Those who require long term care are some of our most vulnerable in society. Because of that, there are many state laws that regulate care agencies or that provide caregiver support to adult children, a family member, or other primary caregiver for older adults or those with a chronic condition.
If you are a caregiver in Pennsylvania, it is important to understand the laws and support set forth by the State of Pennsylvania, the Area Agency on Aging (sometimes referred to as the Department of Aging), the Department of Human Services, and programs such as Community HealthChoices.
While there are regulations for care agencies and around who is considered a family caregiver, there are also plenty of programs that provide caregiver education and training as well. In this article, we take a look at some of the basic Pennsylvania Caregiver Laws that you should know about.
There are many different programs and agencies in the state that offer caregiver support, including caregiver education and training, or financial reimbursement. We’ll go over some of the most popular programs and some laws you should know about. It’s important to note that each program has its own regulations and stipulations, and we recommend that before applying for any program, that you visit that program’s website to learn more about these laws and regulations in-depth.
The Pennsylvania Caregiver Support Program is administered through your local Area Agency on Aging. This program provides support to primary caregivers. The goal is to ensure the provision of care and to encourage a healthy, ongoing relationship between the caregiver and the care recipient. The program does this by relieving stress associated with caregiving, focusing on the well-being of the caregiver, providing access to respite care and financial reimbursement for out-of-pocket expenses associated with caregiving related services.
There are regulations and laws on eligibility for the program. There are three different eligibility categories, and you must only meet the qualifications for one of the categories, plus the caregiver and care recipient must both reside in the state of Pennsylvania. (There are no eligibility regulations based on finances.)
Eligibility Category 1:
Eligibility Category 2:
Eligibility Category 3:
HealthChoices is Pennsylvania’s managed care programs for medical assistance recipients operated through the state’s Department of Human Services (DHS). Through managed care organizations, eligible individuals receive quality physical and behavioral medical care, as well as long-term care supports. This umbrella program includes Behavioral HealthChoices, Physical HealthChoices and Community HealthChoices. Let’s take a look specifically at Community HealthChoices.
Community HealthChoices is for Pennsylvania individuals with physical disabilities and allows them to remain in their homes. If you are 21 or older and have both Medicare and Medicaid, or you receive long-term care supports through Medicaid because you need assistance with tasks of daily living, then you will be covered by this program. To learn more specifics about eligibility requirements and to apply for Community HealthChoices, visit the Department of Human Services’ application page.
There are many different regulations and laws for long-term care facilities and agencies in order to protect the rights and humanity of care recipients. This is not a complete or substantive look, however this is a great starting point for care agencies and facilities, as well as for a family caregiver who wants to learn more about their family member’s rights as a patient.
Community HealthChoices, as looked at above regarding eligibility requirements for care recipients, is a program under the umbrella Pennsylvania HealthChoices program administered and operated through the PA Department of Human Services. CHC was developed to enhance access to and improve coordination of medical care, while creating a patient-centric, long-term care support system that allows care recipients to have choice and control over their care and services.
This managed care program works with approved and licensed Community HealthChoices providers. This ensures a higher quality of care for individuals. To learn more about how organizations are approved to provide care through Community HealthChoices, or to become an approved provider, please contact Community HealthChoices directly.
The Pennsylvania CARE (Caregiver Advise, Record, Enable) Act took effect in April of 2017. This law helps out a family caregiver when their family member goes into the hospital and as they transition home, generally for long-term care.
The CARE Act requires Pennsylvania hospitals to:
AARP Pennsylvania fought for the CARE Act to support caregivers and their loved ones and has been passed in over 40 states and U.S. Territories, including Pennsylvania. The AARP has a downloadable information wallet card that you can download here. Caregivers can also visit the AARP Caregiving Resource Center for more support and information.
The legal landscape for caregivers, agencies and long-term care facilities can be a confusing one. If you ever have questions about the laws regarding patient care and patient or family caregiver rights in the state, contact the Pennsylvania Department of Human Services, PA Medicaid (COMPASS), Medicare or your local Area Agency on Aging for additional information and questions.