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Consumer- Directed or Agency -Directed Home Care-Which Model is Best?

Consumer- Directed or Agency -Directed Home Care-Which Model is Best?

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Published by Murphy Ortiz
This articles discusses the two models of home care-the registry and agency. Pros and cons are discussed to help seniors choose what best meets their needs
This articles discusses the two models of home care-the registry and agency. Pros and cons are discussed to help seniors choose what best meets their needs

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Categories:Types, Research
Published by: Murphy Ortiz on Jul 30, 2008
Copyright:Attribution Non-commercial


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Consumer- Directed or Agency -Directed Home Care-Which Model is Best?Seniors and their families throughout New Jersey and the Philadelphia area suburbsuse home health care services to remain living independently in their homes. Homecare services, such as live-in caregivers and hourly companions allow seniors toage in place for as long as possible. There are basically two different models ofhome care, the registry (or consumer directed) model and the employee based (oragency directed). Both types can offer a variety of services to consumers,including nurses, home health aides, physical and occupational therapists, andcompanions. Each model has its pros and cons.For most people, their first introduction to home care is through a referral bytheir physician, a discharge planner, social worker or geriatric care manager atdischarge from a hospital stay or after finishing rehabilitation at a sub-acutecenter or rehab facility. People generally are not aware of the difference betweenconsumer directed care and agency directed care.The consumer directed care model is fashioned after the nurse registries thathave been around since the civil war. In this model, an agency completesbackground checks on the candidate, such as criminal background checks, referencechecks, interviews, social security checks and any other checks the agency feelsnecessary. Once the candidate is approved the agency will then refer them to theclient in need of service. In this situation, the consumer is in charge, thus theterm consumer directed model. They have the power and control to tell thecaregiver what, when and where they want their services performed. They alsodecide how much they are willing to pay for services. Since caregivers set theirown rates and families dictate what they are willing to pay, one of the registriesmain jobs is to find a good match between the two. Because the registry takes amuch smaller fee than an agency, it is usually possible to make both the consumerand caregiver happy financially, thus creating a mutually happy relationshipThe other model of home care is the agency directed care model. The agencydirected model evolved out of the government funded programs that pay agencies tobe the provider of services. With the agency directed model, the agency recruits,hires, trains, supervises, disciplines and sets the rate it charges patients andthe wages it pays the caregivers. The agency would also develop the plan of carefor the patient and selects the caregiver(s) to provide the care.There are advantages and disadvantages to both models of home care. You need todecide which type of business is right for you or your loved one. Some of theadvantages of the registry model are:The cost of service is usually lower than the agency modelThe client decides who provides their care, what services will be provided,and when service is providedThe caregivers typically earn more, therefore attracting a higher calibercaregiverThe client can obtain service on a long term, emergency, short term, orrespite basisOnce the client selects a caregiver, the agency doesn't have the authorityto reassign that caregiver. The client determines if/when service ends.The registry can serve as the liaison between client and care providerSome of the disadvantages of the registry model are:The care provider is not supervised by an agency nurseMost caregivers carry their own liability insurance but are not coveredthrough the agency for worker's compensation. The consumer should check with their

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