Agency with Choice in PA — How It Works and Why Family Caregivers Love It

If you’ve been researching how to get paid as a family caregiver in Pennsylvania, you’ve probably come across the term “Agency with Choice.” It’s actually the specific mechanism that makes paid family caregiving possible in PA.

What Agency with Choice Actually Means

Agency with Choice (AWC) is an employment model with three parties. The participant is the person receiving care — they choose who provides it and direct the day-to-day tasks. The caregiver (often a family member) is the employee with a paycheck, tax withholdings, and workers’ compensation. The AWC organization is the administrative employer handling payroll, taxes, and compliance.

Think of it this way: your loved one is the boss. The family caregiver does the work. The AWC organization is the HR department.

Why AWC Exists

Before participant-directed models, Medicaid home care worked almost exclusively through traditional agencies that assigned strangers. For many families — especially in Philadelphia’s tight-knit communities — that didn’t work. AWC lets families keep care in the family while meeting Medicaid’s requirements for accountability and proper employment practices.

How AWC Works in Practice

The participant names their family member. The family member completes background checks (PA State Police, FBI, ChildLine), tax forms, and I-9 verification. Once cleared, they begin providing care, logging hours through electronic visit verification, and receiving biweekly direct deposits.

Who Can Be Hired Through AWC?

Adult children, siblings, parents of adults, grandchildren, grandparents, aunts, uncles, nieces, nephews, and cousins are generally eligible. Spouses are typically not eligible. No prior professional caregiving experience is required.

What Family Caregivers Appreciate

The flexibility to arrange hours around family life. The legitimacy of W-2 employment with protections. And the fact that care stays personal — the caregiver already knows the participant’s preferences, language, culture, and routines.

Learn more → Contact CareChoice in Philadelphia