How to Enroll Your Parent in Adult Day Care Through Community HealthChoices

If your parent or loved one qualifies for Medicaid in Pennsylvania, you can enroll them in adult day care through a program called Community HealthChoices — and in many cases, the cost of care will be covered entirely. The process has several steps, but it’s manageable, and SarahCare’s enrollment team can help you through it. 

Before You Start: Understanding the Two Eligibility Requirements 

CHC enrollment requires two separate eligibility determinations: functional eligibility (based on care needs) and financial eligibility (based on income and assets). Both must be met before adult day services can begin under CHC. 

Functional eligibility is determined through a standardized assessment of daily living needs. Financial eligibility is handled by the County Assistance Office (CAO) through a standard Medicaid application. These processes can run simultaneously — you don’t have to wait for one to complete before starting the other. 

Step-by-Step Enrollment Process 

1. Call the PA Office of Long-Term Living (OLTL) at 1-800-753-8827 or contact your local Area Agency on Aging (AAA) to request a Long-Term Services and Supports (LTSS) assessment. This is the starting point for CHC enrollment. 
2. Complete the LTSS Needs Assessment, conducted at home by a DHS assessor. The assessor will evaluate your loved one’s ability to perform activities of daily living (ADLs) — bathing, dressing, eating, toileting, transferring — and instrumental activities. Be specific and honest about difficulties; this is not the moment to minimize. 
3. If not already on Medicaid, submit a Medicaid application through your County Assistance Office. In Montgomery County, the CAO is located at 1430 DeKalb Street, Norristown. For Philadelphia County, contact the Philadelphia County Assistance Office. 
4. Once functional eligibility is established, choose one of the three CHC Southeast Zone MCOs: Keystone First, UPMC Community HealthChoices, or PA Health & Wellness. All three are accepted at SarahCare. 
5. A Service Coordinator from your chosen MCO will contact you to develop a care plan. During this conversation, specify that you’d like adult day services and that you want to attend SarahCare Adult Day Center in Jenkintown. 
6. The MCO issues an authorization to SarahCare. Our enrollment team contacts you to schedule a pre-enrollment visit, complete our intake process, and set a start date.

What We See in Practice 

The step families most consistently underestimate is the LTSS assessment. Because the evaluator is measuring what the person cannot do independently, families sometimes try to help their loved one ‘perform well’ during the assessment — which can result in a needs picture that doesn’t reflect reality and a determination that doesn’t qualify. Our guidance: let the assessor see the real situation. If your parent struggles to button their shirt, don’t button it for them before the assessor arrives. The assessment exists to get your loved one the help they need. 

How Long Does Enrollment Take? 

From initial contact with OLTL to the first day of adult day care, the process typically takes 4 to 8 weeks, depending on assessment scheduling, Medicaid processing times, and MCO care plan development. In urgent situations, some elements can be expedited — contact the OLTL and your CAO to explain the urgency. 

SarahCare can sometimes begin care on a private-pay basis while CHC authorization is pending, then transition to Medicaid billing once the authorization is in place. Call us at 215-999-1200 to discuss your specific situation. 

Frequently Asked Questions 

 Ready to Learn More? 

Schedule a free tour of SarahCare Adult Day Center in Jenkintown. 

Call us: 215-999-1200 or contact us here.