Understanding the Distinctions Between Different Types of Home Care Providers

Do you know the differences between Home Care Agencies, Home Care Placement Agencies, and Independent Home Care Workers? Knowing these key differences can help you, or your loved one, get the care you need while protecting yourself from liability. First, some definitions: Home Care Agencies employ trained staff who provide medical home health or non-medical personal care services in the home care consumers temporary or permanent home or place or residence. Home Care Placement Agencies (a.k.a., registries) make referrals of Independent Home Care Workers to home care consumers seeking services. Independent Home Care Workers are unaffiliated individuals who may or may not have home care training who hold themselves out to the public as providing home care services.

In order to better ensure the safety of home care consumers, Gov. Bill Ritter signed legislation in the summer of 2008 requiring all Home Care Agencies to be licensed by the State of Colorado. This new law requires that all medical Home Care Agencies become licensed prior to January 1, 2010, and all non-medical Home Care Agencies become licensed prior to January 1, 2011.
In order to become licensed, Home Care Agencies must comply with a significant set of requirements that are designed to protect the rights and safety of home care consumers. These requirements include carrying general liability insurance or a surety bond, and training, scheduling, supervising, disciplining, and performing background checks on all home care workers. Home Care Agencies must also pass an extensive onsite survey by the State of Colorado Department of Health. As the employer of record, Home Care Agencies are also required to withhold and remit federal and state income taxes, Social Security and Medicare taxes, and provide unemployment insurance and workers compensation insurance for all home care workers.

By comparison, since they are not legally the employer of the home care workers whom they refer, Home Care Placement Agencies are not required to withhold payroll taxes or provide unemployment or workers compensation insurance for those home care workers. This means the consumer can be held directly and personally liable for any unremitted payroll taxes and any medical expenses should a referred home care worker become injured while providing care for the consumer. Likewise, since they are not the employer of record, Home Care Placement Agencies cannot be required to train, schedule, supervise, or discipline their referred home care workers. Generally speaking, because Home Care Placement Agencies are not able to exercise management and control over the performance of their referred home care workers, the State of Colorado does not currently allow Home Care Placement Agencies to become licensed.
While some Independent Home Care Workers choose to accept referred assignments from Home Care Placement Agencies, others choose to work exclusively on their own. For those working on their own, all background checks, training, scheduling, supervision, and discipline become the responsibility of the consumer. And, as in the case of Home Care Placement Agencies, the consumer can be held directly and personally liable for any unremitted payroll taxes and any medical expenses should an Independent Home Care Worker become injured while providing care for the consumer. Caveat Emptor. Consumers are strongly encouraged to request an Agency Disclosure Form, which the Colorado Department of Health requires all Home Care Agencies and Home Care Placement Agencies to provide to consumers, and which specifies whether a provider is a Home Care Agency or a Home Care Placement Agency and lists the consumer safeguards that the home care provider is responsible for as well as the responsibilities of the home care consumer.

Editor's Note: This article was submitted by Lorin Chevalier, Managing Director of the licensed Home Care Agency, Senior Helpers, and a member of the Home Care Association of Colorado, the National Private Duty Association, and the Colorado Gerontological Society. He may be reached at 303-452-6500 or at www.SeniorHelpersBoulder.com