8/19/2011 2:40:00 PM 2011: Selecting in-home service providers
Seniors and people with various illnesses or disabilities often need in-home services to assist them with everyday tasks they cannot do themselves. There is a wide range of in-home care available, from cleaning services through skilled nursing. Jon Hoaglund, General Manager of The Caring Presence says, “in-home, non-medical care industry is growing rapidly.”
Cheapest may not be best
Some consumers are unaware of potential legal, tax and ethical consequences of using in-home providers. In 2003, The National Private Duty Association (NPDA) wrote, “consumers are turning to companies that offer them the cheapest price for care without understanding the implications of their choice. Similar to day labor companies, many consumers are hiring workers from registries and companies that do not employ or supervise their workers, but merely ‘place’ them in home care settings.”
According to Attorney James D. Atkinson, “The risks are numerous. Independent caregivers are not eligible for workers’ compensation benefits and typically must look to the consumer to try to recover for any injuries they incur on the job. In most cases, the consumer’s insurance will not provide coverage for such injuries.”
The Better Business Bureau’s paper Home Care Options notes, “Before using any agency or company, be sure to check with the state to see if it is insured and licensed.”
Who is the employer?
IRS publication 15-A states that “anyone who performs services for you is your employee if you can control what will be done and how it will be done. The substance of the relationship, not the label, governs the worker’s status.”
NPDA notes, “registries and independent contractor agencies cannot provide any substantive work supervision, scheduling or training to workers in home care without becoming employers.” Thus, in addition to other consequences, these workers are not supervised or trained.
Hoaglund says, “A quality agency like The Caring Presence meets AHCCCS regulations for their services, and is bonded. Employees are supervised and trained, background checks and fingerprinting are requirements. We also do random substance (drug) tests every month.”
Non-medical in-home care
Hoaglund believes that issues such as abuse and exploitation of frail or disabled people can be of great concern as many of them feel insecure because of their limitations. “Because registries or placement agencies want to avoid the employer relationship, they may not do background checks.”
The consumer, whether a senior who wants to remain comfortable at home, or someone with a short term health crisis; may be unable to make important decisions.
Family is often far away, unable to assist in the care and the decision-making process.
Check with the Better Business Bureau and the AZ Non-Medical Homecare Association.