Health and Disability

Thanks and a hat Tip to Patti Elaine Kefalas Dudek

It's not just about the "nanny tax." When using a home health caregiver, it's crucial to know whether you are the caregiver's employer or someone else to avoid tax and legal snags.

With more baby boomers seeking help for aging parents, the in-home care industry is booming with a wide range of service providers, from geriatric-care managers to home-care agencies. Contractual arrangements and employment policies vary just as widely. So it's wise for consumers to ask questions up front about tax obligations and insurance coverage.

"Families need to be aware of all the ramifications," says Bernard A. Krooks, a certified elder-law attorney and founding partner of Littman Krooks LLP, a New York law firm.

WSJ Article

A successful effort to improve quality of life for home care workers and the people they assist is described in HHA Partnering Collaborative Evaluation: Practice/Research Brief, a publication of the U.S. Department of Health & Human Services Office of Assistant Secretary for Policy & Evaluation.

The initiative was launched in 2003 by the Visiting Nurse Service of New York. Its goal is to improve the work life of home care aides and increase support for their patients' improvement in key activities of daily living. Components include:

• Implementation of the "Five Promises" -- a set of field supervision practices designed to promote positive and effective communication among all caregivers while in the patient's home.
  
• Use of an ADL Tool to structure common goal-setting among nurses, patients, and aides in order to improve functional health.
  
• Proactive communication between patient service managers and licensed agency coordinators to cover aide supervision and service delivery issues.
  
• Increase in field support and supervision provided to aides.

In addition, it has changed the culture of health service delivery by moving from a purely professional model toward one of self-care management. In the self-care management model, patients and informal caregivers are active participants in decision-making and goal-setting, and home health aides play a key supportive role.

H.R. 3582 offers Congress an historic opportunity to send three important economic and
social signals:
1. Homecare workers should be on an equal footing with respect to all other low‐wage
occupations.
2. Within long‐term care, the homecare labor market should not have second‐class status
with respect to compensation and, therefore, with respect to its ability to attract and
retain workers.
3. Federal lawmakers can work together to coordinate, rather than send conflicting
messages about, the direction of our nation’s long‐term care policy.