• Santa Rosa and Oakmont Home Care
  • (707) 843-3838

Full-Service Agency, Referral Agency or Private Hire?

When making the decision about homecare services, one must decide between these three sources of caregivers. The questions below can help you assess what level of responsibility and risk you may wish to undertake. Basically, a full-service homecare company, such as WeCare Home Assistants, is the caregiver’s employer. If you choose to find a caregiver through a referral agency or on your own, you may be assuming the employer’s responsibilities for screening, training, employment taxes, insurance and more.

Some of WeCare’s present clients discovered their obligations after hiring casual help and discovered they could have WeCare assume the employer obligations and responsibilities for not much more than what they’d been paying.

If you have questions regarding employer responsibilities, contact the California Employment Development Department at (916) 657-0529. It is further advised to consult an attorney and your insurance company regarding your risks, rights and responsibilities.

Who is the employer?

HOMECARE AGENCY:
Caregivers are employed by the homecare company and are paid by the company.

REFERRAL AGENCY:
Depending on the arrangement, you are likely to have the employer responsibilities.

PRIVATE HIRE:
Caregivers are employed by the client or the client’s family.

Who screens the caregiver’s references, performs criminal background checks and tests for TB?

HOMECARE AGENCY:
Usually does this [WeCare does].

REFERRAL AGENCY:
Client can ask whether the agency has done this.

PRIVATE HIRE:
Client must screen or else assume the risk of not screening for criminal and TB history.

Who is responsible for withholding and paying Federal and State Income Taxes?

HOMECARE AGENCY:
Prepares and files quarterly and annual employer payroll tax returns.

REFERRAL AGENCY:
Client is responsible for preparing and filing quarterly and annual employer payroll tax returns.

PRIVATE HIRE:
Same as referral agency.

Who is responsible for withholding and paying Social Security and Medicare Tax?

HOMECARE AGENCY:
Pays the cost of the employer’s share of these taxes.

REFERRAL AGENCY:
Client pays the cost of the employer’s share of these taxes.

PRIVATE HIRE:
Same as referral agency.

Who coordinates services, including replacements when caregivers are sick, or need time off?

HOMECARE AGENCY:
Usually does this [WeCare does].

REFERRAL AGENCY:
Day-to-day coordination is worked out between the caregiver and the client. A substitute may be available through the agency.

PRIVATE HIRE:
Day-to-day coordination is worked out between the caregiver and the client.

Who resolves problems when they come up?

HOMECARE AGENCY:
Supervisors or case managers usually do this [WeCare does].

REFERRAL AGENCY:
Client and caregiver generally need to resolve day-to-day problems themselves.

PRIVATE HIRE:
Same as referral agency.

How is payment made?

HOMECARE AGENCY:
Typically submits an itemized statement, based on the hours authorized and agreed-upon rates [WeCare invoices every two weeks].

REFERRAL AGENCY:
Client usually pays a combined referral agency fee and caregivers’ wages into a trust account of the referral agency, or separately pays the referral fee to the agency and wages to the caregiver. Client and caregiver negotiate wages and raises.

PRIVATE HIRE:
Client pays caregiver directly on a daily or weekly basis. Client and caregiver negotiate wages and raises.

Who is responsible for paying Caregivers’ Workers Compensation, professional and bonding insurance?

HOMECARE AGENCY:
Usually provides and pays for this [WeCare does].

REFERRAL AGENCY:
Client, or homeowner where the client resides. Contact homeowner’s insurance carrier for details and coverage limits. Normally, a Workers Compensation extension needs to be added to a homeowners policy in order to cover domestic help.

PRIVATE HIRE:
Same as referral agency.

Adapted with permission from the California Association for Health Services at Home (CAHSAH).