What is Home Care?
A personal care/private duty home care agency provides services that do not require a licensed professional of a physician's prescription. A home care worker can help a person with activities of daily living (ADLs) like remembering to take medications, preparing meals, transferring from a chair, toilet or bed, bathing, getting dressed, light housekeeping or transportation to and from doctors appointments. A home care worker can also provide companionship to an older adult or an adult with a disability - engaging in a favorite hobby, watching movies or simply conversing about their past or events of the day.
What is the cost and is it covered?
This type of home care is not covered by Medicare and is usually paid for by the consumer. However, there are government-funded programs that can help. Many home care services are reimbursed by Medicare, Medicaid, worker's compensation, private or group health insurance, HMOs, Veteran and military benefits (VA/Champus), or through other special funds such as block grants. Also, private payment may be arranged with many home care agencies on an individual basis. When services are reimbursed by either public sources of funding or through insurance, it's important to understand the eligibility criteria for reimbursement.
While the Medicare and Medicaid home health programs reimburse home care services for homebound patients, other Medicaid programs also cover in-home services. These include: Medicaid Personal Care Services (PCS), Medicaid Community Alternatives Programs (CAP), Medicaid Durable Medical Equipment (DME), and Medicaid Private Duty Nursing (PDN).
How to find a personal care/private duty home care agency
Home care agencies are licensed by the North Carolina Division of Health Service Regulation
. Some agencies are franchises, while others are independently owned. You will also find that some home health agencies also offer this type of personal care. The Association for Home & Hospice Care of North Carolina offers a Home Care & Hospice Directory
where you can search for an agency by county.
Patients and/or family members may directly contact home care agencies to access services. Your physician may also make recommendations about home care and, if needed, will provide the necessary medical orders for home care services.
What to Ask
When you interview personal care/private duty home care agencies, there are a number of important questions to ask:
- May I see a sample service agreement and a listing of your prices?
- Are you licensed?
- How do you supervise and oversee the care provided by your caregivers?
- Are your services covered by long-term care insurance and will you process the paperwork?
- Are the caregivers your employees or are you a referral agency (a registry)?
- What type of training do your employees receive when they're hired? Do you provide ongoing training? Please describe it.
- Are your employees bonded?
- How long have most of your employees worked for you?
- What is the background of your average caregiver (i.e. homemaker, certified nurse aide, high school graduate, retiree)?
- How do you ensure that the caregiver and the person receiving care will be compatible?
- What happens if the caregiver doesn't show up?
- Please describe how workers have been trained to communicate with people who have cognitive (thinking) disabilities such as dementia.
- If you provide transportation, have you checked out your caregivers' driving records?
- What kind of weekly (or daily) report will I receive?
- Can you put me in touch with someone who has used your services?
- Have you received any type of national accreditation?