Transparency in Home Care
The average consumer of private-duty in-home care in California is unaware of critical differences in the types of agencies offering services. Unfortunately, lack of information may lead families down a costly and litigious path.
Home Care Services Protection Act of 2013
Prior to the passage of the Home Care Services Protection Act (AB-1217) in October 2013, private-duty home care in California lacked licensure and oversight by any government agency. When the new law went into effect on Jan. 1, 2016, California became the 25th state to require licensure for private-duty, or non-skilled, home care agencies.
Consumers must choose between a full-service, licensed agency (Home Care Organization) and a direct-referral agency.
Home Care Organizations (HCOs)
A full-service agency, licensed by the California Department of Social Services (CDSS), is now called a Home Care Organization (HCO). Each HCO obtains a license number, which may be verified on the CCLD website. secure.dss.ca.gov/CareFacilitySearch/
Keen Home Care is a full-service, licensed Home Care Organization.
ALL caregivers who work for an HCO must be registered with the Department of Social Services and approved to work based on the findings of an extensive background check completed by the Department of Justice.
The Department of Social Services conducts unannounced quality visits to ensure that HCOs are providing mandatory training and oversight of their caregivers.
Insurance Requirements for an HCO
- The consumer should be fully protected from liability by the HCO’s insurance.
- HCOs are subject to unannounced visits by the CDSS to verify appropriate training, recordkeeping, and insurance coverage.
Direct Referral Agencies (DRAs)
- Direct Referral Agencies send private-contractor caregivers to the client upon request. The agency either charges the client a fee for referring a caregiver or charges caregivers a percentage of their earnings.
- DRAs are not licensed (other than obtaining a local business license), nor are they overseen by any state or federal government agency.
- Are not required to have a criminal background check
- Are not required to complete any training
- Do not work for the DRA and instead represent themselves as independent contractors
- 1099 workers, not W-2 employees
- Work independently, without oversight
- Client is responsible for payroll liabilities and unemployment insurance if caregivers do not provide proof that they have paid liabilities
- Caregivers must show proof that they carry professional liability insurance
- Client is vulnerable to workman’s compensation expenses
Caution for Consumers
Many consumers do not realize that they may be held accountable as the “employer” for the 1099 worker, as California does not recognize domestic workers as 1099 contractors. Consequently, this may be the most expensive option in the long run.
You may be responsible for:
- Workman’s compensation claims, even after work is terminated
- Penalties for “worker misclassification” by the US Department of Labor
- Payroll taxes for the period of service
- Unemployment insurance
- Penalties related to unpaid wages or overtime under California law