Through the years of working with adult children and aging parents I have found that one of the barriers to starting services is due to a misunderstanding about non-medical in-home care. Some of the frequently asked questions are:

Is there any state oversight/regulations for non-medical in-home agencies?
At this time the state of Wisconsin has NO requirements for these agencies. Because of this it is important for the customer to be very cautious and ask the right questions when talking with an agency. Although franchise agencies may cost a little more, franchises are regulated by the corporate office and must maintain certain levels of protection for the clients.

Is the person coming into my home insured and bonded?
MOST agencies will provide some level of insurance but are not required to. The consumer can ask to see the provider’s certificate of insurance. The certificate will show levels of coverage and policy coverage dates. If you are requesting transportation services, the policy should also have a separate rider for non-owned autos.

How much should I expect to pay?
The latest Genworth Insurance study shows the Wisconsin state average for non-medical care is $18/hour. One has to balance the cost with the desire to remain at home. There may come a time when the cost exceeds other levels of care that are available.

How will I know the people coming into the home are trustworthy?
A reputable agency will do various background checks on their potential employees. This will include criminal and civil charges. If transportation services are included the agency should be requesting a copy of the employees insurance, driving record, and a copy of their drivers license. Agencies providing services for the Department of Health and Human Services are required to perform additional background checks.

Will I have to sign a contract?
Not all agencies require a contract. Contracts are generally created to benefit the agency, not the consumer. If you chose to sign a contract, study the contract very closely and read the details. Most require cancellation notices, termination notices or they will charge even if services are not provided. It is recommended to ask for a blank copy of the contract to review. It is appropriate to request 24 hours to look over the contract before signing.

Do providers have a minimum hour requirement?
Yes, but they all vary. Many times people are forced into signing for more hours than the actually need. This is a good questions to ask at the intial contact with the agency.

What happens if I don’t like the person doing the work?
Call the provider immediately and ask for a new person. You have the right as a consumer to be comfortable with the workers coming into your home.

Should I wait until I need someone or plan ahead?
I recommend planning for the day when you will need services. In most cases it’s not IF services will be needed, but WHEN they will be needed. Gathering information and talking with providers will keep you from making a bad decision when a crisis happens.

Medical Home Health Care vs. Non-medical Home Health Care…if you are reading this, you are likely among the thousands of caregivers needing help caring for a loved one at home. What is the difference?

One significant difference is who pays the bill… you or insurance?

With a doctors order and insurance that is accepted by the agency and covers home care, these services are generally covered. Medical home care provides skilled medical services such as:

Registered Nurse Physical Therapy Occupational Therapy Speech Therapy Home Health Aid Medical Social Worker

These medical personnel can only come to your home by an order from the doctor. This can be initiated by a trip to the doctor, a call to the doctor and sometimes a call to a home care agency explaining your difficulty. They can then contact the doctor.

Several questions need to be answered at this point to help you decide what you need.

Is the patient recently home from the hospital? Is the patient falling at home? Are you confused about what medications to give the patient? Is there a significant change in functional ability or decline in activity level recently? Is the patient frequently going to the ER?

Yes to 2 or more of the above questions may indicate a potential need for medical home health care.

Discussing your felt need with your doctor will help you understand the issues and the answers.

Non-medical home care

If you and your doctor have ruled out the need for medical home care but you still feel you need some help, consider non-medical home care. Non-medical care means just that. Non medical. These services are often referred to as companion services.

Your best bet is to Google “home health assistance” or the like. You can always call a business and ask if they provide non-medical home care assistance. Beware though, most medical home care company’s WILL provide solely a home health aid but at a ridiculous price. You may find better rates by hiring a company who provides only non-medical home care assistance. This is what they do best and they generally do it well.

Do your homework and use your phone. Ask the agency how long their workers have been there. Don’t be afraid to pay a little more if you feel you are following your gut. You are depending on these people to give you or your loved one the proper care and respect that they need and deserve.

You may qualify for home health care physical therapy under Medicare – it’s worth a look!

You may also want to consider how your care may be affected by the way your home care team is paid.

Depending on the nature and severity of your injuries, you may end up in a health care facility that is more specialized than a regular hospital of health center. Here are some of the types of specialized health care facilities you may be transported to, depending on the nature of your injuries.

Trauma Center
A trauma center is a hospital that is equipped to provide extensive emergency medical services to patients suffering from traumatic injuries. The injuries that a trauma center treats are ranked from Level I to Level IV, with the most serious cases at Level I facilities. Because trauma centers are expensive to run and not very common; patients outside major cities have to be airlifted to one. Washington State’s main trauma center is Harborview Medical Center which is located in Seattle, Washington.

Rehabilitation Center
A rehabilitation center is a facility where patients work to reestablish or relearn abilities they lost because of a serious injury through therapy. Physical therapy helps with movement or previous loss of movement, which occupational therapy might focus on relearning activities of daily life or finding ways to perform them despite a new disability.

Burn Center
A burn center focuses on patients with serious burns. They not only treat burn injuries, but work to help patients return to everyday life often with therapists, social workers, psychiatrists and other professionals who are not conventional doctors. Many hospitals have burn areas in them but the Specialized Burn Centers in Washington are located at Seattle’s Harborview Medical Center, Tacoma’s St. Joseph Medical Center and Spokane’s Sacred Heart Medical Center.

Assisted Living Facilities
These facilities may be appropriate for injury victims who need long-term physical or occupational therapy and help with everyday living. This might be true of someone with a severe brain injury or spinal damage. In addition to providing meals and housekeeping, as at a nursing home, the staff at an assisted living facility works with patients to help them regain independence and abilities. Some patients are able to return home eventually; others may need to remain in a facility throughout their lives.

Home care
Home care is an option for patients whose injuries do not require full time hospitalization. A nurse or other health care professional might visit everyday or a few times per week. Depending on the injuries, the professional might do anything from changing bandages to administering a treatment with an IV to helping with personal needs.