12/04/2023
Mechanicsburg, PA –Today, the Shapiro Administration kicked off Older Driver Safety Week by highlighting the resources the Commonwealth provides older drivers to address the unique challenges they face. A quarter of Pennsylvania's licensed drivers are 65 years of age or older, underscoring the critical need for these resources.
Pennsylvania has a network of shared-ride service providers dedicated to keeping older adults mobile, safe, and engaged in their community. This free transportation program allows citizens aged 65 or older to ride for free on a local, fixed-route service whenever local public transportation is operating. During FY 2022-23, there were more than 2.2 million Senior Shared Rides.
"Mobility is essential to quality of life at any age," said Pennsylvania Department of Transportation (PennDOT) Secretary Mike Carroll. "While many older drivers have a lifetime of valuable driving experience to draw from, PennDOT continually seeks to balance the safety of our roadways with the need for independence and autonomy."
Approximately 25 percent of Pennsylvania's 9.1 million licensed drivers are 65 and older. In 2022, there were 20,590 crashes involving at least one driver aged 65 or older that resulted in 287 total fatalities. This represents 17.7% of all crashes and 24.3% of all fatalities. Older drivers generally have fewer crashes per driver than the national average – but they have more crashes per mile of driving.
"As Pennsylvania's aging population continues to grow, the Shapiro Administration is committed to ensuring that older adults have the resources they need to remain active in and connected to their communities," said Secretary of the Pennsylvania Department of Aging (PDA) Jason Kavulich. "Driver safety is an important part of how older adults navigate in our community but what is equally important is working with our partners to provide accessible and flexible transportation alternatives to older adults. Pennsylvania is fortunate that our lottery proceeds help to fund alternative services in transportation for its older citizens."
Additionally, working with the PA Department of Human Services and transit agencies, PennDOT developed an online tool called Find My Ride that allows older drivers to access free ride services online. The app allows transit agencies to process applications more efficiently, so users can access benefits more quickly. The app can be found at: findmyride.penndot.pa.gov or at www.penndot.pa.gov by clicking on Travel in PA, then Public Transit Options.
"Along with the unique challenges already faced by older drivers, seasonal factors such as winter weather conditions, longer nights, and heavy holiday traffic create challenges for drivers of all ages," said Lieutenant Adam Reed, Director of the Communications Office with the Pennsylvania State Police (PSP). "Before getting behind the wheel, older drivers should ensure that their eye exams are up-to-date and understand how prescribed medications could affect their driving. It's also important for all drivers to remember to buckle up every time!"
Representatives from PennDOT, PDA, PSP, AAA and AARP manned information booths to share advice and methods for helping The Manor at Oakridge residents safely extend their years on the road. Advice ranged from knowledge of current and less emphasized laws to recognizing signs that it may be time to give up driving. For example, one program discussed was CarFit, an educational program created by the American Society on Aging and developed with AAA, AARP, and the American Occupational Therapy Association. CarFit is designed to help older drivers find out how well they currently "fit" their personal vehicle, to learn how they can improve their fit, and to promote conversations about driver safety and community mobility.
"We remind all our older Pennsylvanian drivers that auto insurance is an important financial protection and that there are ways to reduce the cost of it," said Jodi Frantz, Chief of Staff for the Pennsylvania Insurance Department. "Older drivers can get a break on their insurance rates. If all drivers on your policy are 55 or older, you can take a PennDOT approved mature driver class and qualify for at least a 5 percent discount. We also encourage these Pennsylvanians to talk to their agent or insurance company if they are driving less or if they think there are coverages that they no longer need."
A list of approved mature driver courses available can be found online on PennDOT's Mature Driver Improvement Courses.
While every person ages differently, aging typically brings certain -- sometimes subtle -- physical, visual, and cognitive changes that could impair an older person's ability to drive safely. Older drivers and their families should work together to identify potential issues that may affect driving, outline courses of action to assist the older driver, and plan for when it's time to hang up the keys.
Signs that can indicate it may be time to limit or stop driving altogether include:
The Shapiro Administration encourages older drivers and their loved ones to review PennDOT's Seniors Driving Safely publication series, which can be downloaded for free from the PennDOT Driver and Vehicle Services website. These publications help older drivers assess their abilities and offer guidance on next steps if their medical condition is reported to PennDOT. The series also includes a publication designed to guide family and friends of older drivers in what can sometimes be difficult conversations about deciding to stop driving, as well as information for healthcare providers on PennDOT's medical reporting program.
The following safe-driving habits, which should be routine at any age, are especially useful to older drivers:
Pennsylvanians with insurance questions can contact the Insurance Department Consumer Services Bureau online or at 1-877-881-6388.
Additional information on older driver safety and mobility resources is available at both PennDOT Driver and Vehicle Services and the Department of Aging websites.
Pennsylvania offers Medicaid waiver programs under the Community HealthChoices (CHC) umbrella and the Pennsylvania Department of Aging (PDA) Waiver (often referred to as the PA Council on Aging Waiver). These programs help older adults and individuals with physical disabilities remain in their homes or community settings instead of entering nursing facilities. CHC and the PDA Waiver provide long-term services and supports (LTSS) based on assessed functional needs, emphasizing assistance with ADLs and IADLs. Covered services may include personal care assistance, adult day services, home-delivered meals, transportation, home modifications, assistive technology, and respite care for family caregivers. In addition, Pennsylvanias CHC Waiver offers Participant-Directed Services that allow participants to hire and manage their own caregivers, including family members. To qualify, applicants must be Medicaid-eligible, at least 60 years old (for PDA Waiver) or 21+ (for CHC), and require a nursing facility level of care as determined through a standardized functional assessment of ADLs/IADLs. In this article, we explain what Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) are and how needing help with these tasks is central to qualifying for Pennsylvanias Medicaid waivers like CHC and the PDA Waiver.What Are ADLs (Activities of Daily Living)?Activities of Daily Living (ADLs) are fundamental self-care tasks that a person must perform daily to maintain independence. Difficulty with ADLs often signals a need for supportive services. Core ADLs include: Mobility (Ambulating/Transferring): Safely walking, getting up from a chair, or transferring from a bed to a wheelchair. Dressing: Selecting and putting on appropriate clothing (including handling fasteners) without assistance. Eating: Feeding oneselfusing utensils to get food from a plate to the mouth and consuming it. Personal Hygiene: Bathing or showering and performing grooming activities like shaving, brushing teeth, and combing hair on ones own. Toileting (Continence): Independently using the toiletgetting to the toilet, transferring on and off, and cleaning oneself afterward. When someone can no longer perform several ADLs without help, it indicates that ongoing care or support is likely needed.What Are IADLs (Instrumental Activities of Daily Living)?Instrumental Activities of Daily Living (IADLs) are more complex tasks that allow a person to live independently in the community. While not necessarily performed daily, they are essential for managing ones household and life. Key IADLs include: Shopping for Essentials: The ability to shop for groceries, pick up prescriptions, or purchase clothing and other necessities. Meal Preparation: Planning and cooking mealsgathering ingredients and safely using kitchen appliances. Housekeeping: Keeping the home clean and livable tasks like cleaning, laundry, and taking out the trash. Money Management: Handling finances, such as paying bills on time, managing bank accounts, and budgeting. Transportation: Getting around or arranging transportationdriving oneself or using public transit or rides to run errands and attend appointments. Medication Management: Managing and taking medications properly remembering to take the correct medicines at scheduled times and refilling prescriptions. Communication: Using the phone or computer to communicatelooking up phone numbers, making calls, sending emails, and staying in touch with others. Trouble with IADLs is often one of the first signs that someone needs more support, even if basic ADLs are unaffected.Why ADLs and IADLs Matter for Medicaid Waiver EligibilityIn Pennsylvania, needing help with ADLs and IADLs is a central eligibility criterion for the CHC and PDA Waiver programs. These waivers serve individuals who would otherwise qualify for nursing facility care but prefer to remain in their own homes or community settings. Eligibility is determined through both financial and functional assessments. The functional assessment evaluates whether an individual requires hands-on assistance with ADLs and/or significant help with IADLs, thereby meeting a nursing facility level of care. Pennsylvania uses standardized toolsoften the Pennsylvania LongTerm Care Assessment System (PaLTAS) or the Minimum Data SetHome Care (MDSHC)to score independence in ADLs and IADLs.During the functional evaluation, an assessor reviews abilities such as transferring from bed to chair, walking safely, eating, toileting, meal preparation, housekeeping, medication management, and managing money. Cognitive issuessuch as memory problems due to dementiaare also considered since they impact daily functioning. If an individual cannot perform multiple ADLs without assistance or has significant deficits in IADLs, they are likely to meet the level-of-care requirement and become eligible for waiver services.Community HealthChoices (CHC) WaiverCommunity HealthChoices (CHC) is Pennsylvanias comprehensive HCBS waiver program for individuals aged 21 and older who require a nursing facility level of care. Administered by the Office of Long-Term Living (OLTL), CHC is a managed care program that combines physical health, long-term services and supports, and pharmacy benefits under a single plan (with behavioral health carved out). To qualify for CHC: Be age 21 or older. Meet Medicaid financial eligibility guidelines. Require a nursing facility level of care (confirmed through functional assessment). Live in a setting that meets HCBS requirements (e.g., home, apartment, assisted living). Be a Pennsylvania resident. Once enrolled, participants receive a comprehensive package of services tailored to their needs. Covered services may include personal assistance, home-delivered meals, adult day services, behavioral support, professional nursing, home modifications, assistive technology, transportation, and respite care. CHC also offers Participant-Directed Services, allowing participants to recruit, hire, train, and supervise their own caregiversoften family membersto assist with ADLs (bathing, dressing, toileting) and IADLs (meal preparation, medication reminders).PDA Waiver (Council on Aging Waiver)The Pennsylvania Department of Aging (PDA) Waiver, also called the Council on Aging Waiver, serves seniors aged 60 and over who require nursing facility level of care but choose to remain at home or in other community-based settings like domiciliary care homes. To qualify: Be age 60 or older. Meet Medicaid financial eligibility requirements. Be assessed as requiring nursing facility level of care (through the functional assessment). Live in a qualifying community setting. Covered services under the PDA Waiver may include personal care assistance, home-delivered meals, homemaker services, personal emergency response systems, respite care, adult day services, minor home modifications, and transportation. Like CHC, the PDA Waiver emphasizes managing ADL and IADL needs to keep participants safely in their homes.Participant-Directed ServicesBoth CHC and the PDA Waiver offer Participant-Directed Services, which empower participants to choose and manage their own caregivers, including family members, friends, or neighbors. Under this model, participants develop a service plan with guidance from a care coordinator, set schedules, and handle payroll tasks. This flexibility helps ensure that personal care and IADL support align with participants preferences and routines.Signs That Your Loved One May QualifyBelow are practical indicators that someone may be eligible for Pennsylvanias CHC or PDA Waiver due to difficulty with ADLs and IADLs: Trouble with Personal Care: Skipping showers, unkempt hair, or wearing dirty clothes may indicate difficulties with bathing and dressing (ADLs). Malnutrition or Weight Loss: An empty fridge or significant weight loss suggests issues with meal prep or feeding oneself (ADLs/IADLs). Mobility Decline and Falls: Struggling to walk without assistance, needing help to stand, or experiencing frequent falls signals reduced mobility (ADL: transferring/ambulating). Medication Errors and Memory Problems: Missing doses, mixing up pills, or forgetting appointments point to challenges with medication management and scheduling (IADLs). Household Neglect: Piles of mail, unpaid bills, or a cluttered home reflect trouble with housekeeping and money management (IADLs). A combination of needing help with several ADLslike bathing and toiletingand difficulties with IADLssuch as meal prep and housekeepingstrongly indicates a nursing facility level of care. Document these challenges for the functional assessment to demonstrate eligibility.Were Here to Help: Next Steps and Contact InformationNavigating Pennsylvanias Medicaid waiver programs can be complex, but you dont have to go it alone. At Passion to Care, we specialize in guiding Pennsylvania families through the CHC and PDA Waiver application processesfrom the initial functional assessment of ADLs and IADLs to completing paperwork and coordinating services once approved. If you notice your loved one struggling with daily tasks or if a professional has recommended nursing facility care, it may be time to explore CHC or the PDA Waiver. Our compassionate, family-first team ensures your loved ones needs are met with dignity and respect. Call us or contact us today to learn how to get started with Pennsylvanias Medicaid waivers for home and community-based services.
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