Caregiver Registries, In-Home Care Agencies and Non-Profit Listing Services/Classifieds?
What is a Caregiver Registry?
A registry is a broker service that matches independent caregivers to consumers. In this model, the consumer selects and hires the caregiver directly for a referral fee, which may be ongoing, temporary, or a one-time, up-front fee.
Here’s how it works: the consumer contacts the registry with a general description of their care giving needs…. such as meals, bathing, errands, medication assistance, etc. and may also request more specific characteristics such as “middle-years female with cooking skills,” “a good sense of humor,” “experience with end-of-life care,” etc. Other features of the registry model:
- Called “consumer-directed care,” the consumer interviews and selects the caregiver candidates from a pool of pre-screened candidates
- Caregivers generally earn a higher percentage of the total fee than employer-based models because operational expenses are simpler
- Consumers (or their representatives) and caregivers control all terms together independent from the registry-ie compensation, scheduling, duties, etc.
- The registry must adhere to independent contractor guidelines; it may not assess the client or supervise the caregivers; rather, it gathers basic information for matching purposes, acting as a “repository of information” between caregivers and clients
- The registry may not end the service unilaterally, though that does not mean that a referral fee is not owed
- Consumers are generally viewed as the employer of the caregiver and may be responsible for payroll taxes
- Worker’s compensation is not provided by the registry and consumers are not required to carry it on their caregivers in Oregon
- Caregivers MAY be bonded and/or liability-insured but it may also be just the registry that is, which costs a fraction of covering the caregivers themselves; thus it is prudent to ask for proof of bonding/insurance on the individual caregivers
- Once the referral has been made, caregivers and clients decide how duties will be performed-no agency restrictions
- Caregiver Registries are now licensed by the State of Oregon, as of 2011; Caregiver Connection, Inc. is the first to be licensed in Oregon; there are 3 seeking licensure in the Portland-Metro area.
What is an In-Home Care Agency?
An In-Home Care Agency are services that employ its caregivers. In this model, the agency directs the actions of the caregiver-it assess the consumers’ needs and supervises the caregivers.
- Called “agency-directed care,” duties and compensation are determined by the agency
- The agency provides worker’s compensation and payroll taxes
- The agency may choose to end the service because the agency-not the caregiver-is regarded as the provider of the service
- Caregivers are generally bonded and liability-insured because they are employees of the agency
- In-Home Care Agency restrictions on how care is delivered is determined by the State of Oregon and sometimes company franchise rules
- Once the caregiver is placed with the consumer, the agency continues to oversee the situation and assumes responsibility for the actions of the caregiver
- In-Home Care Agencies have been licensed by the State of Oregon since 2001. There are about 140 in the Portland-Metro area.
What are Non-Profit Listing Services/Classifieds?
Counties and hospital affiliates offer free lists to consumers, where the caregivers self-advertise their services, with little or no active brokering component; it is a static list in which consumers contact caregivers directly. Caregivers may be screened and/or required to take classes to be on the list. Internet-based searches may also be done; www.Care.Com are two ways in which consumers can seek private caregivers. Features:
- Like a for-profit registry, the consumer or representative selects and hires the caregivers and may be responsible for payroll taxes
- Caregivers and consumers control all terms directly-duties, compensation, etc.
- There is generally no referral fee charged, or a minimal one-time fee to acquire the list or to be listed
- “Anyone can join” means that aside from basic criminal background and reference checks, there is minimal refinement in the requirements to be listed
- Least expensive option for consumer but also carries the greatest responsibility