COSA - County of Delaware Office of Services for the Aging

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Friday, January 18, 2019

In-Home Services

All In-Home services are provided after a required COSA assessment is completed to determine needs and eligibility.


Assessment Procedure

Each COSA assessment, generally conducted in the home, includes questions on the applicants' physical health, functional ability, mental and cognitive functioning, caregiver and other supports, physical environment, and financial resources.

  • A Community Assessment determines the need and eligibility for In-Home Services or Nursing Home Care.
  • A pre-Admission Assessment is conducted to determine clinical eligibility for Nursing Home placement. This assessment is primarily intended for adults, 18 years and over, for whom placement in a nursing home is being considered and for whom state funding for a nursing home bed is being sought. Other groups appropriate for a nursing home evaluation are: Anyone considering a nursing home and who desires having an assessment completed; individuals, regardless of their financial situation, who have a primary or secondary diagnosis of mental illness, intellectual disability, or other related condition.

All In-Home services require either a Community or Pre-Admission Assessment. 

Apply for Services

Adult Daycare

Adult Daycare Centers provide a protective environment for older adults who are not capable of full-time independent living. During daytime hours, participants can receive supervised care in a supportive, safe, and structured environment. Services may include basic medical services, nursing services, nutrition, occupational therapy, physical therapy, recreation, transportation and more intensive personal care but vary by location.

For more info

Adult Day Care Centers reduce stress on full-time caregivers by offering reassurance and time to meet other responsibilities.Please click here to see Adult Day Care Centers under contract with COSA.

Aging Waiver Program

Home and Community-Based Services Waiver for Individuals Aged 60 and Older

The Aging Waiver Program is for people 60 years of age and older. Under the program, home and community-based long-term care services can be provided as an alternative to nursing home care. It is called a "Waiver" program because services are funded through a special waiver of certain Medicaid restrictions, allowing payments typically used for nursing home care to be used for in-home services.

To be eligible for the Aging Waiver, you must:

  • Be a resident of Pennsylvania
  • Be a U.S. citizen or a qualified Non-citizen
  • Have a Social Security Number
  • Be 60 years of age or older
  • Income and resource eligible
  • Meet the required level of care for a nursing facility

Effective 4/1/16, Maximus, the PA Independent Enrollment Broker (IEB), handles  the enrollment process for all of the Waiver programs. 

Click here for the Steps to Apply for Waiver:

Click here for a printable referral form:

There are several ways that you can make a referral to Maximus:

Participant Help Line can be reached by calling 1-800-757-5042.

COSA is one of the many entities providing Service Coordination for the Aging Waiver Program. Once you are approved for the Aging Waiver Program, you will be given a randomized listing of all Service Coordination Entities so you can choose the entity you wish to provide your service coordination.

If you would like COSA to provide the service coordination, you will need to select COSA-County of Delaware Services for the Aging-0024 from the list of Service Coordination Entities you will be asked to pick from.



If you are determined to be eligible, the following services may be available at no cost to you, enabling you to live more comfortably at home:

  • Adult Daily Living Services
  • Community Transition Services
  • Environmental Modifications
  • Financial Management Services
  • Home Delivered Meals
  • Home Health Services
  • Home Support Services
  • Non-Medical Transportation Services
  • Participant-Directed Goods and Services (Services My Way)
  • Participant-Directed Community Supports (Services My Way)
  • Personal Assistance Services
  • Personal Care Services
  • Personal Emergency Response System
  • Respite Services
  • Specialized Medical Equipment and Supplies
  • TeleCare

Once you are enrolled in the Aging Waiver Program, you will be assigned a Service Coordinator. An individual service plan is developed jointly by you and the Service Coordinator, after which services are authorized. You will then be able to choose any company or agency from a list of participating providers. All service providers are certified by the Pennsylvania Department of Human Services (DHS) to ensure that they meet Medicaid standards.

There are no cost sharing or contributions for Aging Waiver participants. However, you may be subject to Medical Assistance (MA) Estate Recovery

In order to qualify for Aging Waiver Services, you must meet eligibility requirements. This includes a level of care assessment and a determination of financial eligibility.

Care Management

A variety of long term services are available to help you get the care you need to stay at home.

Community-Based Long Term Care

Home and community-based services describe a range of personal, support, and health services provided to individuals in their homes or communities to help them stay at home and live as independently as possible.
In-Home Services include but are not limited to the following: Adult Day Care, Care Management, Home Delivered Meals, Home Health, Medical, Equipment & Supplies, Personal Care and Respite.
All In-Home services are provided after a COSA assessment to determine needs and eligibility.  Apply for Services

Caregiver Support Program

Providing care to a loved one is challenging, demanding and rewarding. COSA's Caregiver Support Program is designed to provide emotional and financial assistance to caregivers.

To qualify, the care receiver must live in Delaware County, and be financially eligible. The care receiver must be at least 60 years of age or have Alzheimer's disease or dementia, and need help with bathing, dressing, and supervision.

The program provides reimbursement for some caregiving expenses such as companions, home health aides, adult day care; supplies such as bed pads, lotions, and disposable undergarments; assistive devices such as tub benches, specialized telephones, and rental of a stair glide; and home adaptations such as ramps, tub bars, and widened doorways.

The Caregiver Support Program also prides itself on providing compassionate and knowledgeable care management to the caregiver and the care receiver. Care managers are there to answer questions, provide support and help caregivers find the necessary resources they need to ensure their loved one is safe and able to remain home.

To request an assessment for the Caregiver Support Program, contact COSA's Information & Assistance Department at 610-490-1300.  Apply for Services


Home Delivered Meals/ Senior Suppers

This program provides daily nutritious meals to home-bound older adults. Hot meals are delivered Monday thru Friday, with cold meals being available for evenings and weekends. Meals are supervised by a Registered Dietician. In emergency cases, home delivery can begin shortly after an In-Home Services Assessment.

Search for Home Delivered Meals

Mental Health Counseling

The Delaware County Mental Health Counseling program provides community based counseling services to older adults and/or their caregivers who are experiencing mental health or emotional issues.  Services include individual, couples and family counseling.
Services are provided by Merakey of Delaware County through 2 distinct programs.
  •  The In-home Counseling Program
  • The Senior Center Behavioral Health Program
In-Home services are provided to home-bound older adults in need of professional counseling to help them deal with issues such as depression, grief & loss, anxiety, loneliness and any age related issues. This service is also available to caregivers who may be overwhelmed and stressed with caregiving responsibilities. To access In-Home Counseling Program, call COSA’s Information and Assistance Department at 610-490-1300 to ask for a referral.


The Senior Center Behavioral Health Program is designed to meet the behavioral health needs of older adults in Delaware County.  Services are designed to:

  •  Respond to the short term behavioral health needs of center participants such as coping with life changes, depression, loneliness, etc.
  • Provide emotional wellness, early intervention and prevention programming to keep older adults active and emotionally fit. 

Services are available in the eight senior centers funded by COSA.  The program staff consist of a behavioral health specialist, an activities facilitator and volunteer peer counselors, who provide individual counseling and wellness groups.  To access the Senior Center Behavioral Health Program, contact the Senior Center in your area.





Nursing Home Transition (NHT)

Nursing Home Transition is a program that assists individuals to transition from Nursing Homes back in to the community.

The only criteria for referring someone to the Nursing Home Transition program is that the individual is in a nursing facility and wants to return to the community. One of our coordinators will meet with the individual and family to explore the options and assist in getting him or her home.  The protocol differs from a regular discharge plan because there are barriers identified that need to be overcome in order for the individual to go home.

Living in the community with supports allows people to remain in better health and thus reduce the costs incurred to care for them.  We are working to enable and empower older adults instead of just caring for them.

For example, an individual may need a place to live. We work with our Housing Director to explore housing options. Furniture, household supplies, security deposit, or services may be needed to get started upon discharge. Without the help of the Nursing Home Transition coordination the discharge may not happen.

Call COSA at 610-490-1300 for more information.  

Residents who are under age 60 should visit



Personal Assistance Services

Personal assistance service (PAS) allows you to select the person to provide you with your care. You can elect to receive services through an In-home provider or from someone you know, and that person will be paid through this service.
In order to utilize Personal Assistance Services you must first have had a COSA assessment. The PAS is available as part of your care plan.


By offering older adults the choice of selecting their attendants, individuals are empowered to tailor services to best meet their needs.
If you select assistance through an In-home provider (agency) the provider is responsible for hiring, firing, scheduling, all payroll tasks, and supervisory activities for each employee.


If you select assistance from someone you know (employer authority), you are responsible for hiring, firing, scheduling, all payroll tasks, and supervisory activities for your personal assistant. If you elect to receive financial management services, you must choose an enrolled Financial Management Service (FMS) provider.


To learn more about Personal Assistance Services contact the COSA Information and Assistance Department at 610-490-1300. COSA will do an assessment and approve service if you are eligible. Apply now  




Personal Care

Personal Care is provided to those older adults needing assistance with activities of daily living such as bathing, dressing, grooming, and using the bathroom. Services are provided by trained, supervised personal care workers in the older adults’ home according to the individual service plan.
Revised 8/16/18

Protective Services

COSA's Protective Services Program investigates confidential reports of abuse, neglect, financial exploitation, or abandonment of county residents aged 60 or older. Services are initiated to protect victims, stop abuse, and prevent future incidents.
Reports can be made anonymously 24/7 - confidentiality is assured in all cases. If you believe someone is in need of  protective services contact COSA at: 610-490-1300. After business hours, please call 610-622-9284.  
For more information in Delaware County, contact the Delaware County District Attorney's Senior Exploitation Unit at visit the PA Department of Aging website.


Respite Care

The primary purpose of respite is to relieve the caregiver by providing supervision for the consumer who cannot be left alone.

Services My Way

If you are receiving services through the Aging Waiver (administered by COSA) or Attendant Care Waiver (administered by Liberty Resources), you may be able to participate in a new and innovative service model where you can design your own spending plan in order to purchase goods and services related to a need identified on your individual service plan. It’s called Services My Way (SMW)

Click to Learn More


Revised 7/10/17

Shopping Assistance

Shopping assistance services provide assistance to seniors who cannot shop independently, and have no family or friends in the area to help them. Shopping assistance is provided twice a month.