How to Hire a Home Helper or Companion in Virginia

When to Hire a Home Helper or Companion

Consider hiring a home helper or companion if your loved one needs human assistance to safely perform activities like meal preparation, light housekeeping, transportation, shopping and errands, medication reminders and assistance with social or entertainment activities.

Regulatory requirements vary by state. This article discusses care in the state of Virginia.

If your loved one needs assistance with activities of daily living like bathing, dressing, transferring, toileting and eating, a Personal Care Aide is a more appropriate choice. See our article at this link.

If your loved one needs in-home medical care, hire a skilled home health provider.

For an overview of the types of in-home assistance, see our article at this link.

How a Home Helper or Companion can Help Your Loved One

For people who are frail, ill, or recovering from injury or surgery, the assistance of a home helper can prevent problems such as injuries from falls, malnutrition, social isolation, and loss of dignity. Home helpers provide needed respite to caregivers.

How Care is There can help:

If your loved one could benefit from a home helper or companion, the care managers at Care is There can:

Determine how hiring a home helper or companion fits into the overall plan for your life
Recommend whether to use an agency or a private aide
Recommend agencies that provide the services your loved one needs and accept the payment sources available to you
Work with your assisted living community to be sure your aide meets their requirements
Communicate with your tax advisors and insurance professionals about the implications of hiring a private personal care aide
Find and interview potential home helpers or companions
Perform background checks and reference checks on potential home helpers or companions
Determine whether your home helpers or companions qualify under your long term care insurance policy
Suggest a process for backup care in case of emergencies
Monitor the service of the aide
Communicate progress, concerns, and suggestions to you, which is especially important if you live at a distance

What do I need to know about Home Helpers and Companions?

The Basics of Home Help and Companion Care Services

Companions or home helpers who are not trained and certified as Personal Care Aides are not licensed to provide “hands-on” care for personal activities of daily living - like dressing and bathing. However, Personal Care Aides can provide companion services such as light housekeeping and medication reminders.
Companions or home helpers who are not trained and certified as health care providers are not licensed to provide medical care such as wound care, taking blood pressure, clipping fingernails, filling pill boxes or dispensing medication.
Some agencies provide only one type of care (companion, personal care, or home health) and others provide two or more types.
Companions/home helpers working hired privately by residents of assisted living communities must comply with regulatory requirements set by the Virginia Department of Social Services. (Check with your assisted living community for the specific ways they apply these requirements.)

Paying for Home Help / Companionship

Home help and companionship is not paid for by Medicare or Medicare supplement policies, but may be paid under Medicaid Waivers for people who are eligible
Home help and companionship is not paid for by private health insurance
Home help and companionship may be covered by long term care insurance, depending on the terms of the long term care insurance policy
Some agencies accept Medicaid, private insurance and private payment. Others accept only certain types of payment
Personal care agencies usually charge a minimum of 2 - 4 hours per visit

Questions to Ask When Choosing a Personal Care Provider:

Is the care receiver likely to need related services in the near future: personal care services, skilled home health services, or hospice services?
If so, consider an agency that provides a broad spectrum of services that the client may need. This prevents the client from having to switch agencies when their care needs change.
What type of payment are you able to provide, and which agencies or private aides accept that form of payment?
Do you have long term care insurance?
If so, find out the policy’s requirements for the type of aide that will be covered.
Do you want the home helper to provide transportation?
If so, find out the agency’s policy on driving, and be sure you know the insurance implications.
Do you want the companion to help with medications?
Virginia law allows unlicensed individuals to administer medications that are normally self-administered by the client. However, each agency and private aide will have their own policies about medication reminders and administration - including filling pill boxes - so inquire in advance. Agencies offering home health services will be more likely to offer medication management services. Agencies certified by Medicare have additional requirements for training and supervision of employees helping with medications.
Is a loved one willing or able to manage a staff of caregivers, including finding backup care, or employ a care manager to do so?
If not, an agency is often a better solution than a team of private aides.

Choosing Between Hiring an Agency and Hiring a Private Aide

Private helpers and companions are often less expensive per hour than the cost of hiring through an agency, but the employer - or a private care manager - is responsible for the tasks that an agency would handle, including:
- Sourcing candidates
- Running background checks
- Interviewing
- Checking references
- Checking credentials
- Hiring and related paperwork
- Training helpers for the client situation
- Finding backup care
- Supervision
- Compliance with overtime and minimum wage laws
- Payment
- Payroll taxes
- Insurance for theft, liability and worker's compensation
Private helpers usually only accept private payment for their services.
Agencies usually have many different aides employed, making it easier to find a good personal fit for the client and for finding backup aides, but sometimes making it more difficult to ensure the the client has the same aide consistently.
In some cases, it works well to combine the use of agency employees and private aides.

What to know about Companion / Home Helper Agencies in Virginia

Some personal care agencies and home health care agencies provide companion / home help services, and some do not

What to Know about Private Personal Care Aides

Be sure you understand the minimum wage, overtime, tax, and insurance implications of hiring private caregivers
- See this guide from the Department of Labor about "Paying Minimum Wage and Overtime to Home Care Workers."
- Contact your tax professional to understand payroll tax, overtime, and minimum wage requirements. Do not assume the aide is an independent contractor; the vast majority are classified by the IRS as domestic employees.
- Contact your insurance professional to understand liability insurance and surety bonding implications. Ask about coverage if you experience a loss of personal property, but also be sure to understand your liability if the aide is injured while providing services to you.
- Consider using a payroll service for domestic workers to handle payroll taxes or insurance. One such company, HomePay, offers this advice about payroll taxes and insurance, and information about myths and mistakes for employing in home caregivers.
- If you already hire private caregivers, consider enrolling them in a registry like CareFamily.com to take advantage of payroll and payroll tax services and insurance benefits.
Individual home helpers can be hired through placement services or caregiver registries or through personal recommendations
Obtain a criminal background check before hiring
Have a backup plan in case one of the helpers cannot fulfill a shift and in case weather emergencies impair travel
Have a plan for finding, interviewing, and hiring additional helpers if a staffing change is required
Speak to references and do personal interviews with potential private helpers

Resources

Administrative Code of Virginia
Department of Labor
CMS (Centers for Medicare and Medicaid Services)
DARS (Department of Aging and Rehabilitative Services)
Eldercare Locator - Department of Health and Human Services

Next Steps

Contact Care is There today for a free consultation!

Central Virginia: 434.326.5323

Toll Free: 800.434.1633
Email: Info@CareisThere.com