Home Care Agencies Can Now Offer More “Non-Skilled” Services!

Good New for Home Care Agencies owners throughout Pennsylvania, on November 23, 2016 the Wolf Administration issued a policy clarification through the departments of Health, Human Services, and State that clarifies the types of non-skilled services/activities that can be performed by direct care workers (DCWs) to assist individuals with disabilities with activities of daily living that could be performed independently but for their disability. DCWs include personal attendants, nursemaids, or other household aides.

These non-skilled activities/services include assistance with bowel and bladder routines, assistance with medication, ostomy care, clean intermittent catheterization, assistance with skin care, and wound care.

This specialized care provided in the consumer’s place of residence or other independent living environment are types of home care services unique to the consumer’s care needs that fall within the licensure exemption for unlicensed persons under the Professional Nursing Law and Practical Nursing Law. DCWs may perform these non-skilled services/activities, provided they do not represent or hold themselves out as being licensed nurses, licensed registered nurses, registered nurses, or practical nurses; or use in connection with their names, any designation tending to imply they are licensed to practice nursing.

The Department of Health will continue to monitor home care agencies and registries’ compliance with Chapter 611 Home Care Regulations relative to the provision of specialized care to consumers and DCW competency requirements through surveys and complaint investigations. The guidance below is a tool for home care agencies and registries to utilize to comply with the Department of Health’s Home Care Agency and Registry regulations.


  • Direct Care Worker: individual employed by a home care agency or referred by a home care registry to provide home care services to a consumer.
  • Home care services: the term encompasses the following activities:
    (i) Personal care – The term includes, but is not limited to, assistance with self-administered medications, feeding, oral, skin and mouth care, shaving, assistance with ambulation, bathing, hair care and grooming, dressing, toileting, and transfer activities. (ii) Assistance with instrumental activities of daily living.(iii) Companionship services. (iv) Respite care. (v) Specialized care – Non-skilled services/activities unique to the consumer’s care needs that facilitate the consumer’s health, safety and welfare, and ability to live independently.

Consumer Characteristics:

The non-skilled activities/services are specialized care that are unique to the individual consumer’s care needs that facilitate the consumer’s health, safety and welfare, and ability to live independently. This applies to consumers regardless of age or nature of disability.

If you are a Home Care Agency owner in Pennsylvania, give Liberty a call and we can help you and your staff prepare and better serve your current and new clients with these exciting changes.

Liberty Licensing & Consulting, LLC.

(215) 709-7070


Taylor M. Fletcher, Esquire ​is the Founder and Principle of Liberty Licensing & Consulting, LLC.