Background checks — criminal background screening for all hired workers
• Fiscal accountability — tracking authorized hours against the service plan budget

The participant directs the care, but Tempus is the employer of record for tax and liability purposes. This structure is what makes the IRS Notice 2014-7 income exclusion possible — caregiver payments made through a Medicaid waiver program and routed through an FMS like Tempus are excluded from federal gross income.

Pay Rates and Budget Management

Reimbursement rates for Services My Way direct care workers typically run $13 to $15 per hour, set by the managed care organization. The total monthly budget equals the authorized hours multiplied by the approved rate.

Participants manage this budget against their authorized service plan hours. If the plan authorizes 120 hours of personal care per month at $14/hour, the monthly budget is $1,680. The participant decides how to distribute those hours across workers and shifts — but can't exceed the total authorization without requesting a service plan adjustment from the MCO.

Eligibility Requirements

Services My Way requires the same eligibility as any Community HealthChoices HCBS waiver participation:

1. Medicaid financial eligibility — gross monthly income at or below $2,982 (2026), assets at or below $8,000 (Tier One) or $2,400 (Tier Two)
2. Nursing Facility Clinically Eligible (NFCE) status — determined through the PA Independent Enrollment Broker assessment process (physician certification via Form MA 51 plus an in-person functional assessment by the Area Agency on Aging)
3. Community HealthChoices enrollment — active enrollment in one of the three MCOs: AmeriHealth Caritas CHC, Pennsylvania Health & Wellness, or UPMC Community HealthChoices
4. Willingness to self-direct — the participant or their authorized representative must be willing and able to manage worker recruitment, scheduling, and supervision

How to Enroll

After Community HealthChoices enrollment is complete:

1. Contact your assigned MCO service coordinator and request enrollment in the Services My Way option
2. The coordinator modifies the Person-Centered Service Plan to reflect self-directed services
3. Tempus Unlimited conducts an orientation — covering payroll procedures, timesheet submission, hiring requirements, and fiscal management responsibilities
4. Recruit and hire workers, submit their information to Tempus for background checks and onboarding
5. Workers begin providing care per the authorized schedule, submitting timesheets to Tempus for payment

The transition from agency-directed to self-directed care can take several weeks for Tempus enrollment and worker onboarding. Start the conversation with your service coordinator as soon as CHC enrollment is confirmed.

Services My Way vs. Agency Care

Agency care is simpler — the agency handles hiring, scheduling, training, and backup coverage. But it comes with less control: you don't choose the worker, you can't guarantee schedule consistency, and agency turnover means your parent may see a rotating cast of unfamiliar faces.

Services My Way trades convenience for control. The family handles the management burden but gets to choose exactly who provides care, when, and how. For families with a trusted relative who wants to serve as the paid caregiver, the self-directed option is the only pathway that makes it financially viable.

The Pennsylvania Hospital-to-Home Guide includes a Services My Way enrollment checklist, a worker onboarding template, and payroll tracking worksheets designed around Tempus Unlimited's timesheet requirements.

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