Government Assistance for Family Caregivers

Caregiver Support Services for Pennsylvania Families

Caring for a loved one can be difficult both emotionally and physically. It is even more difficult with memory issues, such as Alzheimer’s disease and related disorders that can cause mood changes and aggressive outbursts.

Family caregivers, and spouses, have a lot to worry about, including health insurance, possible home modifications, whether to hire a paid caregiver, and what long-term services and supports you’ll need. You may also be thinking about services including home care, respite care, caregiver training, and support groups. It can be difficult to think of all the options that are available to you, let alone how you will pay all of the bills associated with the care of your loved one.

You might be wondering if there is a services program out there that offers to pay family members for caring for a loved one. There are support services available that offer government assistance to family caregivers, including the Program of Comprehensive Assistance for Family Caregivers (PCAFC), the Pennsylvania Community HealthChoices program, and the Pennsylvania Caregiver Support Program administered by your local Area Agency on Aging.

Many of these programs have eligibility requirements, like the individual age of care recipients (for older adults it is generally 60 years of age and older, for child dependents it is under age 18), the health status of the care recipients, as well as the individual age of the caregiver (in some cases it is aged 18 or older, in others it is 55 years of age and older). Let’s take a look at some of the options that may be available to Pennsylvania families.

Program of Comprehensive Assistance for Family Caregivers (PCAFC)

This program is offered through the U.S. Department of Veterans Affairs (VA) and offers enhanced clinical support for family caregivers of eligible veterans. You can apply online for this program on the Veterans Affairs (VA) website.

Eligibility Requirements for the Program of Comprehensive Assistance for Family Caregivers (PCAFC)

A Veteran is eligible for the Program of Comprehensive Assistance for Family Caregivers (PCAFC) if they:

• Have a sustained or aggravated serious injury or illness while in the line of duty in the active military, naval or air service during any service era.
• Have a single or combined service-connected disability rating by the Department of Veterans Affairs (VA) of 70% or more.
• Be in need of personal care services (requiring in-personal personal care services) for a minimum of six continuous months based on any one of the following:
• An inability to perform an activity of daily living.
• A need for supervision or protection based on symptoms or residuals of neurological or other impairment or injury.
• A need for regular or extensive instruction or supervision without which the ability of the Veteran to function in daily life, would be seriously impaired.

Support Services Offered by the Program of Comprehensive Assistance for Family Caregivers (PCAFC)

Veterans can designate one primary family caregiver and up to two secondary family caregivers on the application. Secondary family caregivers serve as a backup support to the primary family caregiver when needed. Support services depend on whether  you are the primary family caregiver or a secondary family caregiver.

If you are the primary family caregiver, you may receive:

• A monthly stipend (paid directly to you as the caregiver via direct deposit).
• Access to health insurance through the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA), if you do not already have health insurance.
• Mental health counseling (including a 24/7 crisis line, substance abuse resources, burnout tips, caregiver training and other services program supports related to mental health).
• Certain beneficiary travel benefits when traveling with the veteran to appointments.
• At least 30 days of respite care per year, for the Veteran. (Respite care is short-term relief for the caregiver in which someone else cares for the veteran.)

If you are the secondary family caregiver, you may receive:

• Mental health counseling (including a 24/7 crisis line, substance abuse resources, burnout tips, caregiver training and other services program supports related to mental health).
• Certain beneficiary travel benefits when traveling with the veteran to appointments.

Program of General Caregiver Support Services (PGCSS)

This is another program offered by the U.S. Department of Veterans Affairs (VA) which provides peer support mentoring (e.g. support groups), caregiver training, telephone support, online programs and referrals to available resources to caregivers of veterans.

You only need to be a general caregiver of a veteran who provides personal care services to a veteran enrolled in VA health care who needs assistance with one more more daily living activities, or needs supervision or protection based on symptoms of residuals of neurological care or other impairment or injury.

While there is no ability to pay family members, you may find valuable resources and support services through this services program. To enroll in the Program of General Caregiver Support Services (PGCSS) visit the Veterans Affairs (VA) informational page on the services program.

Pennsylvania Community HealthChoices (CHC)

HealthChoices is the name of Pennsylvania’s managed care services program for Medical Assistance recipients. Eligible individuals receive quality physical and behavioral medical care as well as long-term services and supports. Community HealthChoices (CHC) is one of the support services offered in the larger HealthChoices umbrella program that works to serve people in their communities, rather than in facilities, by providing the necessary support. To apply for the Pennsylvania Community HealthChoices (CHC) services program, visit the Pennsylvania Department of Human Services site.

Eligibility for Community HealthChoices 

Pennsylvania individuals will be enrolled in the program if they:

• Are 21 years of age and older.
• Receive both Medicare and Medicaid.
• Receive long-term services and supports through Medicaid because you need assistance with everyday personal tasks.

Benefits and Support Services Provided by Community HealthChoices

The benefits offered through the Community HealthChoices include a wide variety of services including  long-term services and supports for patients as well as  caregiver support services. The program offers services including but not limited to:

• Adult daily living services/adult day health
• Assistive technology/durable medical equipment
• Medical supplies
• Home health aide/nursing
• Therapies (occupational, physical, speech, and language)
• Meal delivery, nutritional counseling, food supplements
• Respite care
• Non-medical transportation
• Personal emergency response systems
• Vehicle and home modifications
• Nursing home/hospice care
• Medical/dental services
• ER services
• Prescription drugs
• Counseling

Pennsylvania Caregiver Support Program

The Pennsylvania Caregiver Support Program provides resources and assistance to individuals who become the primary caregiver or primary family caregiver for another individual in need of home care. This services program works to alleviate the stress associated with caregiving in multiple ways, including focusing on the wellbeing of the caregiver, providing access to respite care, addressing the need for both formal and informal supports, as well as by providing reimbursement for out-of-pocket expenses associated with caregiving-related services (e.g. paid caregiver for respite care, supplemental home care, home modifications) and supplies (e.g. assistive devices).

This support program is administered by your local Area Agency on Aging.

Eligibility for the Caregiver Support Program

Both the caregivers and care recipients must be a resident of Pennsylvania. The caregiver must be an adult who is primarily responsible for providing care on a regular basis, and meet one of the following eligibility categories:

Category 1

Caregivers are::

• An individual aged 18 or older

Care recipients are:

• An individual 60 years of age and older with functional deficits or
• An individual of any age with Alzheimer’s disease or related disorders

*In this category, the caregiver and care recipient are not required to be related or live in the same residence.

Category 2

Caregivers are:

• An individual 55 years of age and older
• Not the biological parent of the child(ren)
• Related by blood, marriage or adoption
• Has legal guardianship, or is raising the child(ren) informally

Care recipients are:

• A dependent child under the age of 18

*In this category, the caregiver and care recipients must live in the same residence. 

Category 3

Caregivers are:

• An individual age 55 years and older
• Related by blood, marriage or adoption
• Can be the biological parent

Care recipients are:

• An individual age 18 to 59 with a disability

*In this category, the caregiver and care recipients must live in the same residence. 

Additional Eligibility Information

No matter the category you fit into, there are no financial eligibility requirements. However, individuals are not eligible for the Caregiver Support Program if:

• The caregiver or care recipients are enrolled in Medicaid Long-Term Services and Supports (Community HealthChoices/LIFE).
• The caregiver has been convicted of or found liable for a crime relating to abuse, neglect, exploitation or abandonment.
• The caregiver is a perpetrator in a substantiated report of need for older adults protective services.

Financial Support Services

However, the amount of financial reimbursement for out-of-pocket expenses is based on the total gross income and household size of the care recipients. The percentage of reimbursement is determined on a sliding scale, based on the current Federal Poverty Level (FPL) guidelines and covers the care recipient’s household income up to 380% of the FPL.

Available Support Services

Support services available through the Caregiver Support Program include:

• Care management
• Benefits counseling
• Caregiver training and education
• Reimbursement for ongoing expenses for caregiving-related supplies/services including:
• Respite care through a paid caregiver
• Consumable supplies (costs not paid for by health insurance)
• Support services
• Supplemental services (cost not paid for by health insurance)
• Home modifications
• Assistive devices (costs not paid for by health insurance)
• Services specific to grandparents/older relative caregivers (55+)

Conclusion

There are plenty of support programs available to Pennsylvania family caregivers, both from the federal government (VA) and through the state of Pennsylvania. If you need assistance locating additional resources, be sure to contact your local Area Agency on Aging.