For more information about the author, click to view their website: www.avondalecaregrouppa.com
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, Pennsylvania’s 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 Pennsylvania’s 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:
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 one’s
household and life. Key IADLs include:
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 Eligibility
In 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 tools—often the Pennsylvania
Long‐Term
Care Assessment System (PaLTAS) or the Minimum Data Set‐Home Care
(MDS‐HC)—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 issues—such as memory problems due to dementia—are 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) Waiver
Community HealthChoices (CHC) is Pennsylvania’s
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:
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 caregivers—often
family members—to 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:
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 Services
Both 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 Qualify
Below are practical indicators that someone may be eligible
for Pennsylvania’s CHC or PDA Waiver due to difficulty with ADLs and IADLs:
A combination of needing help with several ADLs—like bathing
and toileting—and difficulties with IADLs—such as meal prep and
housekeeping—strongly indicates a nursing facility level of care. Document
these challenges for the functional assessment to demonstrate eligibility.
We’re Here to Help: Next Steps and Contact Information
Navigating Pennsylvania’s Medicaid waiver programs can be complex, but you don’t have to go it alone. At Passion to Care, we specialize in guiding Pennsylvania families through the CHC and PDA Waiver application processes—from 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 one’s needs are met with dignity and respect. Call us or contact us today to learn how to get started with Pennsylvania’s Medicaid waivers for home and community-based services.
Aging should be about enjoying the comfort of homenot worrying about whether its still safe to live there. At TruBlue, we believe every senior deserves to feel confident, supported, and secure in the home they love. Thats why we provide professional home safety modifications and ongoing home maintenance, tailored specifically for older adults who want to age in place with dignity.Aging in Place Is the GoalBut Safety Comes First75% of adults aged 50 and older want to remain in their current homes as they age, according to a 2024 AARP study.But most homes werent designed to support long-term independence. Even small updates like adding grab bars, improving lighting, or adjusting door thresholds can dramatically reduce fall risk and make daily activities easier.Thats where TruBlue comes in.What Senior Home Modifications Can IncludeEvery home is different. Our team takes time to assess each space and recommend modifications that truly make a difference. Some of the most impactful changes we offer include:Grab bars and safety rails in bathrooms and stairwaysZero-threshold entries and widened doorways for walkers or wheelchairsNon-slip flooring to reduce fall risksImproved lighting in dim or high-traffic areasSmart door handles and lever fixtures for easier useThese adjustments dont just improve safetythey empower seniors to live with more ease, comfort, and confidence.Trusted, Compassionate TechniciansTruBlue technicians are trained, background-checked, and many are certified through Age Safe America, so you can feel confident youre working with professionals who genuinely care. We treat every project like its for our own familybecause thats the TruBlue way.Were not just handymen. Were your Home Ally here to make sure every senior feels secure, supported, and seen.Ongoing Support with the Maintenance PlanModifying a home for safety is just the start. Ongoing upkeep can be just as important for long-term peace of mind. Our Maintenance Plan offers:Quarterly home checkupsProactive seasonal maintenanceA trusted technician you can count onPriority scheduling when issues ariseIts a simple, stress-free way to ensure a home remains safe and well-maintained, without burdening family members.Start a Conversation TodayWhether youre helping a parent stay independent or planning for your own future, TruBlue is here to help. We make it easier to age in place, safely and confidently with services you can trust and people who truly care.Lets create a safer home together.
Suppose youre an early retiree living on a fixed income. In that case, 2026 brings confirmed changes you need to understandespecially around staying under the 400% Federal Poverty Level (FPL) to maintain ACA premium subsidies.The Two Key Updates:Enhanced ACA tax credits will expire after 2025.Congress has now passed legislation letting the expanded premium tax credits (originating in the American Rescue Plan and extended by the Inflation Reduction Act) lapse beginning in 2026.The subsidy cliff returns in 2026. With enhanced credits eliminated, the traditional cutoff at 400% FPL is reinstated, and crossing that threshold could result in the loss of all subsidy eligibility, leading to significant premium increases. What Early Retirees Should Know On-Exchange (Marketplace) Plans:Subsidy eligibility will once again be limited to households at or below 400% FPL. Exceeding that income level in 2026 could mean losing all premium assistance and facing significantly higher costs.Off-Exchange Plans:These are direct-to-carrier, full-price planswith no subsidies or Marketplace involvement. Silver options might offer better pricing directly through the carrier than on the Marketplace.Consider Smart Income Planning:To retain subsidies, many early retirees are working with both their broker and financial advisor to manage how income is recognized throughout the yearsuch as timing withdrawals or shifting income sourcesto remain under the 400% FPL threshold.This is not financial advicejust a reminder to consult trusted professionals. Aligning your retirement income strategy with your healthcare needs can help maintain premium support until you become eligible for Medicare.Why It Matters:Exceeding 400% FPL in 2026 could result in hundreds of dollars more per month in premiums.With no Medicare yet, coverage costs could remain high for years.Thoughtful income planning now can preserve subsidies during your critical early retirement years.Final Thoughts:As an early retiree, planning is essential. Your health coverage and income are deeply interconnected, primarily through 2026 and beyond.To navigate these changes successfully:-Consult both your financial advisor and your health insurance broker-Monitor your FPL percentage annually.-Strategize income timing and coverage decisions together. If youd like to explore your optionsor are curious how this applies to your householdplease feel free to reach out to us at Baker Consulting Services at 724-594-7648.
If you or a loved one needs more hands-on care, living assistance can help put your mind at ease. Living assistance is flexible, personalized, and fosters a safe home environment while maintaining a sense of independence and privacy. It can give you or your loved one the freedom to make everyday choices and receive a helping hand whenever needed.At St. Barnabas, we understand that the transition from full to partial independence isnt easy and how important it is to ensure your needs and preferences are both addressed. Here are a few ways living assistance is provided without intruding.Receiving Help As NeededEncouraging independence is one way to foster non-intrusive assistance. At a senior living assistance campus, the staff is always available to lend a hand without eliminating decision-making. You or your loved one can retain a sense of autonomy by participating in the daily tasks and chores and receiving help on an as-needed basis. Intervention comes in varying degrees, depending on individual ability. A personalized care plan may include: Incontinence support Wheelchair assistance Medication management Help with grooming, dressing, and bathing Wound, ostomy, or catheter care Care staff is attentive and sensitive to your needs, and they can offer a little help throughout the day or when needed. By participating in daily activities, you or your loved one can plan your day based on your personal preferences.Collaborative SchedulingAs an alternative to making a pre-set schedule and asking the resident to stick to it, working together to create a personal care plan that suits everyone can be beneficial. When it comes to weekly meals, exercise routines, and social activities, residents have the freedom to choose. Maybe they enjoy hearty, home-cooked meals, or perhaps they like to do stretching exercises versus walks. Wherever passions lie, the staff can incorporate those into the regular daily routine to help encourage healthy living and socialization in ways that suit personal preferences.Collaborating with staff can also ensure that activities are both enjoyable and safe. When a resident cant do an activity they love, the team can work with them to find ways to feel that same sense of joy without putting them in danger.Respecting Boundaries and Private SpacesSpending time alone gives us a chance to relax, decompress, and gather our thoughts. In a living assistance care center, its imperative that residents still have some time for themselves. Caregivers respect boundaries and private spaces. Before entering a room, they knock on the door and wait for the resident to respond. Designating a private area for residents to turn to when they feel overwhelmed also aids in creating independence and ultimately gives them a space to de-stress and unwind.Places like the bathroom or shower are understandably uncomfortable areas for intrusion, so caregivers are sure to give residents the space they need to complete these tasks in private. The staff still makes sure the resident is safe by remaining nearby and listening for signs that something may be wrong. Learn More about Living Assistance at St. Barnabas Serving the Greater Pittsburgh, Pennsylvania area, including Allegheny, Beaver, and Butler counties, St. Barnabas is here to give you the support you need. With a dedication to providing comfortable and compassionate living assistance services, you can count on us for all of your care requirements. To learn more about our senior living assistance program, contact us today.
Avondale Care Group of Pennsylvania is a leading provider of in-home senior care services in the Pittsburgh area, offering compassionate, reliable, and affordable home care tailored to meet the needs of seniors and adults with disabilities. With more than two decades of experience in home health care, Avondale is dedicated to helping older adults age comfortably and safely at home while supporting families through personalized, professional assistance.We're here to help you navigate care options with trusted guidance and compassionate support. As a leading provider, we accept Medicaid, VA, and Private Payoffering personalized in-home care to help you or your loved one thrive.Get Paid to Care for a Loved One: Paid Family Caregiver ProgramSpecializing in Medicaid home care services and paid family caregiver programs, Avondale Care Group empowers families to care for their loved ones while receiving the financial support they deserve. Whether youre a family member seeking home care for seniors or a caregiver looking for paid opportunities, Avondale offers flexible solutions that make quality care accessible and sustainable.This program is ideal for:Adult children caring for elderly parentsRelatives or friends supporting seniors with daily tasksFamilies seeking affordable home care in Pittsburgh without compromising on qualityQualified caregivers may earn up to $700 per week, depending on hours worked and level of care provided. Its a unique opportunity to support a loved one while easing the financial burden so often associated with caregiving.Comprehensive In-Home Care Services in PittsburghAvondale Care Group provides a full range of non-medical home care services, tailored to each clients unique needs. Services include:Assistance with daily living activities: bathing, grooming, dressing, meal prepCompanionship and emotional supportMobility and transfer assistanceLight housekeeping and errandsMedication reminders and wellness monitoringThese services are designed to help seniors maintain independence and quality of liferight where they feel safest and most comfortable: at home.Easy Enrollment & Medicaid Waiver AssistanceUnderstanding how to qualify for Medicaid home care services in Pennsylvania can be overwhelming. Avondale Care Group makes the process simple by guiding you through every step, including:Confirming eligibility for the PA Medicaid waiver programCompleting the necessary documentationHelping seniors and caregivers access state-funded care benefitsThis hands-on assistance ensures families can focus on what matters mostcaring for one anotherwhile Avondale handles the red tape.Caregiver Training & Ongoing SupportAvondale equips every caregiver with the tools and knowledge to succeed. Their structured training ensures caregivers are prepared to deliver high-quality care that meets each seniors individual needs. Ongoing coaching and support from licensed professionals provide peace of mind for both caregivers and care recipients. Whether youre new to caregiving or have years of experience, Avondales team is available to answer questions, offer guidance, and adjust care plans as needs change over time.Whos Eligible for the Paid Caregiver Program?To qualify for Avondales paid caregiver program, the care recipient must meet the following requirements:Be 21 years or olderLive in the Pittsburgh, Pennsylvania areaBe enrolled in Pennsylvania Medicaid or eligible for a Medicaid waiverRequire assistance with one or more activities of daily living (ADLs), such as bathing, dressing, or meal preparationCaregivers can include:Children and adult children of the care recipientSiblings, cousins, or other relativesTrusted friends or neighborsThis flexibility allows seniors to receive care from someone they already know and trustenhancing both emotional well-being and continuity of care.Why Choose Avondale Care Group of Pennsylvania?Avondale Care Group is a trusted name in home care for seniors in Pittsburgh, known for its personalized approach, responsive team, and strong commitment to families. Their mission is to ensure that every senior receives the respect, dignity, and support they deserve while enabling caregivers to thrive in their roles.Key benefits include:A fast and simple enrollment processAccess to Medicaid-funded caregiving jobsHands-on help with paperwork and eligibilityComprehensive training and 24/7 supportA dedicated care coordinator for every familyBy combining compassion with convenience, Avondale makes senior home care in Pittsburgh easier and more rewarding than ever before.Get Started TodayIf youre looking for affordable home care in Pennsylvania or want to learn more about how to become a paid caregiver for a family member, Avondale Care Group of Pennsylvania is here to help.Visit our website to start the application process, or call our friendly support team at 412-370-2425 for a free consultation. Our knowledgeable staff is available to walk you through eligibility requirements and help you take the first step toward safer, more supportive care at home.