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, and receives care assistance in their home.
The care recipient is referred to as the Dom Care resident or client, and the caregiver is called the provider. Providers are screened by the Pennsylvania Area Agencies on Aging to make certain both they and their homes pass safety and background checks. Dom Care providers are permitted to care for a maximum of three residents, but the majority of providers care for only one resident, or, occasionally, a married couple.
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.
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 that residents pay to their providers is set by the Department of Aging and revised annually. In 2023, individual residents pay $1,270.96 / month, and couples pay $2,237 / 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 assistance with their Activities of Daily Living (ADLs) — such as toiletry, bathing, grooming, and eating — and not be able to live independently without assistance.
However, they cannot require so much care that they would otherwise be placed in a nursing home. Furthermore, when it comes to an applicant’s degree of self-mobility, he / she must be able to get around independently or at least be semi-mobile.
To be financially eligible for Dom Care, Pennsylvania residents must meet the income requirements for Supplemental Security Income (SSI). As of 2023, this means individuals must have income less than $914 / month. Married couples seeking Dom Care together can have income up to $1,371 / month.
*Individuals who don’t meet the financial requirements can participate in Dom Care as “private payers.”
One might note that the cost of Dom Care per month ($1,270.96 & $2,237) exceeds the income limit for SSI ($914 & $1,371). Pennsylvania provides program participants with the Domiciliary Care Supplement to make up for this shortfall. As of 2023, eligible single applicants can receive $634.30 / month, and eligible couples can receive $1,347.40 / month.
In addition to room and board, Pennsylvania 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.
Dom Care providers are responsible for providing the following:
It is worth noting that medical care is not a covered benefit of this program, but most program participants receive medical coverage via Medicaid.
Reduced-Cost Assisted Living
Participants receive room and board, and care services in the provider’s home at a cost significantly less than at a traditional assisted living facility.
Dom Care Supplement
To help with the cost of Dom Care, SSI participants can receive a monthly supplement. After paying the monthly cost for Dom Care, any money remaining from the supplement can be used by the resident as a personal needs allowance.
*All figures are current for 2023.
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.