PA to End Practice of Paying Parents as Home Health Aides

PLEADE NOTE: This policy has been updated and this article is out of date. Please see most current update on parents as paid caregivers here. 

Throughout the public health emergency (PHE), and in some cases even prior to the PHE, parents in Pennsylvania have been able to receive payment for providing their own children with home health aide services under our Medicaid program. Paying parents as home health aides is an invaluable practice that has benefited hundreds of children with complex health conditions, allowing parents to financially support their families while giving children the care they need during a nationwide direct care worker shortage.

With the end of pandemic in sight, Pennsylvania Medicaid officials recently announced that when the PHE ends, they will no longer allow parents of children under age 18 to be paid to provide medically necessary home health aide services to their children.  This change does  not impact those parents who are providing care to their adult children over the age of 18. State officials reported that Pennsylvania must end its current policy and practice because federal law does not allow it, citing conversations with federal officials at the Center for Medicaid and CHIP Services.

Approximately 450 households across the state—living in rural, suburban, and urban areas—will be affected. Some parents have already received verbal communications from their Medicaid managed care organizations that the reimbursement practice they have relied on for months (if not years) will end May 11, 2023. All impacted families will receive a letter from their Medicaid managed care organization in the coming weeks informing them of the end of this practice. 

PHLP and advocates from Disability Rights PA, the Imagine Different Coalition, and the Pennsylvania Homecare Association are urging the state and federal government to allow this policy and practice to continue. We objected to the stated rationale for ending the practice, and we believe the law as written allows parents to be paid as home health aides for their children.

Impacted families who wish to make their voices heard should contact Governor Josh Shapiro’s office and their elected officials. To find your elected officials using your home address, use this Find Your Legislator tool.

We will continue monitoring this situation and provide updates as we have them.