1. Program Definition and Services

Homemaker Services in Pennsylvania provide non-medical, instrumental supports to adults with physical disabilities, chronic health conditions, or aging-related care needs. The program aims to help maintain individuals in their own homes and community settings, averting the need for long-term institutional services and supports. Services include:

• In-Home Household Support: Hands-on assistance within the individual’s private residence (light housekeeping, dusting, vacuuming, mopping, laundry support, and tidying living areas)
• Routine Daily Living Assistance: Practical help to support independent routines (basic meal preparation according to dietary needs, running essential household errands, grocery shopping, and non-medical companionship)

2. Regulations

The program is governed by the following regulations:

• 55 Pa. Code Chapter 52 (OLTL Home and Community-Based Services)
• Federal 1915(c) Home and Community-Based Services (HCBS) waiver provisions
• Electronic Visit Verification (EVV) standards under the federal 21st Century Cures Act (where applicable)

3. Licensing or Certification

Providers strictly delivering non-medical homemaker services that do not involve hands-on Activities of Daily Living (ADLs) are not required to hold a Home Care Agency License from the Pennsylvania Department of Health. However, they must be formally certified and qualified as a Medicaid waiver provider through the state's enrollment framework.

4. Responsible State Agency

The Department of Human Services (DHS) Office of Long-Term Living (OLTL) is responsible for reviewing provider qualifications and overseeing the service lines. Regional Community HealthChoices (CHC) Managed Care Organizations (MCOs) handle direct care plan authorizations and network management.

5. Application Process

The application process is conducted through the electronic PROMISe™ Medicaid Provider Portal. Providers must submit enrollment applications online to establish a billing profile and subsequently finalize network participation contracts with regional CHC MCOs.

6. Required Documentation

While specific documentation requirements vary based on the target waiver, providers typically need to submit:

• Pennsylvania Business Registration and Articles of Organization (filed via PennFile)
• IRS EIN confirmation document and Type 2 Organizational NPI lookup profile
• Certificates of active Workers' Compensation and Commercial General Liability insurance
• An operational Policy Manual featuring client intake workflows, task log templates, grievance protocols, and worker conduct guidelines

7. Timeline for Approval

The exact timeline for approval fluctuates based on agency and state review capacity. Navigating the sequential steps of background vetting, PROMISe™ digital enrollment, and regional CHC MCO contracting generally takes 2 to 3 months.

8. Pre-Application Process

Prospective providers must complete specific foundation tasks before applying. They must establish their legal business entity structure with the Pennsylvania Department of State, secure a federal IRS EIN, set up a functional business office space, and obtain an organizational Type 2 NPI.

9. Pre-Application Training

The state mandates administrative compliance guidelines for all home-based service lines. Agency managers must review online waiver compliance frameworks. Frontline homemakers and household aides must clear mandatory state criminal background checks, pass child abuse clearances (if applicable), and complete training modules covering consumer privacy, fraud prevention, and task documentation.

10. Additional Notes

• Homemaker services must be explicitly detailed and authorized within the participant’s person-centered service plan by an assigned MCO Service Coordinator before care can be delivered
• All services must be provided directly by the certified agency's employed personnel rather than unvetted independent contractors
• Frontline staff must comply with relevant Electronic Visit Verification (EVV) logging guidelines if their shifts are layered with broader personal assistance models
• Providers must maintain detailed task logs, precise visit timestamps, and signed service verification forms to satisfy state Medicaid documentation standards and audit readiness

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