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If you are considering receiving home care, you may receive advice to hire a private attendant. Due to the cost and the increasing shortage of quality in-home caregivers, many families turn to private individuals rather than working through an agency. While at first glance this may seem reasonable, it can cause numerous problems and create unexpected liabilities for the family, who may become the employer of the caregiver.

There are a number of very compelling reasons why it is a much wiser decision to utilize Central Coast Senior Services, Inc. as the employer of your in-home attendants.

Tax Issues

As a private employer, you are required to pay Social Security, unemployment and payroll taxes, and workers compensation insurance. Many private caregivers will represent themselves as independent contractors, ostensibly relieving you of these tax obligations. However, this can be a dangerous misrepresentation of the facts.

When a caregiver works in your home privately typically you will be considered the employer. If your worker does not meet his or her payroll tax obligations, this responsibility falls to you as the employer. This can be a serious obligation because it may involve back payroll taxes with interest and penalties, civil fines and the possibility of criminal penalties.

If your worker is ever injured while working for you, or files for unemployment insurance when she or he stops working for you, or if your worker becomes unhappy and develops a grievance against you, and decides to report you or file a legal claim or lawsuit, you could be become subject to significant costs and penalties.

If you had that worker for a few years, the back taxes, penalties and interest could be enormous. This is not an exaggerated fear. This writer (Steve Raymond) has seen a case in which a daughter was liable for four years of back taxes for care provided by a private caregiver to her parents.

If you are judged to be the employer, you will also be held accountable for proper payment under California Industrial Commission Order # 15-2001, “Regulating the Wages, Hours and Working Conditions in the Household Occupations.” The working conditions and wages are very specifically defined, and you could be held financially liable for a variety of violations. A private caregiver who becomes angry with you for whatever reason has a tremendous amount of leverage against you by threatening to report you to the Labor Board. There is no price that can be placed upon the financial cost and emotional stress if you found yourself in this difficult situation. (Link to California Industrial Commission Order # 15-2001)

Protection from Elder Abuse and Exploitation

Unfortunately, there is the potential for both physical abuse and financial exploitation when work is being done on behalf of a frail, functionally limited, and often cognitively impaired individual.

While most individuals who become private caregivers do so out of a desire to help others and to contribute to the community, there are predators who seek caregiving jobs with the intention of taking advantage. This becomes especially easy when the attendant and the recipient of care are isolated in a private home with little or no supervision.

Families usually do not fail to provide supervision out of malicious neglect. Supervision is often difficult because of geographic distance, lack of expertise, or a strong emotional dependence of the senior upon the attendant. Furthermore, families often do not have the time or the resources to do criminal background checks, or to contact references, if they even think to ask for references. Sometimes families are so grateful for the care provided by an aide that they are also vulnerable to dependence, then manipulation and exploitation. Even if these crimes are not pre-meditated, they are frequently crimes of opportunity.

Agency Supervision

Our Home Care Coordinators provide regular supervision to our Personal Attendants. (click here to read more on our Home Care Coordinators)

The most essential role for our Home Care Coordinators is in reducing the potential for harm to your parents. (Click here for a deeper discussion of Harm Reduction for the Elderly.)

These are just a few of the benefits of supervision:

• Being the eyes and ears for family members who may live far away.
• Helping the Personal Attendants to understand the changing needs of clients.
• Assuring the proper limits of care and scope of practice acts.
• Being a resource and support to caregivers in a wide variety of very challenging situations in the isolation of the private home situation.
• Help to clarify the roles of the home health aide, and the expectations of both worker and care recipient.
• Support the attendant in setting appropriate limits on the types of care that can be provided. For example, an older adult might expect an aide to help with dressing changes or high tech care that is legally the responsibility of a licensed nurse.
• Assisting with recognizing and coping with personality issues because of cognitive changes or a history of challenging relationships. The support of a supervisor can help the aide understand that this is part of the disease process and cope with behaviors so that the aide and the client can have a successful relationship. Often, supportive supervision is the key to making this type of challenging situation work.
• Communicating effectively with physicians and healthcare professionals, assuring new orders and recommendations are accurately passed on to family members and implemented in the home.

There are many responsibilities and liabilities in being an employer:

• Conducting background checks
• Supervising your employee
• Compliance with Wage Order #15-2001
• Payment of Payroll Taxes, including state and federal unemployment taxes, FICA and Medicare, withholding federal and state income taxes, and filing of quarterly state and federal payroll tax returns
• Paying Worker’s Compensation insurance, and having Liability Insurance that protects your home and assets

If you are unwilling or unable to assume these responsibilities, you should seriously consider hiring Central Coast Senior Services, Inc. to provide the necessary Executive Management to protect you from the many hazards of being an uninformed employer.

If you choose to hire privately, you should consult a lawyer and an accountant to assure that proper arrangements are made for all obligations. In addition, you should be frequently present to assure proper care and a non-exploitative relationship.

Cost

It takes much more than a caregiver to support aging safely in the home. When you factor in the level of supervision, coverage of payroll taxes and workers compensation insurance, unemployment insurance, liability insurance, and executive management, the costs you incur utilizing Central Coast Senior Services, Inc., while not inexpensive, is a bargain.

We are not providing legal or tax advise.  Please consult with your professional advisers before you engage any private caregivers.