3 Ways of Accessing Private Caregivers

There are basically 3 ways of accessing private caregivers in Oregon. Each has its benefits.

1. Licensed In-Home Care Agencies (“Agency-directed models of care)” These companies employ and supervise its caregivers.

Features include:

Licensed by the State of Oregon
Agency manages working conditions between caregivers and clients
Agency payrolls its caregivers
Agency covers workers compensation and payroll taxes
Agency may provide benefits such as paid vacation or health insurance
Agency usually provides ongoing education and materials
Agency screens and trains its caregivers
Lines of accountability: Adult Protective Services, Department of Human Services, company liability insurance, worker’s compensation, criminal background checks. May include bonding for theft and drug screening

By far, the most common type of model (over 40 in Portland; eg.Addus, Adeo, Express Home Help, Home Instead, Caring Heart, Visiting Angels, Making Life Easier, etc.)

BENEFITS: agency directs terms between caregivers and clients, and provides supervision; agency employs, trains and performs background checks on caregivers

Average cost to clients: $18 to $24 per hour
Average caregiver wage: $9 to $14 per hour; caregivers earn 50-60% total fee

2. Registry or Referral Services for Independent Caregivers (“Consumer-directed models of care)” These services refer-but do not employ-caregivers.

Features include:

Clients hire caregivers and control terms directly with them
Clients pay caregivers directly with private funds; or sometimes thru an escrow or 3rd-party or government billing process, ie State of Oregon’s registry for Medicaid recipients
Caregivers are responsible for their own taxes, insurance, and other expenses, such as ongoing education
Caregivers may classify themselves as independent contractors, but usually qualify more closely as domestic employees of clients
Caregivers are not covered by workers compensation (unless clients wish to cover this)
Registries are not licensed by the State of Oregon
Lines of accountability: Adult Protective Services, Criminal Justice System, criminal background checks by registry, client homeowner insurance; may include caregiver liability coverage, bonding, drug screening, or clients/caregivers may acquire these on their own

Examples of for-profit registries in Portland include Caregiver Connection, Inc. and Auntie Faye Agency

BENEFITS: clients/caregiver autonmomy and control; registry performs background checks, and for-profit models include personalized matching service. Caregivers earn greater percentage of total fee

Average cost to clients: $18-$24 per hour
Average caregiver wage: $14-$20 per hour; caregivers earn 75%-85% total fee

Caregiver Connection, Inc. is a local, private caregiver registry that has been in business in the Portland-Metro area for 10 year. Owner Micki Carrier says, “Our model is a sort of hybrid that offers consumers another option to the full-service in-home care agency model or local classifieds. We incorporate the best features of both-security plus choice over who comes into your home.”

The simplicity of our registry model, in which clients and caregivers control terms, leads to a high degree of satisfaction for both parties,” states Carrier. “Our referral fee is just $3.50/hour (up to $45/day), and caregivers are required to provide their own bonding and liability insurance and ongoing training, co-op style.”

3. Independent Caregivers, Listing Services. (Includes classifieds, Internet or non-profit listing services)

Features include:

Caregiver/client autonomy; clients hire and pay caregivers directly and control terms
No agency fees
Caregivers are generally not supervised except by client, family or visiting nurses
Caregivers are minimally screened or not at all
Generally training is not required or is minimal
Caregivers may carry own bonding, liability or worker’s comp, but usually don’t
Lines of accountability: Adult Protective Services, Criminal Justice System, client homeowner insurance; caregivers may be voluntarily bonded or insured
Examples include Legacy Caregiver Services, Senior Citizens Council (Clackamas County), Craigslist, Oregonian, etc.

BENEFITS: cost containment (no agency fees); clients/caregiver autonomy.

Average cost to clients: $12-16 per hour, generally; caregivers earn 100% of fee

Article Provided by:
Caregiver Connection, Inc.
503-246-4672