We often have people tell us they are considering hiring an independent caregiver for their homecare needs. Sometimes the person they are considering is a neighbor or a friend who has worked with the elderly or disabled at some point. All situations are unique and every need for homecare will have a slightly different solution, whether it be hours of need or type of services. We believe each family seeking homecare solutions should have the best care for their situation whether it be an agency or an individual, but we also believe each family in order to protect themselves and their loved one should be thoroughly informed when they hire.
Here are a few things you should be aware of when weighing your homecare options.
1. Many families are not aware there are certain things which are required by law of any individual or any agency who performs home care / personal care services. For example: the state of New Hampshire requires all homecare agencies to be licensed but many are not aware that any individual performing personal care / homecare services must also be licensed. This state licensing was established to protect the individual. An agency must go through a thorough licensing process in order to obtain a state license, an independent caregiver must go through a similar process. This license is different than having an LNA certificate. An individual can have their LNA certificate and still not be state licensed.
2. Many families are not aware that when they hire a caregiver independently, the IRS then considers them an employer. We have had families call us who have hired caregivers independently and when the family no longer needs as many hours of coverage they let a caregiver go. The caregiver then goes to the unemployement office and the family receives a bill for back employee taxes. Taxes which must be paid by an employer include Federal, Social Security, Meidcare, and state taxes if you are outside of NH.
3. There is a state registry called the BEAS registry, we find there are many people who are not even aware this exists. This registry of the Bureau of Elderly and Adult Services is maintained to keep a registry of those who have abused, exploited or neglected elderly or disabled adults. Running a check of this registry is not the same as running a criminal background check. We have seen situations where someone is on this registry yet has a clean criminal background check.
4. Many families are not aware that a negative TB test is required of all home care employees employed by an agency or working independently. TB can be carried by an individual for years without signs or symptoms. Any caregiver you are considering hiring independently should also be tested for TB.
5. Drug Testingfor illegal drug abuse or prescription drug abuse. Many of the homes in which homecare services are performed have prescription medications in them. In fact, medication reminders is often one of the primary needs of homecare clients. Yet when seeking homecare services, many families often are not aware of this potential problem. All homecare providers should be drug tested.
6. Any homecare agency must provide, as required by law, Workers Compensation Insurance. In addition an agency provides Liability Insurance and Bonding. If you are considering hiring independently, your homeowners policy may not cover such things. Talk with your insurance agent and make sure your homeowners policy is going to cover any incidents which may occur. This is not the time to think "oh, nothing will happen", we live in a society which loves lawsuits and you put at risk your home and anything else you have worked hard for if there is an accident.
7. Other considerations.
Sick Days: If homecare is something which you can not be without day in and day out, make certain you will have replacement if the caregiver should call out sick.
Qualifications and Training. Be certain the individual you hire has experience and training in the skills you are asking them to perform. For example; just because someone has worked in a nursing home does not necessarily mean they have done transfer assistance. Transfering an individual to their bed or in and out of the shower requires specific skills and techniques and must be done correctly to avoid injury to both the caregiver and the client/patient.
Transportation: If your caregiver will be providing transportation it is important that a motor vehicle background check be conducted prior to hire. Also, make certain your motor vehicle insurance will cover this situation or the caregiver is carrying their own motor vehicle liability policy. Our agency has a policy which will cover transportation of a client whether in the employees vehicle or the clients vehicle.
Physical: All state licensed agencies and individuals must have a physical from their doctor stating they are medically cleared to do such work. You should make certain you obtain the same if you are hiring independently.
These above considerations are just a few of the things we believe every family hiring homecare services should consider. For more considerations you can download the following PDF document.