Self-Direction and FMS in Pennsylvania

All states: self-direction map

Pennsylvania self-direction at a glance

Last verified against state sources: 2026-10-13.

Which Medicaid programs in Pennsylvania offer self-direction?

Pennsylvania has no single self-direction program. The Department of Human Services (DHS) offers it through two offices. The Office of Long-Term Living (OLTL) runs Community HealthChoices, the OBRA waiver and the Act 150 program. The Office of Developmental Programs (ODP) offers Participant-Directed Services in three waivers for people with intellectual disabilities or autism. In every program the participant, or someone acting for the participant, hires and manages the workers.

• Community HealthChoices (CHC) self-directed Personal Assistance Services: serves CHC participants who receive long-term services and supports through one of the three CHC managed care organizations. OLTL runs the program and the plans deliver it. The participant has employer authority but not budget authority.
• Services My Way (CHC budget authority): an option inside Community HealthChoices for participants who choose to turn their authorized personal assistance hours into a budget they direct. The participant has both employer authority and budget authority. The budget equals the authorized hours times the regional rate, and it covers Participant-Directed Community Supports and Participant-Directed Goods and Services. The managed care organization approves the spending plan.
• OBRA waiver participant-directed Personal Assistance Services: a fee-for-service Medical Assistance waiver run by OLTL. The participant has employer authority. We did not find a state source that confirms budget authority.
• Act 150 program participant-directed Personal Assistance Services: a fee-for-service attendant care program run by OLTL. The participant has employer authority. DHS lists Act 150 separately from the Medical Assistance waivers, and we did not find a state source that confirms budget authority.
• ODP Participant-Directed Services (Consolidated, Community Living and P/FDS waivers): three 1915(c) waivers that serve people with intellectual disabilities or autism who live in their own home or in the home of a family member or friend. ODP runs them with county Administrative Entities. The individual, or a surrogate, has employer authority and picks one of two FMS models, described in the next section. We did not find a state source that confirms budget authority.

Employer authority means the participant recruits, hires, schedules and supervises the workers. Budget authority means the participant also manages a set amount of money for services. For the long-term living programs, start at the DHS Consumer Directed Services page. For the developmental programs, start at the DHS participant direction page. That page names only the Consolidated and P/FDS waivers, while ODP Announcement 25-073 names all three.

Who handles financial management services (FMS) in Pennsylvania?

It depends on the program. Tempus Unlimited is the FMS organization for Community HealthChoices, including Services My Way. Public Partnerships LLC (PPL) is the FMS vendor for the OBRA waiver, Act 150 and the ODP Vendor Fiscal/Employer Agent model. In the ODP waivers a person can instead use Agency With Choice, where a local organization assigned by county area provides FMS.

Pennsylvania uses two FMS models. A Fiscal/Employer Agent (F/EA, called a Vendor Fiscal/Employer Agent or VF/EA in some programs) handles the paperwork side of being an employer. It processes payroll and taxes as the employer's agent, while the participant stays the legal employer. In Agency With Choice (AWC), an organization shares the employer role with the individual, who directs the day-to-day work.

• Community HealthChoices and Services My Way: Tempus Unlimited is the F/EA. The participant, or a representative the participant chooses, is the Common Law Employer, which is the legal employer of the direct care workers. In Services My Way the F/EA also pays vendors for approved goods and services under the spending plan. The DHS-approved Services My Way manual names Tempus as the FMS for Community HealthChoices.
• OBRA waiver and Act 150: Public Partnerships, LLC is the VF/EA, and the participant is the Common Law Employer. An OLTL notice dated March 2, 2026 names PPL as the FMS vendor for both programs.
• ODP Vendor Fiscal/Employer Agent model: PPL is the statewide VF/EA. The individual or a surrogate is the Common Law Employer of the workers, who are called Support Service Professionals.
• ODP Agency With Choice model: a local AWC organization provides FMS, and the individual or surrogate is the Managing Employer. ODP requires each Administrative Entity to have at least one qualified AWC organization. Every area has one, except Carbon, Monroe and Pike, which has two. So the choice in ODP is between the two models, not among several agencies in most areas.

The fiscal year 2025 to 2026 list in ODP Announcement 25-073 names 20 AWC organizations: UPMC Western Behavioral Health of the Alleghenies, UCP of Central PA, The Arc of Franklin-Fulton Counties, Compass Community Connections, The Arc of York County, Abilities in Motion, Futures Community Support Services, Fitzmaurice Community Services, Human Resource Center, Caregivers America, The Arc of Lehigh and Northampton Counties, The Arc of Chester County, PathWays of Southwestern Pennsylvania, Beaver County Rehabilitation Center, Alliance for Nonprofit Resources, The Arc of Crawford, Clarion Vocational Services ISO, Dr. Gertrude A. Barber In Home Services, Community Resources for Independence and The Arc of Mercer County. We did not find a newer list, so ask the county Administrative Entity which organization serves an area today.

In Community HealthChoices the participant sets each direct care worker's pay rate within a maximum. In Services My Way, the F/EA tells the participant, the service coordinator and the managed care organization when monthly spending runs 10 percent or more over budget or falls to 80 percent or less of it. Three such events in 12 months can lead the plan to end the model for that participant.

Who can be a paid caregiver under self-direction in Pennsylvania?

Relatives can be paid workers in Pennsylvania's self-directed programs, but the limits differ by program. Community HealthChoices will not pay a spouse, legal guardian, representative payee or power of attorney. The ODP waivers allow relatives, legal guardians and legally responsible persons to be paid, with weekly hour limits.

• Community HealthChoices and Services My Way: family members can be paid for Personal Assistance Services and Participant-Directed Community Supports. The waiver will not pay a spouse, legal guardian, representative payee or power of attorney. The Common Law Employer and any designated representative cannot also be the paid direct care worker. A spouse, guardian or power of attorney may serve as the unpaid Common Law Employer.
• OBRA waiver and Act 150: PPL says participants can hire a family member, friend or neighbor who meets the eligibility requirements and passes a background check. We did not find a published spouse or guardian exclusion for these two programs. Ask PPL or the Long-Term Living Helpline at 1-800-753-8827 before assuming the Community HealthChoices exclusions apply or do not apply.
• ODP waivers (both FMS models): relatives, legal guardians and legally responsible persons can be paid Support Service Professionals. The employer may not schedule any one worker for more than 40 hours a week. When more than one relative, guardian or legally responsible person provides services, their combined In-Home and Community Support and Companion hours may not go over 60 a week.

ODP allows the hour limits to be exceeded only for unforeseen circumstances that affect worker availability, and for no more than 13 weeks in a fiscal year. For families who want more than 60 hours a week of care from relatives, ODP points to the Life Sharing service. These rules come from ODP Announcement 26-067, updated August 11, 2026.

On overtime in the OBRA waiver and Act 150, PPL says authorized hours over 40 a week are paid with an extra 50 percent of the regular rate, unless a live-in exemption from overtime applies.

Does EVV apply to self-directed workers in Pennsylvania?

Yes. Electronic visit verification (EVV) applies to participant-directed services in Pennsylvania, and Fiscal/Employer Agent and Agency With Choice providers are both in scope. Workers record visits in the EVV tools of their FMS organization. Personal care claims without a matching visit in the state's EVV Aggregator are denied, and live-in caregivers are not exempt.

• Community HealthChoices: direct care workers use Tempus tools: the evvie app, the evvie portal or a telephone line. A shift can be paid only after the employer approves and locks it. A worker who calls from a phone number that is not registered with Tempus is not paid for that visit, according to the Tempus FAQ.
• OBRA waiver and Act 150: workers use PPL's Time4Care mobile app or PPL's telephone system from a landline that has been registered first.
• ODP Vendor Fiscal/Employer Agent model: PPL operates the EVV system, and the Common Law Employer must sign the timesheet. We did not confirm the product name PPL uses for the ODP program.
• ODP Agency With Choice model: the AWC organization captures EVV, using either the free DHS Sandata system or an alternate EVV system. The Managing Employer does not have to approve timesheets for EVV services.

Pay and claims depend on it. A DHS Medical Assistance Bulletin says personal care claims and Community HealthChoices encounters without a matching EVV visit are denied for dates of service from January 1, 2021. A later bulletin applies an 85 percent threshold to participant-directed services, meaning at least 85 percent of visits should be recorded without manual edits. Continued noncompliance by a Common Law Employer can end in involuntary termination from the participant-directed model.

The DHS EVV FAQ says live-in caregivers must comply with EVV. So there is no published live-in exemption from EVV, even though a live-in exemption can apply to overtime pay.

What is changing next for self-direction in Pennsylvania?

The state plans waiver and regulation changes on relative caregiver hours in participant-directed services, with a public comment period anticipated in January 2027. ODP has described this as a plan, not a final rule, and no effective date has been set. Until those changes are final, the hour limits in the ODP employer agreements apply.

The plan follows a court ruling. On February 17, 2026 the Commonwealth Court, in Dunkelberger v. DHS, voided ODP's 40 hour limit for a single relative, its 60 hour combined limit for relatives and its 90 day limit on out-of-state services, because they had not been adopted as regulations. ODP then wrote equivalent scheduling limits into new Common Law Employer and Managing Employer agreements. According to ODP Announcement 26-067:

• New agreements: agreements signed before May 8, 2026 became invalid on August 6, 2026. Employers who did not submit a new agreement face notices of noncompliance, suspension of payroll processing and involuntary termination of the employer role, which cannot be appealed. We did not find a report on whether ODP has taken those steps since the deadline.
• Where services can be delivered: participant-directed waiver services must be delivered in Pennsylvania or a bordering state (New York, New Jersey, Delaware, Maryland, West Virginia or Ohio), with an exception for required out-of-state medical treatment.
• What ODP expects to amend: its regulations, the Consolidated, Community Living, P/FDS and Adult Autism waivers, and its bulletins on the Vendor Fiscal/Employer Agent and Agency With Choice models. Relative caregiver hours, provider qualifications and out-of-state service delivery are the topics named. The timing is ODP's estimate and can move.

One recent change on the long-term living side concerns wages. A Pennsylvania Bulletin notice raised the fee schedule rates for participant-directed Personal Assistance Services in the OBRA waiver and Act 150, effective January 1, 2026, to fund a wage increase for direct care workers. The notice ties the increase to federal approval of an OBRA waiver amendment, and we did not confirm that approval. Ask PPL or OLTL for the rate that applies in a region today.

Pennsylvania self-direction sources

• PA DHS: Consumer Directed Services (Office of Long-Term Living)
• PA DHS: Participant Direction Services (Office of Developmental Programs)
• Tempus Unlimited: Services My Way manual (DHS approved)
• Tempus Unlimited Pennsylvania: Frequently asked questions
• Office of Long-Term Living: listserv notice of March 2, 2026 (OBRA and Act 150)
• Public Partnerships: Pennsylvania OLTL program
• ODP Announcement 25-073: Agency With Choice FMS organizations for fiscal year 2025 to 2026
• ODP Announcement 26-067: operational guidance after the Dunkelberger court decision (updated August 11, 2026)
• PA DHS: Medical Assistance Bulletin 05-25-03 (EVV compliance)

Related reading

• Self-Directed Medicaid Home Care Services in 2026
• Understanding Self-Direction and FMS
• Self-Direction Fiscal Intermediary: A Guide for Participant-Directed Care
• 5 Big Challenges in Self-Directed Care And How FMS Providers Can Solve Them
• Self-direction in every state (map)
• Pennsylvania EVV requirements

Page history

• October 13, 2026: Page rewritten and checked against state sources.

This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.

Ankota provides software for FMS organizations and agencies that support self-direction. If you would like to talk through your program, contact Ankota or read more about Ankota's self-direction and FMS software.