My DH has been approved by LTC for an aide to come into home to help me. I asked the one I interviews if they had insurance and were bonded. They said no. The friend who referee them has used them for her mom and dad for years. But I know even though I really liked them and DH seemed receptive to them. I am going to have to find someone else.
If anyone can give me suggestions of other questions I need to ask. Or anything I need to research on an agency please let me know. I want DH to be safe and our assets to be safe from a law suit.
One advantage of dealing with agencies is that they are usually insured and bonded.
Talk to your home insurance company and talk with them about appropriate insurance to cover you in case you hire an uninsured aide. See if it provides the same protection for you and the aide. Even call them if you hire through an agency.
In the US an aide you hire directly is considered to be a household employee. So you will need to deal with SS taxes and unemployment insurance. With federal govt dealing with this is simple, you make payments as part as filling out your tax return. And you can then treat time spent caring for your LO as medical expense (time cleaning and cooking does not count). I found that state govt was much less friendly, had to do quarterly filings, and was treated like a business. I would not consider hiring anyone who wanted to be paid under the table. Again, working with an agency you can avoid all of these issues.
Ask what they will do to occupy your husband. Ask how they will deal with specific issues.
I asked our local Alzheimer's Association for agencies they could recommend. I also have supervisory care of my 97 year old mother who lives 45 minutes away so I specified that I needed an agency that could provide emergency care if I must go to her.
Recently, I ended up in the emergency room overnight with her and husband was home alone. I knew that should not have happened. The agency I hired requires all employees to attend training provided by the Alzheimer's association, is bonded and insured, does multiple background checks, requires a clean driving record, inspects vehicles, and requires the caregiver have auto insurance.
Ask how they find their caregivers. Do some Craigslist searching for their ads, etc. are the caregivers direct employees or are they contract help?
I hope I have chosen well. Husband is very resistant, so time will tell.
Jackie, a few suggestions. Have you spoken with your husband's case manager at the LTC company? My husband has John Hancock and they assign a case manager to everyone who begins using the LTC insurance. The case manager was quite helpful and outlined in detail the conditions under which I could hire an aide and have the cost covered by the LTC insurance. Of course I could hire through an agency if the agency was preapproved (simple process, decide what agency you want to use and then call the LTC insurance company for approval). I could hire an individual privately but I would need an RN to supervise the aide and do periodic reviews (the RN could be a friend or relative) and they would be submitted to JH. I recommend that you speak with the lTC company BEFORE you hire anyone so you have a full understanding of what they will cover.
JH also works with a separate company CHCS services, Inc which contracts with various home health care agencies in our area for a preferred rate for JH LTC insured. I requested a list of HHC companies which provide live-ins but they have rates for both live-ins and hourly aides. Foe example, one of the companies normally charges $206/day for live-in, but the rate for JH insureds in $195/day, but you must tell the company you are with JH and want the JH rate BEFORE you sign a contract.
If you plan on hiring a private aide with no home health care affiliation, I would definitely perform a complete criminal, drivers license and credit background check for your own protection. Of course the person would have to agree in writing and provide their ssn and address. There are any number of reliable background check companies on the web (the company I worked for used absolute hire). This is necessary to protect you, your husband and your assets. You need to know who is coming into your home and caring for your spouse as well as who might have access to sensitive information (banking, credit card statements, etc) if it is not securely put away. Also if you hire a private aide, what would be the plan for getting a substitute to cover him/her if she was sick or couldn't make it?
I would also call my homeowners insurance to find out what if any additional insurance you will need should someone get injured in your house or property. We have an umbrella policy to cover something unexpected but it has limitations if someone who is not a family member resides in our home or drives my vehicle.
Using an agency to provide you with an aide helps mitigate much of the insurance issues...they usually provide workers comp and bond their employees, as well as perform background checks. Some agencies will not allow the aide to drive your vehicle, only the aides and you would be required to reimburse the aide for the mileage. Don't assume that the agency has done all the necessary background checking, etc. you have to ask each agency to be sure they have fully vetted their workers.
If using an agency make sure you get a copy of their policies for both the aide and you to follow and ask questions if it's not clear. Is there a hourly minimum per day? The agencies in our area have a 3 or 4 hour minimum per day. Are you required to provide meals/food? What are the use of telephone policies? (This has been a huge issue for us because the aides we've had tend to abuse the priveledge and are on the phone a lot, thus ignoring my husband).
I will email Joan with my email address to send to you...I have a 3 page list of questions I put together to ask agencies before contracting with them. After almost 6 years I've learned a lot - some of it the hard way. I will email you my list if you contact me via email.
We have Hancock LTC for ALF but they never offered a case manager. Is that only for families using aides in home? Is there any reason I should ask for the service at this point?
Hancock's payout system is a bit cumbersome. Our agent sends in the ALF bill (that I take to her office) and they only pay after the service, so I am always a month or two behind in receiving checks. One month they forgot to process it and told the agent that it would be processed the next month. Fortunately for me, she argued with them and got it bumped up a bit although still weeks late. Our agent told me that everything is done by a person, at a desk. by hand every month. Nevertheless, I am grateful for the help and for the knock on the head that caused me to look at LTC insurance in the first place.
I did hire two aides under the table, one for several years, the other the last few months my husband was home, and had a good experience. I offered to pay Social Security, but they declined. Risky, but also I hate supporting the agency system where I would pay $15 an hour (I live in a rural area in a low cost of living state) and the aide would only get $8 or $9.
I agree about that caregivers working for agencies get little pay but sometimes get benefits such as health care and vacation.
But if you pay under the table then LTC will not reimburse their pay and you cannot deduct wages from your own taxes and you risk arrest for yourself for not paying SS taxes or reporting their wages to tax authorities. The last is really big because if they steal from you or if something happens you may not want to report it to the authorities.
I just called the ladies that I interviewed and she said they are applying for their insurance and to be bonded. I told her to call when they get it. I also took out an umbrella policy so that I would be covered that way. Last night was not good. I have a key finder on his keys. He has lost a whole set of keys to the house and cabinets. He has had it on there since Christmas. His sister he loves gave it to him. But last night he said that I was tracking him. It only works if you are 45 feet within range of the keys. He then started he did not trust me. The paranoia is setting in big time. I really need to get the help started. I cannot do this much longer. In another post someone stated seeing the train coming. I posted I am 6 months out. Wrong I am right on the tracks and it is heading my way. It sure can take a turn quick.
I will find an other agency until she works out her insurance.
Just to add to what paul said about hiring under the table, since you and the aide do not pay social security and state workers comp taxes, if the aide gets hurt they will not be able to qualify for or collect workers comp or social security disability since nothing was paid into the system on their behalf. When they want to retire they will not be eligible to collect social security unless they have paid into the system with another employer and meet the 40 quarters requirement.
Trust me I know from personal experience that when someone who does physical labor most o f their working lives and can no longer perform those services to earn a living, they are looking for a way to be compensated for their lost income or a retirement income. If they have to tell an agency (ss, workers comp) they were paid under the table and worked for you (or got injured working for you), they will so they can get some form of income. Depending on what services the aide will perform (transferring, bathing, etc) there is a likely probability that they could risk injury. Just be aware.
If you decide to hire anyone, whether through and agency or private, I also recommend getting workers comp coverage from your home owners as extra protection. It is not expensive and offers an additional layer of protection.
Jackie, make sure the umbrella will cover someone working in your home. As soon as joan sends me your contact info I'll send my list.
ps I too hate that the agencies take so much of what I pay them but it is easier for me to use the agency, particularly when it comes to substitute coverage.