As we age, the odds of having health care challenges, including a serious illness, hospitalizations, declining abilities and more becomes a reality for many. In fact, care may be needed at ANY age. When you or a loved one are in need of private duty help, ensure the best care possible by researching the options.
Private Duty care, also known as Custodial or Companion Care, Non-Medical or Non-licensed Home Care, provides one-on-one assistance with activities of daily living in a home setting, which could be a private residence, an assisted living facility, a skilled nursing facility or a hospital.
Provided services typically include assistance with ambulation, transferring from place to place, toileting, medication reminders, bathing and dressing, meal preparation, light housekeeping, laundry, changing linens, transportation, errands and other tasks.
Services are available by the hour or the shift. “Live-in” 24-hour care is also possible but has become so costly that most people opt for round-the-clock care in two 12-hour shifts. Referred to as Custodial Care, this care coordinates with any licensed home health or hospice care and is typically paid privately or with long-term care insurance. Options for private duty care are as follows:
1. State-Licensed Home Care Agency
A State-Licensed Home Care Agency provides caregivers who are employed by them. They cover payroll, required taxes and workers’ compensation insurance and provide backup caregivers when the main caregiver is ill or needs time off. Caregivers who work for a State-licensed agency must be cleared by the State on an approved Caregiver Registry. Extensive background clearance (DOJ and FBI), a TB test and ongoing training is required in order for caregivers to be cleared to work. Licensed agencies are prohibited from hiring caregivers who are not on the Registry.
2. Direct Referral Agency or Privately Hired Caregiver
The agency refers you to a caregiver but is NOT the caregiver’s employer. They may do a background clearance, but there is no guarantee how comprehensive it is. In these situations, you are the employer, responsible for payroll, Social Security and Medicare taxes, as well as adequate Comprehensive Liability Coverage for workers’ compensation. You will pay an ongoing referral fee to the agency for the caregiver, in addition to paying the caregiver, normally daily or weekly, either by check or via a payroll service. Coordination of duties is between you and the caregiver and you resolve work-related issues with them directly. The agency may not provide a backup if your regular caregiver is ill, takes time off or doesn’t show up. You hire and fire the caregiver, conduct background clearances, check references, negotiate rates and raises, prepare/file quarterly and annual payroll tax returns and pay for a caregiver’s costs if they are injured in your home (check your homeowner’s insurance regarding coverage).
Most people find the safest, most efficient and dependable option is to use a State-licensed agency. When looking into home caregivers, be aware of the risks, ask for references and know what your responsibilities entail. As always, you get what you pay for.
Melanie Farber is the CEO/Supervisor of Direct Care at AdvantagePlusCaregivers.com. For a free consultation, call 805.322.8822.
