Page Reviewed / Updated - Apr. 2019
The Pennsylvania Domiciliary Care program is more commonly referred to as Dom Care. Dom Care is offered as an alternative to assisted living. Under Dom Care, the person in need of care moves into the home of a caregiver, who is over the age of 21, and receives care assistance in their home. The individual in need of care is referred to as the Dom Care Resident and the caregivers are called Dom Care Providers. Providers are screened by the PA Area Agencies on Aging to make certain both they and their homes pass safety and background checks.
Dom Care Residents receive room, board, and care services at a cost significantly lower than traditional assisted living or nursing home care, but the real attraction for most participants is the family home environment into which they move. Dom Care Providers are permitted to care for a maximum of three residents, but the majority of them care for only one resident, or occasionally, for married couples.
Providers cannot be related to their residents. To be clear, an elderly individual cannot move into the home of another family member and pay them for their care services. However, an elderly individual can move into the home of a friend, provided they meet the other qualifications to provide care. The monthly rate Residents pay to their Providers is set by the Department of Aging and revised annually. In 2019, individual residents pay $1,001.60 / month and couples pay $1,751.20 / month to their Dom Care Providers.
To participate in the Dom Care program as a Resident, applicants must be at least 18 years of age.
Although this program is sometimes viewed as an alternative to nursing home care, it is perhaps better thought of as an alternative to assisted living. Participants must require sufficient care with their Activities of Daily Living (ADLs), such as toiletry, bathing, grooming, and eating, that they cannot continue to live independently without assistance. However, they cannot require so much care that they would otherwise be placed in a nursing home. The applicant's degree of self-mobility is typically one of the major determining factors in evaluating candidates.
The financial criteria can be quite confusing. Individuals can participate in Dom Care as "private payers," in which case there are no financial limits. However, most participants receive financial assistance in the form of a domiciliary supplement. To be eligible, PA residents must be eligible for Supplemental Security Income or SSI. As of 2019, this means individuals must have income less than $771 / month. Married couples seeking admission to Dom Care together can have incomes up to $1,157 / month.
One might note that the cost of Dom Care per month exceeds the income limit. Pennsylvania provides program participants with the Domiciliary Care Supplement to make up for this shortfall. As of 2019, eligible single applicants receive $434.30 / month and eligible couples receive $947.40 / couple.
In addition to room and board, PA Dom Care participants receive personal care and assistance with their ADLs. They receive case management services from the state and monitoring of their wellbeing, as well as monitoring of their home's safety. Laundry, housekeeping, transportation assistance, medication management, and recreational activities are all the responsibility of the Dom Care Providers. It is worth noting that medical care is not a covered benefit of this program.
As of 2019, SSI eligible, single program participants receive $1,205.30 / month. Of that amount, $1,001.60 goes immediately to pay their Dom Care Provider. The remainder is their "Personal Needs Allowance". Couples receive $2,104.40 / month, $1,751.20 of which goes to their Dom Care Provider.
In addition to meeting the qualifications outlined above, program candidates must receive final approval for participation in Dom Care from their local Area Agency on Aging. This office will also assist the individual in all other aspects of applying for the program. Find your local AAA here.