One person
Best starting model.
One written housing agreement or one approved caregiving assignment with limited hours and clear duties.
Two people
Possible after stability.
Could mean two separate care recipients, or an approved Life Sharing home serving up to two individuals.
Three people
Not an informal household plan.
May be possible as separate employment clients, but living with and caring for three people can trigger provider, licensing, occupancy, zoning, insurance and staffing requirements.
Four different arrangements—do not mix them together
| Arrangement | Who receives the government benefit? | What you may receive | Can it involve 2–3 people? |
|---|---|---|---|
| SHARE housing | The program facilitates a screened housing match; it is not Medicaid. | Lower-cost housing in exchange for rent, agreed help, or both. | Usually a specific host/home-seeker match. Do not assume multiple care recipients or wages. |
| Participant-directed HCBS caregiving | Each older or disabled participant must qualify for Medicaid/waiver or Act 150 services and have authorized care. | Wages as an approved personal attendant/direct-care worker. | Potentially yes, but each person requires a separate plan, approved hours, timesheets and payroll relationship. |
| Life Sharing | Eligible people with intellectual disabilities/autism receive approved ODP services. | Approved provider compensation and household support under a formal program. | Pennsylvania states that up to two individuals may live in a Life Sharing home. |
| Ordinary volunteering | No Medicaid payment to you. | Purpose, experience and references—but generally no wage or rent guarantee. | You can volunteer with several people only within the organization’s rules and your capacity. |
The safest 1→2→3 transition
Apply for Medicaid, SNAP, housing help and behavioral-health care. Document depression and work limitations.
Begin with limited companionship, technology help, errands or authorized attendant hours. Avoid 24/7 responsibility.
Add a second person only after 60–90 days of reliable attendance, stable sleep, treatment and accurate paperwork.
Use separate schedules and employers. Do not create a three-person residential care home without professional licensing and zoning review.
Procedure for your own assistance
- Apply for Pennsylvania Medical Assistance and SNAP through COMPASS or call 1-866-550-4355.
- Tell the caseworker you are unemployed and report all current income, assets, household facts and living arrangements accurately.
- Request behavioral-health coverage and schedule a clinical assessment for depression and functional limitations.
- Review SSI/SSDI if a medically documented condition prevents sustained work.
- Call PA Link at 800-753-8827 for housing, disability and long-term-support navigation.
- Call 211 for local rent, deposit, food, shelter and mental-health programs.
Procedure for becoming a paid caregiver
- The person needing care applies. They must be assessed and approved for LTC/HCBS, Community HealthChoices, an applicable waiver, or Act 150.
- A service plan authorizes care. The plan defines tasks and hours. You cannot decide the paid hours yourself.
- Participant direction is selected when available. The participant may employ a personal attendant rather than receive only agency-assigned workers.
- You complete onboarding. This may include criminal-background checks, competency review, health/TB screening, tax and payroll documents, training and electronic visit verification.
- Each client remains separate. Never bill two people for the same time. Travel, overlapping shifts and overnight responsibility must be addressed honestly.
Housing paths that may work with your plan
SHARE
A home host and home seeker can agree on rent, help around the home, or both. Lancaster County currently directs inquiries to its Office of Aging.
Lancaster SHARE: 717-299-7979 SHARE detailsLife Sharing
For eligible people with intellectual disabilities or autism, Pennsylvania Life Sharing places up to two individuals in a supportive home with caring adults. This is a regulated service model—not casual roommate caregiving.
Life Sharing detailsReadiness test before adding another person
| Question | Ready signal | Stop signal |
|---|---|---|
| Can I arrive reliably? | Consistent attendance for at least 60–90 days. | Frequent missed shifts, inability to leave bed, or unpredictable crises. |
| Can I document care accurately? | Separate notes, timesheets and service plans for every person. | Overlapping hours, memory gaps or informal cash arrangements. |
| Can I maintain boundaries? | Written duties, scheduled time off and emergency backup. | Being expected to remain available all day and night. |
| Is my own housing secure? | Written lease/SHARE agreement and clear termination terms. | Housing can be withdrawn immediately if you become ill or cannot work. |
| Is the care safe? | Training and authorization match the person’s needs. | Transfers, medication, dementia wandering or medical procedures beyond your training. |
Illustrative workload—not a benefit promise
| Stage | Possible schedule | Total weekly hours | Housing structure | Risk level |
|---|---|---|---|---|
| Start | One person × 8–15 hours | 8–15 | Your own subsidized housing or a written SHARE arrangement | Lower |
| Stable | Two people × 10–15 hours | 20–30 | Housing kept legally separate from wages when possible | Moderate |
| Expanded | Three people with non-overlapping shifts | Up to your medically sustainable capacity | Separate employment records; no informal group-home promise | High |
Actual wages and hours depend on the participant’s approved plan, program, fiscal-employer system and applicable pay rate. Any earnings must be reported to programs that require income reporting.
Call script
I am 54, unemployed, and rebuilding after prolonged depression and a difficult divorce. I need help applying for my own Medicaid, SNAP and housing assistance. I am also exploring a future role as a participant-directed caregiver or approved shared-housing provider. I want to start with one person and understand the training, background checks, authorized hours, payroll, housing rules and benefit effects before considering two or three people. Please connect me with PA Link, SHARE, the Independent Enrollment Broker, and a participant-directed services counselor.
Do not do these
- Do not advertise yourself as a Medicaid provider before enrollment or authorization.
- Do not promise housing and personal care to three vulnerable adults informally.
- Do not accept responsibility for medication, lifting, bathing or dementia supervision without training and authority.
- Do not hide caregiving wages from Medicaid, SNAP, SSI, SSDI, housing or tax agencies.
- Do not make your housing dependent on uninterrupted 24-hour caregiving without backup and written protections.