the home care hiring dilemma

You visited mom over the holidays and you both agreed it was time to hire a home health aide to help care for her. But should you hire through an agency or find someone on your own? Not surprisingly, there are many things to consider when striving to make an informed decision that’s right for your family. The following are some important items to keep in mind, understanding that the criteria for hiring companion care may differ somewhat.

SERVICE AND RESPONSIBILITIES In New York State, agencies are required to adhere to a strict set of standards, which directly benefit the person receiving care. All home health aides working for an agency are New York State certified. A registered nurse is also required to be on staff to work with families to develop a plan of care and supervise the delivery of care. Agencies accommodate a broad range of services as needs change. Hiring on your own is always a valid option. In that case, you are taking full responsibility for making sure the aide is qualified and doing what she/he is supposed to be doing. The family is responsible for developing a plan of care and ensuring the plan is being followed.

FLEXIBILITY When hiring on your own, perhaps through an ad in a neighborhood paper or word of mouth, you are more likely to find a local caregiver who is willing to take on short shifts and unusual schedules. As care needs change, you should have a plan in place to ensure continuity.

VETTING An agency has access to a pool of proven caregivers who have met agency standards, which include valid certifications, verifiable references and work experience, a clean criminal background and driving record, as well as a negative drug screening. If hiring on your own, plan on doing some due diligence; check references, training and work experience, along with criminal and motor vehicle background records. This is not a step to skip when bringing someone into your home.

SELECTION An agency will typically have you meet with a few candidates so you and mom can select the person who will best match your family situation. When seeking home care on your own, you have full autonomy over the recruiting and selection process.

BACK-UP CARE Planning for vacation coverage or for unexpected sick days is part of the service you should expect to receive from any agency. If you don’t use an agency, have an ongoing back-up plan in place should the caregiver get sick or need some vacation time. A back-up plan can be as simple as relying on a family member, friend or neighbor.

PAYROLL, TAXES, ETC. If you hire through an agency, they are responsible for handling payroll taxes, unemployment insurance, disability insurance and workers compensation. You/your family will be paying a fixed hourly rate to the agency. In turn, they cover these expenses. If you hire on your own, you become the employer and are legally responsible for adhering to all federal, state and local taxes such as payroll taxes, as well as unemployment insurance, disability insurance and workers compensation. Household employers are also legally required to withhold Social Security and Medicare taxes from any employee earning $2,000 or more in a calendar year. You may find that hiring on your own appears to be less expensive, but factor in these costs for a true comparison. Always consult your accountant to ensure compliance. And you may want to consider using an online household payroll company to manage these items.

Understanding your needs and feeling comfortable about your home care hiring decision is important; as other challenges present themselves, you’ll want one less thing to worry about.

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