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Senior Citizen's Guide to Connecticut

Caring for Yourself or a Loved One
What Consumers Should Know Before Hiring a Non-Licensed Personal Caregiver

Here are some guidelines to follow for hiring personal caregivers to help ensure that its member agencies adhere to certain standards and take reasonable and prudent steps to hire the highest quality workforce to provide care for patients. These best practices provide guidance and protection to give patients and their families a way to evaluate qualifications and credentials. They are intended for all individuals who need personal care. As the need for home care services increases, we must ensure that the caregivers who are hired to care for our loved ones are qualified and competent.

When people are looking for non-licensed caregivers, the process can be very confusing. Whether you choose to use a licensed home health agency, non-licensed agency, or private hire, you should consider the following:

Contract/Written Agreement
Be sure to have a contract or written agreement with the private care worker that specifics the anticipated schedule, planned duties, and payment arrangement.

Taxes/Workers Compensation
Be sure to determine if you are responsible for paying taxes. If you hire someone directly, then you are the employer and you as an individual or your family are required to pay unemployment, social security and payroll taxes (and possibly worker’s compensation). If you are using an agency, do not assume that all agencies pay employee related taxes. Be sure to inquire as to whether the agency that you are working with is paying the taxes.

Comprehensive Background Checks
Be sure that the agency conducts comprehensive background checks, which at a minimum should include a criminal background check. Be sure to determine if the scope of the criminal background check is national or just statewide. Also, find out how far back the check goes and if it includes physical and drug screening, a personal and professional reference check, verification of appropriate education or training (if applicable), driving records (if applicable) and a review of appropriate registries (such as the sex offender registry or Certified Nursing Assistant (CNA) registry). Clients or family members can contact either the Department of Public Health or the Department of Consumer Protection to determine if an agency has had any complaints filed against them. Please note that the CNA registry only lists those CNAs licensed in CT who have worked for Skilled Nursing Facilities. Complaints from home health or other settings are not logged there.

Credentials
Be sure to inquire if the agency is licensed or registered. If a home health agency is licensed they must be licensed through the state’s Department of Public Health. If a homemaker/companion agency is registered they must be registered through the state’s Department of Consumer Protection.

Education
Be sure that agency staff is properly trained. Appropriate education and training is currently required for Certified Nurse Aides and Home Health Aides. Also inquire if non-licensed personal care providers (i.e. PCAs), receive agency orientation and ongoing in-service education to ensure clinical competence and compliance with agency policy.

Back Up/On Call Services
Be sure that there is a back-up plan in place for the provision of care if the personal care worker is unavailable. If you are using an agency, the plan should be provided through the agency. If you are working with a private hire then be sure to have pre-established arrangements if the regular caregiver is unavailable.

Oversight
Be sure that there is appropriate and frequent supervision of personal care workers and that there is a plan for follow-up in place if there is a problem with the contracted caregiver. Also, determine if there is a formal complaint process in place either through the agency or by contacting the appropriate officials.

Types of Agencies that Provide Non-Licensed Personal Caregivers

Licensed Home Health Agency:
This agency is a full service agency that provides skilled services (nursing, rehabilitation services and social work) as well as home health aide services. These agencies may also provide specialty services such as hospice, behavioral health, and telemonitoring. These agencies may choose to provide homemakers and other non-licensed services. Services may be paid for by Medicare, Medicaid, Private Insurance or private pay. This agency holds a license with the State of Connecticut and is surveyed by the Department of Public Health.

Licensed Homemaker/Home Health Aide Agency
This agency can provide services to the private pay or Medicaid population. This agency holds a license with the State of Connecticut and is surveyed by the Department of Public Health. They can provide companion, homemaker, home health aides and live in caregivers.

Registered Companion Homemaker Agency
This agency is a registered business with the Department of Consumer Protection. Effective October 1, 2006 an agency that provides these services must be registered as an employer. This agency can provide personal care attendants, companions, homemakers, and live in caregivers to chronic and stable private pay clients.

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